Other ways for the treatment of alcohol dependence: A patient treated with nalmefene

2017 ◽  
Vol 41 (S1) ◽  
pp. S484-S484
Author(s):  
O. Porta Olivares ◽  
M. Juncal Ruiz ◽  
M. Gómez Revuelta ◽  
G. Pardo de Santayana Jenaro ◽  
L. Sánchez Blanco ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Dependence ◽  
Alcohol Use Disorder ◽  
Opiate Receptors ◽  
Heavy Drinking ◽  
The European Union ◽  
Total Consumption ◽  
Excessive Alcohol Consumption ◽  
Competing Interest

IntroductionAlcohol dependence belongs to one of the major risk factors to health worldwide. Alcohol consumption is a significant factor for mortality in the world: 6.3% in men and 1.1% in women. The alcohol use disorder is also very common: 5.4% in men, 1.5% in women. Despite its high frequency and severity of this disorder, only 8% of all alcohol dependents are treated once.AimsAn interesting treatment option is geared toward reducing alcohol intake. Some patients in treatment for alcohol use disorder prefer an initial target of reducing consumption. Nalmefene, an antagonist naltrexone associated with opioid receptors, has been authorized in the European Union to help alcohol-dependent patients reduce their consumption. Antagonists’ opiate receptors are associated with reduced reward in relation to alcohol consumption, thus helping patients in reducing energy consumption.MethodsA man of 39 years old, with a diagnosis of alcohol use disorder and depressive disorder and poor outcome despite different types of treatment (as aversive agents) was treated with nalmefene.ResultsAfter a few months, nalmefene had a beneficial effect on the patient, with a significant reduction in the number of days of excessive alcohol consumption and total consumption in the sixth month. In addition, treatment was well tolerated, with no observed secondary effects.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking. Drugs such as nalmefene have demonstrated efficacy in association with a biopsychosocial approach to help patients achieve their personal objectives for this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Nalmefene against alcohol use disorder: A report of one case

2017 ◽  
Vol 41 (S1) ◽  
pp. s866-s866
Author(s):  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
L. Sánchez Blanco ◽  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Opioid Receptor ◽  
Treatment Option ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Family Relationship ◽  
Heavy Drinking ◽  
Alcohol Withdrawal Syndrome

IntroductionAlcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.AimsTo describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.MethodsA 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.ResultsBefore to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

2021 ◽  
Author(s):  
Kevin D. Shield ◽  
Jürgen Rehm ◽  
Gerrit Gmel ◽  
Maximilien X. Rehm ◽  
Allaman Allamani
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Burden Of Disease ◽  
Heavy Drinking ◽  
International Study ◽  
Years Of Life Lost ◽  
The European Union ◽  
Treatment Coverage ◽  
Life Years ◽  
Disease Study

Background The tradition of consuming alcohol has long been a part of Italian culture and is responsible for a large health burden. This burden may be reduced with effective interventions, one of the more important of which is treatment for Alcohol Dependence (AD). The aim of this article is to estimate the burden of disease in Italy attributable to alcohol consumption, heavy alcohol consumption, and AD. An additional aim of this paper is to examine the effects of increasing the coverage of treatment for AD on the alcohol-attributable burden of disease. Methods Alcohol-attributable deaths and the effects of treatments for AD were estimated using alcohol-attributable fractions and simulations. Deaths, potential years of life lost, years lived with disability, and disability adjusted life years lost were obtained for 2004 for Italy and for the European Union from the Global Burden of Disease study. Alcohol consumption data were obtained from the Global Information System on Alcohol and Health. The prevalences of current drinkers, former drinkers, and lifetime abstainers were obtained from the GENder Alcohol and Culture International Study. The prevalence of AD was obtained from the World Mental Health Survey. Alcohol relative risks were obtained from various meta-analyses. Results 5,320 deaths (1,530 female deaths; 3,790 male deaths) or 5.9% of all deaths (4.9% of all female deaths; 6.3% of all male deaths) of people 15 to 64 years of age were estimated to be alcohol-attributable. Of these deaths, 74.5% (61.3% for females; 79.8% for males) were attributable to heavy drinking, and 26.9% (25.6% for females; 27.5% for males) were attributable to AD. Increasing pharmacological AD treatment coverage to 40% would result in an estimated reduction of 3.3% (50 deaths/year) of all female and 7.6% (287 deaths/year) of all male alcohol-attributable deaths. Conclusions Alcohol was responsible for a large proportion of the burden of disease in Italy in 2004. Increasing treatment coverage for AD in Italy could reduce that country’s alcohol-attributable burden of disease.

