The Pills That Reduce Alcohol Consumption

Alcohol is, of course, unhealthy. Not even the famous “small glass of red” is recommended:

Can We Drink To Good Health? ← this was mostly about the purported heart health benefits, and the answer to the question is: no, we cannot, and as WHO has declared, “the only safe amount of alcohol is zero”)

See also: How Much Alcohol Does It Take To Increase Cancer Risk? ← the answer is “any” (although, the risk is dose-dependent, so if not abstaining completely, less is still better than more)

A lot of why people think that moderate drinking is healthy, that widespread popular belief stems from flawed associative studies that compared the following two categories of people:

• non-drinkers, including many former heavy drinkers who stopped because they realized the harm they were doing to themselves
• light drinkers, who have been able to continue drinking because of their otherwise good health

In other words, they looked at now-teetotal former alcoholics whose health was ruined by drinking and concluded “aha, non-drinkers have bad health; clearly some drinking is best”.

You can read more about this and how that flawed research was later disproven once the confounding variables were removed, here: Are You Making This Alcohol Mistake?

Drugs to the rescue!

“Take drugs to reduce the consumption of alcohol (another drug)” may seem like odd advice, but we’re not talking narcotics here.

Although! The drugs in question are active on the dopamine system, so yes, it is actually rather relevant. In other words, they reduce alcohol cravings (and thus, alcohol consumption), by improving dopamine signalling, which means people are less likely to reach for a bottle to self-medicate in order to try to get certain parts of the brain to light up.

Here some readers may be thinking “but I’m not trying to self-medicate; I just like enjoying the drink”, and if that’s you, then well, consider double-checking, for example:

The Alcohol Experiment – by Annie Grace ← it’s a 30-day no-alcohol challenge. If it’s not a dependency, you can do it no problem, right? Compare how willing you are (or not) to do this challenge, compared to, say, abstaining from some other thing that you frequently enjoy but isn’t addictive.

For example, this writer drinks, on average, 6 cups of spearmint tea per day. I love it. But it’s not addictive, and if challenged to skip it, I wouldn’t be counting the days or having to plan coping strategies.

So, with the knowledge in mind that alcohol is indeed addictive and does hijack dopamine circuitry (and more), a team of researchers (Dr. Andrea de Bejczy et al.) investigated the combination of two existing medications (varenicline, for smoking cessation, and bupropion, an antidepressant that works on the dopamine system) in treating alcohol use disorder.

The study

It was respectably large (n=384) 13-week randomized controlled trial, with adults aged 25–70 years with moderate-to-severe alcohol use disorder. About two thirds of the participants were male, the rest were female.

As for how effective it was: compared to placebo, the combination of both drugs reduced a blood alcohol biomarker (B-PEth) by about 39% and the percentage of self-reported heavy drinking days by about 31%.

It’s worthy of note also that actually varenicline achieved this reduction when tested alone, too; adding buproprion didn’t increase the effectiveness but did decrease the side effects:

❝Nausea is a well-known and troublesome side effect of treatment with varenicline. It was surprising but very encouraging to see that nausea decreased when bupropion was added. The fact that the combination treatment is more tolerable for patients increases the chances that they will complete the full course of treatment❞

~ Dr. Andrea de Bejczy

You can read the paper in full, here: Efficacy and safety of varenicline and bupropion, in combination and alone, for alcohol use disorder: a randomized, double-blind, placebo-controlled multicentre trial

And if you’d prefer a drug-free approach, check out: Rethinking Drinking: How To Reduce Or Quit Alcohol

Worried you’ve already done too much harm?

It’s never too early to quit drinking, but it’s also never too late:

What Happens To Your Body When You Stop Drinking Alcohol ← for a detailed timeline which parts of your body recover when

Take care!