Anti-Craving Drug, Counseling Help Homeless Cut Back
Homeless alcoholics who received monthly injections of an anti-craving medication experienced fewer cravings and lowered their consumption of alcohol, according to a preliminary study from the University of Washington.
Participants who took part in the 12-week program met regularly with study physicians to set their own goals for treatment and also received monthly injections of extended-release naltrexone. This medication, unlike some anti-abuse drugs, does not cause a bad reaction if alcohol is consumed.
Instead, it “acts as a pacifier to quiet brain receptors that are crying out for more alcohol,” said clinical psychologist Susan Collins, Ph.D., of the University of Washington Department of Psychiatry and Behavioral Services, and safely reduces craving in active drinkers.
“Abstinence-based alcohol treatment has not been effective for or desirable to many homeless people with alcohol dependence.”
One problem with alcohol treatment programs for the homeless is the expectation that they must change their drinking habits. Homeless people who are also alcohol-dependent often have several health, social, economic, legal, and other problems.
Collins explained that her team wanted to test a new and practical treatment; something more acceptable to people with this background, and capable of measurably improving their lives.
The counseling approach had a non-judgmental, empathetic style. This is unlike traditional treatment, in which participants are expected to embrace sobriety. Instead, participants were completely in control of their own goal-setting.
Participants were not specifically asked if they wanted to lower their alcohol consumption, but were asked instead, “What would you like to see happen for yourself?”
Many spontaneously said that they wanted to cut back on their drinking. Other treatment goals that were mentioned included reconnecting with families, finding work or volunteer positions, fixing health problems, and improving personal hygiene.
The participants were given safe drinking tips and were reminded of the warning signs of alcohol withdrawal, which can progress to delirium tremens, a severe, potentially deadly form of alcohol withdrawal.
“Suddenly stopping drinking can be a serious hazard for people with severe alcohol dependence. Often their bodies literally depend on alcohol to survive,” Collins said.
The results of the treatment included decreases in alcohol craving (33 percent), drops in amount of alcohol consumed on typical and peak drinking days (25 precent and 34 percent, respectively), decrease in frequency of alcohol use (17 percent), and decrease in problems associated with alcohol use (60 percent).
“We think the initial results suggest that extended-release naltrexone and harm reduction counseling is a promising means of supporting reductions in alcohol use and in reducing alcohol-related harm among chronically homeless, alcohol-dependent individuals,” said the researchers.
“At the same time,” they cautioned, “the findings should not be over-interpreted. This was a small, single-arm, open-label study. Larger-scale, well controlled studies are needed to test treatment efficacy.”
Source: University of Washington
Pedersen, T. (2018). Anti-Craving Drug, Counseling Help Homeless Cut Back. Psych Central. Retrieved on September 29, 2020, from https://psychcentral.com/news/2014/05/25/anti-craving-drug-counseling-help-homeless-safely-consume-less-alcohol/70347.html