New treatment could help alcoholics cut alcohol before it becomes a problem

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Ed Senter, 51, says he has long since forgotten about his “young gay hangout phase” in the rearview mirror. But when Covid hit, he seized on a way to deal with stress.

“I needed to be numb,” Center said. “It was at this point that I developed the ‘bottle of wine at night’ habit.”

But the Center wanted to support its two children as they went through their own hardships in the pandemic era, and that was harder to do after a couple of drinks. He tried to make changes.

“I didn’t have alcohol in the house on purpose, and then stress happened, and I would go to the supermarket and take a bottle,” Center said.

It was then that he learned that a local researcher was looking for queer men from the Bay Area to participate in an experiment with a new treatment for mild to moderate alcohol use disorder, a condition better known as alcoholism. He decided to register.

Historically, the talk of drug treatment for people with alcohol use disorder has focused on the most severe cases. But the vast majority of people who drink have a more mild form of the condition, explained researcher Glenn-Milo Santos, professor of public health systems at the UCSF School of Nursing and author of the local study.

And people who drink alcohol in moderation can still experience significant negative health effects from alcohol consumption, not to mention an increased risk of alcohol-related accidents.

“So, thinking about a different treatment paradigm [for moderate drinkers] was something that I felt was missing,” Santos said.

A UC San Francisco researcher wanted to see if he could find a way to help drinkers who want to cut down on alcohol but don’t have a problem so severe that it reaches a critical threshold. He also wanted to focus his research on queer men, a demographic who, burdened with the stress of facing homophobia and transphobia, drink more than the general public.

Naltrexone is a medicine that reduces the amount of dopamine released by the human body after drinking alcohol. In essence, it dampens the euphoric high that comes with being drunk, reducing the desire to reach for the next drink.

As a rule, doctors prescribe the drug in the form of a daily dose, which is effective for heavy drinkers who get drunk during the week. But Santos thought that people with occasional drinking habits might be more interested in using the drug as needed, as a way to make sure they don’t overeat at a workday party, for example.

So, Santos and his team recruited 120 people like The Center: queer men living in the Bay Area who were open to taking naltrexone when they thought they were going through a binge period.

The study, which was published in the American Journal of Psychiatry last October, supported Santos’s theory that taking naltrexone as needed was effective in reducing drinking in study participants.

Santos’ work is part of a growing addiction treatment movement to offer people care once their substance abuse begins to cause problems in their lives.

“Too often someone is expected to hit bottom before a treatment can work,” Nora Volkov, director of the National Institute on Drug Abuse, wrote in a press release last summer. “But it’s a myth that could have dire consequences.”

The center says it has definitely seen queer men drink more in its lifetime than other demographics.

“Gay bars and gay parties have always been safe and social places,” he said. “It’s great, but it revolves around alcohol.”

According to a recent report from the Centers for Disease Control and Prevention (CDC), San Francisco’s historic center of queer culture, the Castro neighborhood, is one of the city’s hottest spots.

Because the study was double-blind, the Center is not sure if he received naltrexone or a placebo. In any case, taking part in the project required him to carefully monitor his drinking, which brought the Center a new understanding of what he drinks and helped him reduce his alcohol consumption.

Even now that the study is over, he says his relationship with alcohol is much happier. He has given up solitary “stupefying” drinking, but can still enjoy cocktail trips.

A lot of support came from his group of friends who use the app to track their drinking and have valuable conversations, helping each other understand what drives them to drink in the first place.

“I think there is a cultural zeitgeist going on right now where people are looking to cut down on their drinking. [so they can] drink consciously and responsibly, without giving up alcohol completely,” the Center said.

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