A new, Canadian-based company that treats alcoholics using a controlled-drinking, medication-assisted model plans to open its third clinic on December 11 in Calgary, Alberta. Using a Finnish treatment which employs the drug naltrexone to block the pleasurable effects of alcohol, Vancouver-based Alavida claims a success rate of 78 percent.
An opioid antagonist which blocks the opioid receptors in the brain to prevent opioids from binding to them, naltrexone has been FDA-approved for alcoholism treatment since 1994.
Since opening its first clinic in Vancouver in September, 2016, Alavida has treated more than 10,000 clients, with a combination of drug therapy and counseling, according to CEO Elliot Stone. It opened its second clinic in Toronto in October.
Alavida has licensed a method developed in Finland by psychologist Dr. David Sinclair, M.D., more than 20 years ago. Sinclair has claimed an 80 percent cure rate for alcohol dependence, at the end of four to six months of treatment, with research published in the peer reviewed journals Alcohol and Alcoholism and the Journal of Clinical Psychopharmacology. The Sinclair Method has been adopted as a standard treatment protocol for alcohol dependence in Finland.
With the Sinclair Method, patients only take naltrexone before drinking. Unlike antabuse (disulfiram) – the most widely used medication for alcoholism – naltrexone does not cause sickness. Taken one hour before drinking, the typical dose is 50 mg, with some adjustment up or down for each individual. By the end of treatment, about 80 percent of alcohol dependent clients are either drinking moderately or not at all, according to Sinclair.
To track each client’s results, Alavida uses detailed logs and lab tests at the beginning and end of the treatment program. The indicators tracked are: how much alcohol consumption decreased after starting the program, in comparison to the average during the two weeks before treatment; and liver enzyme levels (a decrease in Gamma GT values usually indicates a decrease in drinking).
The company says a survey of 147 clients from the first Alavida clinic showed that 78 percent of clients reduced their drinking to less than half of what it was when they began the program or to below a level of increased risk for mortality and morbidity. Twenty-five percent of clients reported having been abstinent during the last month of the program. Twelve percent of clients were unsuccessful, with the most common reason being failure to follow instructions.
Alavida acknowledges that the long-term efficacy of the program remains to be seen, because the method is relatively new.
“We remove the power that alcohol has over the brain by prescribing naltrexone and interrupting that reward cycle,”Alavida founder and medical director Diane Rothon, M.D. told the Toronto Sun.
“The patient no longer associates alcohol consumption with positive reward — it becomes neutral. By the third drink, they call it a ‘why bother?’ … It kind of resets the clock to a time before the person was having problem with their alcohol intake,” said Rothon, who has treated alcoholics for more than 30 years, using conventional methods, with much lower success rates.
Before founding Alavida, Rothon says, she tried treating alcoholics with a combination of naltrexone and total abstinence, with disappointing results. “This is the alcohol recovery treatment of the future.”
In the U.S., a Veterans Administration study compared treatment of alcoholics who abstained and took daily naltrexone, with a group who abstained and took a placebo. The study of 627 subjects found no significant difference in success rates between the two groups.