scholarly journals Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: a narrative review

2020 ◽  
Vol 28 (5) ◽  
pp. 524-526 ◽  
Author(s):  
Rodrigo Ramalho
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Partner Violence ◽  
Alcohol Use Disorder ◽  
Mental Health Problems ◽  
Narrative Review ◽  
Excessive Alcohol Consumption ◽  
Potential Increase ◽  
The Impact ◽  
Alcohol Related Problems

Objective: To summarise publications reporting on alcohol consumption and alcohol-related problems during the Coronavirus disease 2019 (COVID-19) pandemic in a narrative review. Methods: ProQuest, Web of Science and Google Scholar were searched for articles published in 2020. This search used two terms: ‘alcohol’ and ‘COVID’. Reference lists of articles were reviewed to identify additional articles. Results: There is growing concern around an increase in alcohol intake and alcohol-related harms. These concerns are related to the impact of excessive alcohol consumption in a person with COVID-19 and/or with alcohol use disorder, as well as with a potential increase in the prevalence of harmful drinking, alcohol use disorder, withdrawal symptoms, intimate partner violence, harm to children, suicide, mental health problems and non-communicable diseases. The need for assessing alcohol use and providing adequate advice during the pandemic have been highlighted. Conclusion: The time for action is now, and all necessary measures to prevent an increase in alcohol-related problems should be adopted. At the same time, healthcare services should also prepare for such potential increase, while adapting to the exceptional circumstances presented by the pandemic, such as physical distancing.

scholarly journals Cloninger's temperament dimensions and longitudinal alcohol use in early mid-life: A Northern Finland birth cohort 1966 study

2016 ◽  
Vol 33 (S1) ◽  
pp. S118-S118
Author(s):  
D. Vladimirov ◽  
S. Niemelä ◽  
J. Auvinen ◽  
M. Timonen ◽  
S. Keinänen-Kiukaanniemi ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Birth Cohort ◽  
Heavy Drinking ◽  
Novelty Seeking ◽  
Multinomial Regression ◽  
Time Points ◽  
Problematic Alcohol ◽  
Competing Interest ◽  
Problematic Alcohol Use

BackgroundLongitudinal studies on how temperament is related to alcohol use in general population are scarce.ObjectivesFinding relations with temperament and problematic alcohol use using prospective birth cohort data.AimsTo investigate trends in self-reported alcohol consumption in adulthood.MethodsIn the Northern Finland Birth Cohort 1966 (n = 5247), alcohol use was studied with questionnaires at ages 31 and 46. Participants were classified into abstainers, bingers, heavy drinkers, steady drinkers, increasers or reducers based on the change in consumption (g/day). Cloninger's TCI-scores were calculated for each group. Multinomial regression analysis was conducted with TCI-scores as factors influencing the change in alcohol consumption.ResultsHigh novelty seeking was associated with increased consumption, binging and heavy drinking among both sexes at both time points (P < 0.01). Lower persistence was associated with increased consumption at both time points among men and among women at age 46. Baseline novelty seeking predicted both increasing (OR 1.1; 95% CI: 1.0–1.1) and reducing (1.1; 1.0–1.1) for men and for women also increasing (1.1; 1.0–1.1) and reducing (1.1; 1.0–1.1), but when adjusted with baseline alcohol use novelty seeking only predicted increasing for men (1.0; 1.0–1.1).ConclusionsHigh novelty seeking and low persistence are associated with problematic alcohol use among middle-aged Northern Finns. Gender differences in predictors existed: novelty seeking predicted increase only for men in the adjusted model. Temperament scores do not seem to affect strongly changes in alcohol use.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: effects of treatment-based interventions on alcohol dependence

