Rats helped develop a cure for alcohol addiction – Why not use it?
Helsingin Sanomat's article of 5.7.2015 "Rats helped develop a cure for alcohol addiction – Why not use it?" discusses rat studies conducted in Finland, based on which naltrexone and nalmefene, which are also connected to the Contral method, have begun to be used in the treatment of alcoholism. You can read the original article here: https://www.hs.fi/sunnuntai/art-2000002835984.html
David Sinclair and the Finnish rat study
Rat studies conducted in the last millennium in Salmisaari, Helsinki, are an important part of our current knowledge of alcoholism and its heritability. They have also had a major impact on the development of drug-based treatment for alcohol dependence. In studies, several successive generations of rats were given alcohol. At the same time, its effects were monitored. The research was initially funded by Alko.
Already in its early days, the research was also known around the world. For example, Science magazine published an article about it in 1968. The result of the study is summed up well in a quote from researcher Kalervo Eriksson:
"The offspring of rats who drank liquor likes liquor, but the babies of sober rats do not."
This is where American psychologist David Sinclair steps in. He had read the newspaper article mentioned above and was immediately interested in the subject. Since the research was conducted specifically in Finland, Sinclair decided to travel to Finland in 1972 to meet these "famous" rats. Alko could not afford to pay him, but Sinclair still wanted to be part of the research project.
Sinclair became an important part of advancing rat studies. He was sure that alcoholism was a chronic brain disease. He believed it was inherited in the same way as rats' preference for alcohol. However, proving the point was not easy.
We all know that alcohol usually makes us feel good. Endorphins are released into the body and attach to opioid receptors in synapses, as is the case with heroin. This creates a chain reaction, as a result of which dopamine begins to create a feeling of well-being and gamma-aminobutyric acid acts as a brake on brain function. The body remembers this relaxed and wonderful feeling and that it was caused by alcohol.
Sinclair began to develop a treatment for alcoholism based on the results he received. He experimented with opiate blockers used for heroin withdrawal symptoms in rats: naltrexone, nalmefene and naloxone. These substances adhere to the same receptors to which the endorphins released during drinking would stick. In the case of rats, they continued drinking alcohol for a while, but then stopped because there was no great feeling or the “high” usually connected to drinking.
Naltrexone and nalmefene also work in humans, according to Sinclar, when taken just before you start drinking. Drinking is allowed, but usually you just don't feel like drinking alcohol anymore.
The Helsingin Sanomat article quotes the first experience of a person who used Naltrexone with the drug:
"Two pints of beer, nothing. The drug was not felt anywhere, but the effect was noticeable. There was no actual sense of intoxication and the actions done were mostly just a bit of nodding and walking. Regardless, the urge to drink was gone. No wild after-parties, no freakouts and hangover, but one of the first to get home before midnight."
"And best of all: there was no need to explain to all the party guests that I was not drinking, there was no need to reveal my problems with drinking. It helped me recover."
Traditional Treatment of Alcoholism – AA
While rat research was conducted in Finland, the Alcoholics Anonymous treatment became popular in the United States . Behind the idea of Alcoholics Anonymous is Bill Wilson, who suffered from alcoholism himself until he experienced a spiritual moment and made a complete turnaround. He began to develop his own 12-step treatment for alcoholics based on the evangelical faith.
Wilson's book Anonymous Alcoholics, also called the "Big Book," became the foundation of this sobriety movement. The first sentence of its treatment regimen goes like this:
"We admitted that we were powerless over alcohol and that our lives had become such that we could not survive on our own."
Based on the methods conducted by AA, many other treatments for alcoholism have been created. One of these is the Minnesota treatment, which arrived in Finland in the 80s. Currently, treatment provided only by private parties costs around €6,000 and requires complete abstinence from its participants. Usually, there are "substance abuse therapists" who are ex-alcoholics and not usually real therapists. It is not possible to train as a substance abuse therapist in Finland, and the National Supervisory Authority for Welfare and Health (Valvira) does not approve this title.
It's actually a great miracle that the AA movement and its derivatives have grown so huge. There isn't really any scientific evidence for it, and doctors in the United States initially ridiculed the idea of peer support as a sole provider of improvement.
About one-fifth of alcoholics are able to get completely sober "just by trying hard." That is, of course, better than nothing, but in today's world, science would offer us other possibilities.
For example, in the mid-90s, a study was conducted in Finland on how Sinclair's drug-based method worked. 78% of those involved managed to reduce alcohol to 9 weekly doses, which is already within acceptable limits. So the difference is huge.
Pharmacotherapy of alcohol dependence in Finland
As you can see above, there can be many opinions about the best treatment for alcohol addiction. Total refusal is a classic habit that is still emphasized by many. We must not rely on medicines, but determination is at the heart of everything. However, for so many, this method is impossible or at least risky due to relapse.
This is also supported by Sinclair's own studies on rats in America. He noticed that when rats were deprived of alcohol for long periods of time, they also drank much more as soon as they got their hands on alcohol again. That is, saying "take it one day at a time" to alcoholics is really not as easy as it sounds. The longer you are without alcohol, the greater the craving becomes.
We have been using the drug-based treatment method for years. Naltrexone was approved in Finland in 1996. Prescriptions were written and medicine distributed. Whole of Finland did not manage to overcome alcoholism with the drug, which led to the medicine being slowly forgotten. Drugs that affect alcoholism are not a miracle cure. Therapy and support are also needed.
Hannu Alho, Professor of Substance Abuse Medicine at the University of Helsinki and a physician who has worked at Contral Clinics, describes the effectiveness of the drug well in an article in Helsingin Sanomat by saying:
"If the doctor prescribes a prescription and says try to reduce it and come back within six months, it won’t really make a difference. The effect of the drug should be substantially strong, and if it were, it would have already won the Nobel Prize. "But it has pretty good efficacy when it's instructed and used correctly."
At the time of writing the article, only 2% of alcoholics were taking medication to treat their illness. In 2010, only 4,000 packages of Naltrexone were sold. The largest of these were purchased with one's own money, because Kela's reimbursement required an official medical certificate and thus an entry of alcoholism in patient records. Alcoholism and its medical treatment are still stigmatized in Finnish culture.
The Helsingin Sanomat article could be summed up briefly by saying that science offers alcoholics many solutions beyond just trying at will, but we in Finland still have a long way to go in terms of attitudes towards accepting it.