Anticipation Builds Over Alcoholism Drugs

Treatment experts, patients, and pharmaceutical companies are hoping that new medications will have big benefits for people with alcohol problems -- a potential market of 18 million people in the U.S. alone.

"There was a long time when we groped around and weren't sure what we were doing in this field," said Robert Morse, formerly director of addiction treatment at The Mayo Clinic and now with the National Council on Alcoholism and Drug Dependence. "But it should be an exciting field in the next decade."

The Associated Press reported Sept. 13 that patients already are hailing expanded use of medications like naltrexone, and more are on the way. The federal government is currently sponsoring more than 50 clinical trials involving drugs to treat alcoholism, and a handful of drugs are already in the pipeline.

Treatment advocates see such drugs as increasingly taking a spot in their tool belt along with traditional counseling and self-help groups. Currently, very few alcoholism patients are prescribed medication other than Antabuse, which makes users sick if they drink alcohol.

Medications "can't solve alcoholism, but they can help some people," said Dr. Raye Litten, a treatment researcher at the National Institute on Alcohol Abuse and Alcoholism. "We want a menu of medications for alcoholism ... If one doesn't work, they can try another one."

Sales of Antabuse and naltrexone totaled less than $25 million in a pharmaceutical industry that sold $235 billion in drugs last year. Forest Laboratories sold about $6 million worth of Campral (acamprosate), a drug that eases withdrawal symptoms for alcoholics. Alkermes Inc., is developing the naltrexone-based drug Vivitrex and hopes to have it approved by the Food and Drug Administration later this month.

Experts tie the clinical and financial success of such drugs to the willingness of doctors to prescribe them and of insurers to pay for them. "Even though there may be some good drugs available, it may take some time until they are more widely accepted," said industry analyst Robert Hazlett. Most insurers do cover Antabuse and naltrexone, while coverage for Campral is mixed.

Alkermes hopes that insurers will embrace Vivitrex, which CEO Richard Pops says could reveal a huge, underserved market. "Alcoholism is so under treated right now that there's room for a number of very important drugs," he said. "I think it's the furthest thing from a zero-sum market I can imagine."