On the Road to a Cure for Alcoholism

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A fascinating new study to be published in the journal, Biological Psychiatry (abstract here) outlines the route to a significant treatment for alcoholism. Researchers have teased out some of the biology underlying the transition from alcohol use to alcohol dependence and identified a target for drug treatment.

The story is one of competing proteins acting on the nerves of the amygdala, a particular region in the brain involved in addiction. (The same region appears on each side of the brain.) A peptide is a type of short-chain protein and they often show up as hormones or other regulatory chemicals.

In the study, two peptides where shown to have opposite effects. The first, CRF (corticotropin releasing factor) is released produced by the amygdala under stress, and leads to alcohol cravings and addiction. The second, nociceptin, blocks the effects of CRF. What’s particularly important is that nociceptin is much stronger and even seems to work in already addicted brains.

That last bit is impressive – a treatment that is useful for those who are already alcoholics to cut the cycle of withdrawal and cravings and a return to drinking.

The model here is rats, and one criticism is that rats aren’t people. But even though the psychology of alcoholism is different in rats and humans, the biology is similar. Rats certainly don’t turn to alcohol when in the midst of a divorce, or to escape the stresses of an emotionally draining job – but where it matters, in the brain, the stress plays out the same, with peptides doing a kind of chemical dance.

Even better, the pharmaceutical industry has an excellent track record of designing drugs to block peptides where they act. Finding a medication that mimics what nociceptin does naturally will be the next task. We already know that opioids act at the amygdala with a similar action, so there may be a candidate in this molecular class. Giving a peptide alone probably won’t work – they aren’t specific enough and usually destroyed if taken in a pill form. Still, this is a significant step toward the ultimate goal, a clear and focused treatment that works against alcoholism as a disease – in the same way we would treat an infection or other medical condition.

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