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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: 4, Insightful) by theluggage on Friday September 22 2017, @02:05PM (11 children)

    by theluggage (1797) on Friday September 22 2017, @02:05PM (#571640)

    Ultimately you are responsible for your own actions.

    That's no excuse for not supporting people who are trying to take responsibility. If quitting was that easy, the problem wouldn't exist.

    Alcohol seems a particularly knotty problem - it would be illegal if judged by the same standards as other drugs (not that prohibition would work), lots of people use it with no sign of dependency, plenty of people abuse it without actually being dependent but a hard core of unfortunate souls do seem to have lost a psychological/physiological lottery and are prone to real dependency/addiction to a "drug" who's use is ingrained in society.

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  • (Score: 2) by Gaaark on Friday September 22 2017, @05:20PM (10 children)

    by Gaaark (41) on Friday September 22 2017, @05:20PM (#571708) Journal

    Yes!
    Help them by not having booze around. Help them by not taking them to the liquor store. Help them make good choices and decisions.

    Definitely!

    --
    --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
    • (Score: 2) by urza9814 on Friday September 22 2017, @09:37PM (9 children)

      by urza9814 (3954) on Friday September 22 2017, @09:37PM (#571835) Journal

      Help them by not having booze around. Help them by not taking them to the liquor store. Help them make good choices and decisions.

      Alcoholics and other drug addicts tend to not have that many people around though, that's often a large part of the problem. Drug use in general correlates pretty strongly with loneliness and isolation. You've got nothing else to do, so you do drugs.

      "Just don't drink" doesn't really help, because it doesn't fix that issue -- it makes it worse. If they're drinking at the bar, they need to find somewhere else to go for fun. If they're drinking at home, they need to find something that will get them out of the house. That's one reason AA *can* actually be helpful -- it gets you to go to meetings, it encourages you to go to church and/or to volunteer somewhere...it also helps you make friends and have people to talk to or hang out with, and a lot of the 12 steps are things that you're supposed to be doing to occupy your time too. Including reaching out to and reconnecting with people you might have lost touch with. It's all about rebuilding social connections.

      So yes, it's very much a personal choice...but it's not really about choosing to quit, it's about choosing to reconnect to society in more constructive ways. Telling an alcoholic that they just need to choose not to drink is like telling someone with the flu that they should choose not to cough. It fails to address or even acknowledge the root cause. And while I'm not sure that I fully agree with the "alcoholism is a disease" concept (seems more like a symptom IMO), that can certainly help if it makes it easier for others to forgive them enough to rebuild those connections.

      • (Score: 2) by Gaaark on Saturday September 23 2017, @01:48AM (8 children)

        by Gaaark (41) on Saturday September 23 2017, @01:48AM (#571936) Journal

        Yes, you need to change the way you 'addict': you need to do a 180. Don't stay home, DON'T go near a bar or liquor store. Go to a games store and play Catan or whatever. Stay active so your mind is occupied.

        You need to choose to not be the old person.

        The one thing I know about AA that I don't agree with is the "you are powerless and need God in your life".
        I think I'd rather be a country music star than go down into THAT hell, lol.

        --
        --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
        • (Score: 0, Disagree) by Anonymous Coward on Saturday September 23 2017, @02:57AM (7 children)

          by Anonymous Coward on Saturday September 23 2017, @02:57AM (#571965)

          From what I've seen you post here, I suspect you have never experienced the pain and struggle of addiction. Count your lucky stars. Quite frankly, until you've actually been there... you have NO IDEA what you are talking about. It's like a virgin trying to guess what an orgasm feels like. You've got a part of it, but by no means even half a clue. I suspect you mean well, but your well-meaning attitude could damn well kill someone who believes what you've bandied about in this discussion.

          It is my fervent hope that neither you nor anyone you care about has to endure the torture of addiction. But, if you do find yourself there, please do keep an open mind and avail yourself of all the help you can find... you're going to need every last bit of it you can find. And that might not even be enough. I've been to way too many funerals to know that is true.

          • (Score: 2) by Gaaark on Saturday September 23 2017, @10:36AM (6 children)

            by Gaaark (41) on Saturday September 23 2017, @10:36AM (#572064) Journal

            Im going through it right now, ass!

            If you don't go to buy booze, you got no booze to drink, RIGHT?!

            If you don't go to a bar, you got no booze to drink, RIGHT?!

            If you keep booze away from you you got no booze to drink, RIGHT?!

            Feck! It's not AA, it's not God, it's me. I choose to be free of the shitand the choice is fecking hard but I got self respect still and people like my son (autistic) and wife who rely on me. I got bills. I got work.

            So I don't buy. I don't drink. I don't blame god. I don't blame a 'disease'. I fecking man up and DON'T 'addict'!

            Feck off!

            --
            --- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
            • (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.