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A drug that cures alcoholism may be the next anti-anxiety medication

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Re: A drug that cures alcoholism may be the next anti-anxiety medication

#91

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"Also anecdote: the easiest way to quit alcohol is with xanax." Ugh. Replacing addiction with addiction. Go this route if you have extreme medical conditions requiring it. EG. You are an alcoholic with serious liver issues, then by all means substitue xanax. Rehabs are full of people with xanax issues.

But we seem to have no issue, with Suboxone. That is, quite literally, replacing one addiction with another.

Opiate/oid withdrawal is pretty awful. You feel like you will die, but that seldom happens (unless you have other issues).

Withdrawal from alcohol, on the other hand, is, quite frequently, deadly (that's why medical alcohol detox is recommended).

Benzo withdrawals make alcohol withdrawals look like a case of the sniffles.

I think that we are best off, with no addiction to anything, but I also know that many folks can't seem to achieve that.

But deliberately addicting to benzos is crazy. They do use drugs like Librium to medically detox folks from alcohol, but that is quite short term, and is meant to keep you from dying.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#92
post #22

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Probably good to have an alert bracelet, but if you were undergoing emergency surgery, the anesthetist would monitor close enough to know something is off and respond appropriately.

How? By upping the pain medication?

Pretty much. Naltrexone is a competitive antagonist against the opioid reception (u being the important one).

They would give the standard amount of opioid (say fentanyl) and if they don't see the desired response they'll up it. Eventually you can "out compete" the naltrexone for the opioid receptor and get an effect.

If they do give 2-3x the dose, they'll be sure to monitor closely after to make sure everything goes well.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#93

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No. Allergic reactions are the immune system responding to a substance in a hypersensitive way[1]. There is however a genetic component to how people respond to alcohol. Some people after having 1 drink have a strong desire to continue drinking to blackout levels. Others are more likely to feel sick or sleepy after 2 drinks and have a desire to stop. It isn't an immune system reaction, but it is a reaction. The AA co…

I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some models are useful" situations with the allergy thing. Most individuals either find that model sufficiently useful that they don't need to expand it. Or, they're more or less fully aware of the gaps but still find that model useful. Or they don't find it useful and…

Are you saying that AA promotes discredited scientific claims because of a belief among their members that such claims have utility in helping their members quit drinking and stay off alcohol? Why even have the quasi-scientific patina then? Just go back to purely religious-era thinking, things like 'You'll burn in hell for all eternity if you don't get off the booze right now".

The problem with groups like AA is that they seem incapable of revising their dogmatic beliefs when presented with new evidence. What if opiate addiction and alcohol addiction are not 'lifelong diseases' at all, but simply treatable conditions? Would AA revise its claims if presented with such evidence?

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#94

I logged out and made a throwaway because I'm somewhat sad to see the responses here. While it isn't helpful to every alcoholic, and should never be forced upon any alcoholic at all, it is to some. It's the alcohol equivalent of suboxone, for better and worse. You cannot force an addict of either sort to recover until the person wants to, for sure, I've been there. I chose to seek Antabuse of my own volition some yea…

Congratulations on finding a method and making it work, that’s all that matters.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#95

Earlier quoted context omitted.

I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some models are useful" situations with the allergy thing. Most individuals either find that model sufficiently useful that they don't need to expand it. Or, they're more or less fully aware of the gaps but still find that model useful. Or they don't find it useful and…

Are you saying that AA promotes discredited scientific claims because of a belief among their members that such claims have utility in helping their members quit drinking and stay off alcohol? Why even have the quasi-scientific patina then? Just go back to purely religious-era thinking, things like 'You'll burn in hell for all eternity if you don't get off the booze right now". The problem with groups like AA is that…

Yeah that's exactly what I'm saying. And if the burn-in-hell model was demonstrably more effective than a medical model I would endorse it. Wouldn't you? What's the value in pushing a scientific model if it isn't actually more practically effective at helping the people who are asking for help?

And look, I'm not saying the medical model isn't more effective. But "new evidence" isn't always easy to apply even when it is clear, and with addiction it very often is not. AA's method despite its serious serious flaws has worked for a lot of people over many decades, so yes there is some natural conservatism about updating it every decade to keep up with new research.

