What If We Found The Magic Bullet?

Ideological and ethical constraints on biological alcohol research and its application
  • Robin Room


Funding for biomedical research on alcohol is justified in terms of the eventual development of pharmacotherapies for alcoholism treatment. Three medications have so far been approved: disulfiram, an aversive substance with a 50-year history, not much used now because of patient noncompliance; and naltrexone and acamprosate, which are now thought to be mildly effective. Ideological and practical limits on the development of medications include the focus on “alcoholism”, rather than on reducing the harm from heavy drinking, and the requirement of abstinence as a goal. These constraints have been argued to limit the effectiveness of naltrexone, and have diverted attention from such substances as propylthiouracil with promise to prevent liver deterioration, and from the success of liver transplantation in reducing alcohol-related deaths. Patient compliance will be a problem with any medication that deters drinking, or takes the pleasure out of it, particularly when the treatment is coerced, as much alcohol treatment is, formally or informally. In light of this analysis, it is hard to imagine a medication (other than another psychoactive substance) which would be both politically acceptable and effective. There is a need for ethical consideration prior to the advent of such future developments as a preventive vaccine interrupting the action of alcohol on the brain. Refocusing on biomedical means of reducing health harms from alcohol would be a useful path forward.

Key words

biomedical research disease concept of alcoholism abstinence goal medications liver transplants patient compliance 


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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Robin Room
    • 1
  1. 1.Stockholm UniversityStockholmSweden

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