Many people express remorse after a drinking binge — yet a pill that treats alcohol use disorder may help.
Binge drinking is responsible for thousands of alcohol-related deaths every year. Now, researchers have found that taking the oral pill known as naltrexone significantly reduced drinking outcomes, according to a December report in the American Journal of Psychiatry.
“Our study found that naltrexone taken on an as-needed basis reduced heavy alcohol use, compared to [a] placebo,” lead author Glenn-Milo Santos told Fox News Digital.
Santos is a professor at the University of California, San Francisco, in the department of community health systems and the division of prevention science in Northern California.
The research exclusively studied men who both binge-drink and meet criteria for mild to moderate alcohol use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It’s a handbook that psychiatrists use to diagnose mental health disorders.
The researchers exclusively studied “sexual and gender minority” men, including men who had sex with men and transgender men.
The participants were directed to take a 50 mg naltrexone pill when they had alcohol cravings or when they anticipated a binge-drinking episode.
“We also found sustained reductions in heavy alcohol use six months after the treatment phase.”
“Specifically, when naltrexone was taken during periods of alcohol craving or in anticipation of heavy drinking, it reduced the number of binge-drinking days; [the] number of weeks with any binge-drinking; [the] number of drinks consumed; and [the] intensity of alcohol cravings,” Santos said.
After the individuals took “naltrexone treatment for 12 weeks, using this as-needed approach, we also found sustained reductions in heavy alcohol use six months after the treatment phase,” he said.
What is excessive alcohol use?
Excessive alcohol use led to more than 140,000 deaths in the United States every year from 2015-2019, according to estimates from the Centers for Disease Control and Prevention (CDC).
“Binge-drinking is just one pattern of excessive drinking, but it accounts for nearly all excessive drinking,” the CDC said on its website.
Binge-drinking is difficult to define — but according to the National Institute on Alcohol Abuse and Alcoholism, it means consuming four or more drinks for a female adult or five or more drinks for a male adult over a period of two hours, Dr. Elie G. Aoun told Fox Digital News.
He’s an addiction and forensic psychiatrist at Columbia University in New York City and a member of the American Psychiatric Association Board of Trustees.
“Naltrexone decreases the reward that you get from drinking.”
“Additionally, binge-drinking is very common, but the majority of people who binge-drink do not have severe alcohol use disorder, so their needs are largely unmet,” Santos added.
The 2019 National Survey on Drug Use and Health estimated that 66 million people, or about 24% of people in the United States ages 12 and older, reported binge-drinking during the past month.
How does naltrexone work?
The study randomized 120 men in two groups — one group that received naltrexone and another group that received a placebo. Both groups were unaware of which treatment they were taking.
Naltrexone is an intramuscular and oral medication approved by the Food and Drug Administration to treat both opioid use disorder and alcohol use disorder in adults.
“Naltrexone decreases the reward that you get from drinking,” Aoun told Fox News Digital.
It works by reducing the release of dopamine, a chemical that makes drinking pleasurable and causes the “buzz” feeling from alcohol, Santos added.
The medication “undermines the purpose of drinking, making it easier for someone either not to drink or if they have a drink, to stop at that, rather than wanting to get a second one,” Aoun told Fox News Digital.
The standard dose for naltrexone for alcohol use disorder treatment is 50 mg, which patients take every day, Santos said.
“However, a single as-needed dose in the study was tested because one 50 mg dose of naltrexone works quickly, and for a long time — longer than a day.”
The naltrexone group in the study experienced more nausea, which is a common side effect of the medication; it eventually resolved.
“We recruited a racially and ethnically diverse sample, with 46% of participants being racial/ethnic minorities — 14% African American, 10% Latino, 5% Asian and Pacific Islander, and 17% multi-racial or from another race/ethnicity,” Santos added.
The study found that naltrexone reduced binge-drinking frequency over 12 weeks, but not the number of drinking days.
“This is supported by our finding that naltrexone reduced the number of drinks people drank, [so] fewer drinks likely meant fewer days of [specifically] binge-drinking,” Santos said.
The mean number of drinks in the past month in the naltrexone group was 104.5, compared to 72.9 in the placebo; but by month three, the mean was 64 drinks in the naltrexone group and 80.9 in the placebo.
“Therefore, the mean drinks in that past month decreased by 38.8% for those in the naltrexone group, but it increased by 10.9% for the placebo group,” Santos said.
But the differences between groups at enrollment for number of drinks in past month were not statistically significant; this particular subset of results may have been explained by chance, he indicated.
The naltrexone group experienced more nausea, which is a common side effect of the medication; it eventually resolved as the participants adjusted to the medication.
Limitations of the study
The authors examined only sexual and gender minority men in the San Francisco Bay Area, so “we should be cautious about generalizing the findings,” said Santos.
“However, the mechanism of action behind naltrexone would apply to other groups beyond this cohort.”
“Even modest reductions in alcohol use can have positive health impacts.”
He said further, “The folks in the study were motivated to reduce binge-drinking through a medication, which might not be true for everyone who binge-drinks.”
The participants self-reported their behaviors, so this could also bias the results, he noted.
Pill might help binge-drinkers without alcohol use disorder
“The main implication of the study is that targeted use of naltrexone (or taking it on an as-needed basis) can be an important tool for people interested in cutting down their heavy alcohol use,” Santos said.
He explained that this flexible approach may help during dates, work holiday parties and family gatherings for those who are not interested in entirely quitting alcohol but still want to have the ability to choose when they don’t want to drink too much alcohol.
There are not many tools for people without alcohol use disorder who binge-drink to help them decrease the frequency of their episodes, Aoun told Fox News Digital.
“This study showed that targeted naltrexone can be helpful for people who binge-drink and want to reduce the amount they drink, even if they do not have severe alcohol use disorder,” Santos said.
“This is important because even modest reductions in alcohol use can have positive health impacts,” he also said.