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posted by martyb on Friday September 22 2017, @09:29AM   Printer-friendly
from the Stopping-is-easy...-I've-done-it-many-times! dept.

A new study published by the scientific journal Addiction has found no reliable evidence for using nalmefene, naltrexone, acamprosate, baclofen or topiramate to control drinking in patients with alcohol dependence or alcohol use disorder. At best, some treatments showed low to medium efficacy in reducing drinking, but those findings were from studies with a high risk of bias. None demonstrated any benefit on health outcomes.

The study pooled the results from 32 double-blind randomised controlled trials representing 6,036 patients, published between 1994 and 2015. The studies compared the effects of oral nalmefene (n=9), naltrexone (n=14), acamprosate (n=1), baclofen (n=4) and topimarate (n=4) against placebo.

Many of the studies provided unreliable results due to risk of bias (potential exaggeration of the effects of the drug). Twenty-six studies (81%) showed an unclear or high risk of incomplete outcome data due to the large number of withdrawals. Seventeen studies (53%) showed an unclear or a high risk of selective outcome reporting, as they did not include a protocol registration number, which would allow another researcher to check whether all outcomes were reported.

Clément Palpacuer, et. al. Pharmacologically controlled drinking in the treatment of alcohol dependence or alcohol use disorders: a systematic review with direct and network meta-analyses on nalmefene, naltrexone, acamprosate, baclofen and topiramate. Addiction, 2017; DOI: 10.1111/add.13974

Back to the drawing board.


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  • (Score: 0) by Anonymous Coward on Saturday September 23 2017, @05:39PM (5 children)

    by Anonymous Coward on Saturday September 23 2017, @05:39PM (#572136)

    Please accept my deepest apologies.

    Having been down this path, myself, I know full-well how incredibly challenging and difficult getting sober is. I commend you for your efforts and wish for you continued success.

    Maybe you are fortunate and had not advanced as far in the progression as I had. At one time, I could, with effort, abstain from drinking. "White-Knuckle Sobriety" The thought was in my mind, would pop up unbidden at the strangest times, my skin felt like it was crawling, ... it sucked.

    I am so happy to report that is not the case for me, today. Any thought of a drink is typically as short as "Hmm, that's new. I wonder what it tastes like. Guess I'll never know." and that is the end of it. Just a short while ago I went to a concert. Beer was available and there were many people drinking. Once in a while I'd get a whiff of the smell. In my early sobriety I'd have thought "Mmmmm, that smells good", and the thought of a drink and avoiding it would consume me. Now? "Ewww, that stuff!" My reaction was much like smelling a fart.

    Again, I wish you the very, very best in your efforts. Realize you are neither the first, nor the last, nor alone. Documented problems with drinking have existed for millennia!

    I can assure you that I am free of the obsession. I neither fight off the thought, nor even have to avoid situations where booze may be present. I know literally hundreds of people who felt as I did, had fallen much further than I, and they, too, have found release and relief.

    If you find, however, that your efforts are not successful, know that you are not alone, that countless others have struggled and lost. Know, too, that others have found a path out, and are willing to share what worked for them. I found a whole community of people in AA who felt as I had and helped me learn a way to look at my life differently. And, as I did so, the need/thought of a drink vanished.

    My heart goes out to you.

  • (Score: 2) by Gaaark on Saturday September 23 2017, @07:13PM (4 children)

    by Gaaark (41) on Saturday September 23 2017, @07:13PM (#572154) Journal

    And please accept my apologies:

    It IS hard and DOES suck.
    Maybe i'm finding it easy(easier?) then some because of what i've had to give up in the past. Lactose intolerance has made me give up cheese/pizza/shakes/so fecking much, than finding i'm also gluten intolerant (had to give up porters and ipa's)...

    Sigh... give up all the food you love and now booze (potato vodka...... shit)

    I have been increasingly irritated lately and sorry i bit at you.
    Hopefully this will be easy, lol.

    Maybe i also don't have as addictive a personality? Here's hoping. But i don't believe in AA, don't believe in God. I believe in me and i guess it irritates me when i hear people say "God/Jesus saved me" when it's so obvious they haven't really changed (saw this in my wife's best friends husband: Jesus had saved him, then he went back on the booze, started fooling around on his wife, started doing drugs... now he's just an idiot i respect even less than before).

    When my son was born 17.75 years ago, i bought a bottle of Chivas Regal to drink with him and the grand-dads, etc, when he turned 18. Feck, i've got only 3ish months to decide whether i want to even go there: wait a few more years, crack it open but don't imbibe, crack it open and promise myself not to be bad.... gluten and alcohol.... maybe i'll just give it away.

    Again, sorry.
    Sigh.

    --
    --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
    • (Score: 0) by Anonymous Coward on Sunday September 24 2017, @07:25AM (3 children)

      by Anonymous Coward on Sunday September 24 2017, @07:25AM (#572256)

      Good to see we are back on the same page, so to speak (umm, write!) Apology accepted!

      No more cheese? (Wallace and Grommit would NOT approve) and no pasta, either. Grrrrr! That's quite the challenge, indeed!

