According to the National Institute on Alcohol Abuse and Alcoholism, 16.3 million adults in the US have some form of alcohol use disorder. Whether it involves addiction or binge drinking, this mental health disorder can be difficult to treat; however, there is continuing research into new and more effective ways to help people with alcohol use disorders achieve and maintain sobriety.
One of the lines of research that is ongoing includes developing medications that can help people stop use, avoid withdrawal, or prevent relapse. An example of these types of medications is acamprosate, known by brand name Campral. The uses, benefits, and challenges of using acamprosate to treat alcohol use disorders are described in detail below.
How Alcohol Abuse Affects the Brain
The HAMS Harm Reduction Network describes research demonstrating that consuming large amounts of alcohol on a regular basis can result in major changes to the brain. These changes include:
- Brain cell shrinkage
- Damage to white brain cells
- Damage to gray brain cells associated with spatial processing
- Thiamine deficiency that can result in brain damage
- Brain damage associated with liver failure
Aside from the damage related to thiamine deficiency or liver failure, the brain of an individual struggling with alcohol abuse can return to normal size with long-term abstinence.
However, there is another type of change in the brain due to alcohol abuse. Addiction or alcoholism results in continued cravings to use alcohol, making it difficult for the person struggling with an alcohol use disorder to stay sober over time. This is thought to be because of the way alcohol use affects certain chemical pathways in the brain, including the gamma-aminobutyric acid (GABA) pathway.
How Acamprosate Helps
Acamprosate or Campral was specifically developed to help people who have stopped using alcohol to remain abstinent. While some medicines used in addiction treatment substitute for the drug of abuse, creating a similar but less intense euphoric effect to help the person reduce use, this is not how acamprosate works. An article from American Family Physician explains that the medicine appears to modify GABA transmission and other chemical pathways in the brain, restoring normal brain activity and helping to reduce the euphoric effects of and cravings for alcohol use.
Because acamprosate doesn’t act by creating euphoria, it is not a substitute for alcohol and is therefore not addictive. This means it can be used in addiction treatment to help people stay abstinent from alcohol use, avoid relapse, and achieve and maintain recovery.
Effectiveness of the Medication
Studies described by CNS & Neurological Disorders – Drug Targets indicate that individuals who take acamprosate or Campral during and following substance abuse treatment are significantly more likely to remain abstinent during the treatment period. The studies involved included short-term treatment of less than four months, as well as treatment periods lasting a year or longer. The majority of studies showed similar effects, with nearly 40 percent of individuals in one long-term study completing the treatment period without relapse (compared to 17 percent for placebo).
In addition to these positive results, acamprosate has been shown to have few significant side effects, and it can continue to be taken without health risks even if the individual does relapse to alcohol use. It can be used by a wide range of individuals, including adults, teenagers,people with liver problems due to alcohol abuse, and individuals who are in treatment for other forms of substance abuse or other mental health disorders at the same time.
Challenges of Treating Alcoholism with Acamprosate
The CNS & Neurological Disorders – Drug Targets article indicates that there are certain situations where acamprosate or Campral may not be as helpful. Most notably, if the person is continuing to use alcohol, acamprosate does not have any effect that discourages alcohol use. In other words, it works only when the person has already stopped using alcohol. In addition, people who are under severe mental or emotional distress when they begin taking acamprosate are less likely to experience the benefits of the medicine for alcohol abuse treatment.
A major factor in the ability of acamprosate to help people stop alcohol abuse is the use of other therapies in combination with the medication. People who receive Cognitive Behavioral Therapy for alcoholism or alcohol abuse while taking acamprosate are more likely to experience continued abstinence and recovery. For this reason, it is important for individuals who are attempting to abstain from alcohol abuse to participate in a well-rounded, research-based treatment program that provides this type of therapy, as well as other supportive therapies, such as peer group sessions, to create the atmosphere most likely to result in continued, long-term recovery.