Anti-smoking Medication Reduces Alcohol Dependence

A smoking-cessation medication can also help lower alcohol craving and dependence. The finding may lead to another treatment option for alcohol problems.

Alcohol dependence, or alcoholism, is a chronic disease. Signs include craving for alcohol, loss of control over drinking, withdrawal symptoms and tolerance (the need to drink greater amounts to feel the same effect). Alcohol dependence takes a serious toll on a person’s health and quality of life. People who are alcoholic may spend a great deal of time drinking, making sure they can get alcohol and recovering from its effects.

Treatment for alcoholism was once essentially limited to the mutual support group Alcoholics Anonymous. Now, therapies include medications and behavioral approaches, as well as combinations of treatments. Researchers have been exploring a variety of alternative strategies that can help people change their drinking habits.

Varenicline, marketed as Chantix, was approved in 2006 by the U.S. Food and Drug Administration to help people stop smoking. It works by partially stimulating receptors for nicotinic acetylcholine on certain nerve cells. These receptors have been implicated in both nicotine and alcohol disorders. In early studies of varenicline for smoking cessation, participants reported a reduced craving for alcohol and lower alcohol consumption. Experiments found that the drug decreased alcohol consumption in rodents.

To further investigate, a research team led by Dr. Raye Z. Litten of NIH’s National Institute on Alcohol Abuse and Alcoholism (NIAAA) randomized 200 alcohol-dependent adults to receive varenicline or an inactive placebo each day for 13 weeks. Female participants reported an average of at least 28 drinks per week prior to the study, with at least 4 drinks on most days. Males had at least 35 drinks per week and 5 on most days.

As reported online on May 30, 2013, in the Journal of Addiction Medicine, varenicline significantly reduced measures of alcohol use compared with placebo. For example, the percentage of heavy drinking days per week decreased nearly 22% in the varenicline group. Craving for alcohol was also significantly reduced in people treated with varenicline. The effects on alcohol use were similar for smokers and nonsmokers.

Varenicline’s effectiveness was comparable to medications already approved by the FDA for treating alcohol dependence. The drug was also well-tolerated. Mild side effects included nausea, abnormal dreams and constipation.

“Drinking and smoking often co-occur, and given their genetic and neurochemical similarities, it is perhaps unsurprising that a smoking cessation treatment might serve to treat alcohol problems,” Litten says.

“This is an encouraging development in our effort to expand and improve treatment options for people with alcohol dependence,” says NIAAA Acting Director Dr. Kenneth R. Warren. “Current medications for alcohol dependence are effective for some, but not all, patients.”

Longer treatment and follow-up assessments will be needed to determine if varenicline can be an effective long-term treatment for alcohol dependence.