      I have been increasingly irritated lately and sorry i bit at you.

      Definitely! That's an extremely common symptom. And a warning. I like to call it "death by a thousand ants". Any single annoyance is no big deal. And, for some reason, when big calamities come my way, I can deal with those, successfully, too. It's the little shit that piles up, day after day, without respite... THAT is what would get me to drink again. Time after time.

      In my experience, there's a lot to it, but just accepting that some things are just going to go whichever way they are gonna go -- that at some level I am powerless over some things -- takes a big chunk of that away. I find it helpful to ask myself "What did I expect?" As I have heard it well put: "An expectation is a pre-arranged resentment [dictionary.com]." (dictionary.com defines that as: "the feeling of displeasure or indignation at some act, remark, person, etc., regarded as causing injury or insult." Basically, anything that keeps coming to mind and is disturbing to my equilibrium and peace-of-mind.

      Yes, it would be nice if things went according to my plans. Doesn't always happen. Expect the unexpected. (Except the Spanish Inquisition -- NOBODY expects THAT! =) It would be nice if that guy didn't chew me out for something that was not my fault, but haven't I done the same thing at one time or another?

      I think that is enough to get the idea across: Little stuff can cause big trouble.

      As for the Chivas Regal? I read very recently where someone said if they didn't have any booze around, then they couldn't drink it and thus could not get drunk. Is it worth the risk of a relapse? Maybe give it to the grandads to celebrate with, instead. At this point, it is not unreasonable to treat any alcohol as being like a poison -- in some respects it is -- that's why there are things called a detox and one can actually die from alcohol poisoning. The fact that you are entertaining the thought of drinking on your son's 18th birthday... and just have one drink... and back on the merry-go-round again. Addiction is cunning, baffling, and powerful. Don't even give it a toe-hold to start from, please! For your own sanity and that of your family.

      These are somewhat abstract concepts that I find myself struggling to put into words that convey the full experience and sentiment behind it, please kindly understand there is no intent to command or direct, but only hopefully share from my experiences something that will soften and straighten your path. You may find at some point, you'll need every bit of help you can find!

      Oh! And as your wife's friend's husband... don't let the clay-of-feet of one person define your total view of what something has to offer. *he* tried, made some progress, he thought he had it made, and relapsed. <dramatic pause /> That could well be you some day. Recovering from addiction is unlike anything else I ever attempted in my life and without equivocation it was the hardest thing I ever did! And, also the most rewarding.

      I wish you only the very best on your journey of recovery.

      • (Score: 2) by Gaaark on Sunday September 24 2017, @10:22AM

        by Gaaark (41) on Sunday September 24 2017, @10:22AM (#572275) Journal

        The Chivas Regal has been almost a ..... ...... A sacrosanct, untouchable god-like statue or idea: my son was born 2.5 months premature. In the hospital, the doctor fecked up and almost killed him (but try to prove that in court). I watched him turn black from his calcium levels being so low. Stopped breathing, cardiac arrest. Pretty much dead. The neonatal NURSES saved his life while the resident doctor almost pissed herself she was shaking so much in fear and inability to act (go nurses!).

        Had bought the Chivas before that and now it is a symbol of celebrating his life, but yeah: will probably just have to give it to my brother and dad.

        What doesn't kill you only makes you stronger.

        (Also makes me glad I'm Canadian: can't imagine how we would have paid his hospital bill).

        Anyway, thanks for 'listening'........it does help.

        --
        --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
      • (Score: 2) by Gaaark on Sunday September 24 2017, @12:16PM (1 child)

        by Gaaark (41) on Sunday September 24 2017, @12:16PM (#572289) Journal

        Actually, it's weird: been sober for about 2 weeks now and have been pretty much fine. Irritable and bothered but fine. Today: can feel my guts churning with my mind. Keep thinking about that chivas and my son.

        Think i'll pass off the chivas to my parents: get them and my brother to have it to celebrate with. Don't think i should have it around anymore.

        THIS is a tough morning. shit!

        Thought this would have hit sooner.

        --
        --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
        • (Score: 0) by Anonymous Coward on Sunday September 24 2017, @01:43PM

          by Anonymous Coward on Sunday September 24 2017, @01:43PM (#572312)

          Very much appreciate the continued chat. Pressed for time as I need to get ready for work. I find it helpful to remember that you are facing a challenge that has been known, and struggled with, since biblical times (search on drunkard in the bible). So you are looking at something on the order of 2,000 years' time (give or take a few centuries). That it still remains a problem to this day suggests that a formidable challenge lies ahead. Hang in there, I'm rooting for ya.

          Also, sorry to hear about your son's childhood challenges... very fortunate that you and he were able to make it through. And yes, healthcare costs are mind-numbingly high... count your good fortunate to not have had to face those, too.

          One idea I found most helpful: each night I made a list of 10 things that happened that very day for which I was grateful. Helped me to not fall into the whirlpool of resentment and dwell on the negatives... a positive attitude and perspective are incredibly helpful!

          Peace.