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New Strategy to Counter Problem Drinking

Problem drinkers who took a craving-curbing drug whenever they felt the desire to imbibe reported fewer heavy drinking days each month than drinkers who took a look-alike placebo pill, but both groups reported marked reductions in heavy drinking days.

Those findings come from a study of 403 heavy drinkers in Finland, who took either a placebo or the drug nalmefene on an as needed basis.

It has a robust and sustained effect in reducing harmful heavy drinking in a large study population, said researcher Sakari Karhuvaara. Alcohol problems have huge negative impacts on the well-being of individuals and families and cause enormous costs to society due to lost working days, accidents, treatment of alcohol-related disease, etcetera.

Before the study, patients assigned to nalmefene treatment reported 15.5 average heavy drinking days each month. They were directed to take the drug whenever they felt a looming urge to drink. During the first three months of treatment, the average number of heavy drinking days was 8.6 to 9.3 for the people in the nalmefene group.

The drinkers assigned to the placebo group had somewhat less dramatic reductions. They averaged 16.2 heavy drinking days a month before the study and 10.6 to 12.0 during the trial.

Researchers double-checked participant-reported alcohol consumption changes with tests that measured alcohol-use biomarkers in the blood.

In the United States, abstinence has been the traditional goal of the treatment of alcohol dependence, but in the last 20 years, there has been a movement to consider harm reduction or drinking reduction as a goal equal to abstinence.

Alcohol dependence is nowadays recognized as a chronic, recurring disorder where relapses almost inevitably occur during and after the treatment, Karhuvaara said. So focusing on harm reduction in the short term is often much more feasible than complete abst
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