Yale researchers are exploring whether certain medications, including one sold to help smokers kick the habit, can help heavy drinkers reduce the amount of alcohol they consume.
Yale School of Medicine is conducting a clinical trial to see whether those who frequently drink heavily and also smoke cigarettes find it easier to cut back on their drinking while taking varenicline.
The drug, sold under the brand name Chantix, is marketed to help smokers quit but could also potentially help heavy drinkers drink less, according to lead researcher Stephanie O’Malley, a psychiatry professor at Yale.
For many, smoking cigarettes and drinking alcohol “kind of go together, hand in hand,” she said. “Many people, when they drink they want to smoke.”
Previous studies, including one by the National Institutes of Health (NIH), have found that Chantix does help reduce drinking for those who want to cut back, she said. The Yale study, which is enrolling participants of all ages through mid-April, will further examine how the drug impacts participants’ desire to drink.
The study is being conducted at Yale and at Columbia University in New York and is funded by the NIH’s National Institute on Alcohol Abuse and Alcoholism. Pfizer, the maker of Chantix, has donated the drug doses being used in the study.
A separate Yale School of Medicine study, also led by O’Malley, recently found that young people who drink alcohol consume less and suffer fewer consequences if they take naltrexone. That drug typically is used to treat opioid and alcohol dependence.
The results of the study were published Feb. 25 in the Journal of Clinical Psychiatry.
The study took place from March 2008 to January 2012 and all of the participants were between the ages of 18 and 25.
Naltrexone did not necessarily lead the participants to drink less often, but it did have other positive effects on those who took it, O’Malley said.
The study found that many who took the drug consumed less alcohol, were less likely to exceed the legal level of intoxication, and less frequently suffered consequences like alcohol-induced blackouts, compared with those in a control group who did not take the drug.
“Many young people are willing to reduce their drinking but not quit entirely,” she said. “We hope to provide a treatment approach that is acceptable and can change the trajectory of their drinking and reduce the development of chronic problems.”
The effects of naltrexone on heavy drinking have been studied in the past, but previous studies focused on an older demographic, with an average participant age of 40 to 50, O’Malley said. The Yale study, in which 128 people took the medication, is the first to focus on young adults between the ages of 18 and 25, she said.
Testing the drug’s impact on young people is important, she said, because 18- to 25-year-olds have the highest rate of alcohol dependence, yet the average age people typically seek treatment for alcohol abuse is in their 40s.
Researchers hope the study’s findings will eventually help get more young people get early treatment to reduce their alcohol consumption, she said.
The “harm-reduction strategy” is a controversial one, according to Yale researchers; critics of the method argue that abstaining from alcohol is the only safe way to treat alcohol dependence.
But the drug’s effects are positive steps, said O’Malley.
“Our study provides an evidence base that could be used by (health care) providers, whether at a college health center or a primary care practice, that they could use to consider as an option for young adults that are perhaps drinking excessively,” she said.
This week the U.S. Food and Drug Administration issued a warning about Chantix and alcohol. Some who have had alcohol while on the drug have experienced “increased intoxicating effects of alcohol,” associated with aggressive behavior or amnesia, according to the FDA, and in rare instances people on Chantix have experienced seizures after drinking.
O’Malley said the warning will not change the study. Researchers obtain “informed consent” from all study participants and distribute a consent form that describes the study in detail, including any risks, she said.
“We are revising the consent form to include this new warning,” she said. “We also obtain a medical history and physical examination prior to participation and we monitor participants carefully throughout the study.”