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A strategy to help problem drinkers cut back, a strategy that involves a prescription drug that's been around for more than 20 years. Here's NPR's Allison Aubrey.
ALLISON AUBREY, BYLINE: Millions of people drink more than they should or want to. And for those who struggle, this may sound familiar.
JOHN: It's hard to admit that you have a problem. I would say, for me, that was the No. 1 thing that held me back initially.
AUBREY: That's John. He asked us not to use his full name. He worries disclosing his trouble with alcohol could affect his career. He says for years, he was a social drinker. He'd grab a few beers with his softball team after a game. But then after several deaths in his family, he sunk into a dark depression.
JOHN: So I definitely tried to seek solace in the bottle, so to speak. You know, I wanted to kind of numb my thoughts.
AUBREY: He'd started about 10 in the morning with hard liquor. He'd pour a glass of vodka and drink it straight up. This went on for months. He works from home, and he continued to do well professionally. So at first, no one noticed. Some afternoons, by the time his family came home, he'd had eight drinks or more.
JOHN: As any alcoholic or anyone that struggles with alcohol will tell you - we become very good at hiding things.
AUBREY: He would sneak empty bottles out on garbage day. But eventually, his wife was on to him.
JOHN: She had come home, and I was rushing to hide a glass that I had been using. And she was furious with me - just absolutely furious.
AUBREY: He knew he needed help, but the prospect of being sent off to rehab or going to AA turned him off.
PAULA DESANTO: I would say his story is not unique.
AUBREY: That's Paula DeSanto, a therapist in Minneapolis area who works with John.
DESANTO: I think a lot of people are reluctant to get treatment because it traditionally can mean a significant disruption in their lives. There's a lot of stigma, shame and embarrassment.
AUBREY: She says there are alternatives to residential rehab and 12-step abstinence programs, and the recommendation she gave John was to get counseling to help him deal with the loss and grief he was feeling and to try a prescription drug. The drug is called Naltrexone. It blocks the opiate receptors in the brain. It's used for treating drug addiction. And George Koob, who directs the National Institute on Alcohol Abuse and Alcoholism, part of the NIH, says it can help drinkers too.
GEORGE KOOB: With alcohol, it tends to blunt the effects of alcohol's pleasurable effects. So you know, the report that people say is they have a drink and it's OK, and then they have a second drink, and it's really not doing much for them.
AUBREY: So they don't keep refilling the glass. Koob says there are multiple studies to show it can help drinkers cut back or even abstain. He says Naltrexone is safe. It doesn't make you feel sick. And above all, as a recent clinical trial shows, it means people can receive effective treatment for alcohol use disorders from their primary care doctors by combining the medication with a series of brief office visits for support.
KOOB: Absolutely. I mean, Naltrexone is an effective medication for the treatment of alcohol use disorders. And its effectiveness is similar to that of antidepressants for major depressive episodes.
AUBREY: John says the first time he took Naltrexone, he noticed a difference. Normally, after one drink, it was hard for him to stop but not after taking this pill.
JOHN: I actually didn't really feel any of the alcohol effects, and it was startling at first.
AUBREY: It's been about five months since he started taking Naltrexone. And he says he has not stopped drinking completely, but he has cut way back.
JOHN: This is clearly helping me. And I can go out with friends and not worry that I'm going to escalate it or that I'm going to end up inebriated and sloppy and all of those things.
AUBREY: Now, Naltrexone won't help everyone, especially if a drinking disorder is too severe. But for John, the combination of Naltrexone and counseling has put him on the right path. And the important thing is he's actually getting help. Here's George Koob again.
KOOB: The biggest problem we have in the field is that less than 10 percent of individuals with an alcohol use disorder get any treatment whatsoever.
AUBREY: This is in part due to patients' resistance but also because many primary care doctors don't get much training in treating alcohol use disorders.
KOOB: Physicians are actually unaware that there are medications. So it's really a problem, and we are stepping up our efforts in the medical community.
AUBREY: And the NIH is also reaching out directly to the public. They have a website called Rethinking Drinking, which guides you through all the treatment options that are available.
Allison Aubrey, NPR News.
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