Many people don't realize the magnitude of the effects that alcohol use disorder has on society, said Howard Becker, Ph.D., a professor in the Department of Psychiatry and Behavioral Sciences in the MUSC College of Medicine and director of the Charleston Alcohol Research Center.
Integrated as it is in all aspects of society - from a beer at a ballgame to a cocktail at an office social - excessive alcohol use is the third leading preventable cause of death. Alcohol misuse costs the U.S. $250 billion each year due to lost productivity, health care costs, crime and more. And none of that touches on the individual suffering. All of those negative outcomes are what steer the work of the Alcohol Research Center.
To be clear, Becker said, he and his colleagues don't advocate a return to Prohibition or anything like it. Instead, they want people to understand that alcohol use disorder is a disease that physically changes the way the brain functions. As such, just as with other diseases, there are medical treatments available.
But there could be more and better treatments, which is where a new contract award comes in. The Medications Development Program at the National Institute on Alcohol Abuse and Alcoholism recently awarded Becker $3.1 million and a five-year renewal to continue testing medications that could help people with alcohol use disorder. The MUSC contract is one of only a few in the nation to test pharmaceuticals preclinically, meaning before the drugs are tested in humans. MUSC researchers use a specific model to do so.
"We developed this model here through our center, and it's viewed as a national resource," Becker said. "It's used internationally now as a model for looking at relapse-like drinking."
There are a few FDA-approved drugs for alcohol use disorder, but, Becker said, "They only work to a certain extent, so there needs to be more drugs in the arsenal for health providers to offer individuals who are suffering from troublesome alcohol use."
The Medications Development Program is meant to encourage the development of such drugs. Under the NIAAA contract, the Alcohol Research Center tests drugs developed by private industry using the model created here. The center's researchers don't know the identity or specific mechanisms by which each drug is supposed to work, so they can deliver impartial reports about whether the test drugs reduced relapse and excessive drinking in the model.
The NIAAA contract started in 2007. Becker said that there have been some interesting prospects identified in that time, but ultimately, it's up to the pharmaceutical company to decide what to do with the information in the center's report.
Becker said the idea behind drug development is to mitigate or reverse some of the changes that happen in the brain because of chronic exposure to alcohol. For some people, alcohol hijacks brain circuits and pathways that are key to normal behavior, and "their behavioral repertoire starts to narrow, so they become mainly focused on procuring alcohol and drinking alcohol," he said.
"Is there going to be a pill that's going to solve the problem of alcoholism? I doubt it," Becker said. "But what we're looking for are medications that will help individuals curb the cravings and urges to drink and gain better control over how much they drink. The idea is to reduce vulnerability to relapse, where one or two drinks often escalate to a half a bottle. And then, before you know it, half a bottle becomes a bottle a day. And then they're back on the bandwagon all over again. It's a vicious cycle."
The preclinical research being conducted under this contract is just one aspect of the center's work, which brings together researchers studying alcohol use disorder from the molecular level to working with people in clinical trials. Becker calls it a "bench to bedside" approach that integrates experimental studies and clinical investigations. With new discoveries, there is great promise for developing more effective medications that will help tackle the problem of alcohol addiction.
Most people are able to drink responsibly, Becker said. Fewer than 10% of adults meet the criteria for alcohol use disorder. Yet that still means millions of people are affected, and their problems with alcohol reverberate through their families and society, he said. About 88,000 people die each year from alcohol-related causes, ranging from liver disease to car crashes.
Founded in 1824 in Charleston, MUSC is the oldest medical school in the South, as well as the state's only integrated, academic health sciences center with a unique charge to serve the state through education, research and patient care. Each year, MUSC educates and trains more than 3,000 students and 700 residents in six colleges: Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy. The state's leader in obtaining biomedical research funds, in fiscal year 2018, MUSC set a new high, bringing in more than $276.5 million. For information on academic programs, visit http://musc.
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