Pubdate: Sun, 30 Sep 1999 Source: Guardian Weekly, The (UK) Copyright: 1999 The Guardian Weekly Contact: 75 Farringdon Road London U.K EC1M 3HQ Fax: 44-171-242-0985 Website: http://www.guardianunlimited.co.uk/GWeekly/ Author: Andrew G Marshall I'LL JUST HAVE THE ONE, THANKS A New Treatment Lets You Drink While You Dry. As drunks go, Catherine Grace was fairly glamorous and amusing. Her drinking exploits were a great source of anecdotes."I'd literally fall out of a trendy Soho bar and into the gutter," she says. "At the time it all seemed quite funny. Telling the story, everybody would laugh, and nobody louder than me. But deep down inside I knew drink had the better of me." Catherine, a 38-year-old mother-of-two, became a "problem drinker" after her marriage of 12 years broke down. Her story, of a gradual descent from social drinking towards alcoholism, is a common one: it is estimated that there are 1m people like her in Britain. But she has found an uncommon solution. Alcoholics are generally forced to accept that they can never touch a drop again without relapsing, but Catherine says a revolutionary treatment has helped her give up binge drinking, while continuing to drink socially. She is the first person in Britain to try the therapy, which is claimed to be astonishingly effective compared with traditional programmes such as Alcoholics Anonymous. It is said to be of use to heavy drinkers who are trying to cut down and to alcoholics trying to give up completely. Dr David Sinclair, a scientist at the department of alcohol research at Helsinki's National Public Health Institute, developed the treatment. On the basis that alcohol affects the brain in a similar way to an opiate drug, he began experimenting with a drug, naltrexone, which was developed in the 1970s to stop heroin addicts from overdosing. He found that naltrexone blocked the receptors in the brain that normally respond to alcohol by producing endorphins, the body's natural opiates. This in turn dulled the effects of drinking and eventually weakened the cravings for alcohol. The drug will now be prescribed at a new chain of private ContrAl clinics in Bristol, Cardiff and London. It will be given to patients in conjunction with a counselling programme. The treatment lasts three to four months and costs about $2,500. In Finnish trials 78% of patients had not relapsed after three years. However, the drug cannot be given to patients who have already seriously damaged their livers with heavy drinking. There are concerns that the treatment fails to deal with the underlying causes of alcoholism. "It's a scandal to mess about with our brain chemistry - - this science is in its infancy," says Dr Robert Lefever from the Promis Recovery Centre, which offers a programme of drying out based on the traditional AA 12-step programme. "What's more, it does not treat the underlying depressive feelings, just suppresses them." But ContrAl doctors say alcoholism is "learned behaviour" that can be effectively "extinguished" with naltrexone. Dr Roger Thomas, who works at the Cardiff clinic, says: "It takes about two years to learn to be an alcoholic. For people with alcohol problems - either because of their genetic make-up or life experiences - the nerve circuits in the brain controlling this behaviour become stronger and stronger until they are closely knitted together. Eventually drinking becomes automatic, like learning the piano . . . You might stay off alcohol for 10 years, but because the underlying chemistry of the brain has not changed, the circuits are still as strong. In just three weeks you can be drinking as much as before." Sinclair believes the drug could revolutionise approaches to other addictions. "What we have here is a new type of medicine to trick the body into using its own extinction process, and probably there are many other disorders going to the same system, like eating disorders, compulsive shopping," he says. "We've shown it works with alcohol. The frontier now in the laboratory is cocaine." Catherine's first attempt to sort out her problem was with AA. At first she found it easy to stay off drink completely. "The only drawback was that it was so time-consuming and it depended on willpower, but I was strong." However, 70% to 80% of patients relapse within a year - and Catherine was no exception. "I was working Christmas Day. When I got back to my empty flat, I thought, 'Screw AA,' and opened the champagne. The first glass was like nectar - 'lovely, this feels like the real me.' Off I went again, and by Boxing Day I was completely drunk." In August last year Catherine, a friend of Dr Thomas, agreed to be the first British guinea pig for the ContrAl programme. "I'd take my tablet half an hour before my first glass, and for three weeks I drank like a fish. I thought, 'Nothing is happening,' because I'd still be up at four in the morning watching anything that moved on the TV. However, after a month I noticed I wasn't opening the third bottle of wine. Next it was the second. A slow decline, but I was detoxing while drinking . . . I knew it was working at Christmas when at parties there were vodka cocktails but I didn't want any of them." Catherine now works as a ContrAl counsellor. "There's four bottles of wine in my kitchen that have been there since November - even my best friend can't believe it." - --- MAP posted-by: Jo-D