opioids and alcohol

[Mumby_63]

Last week took my brother to addiction counseling Virginia center for his addiction. He was given really good treatment that made his get over the addiction within few months. Really happy with their treatment and best service.

[drpasser]

I think it's probably some sort of Final Common Pathway deal, likely involving Dopamine; although such an explaination may be a tad reductionistic.

I have seen bupe help Alcoholics, when nothing else worked.

Have you noticed that, on the street it's common knowledge in some quarters, that Crystal Meth decreases opiate wdrl symptoms?
That would tend to support the Dopamine paradigm.

:-)

[gordon2441]

How many hoops would we have to jump through to get approval for clinical trials using bup to treat alcoholism??

It certainly would be a worthwhile study, but I can't see it happening in this political/legal climate..

Gordon

[tstinson]

This is a well-known phenomenon and was relied upon by late 19th and early 20th century physicians as a treatment for alcohol abuse, since oral opiates were perceived (IMHO correctly) as being less harmful to the body than alcohol. This practice ceased after enforcement of the Harrison Act and the US v. Wade decision began in the 1920's.

[Dave]

I recall an elderly lady who was taking Suboxone for several years and who finally admitted to me that she spent the whole day in bed drinking scotch while she worked at home with a laptop computer. She said she was just killing herself with alcohol and wanted help with that. We sent her to a rehab center where she got off the alcohol. Then a few months later she did not show up for her office visit. A few weeks later she called to cancel her Suboxone visits because she had weaned herself off that too and was feeling fine. People are just different. This lady was very frail and suffering from osteoporosis and spinal vertebral collapse, yet she did what the big guys often cannot seem to do.

[rickbennettmd]

mattkeene

http://www.ncbi.nlm.nih.gov/pubmed/16533497

Biol Psychiatry. 2007 Jan 1;61(1):4-12. Epub 2006 Mar 14.
Buprenorphine reduces alcohol drinking through activation of the nociceptin/orphanin FQ-NOP receptor

Thank you for this at least partially explanatory study reference

Richard Bennett

[rickbennettmd]

Yes, I see this as well.

In fact I don't think I've identify ANY patients who admit to me that they have a current alcohol problem.

Very, very counterintuitive, and difficult to accept as valid.

I hope a lot of posters will share their experince on this issue.

[gordon2441]

Many thanks for your responses.

Sslonim, I would say that my patients have stopped drinking when their opoid addiction started, and continues with bup therapy, that is, no ETOH relapses.

It may sound perverse, but in many ways alcohol addiction is worse than opiate addiction, if, for no other reason, we have a treatment for opiate addiction, and really no treatment for alcoholism.

Matt, thanks for the reference.

NoDrugs4u, the name is Gordon, last name Clark :)

[mattkeene]

Yep...certainly see it in practice but by no means a universal finding. Some good theory/findings here:

http://www.ncbi.nlm.nih.gov/pubmed/16533497

[sslonim]

For clarification are you saying they stop drinking when they start using opioids ... or when they have their opioid dependence treated? My experience is a few patients who tell me they lost their desire to drink when we started Suboxone.