Naltrexone was initially approved to treat opioid addiction in 1984. Later, scientists tested naltrexone in rats and found that it decreased alcohol consumption. In 1991 this led to clinical trials at Yale University that showed additional positive effects. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provided research funding, and in 1995, the FDA approved use of the drug for alcohol abuse.
But despite being available for more then 30 years, very few doctors and patients even know the drug exists.
How can a drug invented in the 1960’s, tested in the 1980’s, and approved in the 1990’s—that is safe, effective, and generic—be almost unknown and hardly used? There is no clear answer, but one of the main problems is that naltrexone decreases but does not eliminate drinking.
For a variety of reasons, almost none of them based on science, the only acceptable treatment outcome in alcohol addiction has been complete abstinence. Additionally, the dominant ideology also says that addicts are spiritually damaged and can never lead a normal life. The best they can do is to improve their relationship with God, and to suffer and struggle eternally—and controlled drinking undermines that struggle.
Addiction professionals and scientists have tried to change this ideology. For example, in 2005, the American Council on Alcoholism (ACA) wrote: “The biggest obstacle to using naltrexone for the treatment of alcoholism is the ‘pharmacophobia’ of many alcoholism-treatment professionals. This near-hysterical resistance to medication for treating alcoholism (or other substance-abuse disorders) has deep and tangled roots.”
The ACA continues, “Many recovering professionals learned in their recoveries that MDs and their prescription pads were evil purveyors of pharmacological lies and temptations. This attitude is often accompanied by a deeply rooted and strongly held belief that recovery has only one successful formula (usually the 12-step program) and that any modification to that approach is unethical.”
Since that time, more evidence has accumulated that naltrexone is safe and effective. Organizations such as the C Three Foundation, founded by actress and activist Claudia Christian, have been ardent supporters of the use of naltrexone, after Dr. John David Sinclair, an American researcher who worked in Finland, first discovered its positive outcomes in treatment for alcohol.
In addition to promoting use of naltrexone, Ria Health has developed technological solutions to these problems, and after one year of work with more than 200 patients, they are showing success. After downloading the Ria app (for iOS or Android), members use it twice a day to follow the care plan designed by Ria’s medical and care team, and personalized for each member. The app reminds users to take naltrexone, and helps them monitor their drinking habits, intake, and blood alcohol levels.
The naltrexone reduces the craving for alcohol—patients who choose to drink may find that their interest in alcohol subsides over time, and that they can have an occasional drink with no ill effects. But some patients will find that the desire for alcohol has evaporated almost completely. To complete the treatment, Ria adds coaching from its trained medical staff and counselors.
As Pamela, a Ria Health member, commented, “I can stop at 1 or 2 glasses of wine and only drink on special occasions. I feel like I am back on a healthier, more positive track.”
As more patients like Pamela report success with naltrexone, more doctors will know about it and want to prescribe it, especially for those patients who struggle with abstinence. As Claudia Christian notes, “It’s a miracle drug.”
(We are pleased to add that Christian recently joined the advisory board of Ria Health.)