Why aren’t Americans embracing the most promising medications for treating over-drinking?

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Alcohol consumption increased more during the COVID-19 pandemic than it had at any time in the past 50 years. Even though bars were closed for weeks on end and fewer people were out on the road doing their daily commuting, Americans were drinking so much that from 2020 through 2021 there were approximately 178,000 alcohol-related deaths - which is more deaths than from all drug overdoses combined, including opioids.

Yet, even as we return to 1960’s Mad Men era drinking habits - most Americans with a drinking problem never speak to their doctors about their drinking and less than 6% of them receive any form of treatment whatsoever. 12-step programs like Alcoholic Anonymous remain at the heart of a majority of American rehab programs, even though their “success rate” (which has historically been very hard to study) hovers around the single digits, while there are more effective medical options available.

Why?

On today’s episode, our friend Katie tells the story of her self-experimentation with the drug Naltrexone to combat her alcohol addiction and helps us grapple with why such medications are so rarely used to help problem drinkers in America.

Our thanks to our guests: Addiction psychiatrist Dr. Mark Willenbring and journalist Gabrielle Glaser.

Music in this episode from Cobey Bienart and Peter Lalish

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Other links:

Glazer’s 2015 article in The Atlantic.

Andy’s 2015 public radio story on addiction treatments.

Washington University’s National Survey Study.

CDC’s study on recent alcohol-related deaths.

2014 NYTimes stories on how Naltrexone and other drugs are rarely used.

2021 NYTimes story on how things have not changed.

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