2021 ◽  
Author(s):  
Kevin D. Shield ◽  
Jürgen Rehm ◽  
Gerrit Gmel ◽  
Maximilien X. Rehm ◽  
Allaman Allamani
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Burden Of Disease ◽  
Heavy Drinking ◽  
International Study ◽  
Years Of Life Lost ◽  
The European Union ◽  
Treatment Coverage ◽  
Life Years ◽  
Disease Study

Background The tradition of consuming alcohol has long been a part of Italian culture and is responsible for a large health burden. This burden may be reduced with effective interventions, one of the more important of which is treatment for Alcohol Dependence (AD). The aim of this article is to estimate the burden of disease in Italy attributable to alcohol consumption, heavy alcohol consumption, and AD. An additional aim of this paper is to examine the effects of increasing the coverage of treatment for AD on the alcohol-attributable burden of disease. Methods Alcohol-attributable deaths and the effects of treatments for AD were estimated using alcohol-attributable fractions and simulations. Deaths, potential years of life lost, years lived with disability, and disability adjusted life years lost were obtained for 2004 for Italy and for the European Union from the Global Burden of Disease study. Alcohol consumption data were obtained from the Global Information System on Alcohol and Health. The prevalences of current drinkers, former drinkers, and lifetime abstainers were obtained from the GENder Alcohol and Culture International Study. The prevalence of AD was obtained from the World Mental Health Survey. Alcohol relative risks were obtained from various meta-analyses. Results 5,320 deaths (1,530 female deaths; 3,790 male deaths) or 5.9% of all deaths (4.9% of all female deaths; 6.3% of all male deaths) of people 15 to 64 years of age were estimated to be alcohol-attributable. Of these deaths, 74.5% (61.3% for females; 79.8% for males) were attributable to heavy drinking, and 26.9% (25.6% for females; 27.5% for males) were attributable to AD. Increasing pharmacological AD treatment coverage to 40% would result in an estimated reduction of 3.3% (50 deaths/year) of all female and 7.6% (287 deaths/year) of all male alcohol-attributable deaths. Conclusions Alcohol was responsible for a large proportion of the burden of disease in Italy in 2004. Increasing treatment coverage for AD in Italy could reduce that country’s alcohol-attributable burden of disease.

scholarly journals Impaired control in heavy drinking and its association with alcohol craving and alcohol use disorder severity

Salud Mental ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 151-157
Author(s):  
Edén Sánchez ◽  
Carlos S. Cruz Fuentes ◽  
Corina Benjet ◽  
María Elena Medina-Mora
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Perceived Control ◽  
Alcohol Use Disorder ◽  
Latent Class ◽  
Heavy Drinking ◽  
Alcohol Craving ◽  
Heavy Drinkers ◽  
Impaired Control ◽  
The Relationship

Introduction. Impaired control over drinking has been frequently cited in diverse theoretical descriptions regarding harmful alcohol use and is considered a DSM criterion for alcohol use disorder. Differences in the frequency of endorsement of impaired control have been viewed as a reflection of the severity of the problem. Moreover, it has been posited that the ability to place a limit on alcohol consumption may be mediated through enhanced craving. Objective. In this study, we addressed the relationship between impaired control, self-reported craving, and alcohol dependence severity among heavy drinkers. Method. We conducted a latent class analysis of impaired control dimensions (perceived control, failed control, and attempted control) of 208 heavy drinkers. To determine whether the identified classes could represent different forms of severity of the disorder, the best-fit model was contrasted with scores on the Alcohol Dependence Scale. Furthermore, we assessed the relationship between impaired control criteria (using the Impaired Control Scale [ICS]) with alcohol craving. Results. We identified a three-class solution based on impaired control severity. A graded increase of the craving scores and alcohol severity among the three classes was also identified. Only the ICS items comprising perceived control and partially those related to failed control, but not those evaluating attempted control, distinguished the gradient among the latent classes. Discussion and conclusion. This study provides further support of the proposal of a unidimensional continuum of severity among heavy drinkers and strengthens the theoretical relationship between impaired control and alcohol craving.

scholarly journals Association of hyperuricemia and gamma glutamyl transferase as a marker of metabolic risk in alcohol use disorder

