WASHINGTON - A single pill appears to hold promise in curbing the urges to
both smoke and drink, according to researchers trying to help people overcome
addiction by targeting a pleasure center in the brain.
A man puts out his cigarette in Strasbourg, eastern France.
Health advocates have called for tougher regulations on tobacco, as
officials from 145 countries met in Bangkok to discuss ways of boosting
global efforts to stop smoking. [Agencies]
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The drug, called varenicline,
already is sold to help smokers kick the habit. New but preliminary research
suggests it could gain a second use in helping heavy drinkers quit, too.
Much further down the line, the tablets might be considered as a treatment
for addictions to everything from gambling to painkillers, researchers said.
Several experts not involved in the study cautioned that there is no such
thing as a magic cure-all for addiction and that varenicline and similar drugs
may find more immediate use in treating diseases like Alzheimer's and
Parkinson's.
Pfizer Inc. developed the drug specifically as a stop-smoking aid and has
sold it in the United States since August under the brand name Chantix.
Varenicline works by latching onto the same receptors in the brain that nicotine
binds to when inhaled in cigarette smoke, an action that leads to the release of
dopamine in the brain's pleasure centers. Taking the drug blocks any inhaled
nicotine from reinforcing that effect.
A study published Monday suggests not just nicotine but alcohol also acts on
the same locations in the brain. That means a drug like varenicline, which makes
smoking less rewarding, could do the same for drinking. Preliminary work, done
in rats, suggests that is the case.
"The biggest thrill is that this drug, which has already proved safe for
people trying to stop smoking, is now a potential drug to fight alcohol
dependence," said Selena Bartlett, a neuroscientist with the Ernest Gallo Clinic
and Research Center at the University of California, San Francisco who led the
study. Details appear this week in the journal Proceedings of the National
Academy of Sciences.
Pfizer provided the drug for the study, but was not otherwise involved in the
research.
More often than not, smoking and drinking go together - an observation
pub-goers have made for hundreds of years. That a single drug could work to curb
both addictions isn't a given - nor is it surprising, said Christopher de
Fiebre, an associate professor of pharmacology and neuroscience at the
University of North Texas Health Science Center at Fort Worth.
"This is an extremely important paper and hopefully it will convince the
major funding agencies that they need to examine the interactions between
nicotine and alcohol to a greater extent than they have done to date," said de
Fiebre, who was not connected with the study.
In fact, the California researchers, together with the National Institute on
Alcohol Abuse and Alcoholism, are now planning the first studies in humans of
the drug's effectiveness in curbing alcohol cravings and dependence, Bartlett
said. That the drug is already Food and Drug Administration-approved should
speed things along.
"This is a drug that people are actually using. That's not trivial - not at
all," said Mark Egli, co-leader of the medications development program at the
NIAAA, part of the National Institutes of Health. "There is plenty of animal
research that looks pretty cool but there is no way those drugs are ever going
to be used by human beings."
In the new study, researchers trained rats to drink alcohol and measured the
effect of varenicline once the animals became the laboratory equivalent of heavy
drinkers. They found the drug curbed their drinking. Even when stopped, the
animals resumed drinking but didn't binge.
Just as varenicline doesn't work for all smokers, it's highly unlikely it
would for all drinkers.
"Is this going to be a cure-all? No, not for smoking or alcoholism because
both diseases are more complicated than a single target or single genetic
issue," said Allan Collins, a professor of pharmacology at the University of
Colorado who was not connected to the study.
Still, Collins, who's worked on the topic for decades, called the drug's
potential use in treating alcoholism a "no-brainer." And Egli said it supports
the emerging view that there is a common biological basis for addictions to both
alcohol and tobacco.
As for Pfizer, the New York company has yet to decide whether to seek broader
FDA approval for the drug, a spokesman said.
"Without having considerable more data on this it would be very difficult for
us to say we might pursue it or not. It's almost a wait-and-see," said Pfizer's
Stephen Lederer.