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In the worlds of medicine and addiction, it’s sometimes still an uphill battle to prove that addiction is a disease. Family members and medical professionals often fail patients by not believing them. Not only have scientists proven alcohol use disorder is a disease, but they may have also discovered a cure in the form of stem cells. What is the connection between alcohol and stem cells?
As healthcare professionals, we see that it may be possible to offer this type of treatment to patients in the near future. There’s a catch, though: during the initial treatment period, patients need to avoid drinking excessive amounts of alcohol, which relates to the root cause of the disease.
During the diagnosis and treatment processes, an integrated medical approach is crucial. This includes support from every doctor and therapist who helps a patient with alcohol use disorder.
Certain factors put patients at risk of developing a disorder, such as:
- Another mental health disorder (frequent comorbidity).
- Heightened stress and trauma, such as constant financial strain, abuse, academic pressure, divorce, or homelessness.
- Exclusion and isolation from family and friends, causing sadness.
- Incident of first use: early alcohol use indicates a greater chance of developing alcohol use disorder.
- Family history, including behavioral patterns and/or patterns of use.
- Gender, as men are more likely to develop this disorder than women.
Stem Cells and Chronic Alcohol Use Disorder
Alcohol use disorder can lead to cancer. In a study published in January of 2018, scientists discovered that the connection between cancer and drinking is due to the scrambling of DNA within cells. This causes cell mutation that is sometimes cancerous.
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This means that alcohol use disorder creates potentially permanent, irreversible genetic damage. The study shows the link between cancer and alcohol use disorder based on a study done on mice. The study hypothesizes that an alcohol metabolite is responsible for the stem cell damage, rendering the stem cells unable to create tissues normally.
Earlier studies examined acetaldehyde, a toxin and breakdown product of alcohol. However, prior studies used higher concentrations of acetaldehyde than would be feasible in chronic drinkers. The 2018 study revealed that acetaldehyde presents a slicing action, creating permanent damage in DNA.
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When mice in the study lacked ample amounts of dehydrogenase 2 (ALDH2), the acetaldehyde proceeded to ravage DNA uninhibited. Additionally, individuals of East Asian ancestry (about 8% of people in the world) produce less ALDH2 than others. Cancers of the esophagus, as well as GERD, are markedly higher in that population.
This inefficiency in the ability to process alcohol, therefore, means anyone with that inefficiency is at higher risk for certain cancers. In the United Kingdom, scientists estimate that alcohol has an impact on the development of at least 12,000 cancer cases each year.
Stem Cells vs. Alcohol Use Disorder: The Facts
In 2018, a study revealed that a single dose of MSC-spheroids affected animal subjects that had been chronically consuming large quantities of ethanol. Over about five weeks, subjects in this study showed reduced interest in drinking by up to 90%.
This begs the question, what is the potential application? The answer is hopefully intravenous treatments for patients with alcohol use disorder. Alcohol use disorder is a major health problem in the United States, contributing to 10% of working-age adult deaths in the country and contributing to many other chronic health problems.
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The study also highlights neuroinflammation associated with addiction and a host of other indicators. On a broader scale, this therapy could help a multitude of disorders and conditions affecting the immune system, including autoimmune diseases, which plague one in five Americans.
Using stem cell therapy, it is hoped that cells will be able to self-renew and compensate for the damage alcohol does to the cells.
Avoiding Alcohol During Treatment
Naturally, alcohol avoidance during this treatment, especially in the initial stages, is key. This is an understandable challenge for any patient suffering from addiction. It is also a point of frustration for doctors.
The treatment itself can place an intense amount of psychological pressure on the patient, and stress can lead to alcohol-seeking behaviors in patients with alcohol use disorder, as well as the consequences of dangerous behaviors such as drunk driving.
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Treatment for alcohol use disorder has come a long way in the past few decades, and a holistic approach to treatment may work best. Patients receiving help for alcohol use disorder and other addictive disorders are more likely to succeed in treatments involving medication if they are also enrolled in programs to help them.
Provide Assessments and Track Patient Progress
Alcohol addiction has physical effects, but it’s not something to combat without integrated help from mental health professionals and behavioral therapists. Working holistically and in concert should be at the foundation of treatment, though it wasn’t always that way in Western medicine.
Especially when considering therapy and medication for alcohol use disorder, it’s important to:
- Perform initial screening, then work with the patient to track improvements and relapses. Data and tracking are important, especially when multiple professionals are working together to improve the life of one patient. You need a base to work from and to see whether certain treatments work better or worse for patients. Some of this is subjective and requires patient input and accountability. Additionally, screening should focus on whether drinking has led to relationship troubles, risky behaviors, legal problems, and trouble at work or school. Don’t just consider the amount of alcohol consumed and the frequency, but how it affects the wellbeing of the patient.
