The Affordable Care Act requires that insurers provide coverage for substance abuse treatments and services. Addiction specialists expect to see increases in the number of people seeking help for alcoholism this year as a result in the changes in healthcare.
Naltrexone and acamprosate are two medications that reduce cravings for alcohol by fine-tuning the brain’s chemical reward system. Both have been approved for treating alcoholism for over ten years. However, there has been some question regarding their efficacy and a lack of awareness among doctors has resulted in the drugs being underused.
According to federal data, about 18 million Americans have an alcoholic abuse disorder, and excessive drinking kills about 88,000 people each year. Less than a third of all people with alcohol problems receive treatment of any kind, and less than 10 percent are prescribed medications.
In a new study published online in the journal of the American Medical Association, a group of researchers compiled findings from the most rigorous trials of medications for alcoholism in the past few decades. They analyzed data on roughly 23,000 people from 122 random trials. The researchers focused on a measure known as the “number needed to treat,” which is the number of people who need to take a pill for one person to be helped. The study found that in order to stop one person from drinking again, the number needed to treat for acamprosate was 12, and for naltrexone the number was 20. The research looked only at the effectiveness of the medications in combination with behavioral interventions like counseling and therapy.
To give a comparison, studies of widely used drugs like the cholesterol-lowering statins, have found that 25 to more than 100 people need treatment to prevent one cardiovascular event.
According to the lead author of the new study and an associate professor of medicine at the University of North Carolina, Dr. Daniel Jonas, “these drugs are really underused quite a bit, and [the] findings show that they can help thousands and thousands of people. They’re not a blockbuster. They’re not going to work for everybody. But they can make a difference for a lot of people.”