The Road Out of Addiction: Baclofen and Its Efficacy on Alcohol Abuse
Addiction. A condition that encompasses a wide field of subjects, yet always circles back to one word : abuse. Addiction comes in many forms, and it can be especially dangerous and heartbreaking when it comes to stimulants and depressants – of which some of the most common are drugs and alcohol. Substance abuse pertaining to alcohol is an issue that affects millions of people worldwide. There are various reasons why people struggle with this battle, and the best thing to be done when dealing with these situations is to offer the best help and support. There are many studies that have been conducted with the hopes of finding an effective cure to addiction, and the following investigation will specifically focus on Alcohol Use Disorders and alcohol related substance abuse.
One such study that focused on AUDs and alcohol related abuse was carried out by a team of researchers from the UNC Chapel Hill Department of Psychiatry, who had the main intention of figuring out if certain medications would be more effective in treating alcohol abuse issues compared to other medications (such as ketamine) which has proven to be a controversial treatment. Many of the researchers are affiliated with the UNC Bowles Center for Alcohol Studies, and the lead researchers included: James C. Garbutt, Alexei B. Kampov-Polevoy, Cort Pedersen, Melissa Stansbury, Robyn Jordan, Laura Willing and Robert J. Gallop.
This study was about the effects of the muscle relaxer and antispasmodic agent baclofen, which is meant to treat muscle spasticity. In other words, baclofen is usually meant to alleviate cramping and muscle spasms caused by conditions such as multiple sclerosis. This drug is also sometimes prescribed for back pain and to improve overall muscle performance (Beaurepaire et al, 2019). This study took place in order to seek a new treatment for alcohol dependence, substance abuse related to alcohol, and Alcohol Use Disorders. Other similar studies have tried to find solutions to alcohol dependence in the form of ketamine, but this treatment has yielded questionable and controversial results due to its history as a strong anesthetic (Witkiewitz, Litten, Leggio 2019). Some of these negative results include cognitive impairment and memory loss when administered long term, along with dissociative and psychotic symptoms. While some studies have found that low dosages and short term use of ketamine can reduce these effects and also improve depression, the outcomes that have been recorded are quite concerning and must be further studied (Zhang and Ho 2016).
Over the course of experimentation, the effects of baclofen were monitored to determine if it is an effective medication when used to treat Alcohol Use Disorders (also known as AUDs). The study was conducted with the hopes of supporting the hypothesis that baclofen can serve as an effective treatment to those struggling with AUDs when factors such as dosage and sex are taken into account to apply to different demographics. By the end of the study, the researchers had found promising results to support their hypothesis.
This study was a 16-week, double blind, randomized, placebo-controlled trial that investigated 30 and 90 mg/day treatments of baclofen. Results were acquired by comparing dosages, sex and level of pretreatment drinking with a total of 120 participants. All factors were randomized, and patients were chosen by qualifying as DSM-IV alcohol dependents between the ages of 21 through 65, and not struggling with other conditions, such as abuse of other substances (excluding nicotine) and psychiatric illnesses. To be considered DSM-IV participants had to meet two of these criteria: consumption of alcohol in larger amounts than intended, persistent desire, unsuccessful efforts to cut down on intake, strong cravings and desires, failure to fulfill lively obligations (work, school, etc.), social and recreational efforts affected by use, alcohol tolerance, and alcohol withdrawal symptoms. Please note that there are minor differences between the classifications of DSM-IV for Alcohol Use Disorders, Alcohol Abuse, and Alcohol Dependence. Procedures took place throughout the 16 weeks by being administered in blister packs (the stereotypical plastic packaging that pills can come in), and interviews and urine tests were also implemented. These methods were meant to monitor the participants and their health over the course of the study and to measure the amount of baclofen in the body over time (Garbutt et al 2021).
This specific study was meant to test if higher or lower dosages of the drug were more efficient over longer periods of time, while finding factors that could affect efficacy (in this case the main factor was sex). Studies and experiments to find treatments for Alcohol Use Disorders have been common in science for years now, as it is now understood that addiction and substance abuse can be highly linked to genetics. While this study did not necessarily factor in whether or not the condition of the participants was genetically linked, the findings (baclofen is shown to be more effective in higher doses) revealed that the craving symptoms of alcohol dependence were alleviated when certain doses were given to certain groups. In this case, men who were given either dose showed some improvement and a decrease in cravings, while women tended to show positive signs and efficacy of baclofen in lower doses. Based on prior research concerning baclofen and alcohol use, signs are pointing to this being an effective treatment that can have much success in the medical sciences.
With this information, researchers can go on to complete other in depth studies that can monitor the effects of baclofen on patients who are affected by Alcohol Use Disorders and abuse. This research can then be applied to other addictions and conditions that can negatively impact one’s overall health. Such a task is important in the STEM field because by finding effective solutions to treat these conditions, the livelihood of those who are directly affected by alcohol related hardships (as well as their peers and those with whom they share relationships) has a greater chance of being improved, and greater advancements in the science behind alcohol related addiction can be applied to others that are also fairly common while overall pushing advancements in the medical sciences forward.
References
Beaurepaire R, Sinclair J, Heydtmann M, Addolorato G, Aubin H, Beraha EM, Caputo F, Chick JD, La Selle P, Franchitto N. 2019. The Use of Baclofen as a Treatment for Alcohol Use Disorder: A Clinical Practice Perspective. FrontPsychiatry. [accessed 2022 January 23]; 9:708. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6328471/. Doi: 10.3389/fpsyt.2018.00708.
Garbutt JC, Kampov-Polevoy AB, Pederson C, Stansbury M, Jordan R, Willing L, Gallop RJ. 2021. Efficacy and tolerability of baclofen in a U.S. community population with alcohol use disorder: a dose-response, randomized, controlled trial. Neuropsychopharmacology. [accessed 2022 January 23]; 46(13):2250-2256. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580979/. doi: 10.1038/s41386-021-01055-w.
Witkiewitz K, Litten R.Z, Leggio L. 2019. Advances in science and treatment of alcohol use disorder. Science Advances. [accessed 2022 January 23]; 5(9). https://www.science.org/doi/10.1126/sciadv.aax4043. doi:10.1126/sciadv.aax4043.
Zhang M, Ho R. 2016. Controversies of the Effect of Ketamine on Cognition. Frontiers in Psychiatry. [accessed 2022 January 23]; 7(47). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809869/. doi: 10.3389/fpsyt.2016.00047.
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