Conquering Cravings
A wave of new drugs targeting addiction offers hope to people battling the habit
By 2003, Brenda Moore was desperate to keep her promise. A smoker since age 16, she had vowed to her daughter two years earlier that she would quit; now, several failed tries later, young Tiffany had developed asthma. Then a Sunday newspaper ad caught Moore's eye, a call for volunteers to take part in the clinical trial of a new antismoking drug. For three months, Moore, now 40, took a pill daily and made regular trips from her home in Beattyville, Ky., to Lexington to be monitored. This time, things were different. "In the first two weeks I was taking the drug, I started to look at the cigarette differently," she says. "It literally took on a new nastiness."
Laurie O'Connor, 49, was also a victim of her cravings-for alcohol. "I needed a drink. I needed that pleasure I got from drinking," says O'Connor, of Wake Forest, N.C. She, too, tried to stop cold turkey and failed. And she, too, joined the trial of a new drug, in 2002. Before long, she says, "the physical urge was totally, totally gone."
No quick fix. Today, Moore and O'Connor are still addiction free, and the drugs they tested-Moore's was Chantix; O'Connor's, Vivitrol-have just hit the market. The medications are two of a growing number of drug treatments approved or under study to battle smoking and heavy drinking. Neither provides a quick fix (and both are intended to be taken in concert with counseling), but physicians hope the drugs will work for people who haven't been able to tame their cravings using other methods. The stakes are high: Tobacco is the world's leading cause of preventable death, responsible for about 435,000 deaths a year in the United States alone. Alcohol abuse afflicts about 8 million American adults and carries with it a host of potentially deadly hazards, including liver damage and a heightened risk of cancer.
Tackling these addictions with drugs isn't new. Some smokers are able to give up the habit by replacing cigarettes with a tapering dose of nicotine delivered by nasal spray, gum, or a patch; others gain the necessary willpower from bupropion (brand name Wellbutrin or Zyban), better known as an antidepressant. Medications that fight drinking include naltrexone and acamprosate, both of which tamp down cravings, and disulfiram (otherwise known as Antabuse), which makes you physically ill if you consume alcohol. While the various treatments do help some people, none come close to being a silver bullet-which is why doctors are excited to be given new weapons.
Chantix, the brand name for the drug varenicline, is believed to block a brain receptor for nicotine, so you don't get that old pleasurable buzz from smoking. At the same time, the drug itself appears to interact with the receptor-blunting cravings and withdrawal symptoms. That one-two punch, researchers say, helps keep the occasional slip from turning into a full-blown relapse. "I didn't have an urge to smoke. Before, it was the only thing on my mind," marvels Robert Allan, 49, of Norwood, Mass. He'd tried to beat the habit many times before succeeding with Chantix-using the patch, hypnosis, and the just-do-it approach-and, many times, smoking had won. Overall, about 22 percent of people on Chantix were able to truly stop smoking for the long haul, roughly the same percentage as those who succeed using nicotine (though many of those people keep needing nicotine). And Chantix helped a greater proportion than bupropion seems to. Nausea was the most common side effect of the new drug.
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