You're on the right track though with the dogma thing. If you're familiar with the sociological study of religions, looking at it through that lens can be very valuable. It has a cultus of belief and ritual, it has a community of believers, and yes a dogma. It doesn't never change, but it is slow to.

To understand this thing you need to try to understand what value it has to people. If you want them to switch to another approach you need to demonstrate the actual practical value of that approach to people. This is literally life and death shit, people aren't going to part with it just because some le atheist engineers don't like that they call it an allergy and ask god for help.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#96

Earlier quoted context omitted.

No. Allergic reactions are the immune system responding to a substance in a hypersensitive way[1]. There is however a genetic component to how people respond to alcohol. Some people after having 1 drink have a strong desire to continue drinking to blackout levels. Others are more likely to feel sick or sleepy after 2 drinks and have a desire to stop. It isn't an immune system reaction, but it is a reaction. The AA co…

I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some models are useful" situations with the allergy thing. Most individuals either find that model sufficiently useful that they don't need to expand it. Or, they're more or less fully aware of the gaps but still find that model useful. Or they don't find it useful and…

I really appreciate your response and respect your experience. I'm very happy for people that have been able to make positive changes in their lives and I'm not suggesting anyone stop doing AA if it works for them.

It would be great if there was a sister organization to AA that was more of a group therapy session, without the spirituality and alcohol abstinence components. But maybe that wouldn't work, since there would be no rules and groups could diverge toward unhealthy behaviors.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#97
post #14

I am an alcoholic myself, sober for five months now after a long-term therapy. I am sceptical about taking meds for this desease. The change of life and coping with stress is the best way to avoid getting in relapse of use. The therapists said meds might be a help, but are not the solution. Its a trap for the dependant who might think now hes cured and does not find himself changing his life and solving problems whic…

Congratulations and huge kudos for seeking treatment for NPD. Most folks with NPD never would.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#98
post #25
post #7

Given the extremely strong negative reaction to alcohol that patients who are taking Disulfiram experience and given that this is apparently the sole effect that alcohol abuse cessation treatment using it relies on, it is my belief that the treatment is unconscionable and inhumane. I quit drinking after more than 25 years of problematic drinking using naltrexone (The Sinclair Method) and, given my experience with alc…

One anecdote to another: Naltrexone isn't all that different from what you're describing Disulfiram as here - it's an opiod blocker so when you drink you get the poison and not the happy chemicals. That doesn't help with addiction, it's subjecting yourself to negative effects / conditioning for drinking. Naltrexone doesn't work for me. It is not very effective for some people.

Naltrexone and disulfram are incredibly different, both in terms of pharmacology and subjective experience. Naltrexone hangovers are an awful experience, but that's due to neurochemistry. It doesn't short citcuit metabolic pathways so you literally poison yourself when you drink alcohol.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#99
post #66

Phenylethylamine works somewhat like that: take 2-3g and don't drink. If you do, you'll heavily regret it as it will fuck up your blood pressure to the point of getting all red and passing out. Not safe at all, but it did work for me for a while. Quitting out of fear can work. A better alternative to treating alcoholism and anxiety are gabapentinoids and gabaergics. There are a few of them, and indeed Gabapentin has…

Informative post, but I have one minor correction: Gabapentin(and pregabalin), while a GABA analogue, doesn't actually interact with GABA receptors og GABA itself at all. It acts on voltage-gated calcium channels, which is in part similar to the downstream signalling effects of GABA, and hence gives the effects you describe.

Yes, I did read all I could about it. Some research does say it could act on GABA receptors indirectly, but most of it does not support that theory.

I can only say for sure the effects are very similar to alcohol's positive ones at low dose, somewhere between alcohol and cannabis at higher doses, and not everyone reacts to it.

Myself, after using it for about a year as an anxyliotic (it can also have some interesting effects on creativity), I stopped for half a year and upon trying it again, I get zero effects. Usual dose was 0.9-1.2g. Now, no effect. I tried up to 6 grams at once, still no effect.

It is very strange, like some sort of permanent tolerance. From what I can gather, others have had the same experience, and some can still get an effect at very high doses. Sad, it was pretty good while it worked.

Pregabalin still works on me, but the effects are less pronounced at low doses and too blunt and stupefying at higher doses... may work well for some people, though.

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