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The Rise of Genetics
By Sadia Naeem
Acamprosate and disulfiram both work in very different ways. Acamprosate, which accounts for the biggest proportion of prescriptions, has a mechanism of action that is not very well understood; however, it is thought that the imbalance of transmitters (and therefore neuronal transmission) caused by alcohol exposure is righted by acamprosate. Disulfiram on the other hand, better known by its brand name Antabuse, is notoriously well-known through what has come to be known as the "disulfiram reaction". Flushing, sweating, nausea, blurred vision and tachycardia are some of the symptoms of the reaction, which for some people is enough to put them off drinking.
However, my mind questions whether either of these drugs work suitably in chronic alcoholics. As I have no personal, anecdotal, physical or written evidence to answer this question, I am using logic. In many cases, chronic alcoholics have risked losing their life, family, career and possessions for alcohol, in which case a little nausea and vomiting may pale in comparison. In addition, should they have a very strong craving for alcohol, they could just as easily stop taking their tablets as they started them. Statistics show that up to 90% of people on an alcohol treatment programme relapse at least once3; therefore, if such a large expenditure of NHS money is to be spent on alcohol treatment programmes, drugs need to be better.
This brings me on to an article I read on the NHS website, regarding a "genetic switch" that the researchers publishing the findings say could be making westerners "programmed" or more prone to eating fatty food and drinking alcohol. The protein in question is galanin and the researchers investigated as to whether "regulatory sequences of DNA positioned near the gene could act as a genetic switch, turning the gene on or off"4.
Obviously, much more evidence is needed before any conclusions can be drawn, but could it be that by interfering with this gene we can, in a way, "switch off" alcoholics' desire to binge drink in a way that will work in chronic alcoholics as well? With the field of gene therapy growing it may be only a matter of time before antisense and gene drugs for alcoholism or other substance abuse, like the ones used to treat genetic diseases such as cystic fibrosis, explode onto the market.
26 Jul 2011
Substance abuse is a very real and threatening issue in Britain today, especially alcoholism with 6,584 alcohol-related deaths reported in 2009 in England1. The number of acamprosate and disulfiram prescriptions, the two most common drugs used to treat alcoholism, written by GPs in order to combat alcoholism is also on the increase, leaping from 102,000 in 2003 to 160,000 in 20102.
Acamprosate and disulfiram both work in very different ways. Acamprosate, which accounts for the biggest proportion of prescriptions, has a mechanism of action that is not very well understood; however, it is thought that the imbalance of transmitters (and therefore neuronal transmission) caused by alcohol exposure is righted by acamprosate. Disulfiram on the other hand, better known by its brand name Antabuse, is notoriously well-known through what has come to be known as the "disulfiram reaction". Flushing, sweating, nausea, blurred vision and tachycardia are some of the symptoms of the reaction, which for some people is enough to put them off drinking.
However, my mind questions whether either of these drugs work suitably in chronic alcoholics. As I have no personal, anecdotal, physical or written evidence to answer this question, I am using logic. In many cases, chronic alcoholics have risked losing their life, family, career and possessions for alcohol, in which case a little nausea and vomiting may pale in comparison. In addition, should they have a very strong craving for alcohol, they could just as easily stop taking their tablets as they started them. Statistics show that up to 90% of people on an alcohol treatment programme relapse at least once3; therefore, if such a large expenditure of NHS money is to be spent on alcohol treatment programmes, drugs need to be better.
This brings me on to an article I read on the NHS website, regarding a "genetic switch" that the researchers publishing the findings say could be making westerners "programmed" or more prone to eating fatty food and drinking alcohol. The protein in question is galanin and the researchers investigated as to whether "regulatory sequences of DNA positioned near the gene could act as a genetic switch, turning the gene on or off"4.
Obviously, much more evidence is needed before any conclusions can be drawn, but could it be that by interfering with this gene we can, in a way, "switch off" alcoholics' desire to binge drink in a way that will work in chronic alcoholics as well? With the field of gene therapy growing it may be only a matter of time before antisense and gene drugs for alcoholism or other substance abuse, like the ones used to treat genetic diseases such as cystic fibrosis, explode onto the market.
References:
1. Table
4.10 Alcohol related deaths by gender, 2001 to 2009, page 76. Statistics on
Alcohol: England, 2011. The NHS Information Centre. Accessed on
26/07/2011. Available at http://www.ic.nhs.uk/webfiles/publications/003_Hea...
2. Table
4.8 Number of prescription items, net ingredient cost and average net
ingredient cost per item of drugs prescribed for the treatment of alcohol
dependence dispensed in the community, 2003 to 2010, page 74. Statistics on
Alcohol: England, 2011. The NHS Information Centre. Accessed on 26/07/2011.
Available at: http://www.ic.nhs.uk/webfiles/publications/003_Hea...
3. Current Statistics, facts on relapse and recovery. Caron Pennsylvania. Accessed on 26/07/2011. Available at: http://www.caron.org/current-statistics.html
4. Gene
implicated in dietary and alcohol cravings. National Health Service. Accessed
on 26/07/2011. Available at: http://www.nhs.uk/news/2011/07July/Pages/gene-impl...
