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28 February 1999
From today (March 1) doctors will be able to prescribe naltrexone, (also called REVIA). This is an historical event, since it is the first drug to be registered in Australia for the treatment of alcohol dependence in 50 years.
Naltrexone, an opioid antagonist, is indicated for use within a comprehensive treatment program for alcohol dependence. The drug was recently approved for marketing in Australia by the Therapeutic Goods Administration.
In Australia, alcohol related problems affect around six to seven per cent of the population and are responsible for approximately 6,000 deaths each year. Alcohol dependency costs the country in excess of $6 billion annually.
Professor Rounsaville, a psychiatrist and Director of Research at Yale University School of Medicine, USA and a leading international expert on alcohol dependency said today that alcohol dependency had been on the increase every decade, parallel with the steady increase in depression.
He said there was a connection between alcoholism and depression - depressed patients were prone to abuse alcohol, and patients with alcohol dependency could also develop depression.
"Every single psychiatric or personality disorder is associated with higher rates of drug and alcohol abuse," he said.
"However the "addictive personality" was a myth. There is no single alcoholic or addictive personality. There are certain stereotypes of behaviour once a person becomes addicted to alcohol or drugs such as preoccupation with alcohol or drugs and a certain amount of deception. These behaviours are caused by being dependent on alcohol or drugs, so as a result people with various kinds of addictions seem to resemble each other in their behaviour," he added.
Professor Rounsaville is in Australia this week to talk to specialists and general practitioners about the increasing incidence of alcohol dependency and depression and to share his own experience with naltrexone in the treatment of alcohol dependency.
He said naltrexone would offer a useful addition to counselling by general practitioners for people with mild to moderate alcohol dependency. Those people at risk of serious withdrawal symptoms, with ongoing medical or psychiatric problems should be treated by a specialist in drug and alcohol dependency.
Although the exact mechanism of action of naltrexone in alcoholism is unknown, its major effect is to block µ (mu) opioid receptors in the brain. The body's own opioids are released in the brain when alcohol is consumed. By blocking the effects of this opioid release, naltrexone reduces craving for alcohol, alters alcohol's rewarding effects and reduces the desire to continue drinking if alcohol is sampled.
Naltrexone is taken as a 50mg tablet once daily. Shortly after the first dose, its effects on blocking the craving for alcohol occur. Treatment with REVIA takes at least three months and should include counselling from a doctor. A successfully treated patient can expect to either reduce or stop their drinking. Some patients may need to be on REVIA for longer.
Naltrexone is also indicated for use as adjunctive therapy in the maintenance of formerly opioid-dependent patients, but not for use in rapid detoxification.
Professor Rounsaville arrives in Melbourne on Sunday 28 February 1999 and travels to Sydney (2-3 March), Brisbane (4 March) and Adelaide (5 March).
For further information and interviews please contact:
Caroline Duell or Nicole Phillips
Hill and Knowlton
Ph: (03) 9820 8999 / 0411 045 908
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