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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, Disagree) by Anonymous Coward on Friday September 22 2017, @04:35PM (6 children)

    by Anonymous Coward on Friday September 22 2017, @04:35PM (#571695)

    Alcoholism is not a disease. AA is not a scientific source and its efficacy as an organization is indistinguishable or inferior to other interventions.

    I'm glad you find personal value in AA, but they are not worth promoting as a general purpose "treatment".

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  • (Score: 2) by DeathMonkey on Friday September 22 2017, @06:02PM (5 children)

    by DeathMonkey (1380) on Friday September 22 2017, @06:02PM (#571722) Journal

    Alcoholism is not a disease. AA is not a scientific source and its efficacy as an organization is indistinguishable or inferior to other interventions.

    And?

    Some things work for some people and other things work for other people.

    You're begrudging someone's recovery, why, exactly?

    • (Score: 0) by Anonymous Coward on Friday September 22 2017, @06:19PM (2 children)

      by Anonymous Coward on Friday September 22 2017, @06:19PM (#571727)

      Because it's not clear that the recovery was actually due to AA. I care about what is actually true.

      • (Score: 2) by DeathMonkey on Friday September 22 2017, @06:30PM

        by DeathMonkey (1380) on Friday September 22 2017, @06:30PM (#571735) Journal
      • (Score: 2) by Anonymous Coward on Saturday September 23 2017, @02:47AM

        by Anonymous Coward on Saturday September 23 2017, @02:47AM (#571958)

        Because it's not clear that the recovery was actually due to AA. I care about what is actually true.

        (Topmost AC in this thread replying here.)

        I used to be able to stop. Easily. Forty days and nights of Lent; not a problem. Even did that several years in a row!! The years passed. When I next tried to quit, I was stunned. I could not quit -- and stay stopped. Sure, I could last a day or two, but always found myself going back. I tried all kinds of things. Exercise, keeping busy, new hobbies, working extra hours, taking extra breaks. Nothing worked.

        Then I had an intervention. I went to my first AA meeting. Found others who went through the wringer, found a way out that worked for them, and were willing to help me get sober, too. Went to lots of meeting, got a sponsor, found a concept of a "higher power" that worked for me, worked the steps, and have been sober ever since that first meeting... over 24 years ago. And the thought of a drink is the furthest thing from my mind! I don't even miss it. But, if I were to pick up a drink today, I have no doubt I'd be a mess all over again. I've seen it happen too many times to count. And too many funerals, too.

        tl;dr at first I could quit on my own. Then I could not. I went to AA. Did some work and I got stopped, and have stayed stopped.

    • (Score: 0) by Anonymous Coward on Friday September 22 2017, @07:14PM (1 child)

      by Anonymous Coward on Friday September 22 2017, @07:14PM (#571751)

      It seems that my information is out of date. The previous Cochrane Review showed no difference, but their upcoming one seems like it is going to show some positive effect.

      I oppose pseudoscientific explanations of reality, especially in a medical context. I also oppose ineffective interventions that are mainly supported by anecdotes and subject to selection bias, survivor bias, and all the other biases that come with them.

      I'm not "begrudging" the OP (the next line of my comment that you failed to quote).

      https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous#Cochrane_Review [wikipedia.org]

      • (Score: 0) by Anonymous Coward on Saturday September 23 2017, @01:12AM

        by Anonymous Coward on Saturday September 23 2017, @01:12AM (#571923)

        You may be underselling the social aspects of AA meetings.

        We mentioned before how rats with cool rat toys and rat friends tend to ignore the water bottle spiked with drugs.
        Portugal Cut Drug Addiction Rates in Half by Rejecting Criminalization [soylentnews.org]

        ...then there's The Placebo Effect where thinking something is effective can make it effective.

        ...and let's not forget that there's lots of drug consumption at AA meetings (coffee and cigarettes).
        So, substitution.

        -- OriginalOwner_ [soylentnews.org]