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."

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