Institute backs medication to treat alcoholism

Alcoholism should be treated with drugs in addition to behavior therapy, according to guidelines issued this week by the National Institute on Alcohol Abuse and Alcoholism, a shift that could boost the prospects of Cambridge biotechnology firm Alkermes, which is awaiting federal approval for an anti-alcoholism drug.

The changes, released Tuesday and presented at an American Medical Association conference yesterday, mark the first time the nation's top alcoholism institute has thrown its weight behind the idea of treating alcohol abusers through medication.

The institute's guidelines for doctors now describe the three approved medications for alcohol dependence and recommend that doctors become more aggressive about screening patients for alcoholism.

The decision to recommend medication marks a ''significant change in perspective" for the institute, said Ian Sanderson, a pharmaceutical analyst for investment bank SG Cowen, who estimates the number of alcoholics on medication could jump from the current 100,000 to as many as 400,000 by 2009.

The Alkermes drug, Vivitrex, is a reformulation of an existing drug called Naltrexone, which blocks patients' pleasure centers and reduces the craving for alcohol. It would allow patients to receive their medication in a monthly shot instead of a daily pill -- increasing their likelihood of staying on the drug, a company spokesman said.

The Food and Drug Administration's decision on whether to approve Vivitrex is expected in September.

Doctors need to think about alcoholism in the same way they have come to think about depression, said Dr. Mark Willenbring, head of treatment research at the National Institute on Alcohol Abuse and Alcoholism. They should realize that treatment for the illness may require drugs in addition to traditional therapy, he said.

''We have a treatment system that worked well in 1975. We don't have a treatment system that works well in 2005," Willenbring said in an interview yesterday.

Dr. Helen Pettinati, an alcoholism researcher at the University of Pennsylvania who has helped conduct tests of Vivitrex and other alcoholism drugs on patients, welcomed the institute's change.

''We've known for some time from the research end that pharmacotherapy treatment is effective in alcoholism," she said. ''The more we get the word out that [medication] is part of the right treatment approach for a lot of people, the sooner we'll be able to get better treatments and outcomes for people."

A study released this year showed that patients using Vivitrex were more likely to show a decrease in the number of heavy-drinking days each month than patients on a placebo. The company signed a deal with Cephalon Inc., to market the drug if it is approved by the FDA.

Alkermes stock fell 15 cents to close at $15.67 yesterday, but it rose 96 cents Wednesday, the day after the guidelines were released.

Stephen Heuser can be reached at sheuser@globe.com.