Editorial [Hot topic: Pharmacotherapies for Alcoholism: The Old and the New (Guest Editor: M. Foster Olive)]

Abstract

Alcoholism and other alcohol use disorders are major public health problems, and the success rates of non-pharmacological treatment of these disorders such as psychotherapy, cognitive-behavioral therapy, group therapy, or residential treatment programs,remain only modest at best. High rates of recidivism (relapse) in alcoholics attempting to remain abstinent are prevalent worldwide. In recent years abundant evidence has accumulated demonstrating that alcoholism is a complex and multifaceted disease of the brain caused by numerous genetic, neurobiological, developmental, environmental, and socioeconomic factors that are still not yet fully understood.There is thus a great need to improve the success rates of all forms of treatment of alcoholism not only in preventing relapse, but curbing active alcohol consumption and craving. The development of improved pharmacotherapies that could be used as adjuncts to the aforementioned non-pharmacological treatment approaches is one avenue of great interest to the scientific community and the general public. Currently there are only three medications approved by the U.S. Food and Drug Administration (FDA) for use in the treatment of alcohol abuse and alcoholism--disulfiram, naltrexone, and acamprosate. Yet medication compliance issues and the modest efficacy of these compounds leave substantial room for improvement. This special issue is devoted to reviewing the current status of these FDA approved medications in the treatment of alcoholism. In addition, preclinical and clinical evidence suggesting that other classes of medications might also be of potential use are reviewed, including anticonvulsants, GABAB receptor agonists, cholinergic receptor partial agonists, corticotropin-releasing factor and cannabinoid CB1 receptor antagonists, nociceptin receptor ligands, and the novel antipsychotic aripiprazole.

Understanding the addiction cycle: A complex biology with distinct contributions of genotype vs. sex at each stage

“…Approximately 90% of alcoholics experience at least one relapse over a 4-year period following treatment (Polich, 1981). Abstinence from alcohol drinking is an important goal for the treatment of alcoholism, but there is limited understanding of factors that influence risk of relapse and as a result few effective treatments (Olive, 2010, Zindel and Kranzler, 2014). Unfortunately, there are no controlled studies that have definitively shown either a single or combined intervention reliably prevents relapse to drinking.…”

“…Current treatments for alcohol dependence are at best only modestly effective (Olive, 2010, Zindel and Kranzler, 2014). Since individuals with alcohol dependence represent a clinically heterogeneous and genetically diverse population, it has been proposed that effective treatments should target specific phenotypes at distinct stages of addiction rather than employ a generic approach to all patients (Kuehn, 2009).…”

Stable Histone Methylation Changes at Proteoglycan Network Genes Following Ethanol Exposure

“…Alcohol use disorder (AUD) is a chronic condition where sufferers may relapse even after periods of protracted abstinence (Olive, 2010). Gene expression and epigenetic changes following acute and chronic ethanol use and acute withdrawal have begun to be characterized (Gavin et al, 2016; Pandey et al, 2017).…”

Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders

“…Naltrexone, a complete opioid antagonist, is a medication that blocks endogenous opioids released through the brain’s mesolimbic reward system (Pettinati & Rabinowitz, 2006), to reduce alcohol cravings in individuals with alcohol dependence (Olive, 2010; Richardson et al, 2008; Tambour & Quertemont, 2007). It is one of four evidence-based medication-assisted therapies (MAT) used to treat alcohol dependence (Garbutt, 2009; Williams, 2005).…”