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anna Hernández-Rubio ◽  
Arantza Sanvisens ◽  
Ferran Bolao ◽  
Clara Pérez-Mañá ◽  
Nuria García-Marchena ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Age Of Onset ◽  
Critical Role ◽  
Gamma Glutamyl Transferase ◽  
Metabolic Risk ◽  
Excessive Alcohol Consumption ◽  
Advanced Liver Fibrosis ◽  
Glutamyl Transferase

AbstractExcessive alcohol consumption leads to overproduction of urates and renal function plays a critical role in serum uric acid levels. We aimed to assess associations of hyperuricemia in patients with alcohol use disorder (AUD) and comparable Glomerular Filtration Rate (GFR). A total of 686 patients undergoing treatment for AUD between 2013 and 2017 were eligible (77% men); age at admission was 47 years [interquartile range (IQR), 40–53 years], age of onset of alcohol consumption was 16 years [IQR, 16–18 years] and the amount of alcohol consumed was 160 g/day [IQR, 120–240 g/day]. Body Mass Index was 24.7 kg/m2 [IQR, 21.9–28.4 kg/m2], eGFR was 105 mL/min/1.73 m2 [IQR, 95.7–113.0 mL], 9.7% had metabolic syndrome and 23% had advanced liver fibrosis (FIB-4 > 3.25). Prevalence of hyperuricemia was 12.5%. The eGFR-adjusted multivariate analysis showed that relative to patients with GGT ≤ 50, those with GGT between 51 and 300 U/L and those with GGT > 300 U/L were 4.31 (95% CI 1.62–11.46) and 10.3 (95% CI 3.50–29.90) times more likely to have hyperuricemia, respectively. Our data shows that hyperuricemia in the context of AUD is strongly associated with serum GGT levels and suggest an increased cardio-metabolic risk in this population.

scholarly journals Microstructural White Matter Alterations in Men With Alcohol Use Disorder and Rats With Excessive Alcohol Consumption During Early Abstinence

2019 ◽  
Vol 76 (7) ◽  
pp. 749 ◽  
Author(s):  
Silvia De Santis ◽  
Patrick Bach ◽  
Laura Pérez-Cervera ◽  
Alejandro Cosa-Linan ◽  
Georg Weil ◽  
...  
Keyword(s):  
White Matter ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Excessive Alcohol Consumption ◽  
Excessive Alcohol

scholarly journals Genetic underpinnings of the transition from alcohol consumption to alcohol use disorder: shared and unique genetic architectures in a cross-ancestry sample

2021 ◽  
Author(s):  
Rachel L Kember ◽  
Rachel A. Vickers-Smith ◽  
Hang Zhou ◽  
Heng Xu ◽  
Cecilia Dao ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Genetic Variants ◽  
Alcohol Use Disorder ◽  
Genetic Factors ◽  
Genetic Correlations ◽  
Heavy Drinking ◽  
Direct Effects ◽  
Heavy Alcohol Consumption ◽  
Program Sample

Recent GWAS of alcohol-related traits have uncovered key differences in the underlying genetic architectures of alcohol consumption and alcohol use disorder (AUD), with the two traits having opposite genetic correlations with psychiatric disorders. Understanding the genetic factors that underlie the transition from heavy drinking to AUD has important theoretical and clinical implications. We utilized longitudinal data from the cross-ancestry Million Veteran Program sample to identify 1) novel loci associated with AUD and alcohol consumption [measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and 2) genetic variants with direct effects on AUD not mediated through alcohol consumption. We identified 26 loci associated with AUD, including 5 ancestry-specific and 6 novel loci and 22 loci associated with AUDIT-C, including 3 ancestry-specific and 8 novel loci. In secondary GWAS that excluded individuals who report abstinence, we identify 7 additional loci for AUD and 8 additional loci for AUDIT-C. We demonstrate that, although the heterogeneity of the abstinent group biases the GWAS findings, unique variance between alcohol consumption and disorder remains after the group is excluded. Finally, using mediation analysis, we identified a set of variants with effects on AUD that are not mediated through alcohol consumption. The distinct genetic architectures of alcohol consumption and AUD suggest different biological contributions to the traits. Genetic variants with direct effects on AUD are potentially relevant to understanding the transition from heavy alcohol consumption to AUD and targets for translational prevention and treatment efforts.

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