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.
The statement provides evidence of a connection between light drinking and an increased risk of esophageal and breast cancer. Heavy drinkers face a much longer list of risks, including mouth cancer, throat cancer, cancer of the voice box, liver cancer, and colorectal cancer. That's a whole lot of cancers.
"The message is not, 'Don't drink.' It's, 'If you want to reduce your cancer risk, drink less," said Dr. Noelle LoConte, lead author of the statement. "And if you don't drink, don't start." She says this "subtle" take on the issue is somewhat less cautionary than the warnings about smoking. But the message rings the same.
The doctors behind the statement aimed to draw attention to what they view as a public health problem and advocate for a push towards better education and research.
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