- Encourage family support, friend support, and community support through supplemental discussion with groups like Alcoholics Anonymous (AA): Patients with alcohol use disorder need support beyond the doctor’s office and treatment centers. Resources like Alcoholics Anonymous are available to provide more regular support, and they are also free.
- Provide diagnosis and support for conditions secondary to alcohol use disorder, caused by heavy drinking. This means monitoring liver functions and preventing cancer with GERD treatments.
- Recognize that some patients are not yet ready to receive help with alcohol abuse. If that’s the case, restate your willingness to help and address at follow up.
- Support the patient with alcohol use disorder even through setbacks. Addiction is one of the hardest things to overcome, and setbacks are likely to happen. These are the times that the patient needs encouraging support the most. Remind them that any progress is a step forward to a healthier life.
Making a Difference in the Lives of Patients with Stem Cell Therapies
While it may seem strange to focus on advanced treatments like stem cell therapies while there are system-wide inadequacies in the healthcare system in the United States, the truth is that stem cell treatments often work for those who are able to access them. One example: a bright, stunning, active seven-year-old Australian boy who can see thanks to the use of stem cell therapy. This therapy used the patient’s own cells to create new cells to target treatment.
Additionally, stem cell therapies are helping patients with other ailments, such as aggressive treatment of spinal cord injuries via stem cell injection.
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As for people with alcohol use disorder, there are significant barriers to treatment that medical professionals are tasked with overcoming:
- Many fail to believe that alcohol use disorder is a disease: This includes some doctors, the patients themselves, their families, and society at large. Alcohol use disorder is a disease because it rewires the brain for dependency. A solution to this barrier is to educate yourself and others about alcohol use disorder. Stay updated on the latest treatments and studies related to an alcohol use disorder.
- Screening and diagnosis: As described above, screening and diagnosis aren’t cut and dry. Some diseases have blood tests and biopsies to give doctors (and insurance companies) concrete proof. Alcohol use disorder does not, as many of the symptoms are behavior based and require self-reporting. The solutions to this barrier are to provide screenings, listen to patients, and check in at each visit.
- Patient responsibility: It takes a lot of commitment, effort, and support for a patient to admit to alcohol use disorder and accept recovery. It is often a lifelong process. When addressing the issue of patient responsibility, suggest holistic approaches that include working with multiple doctors. Also, encourage the patient to go to community support groups.
- Post-treatment: While using stem cell therapy and medications can help, treatment for alcohol use disorder is lifelong. There is no cure for alcohol use disorder, even if stem cells may help. This barrier can only be overcome by educating the patient on this issue so that they know an ongoing effort is a part of the recovery process.
- Health insurance and treatment costs: Due to the Affordable Care Act, Americans’ health insurance must cover some of the cost of addiction recovery. You and the patient will need to consider a complex amount of costs, some of which the patient may incur while out of work or on reduced hours due to recovery. Costs include detox, initial medications, constant counseling, and maintenance meds, as well as outpatient and inpatient care. New treatments only add to these costs. It costs about $14,000 to provide treatment for a person suffering from addiction each year; it costs $37,000 per year to keep them in jail. Still, even the best of insurance have high copays at times, and often experimental treatments like those involving stem cells are not covered. This can be one of the toughest barriers, so it’s important to help the patient navigate the insurance system and devise the treatment that works best for their lifestyle and means.
Facts About Alcohol Use Disorder and Health
Potential stem cell treatment is crucial to the lives of those suffering from alcohol use disorder because of the detrimental impacts it can have on the lives of patients suffering with it as well as their families, friends, and coworkers. Here are some facts surrounding the disease:
- Nearly 27% of adults have alcohol use disorder or a history of binge drinking. The faster we can normalize the treatment of alcohol use disorder as a disease and identify the problematic behaviors associated with binge drinking, the more quickly we can secure further funding for testing and treatments.
- Drunk driving comprises 31% of driving fatalities in the United States.
- Over 10% of children in the U.S. live with an alcoholic parent, significantly affecting their mental health and development in most cases, and increasing the cost of healthcare overall.
- Around 13% of adults binge drink monthly and one in four college students’ academics are negatively affected by the prevalent use of alcohol.
- A startling 47% of liver-related deaths result from alcohol use, and it’s the cause for one in three liver transplant surgeries.
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Patients are rarely informed about the significant link between frequent alcohol use and cancer. The more alcohol a person consumes, the more likely they are to experience cancer of the:
- Breast (especially in women)
- Larynx (voice box)
Therefore, frequent alcohol users should be screened for cancer as well as other disorders associated with risk-taking behaviors.
Treatment Options for Alcohol Use Disorder
In addition to upcoming stem cell treatment possibilities, there are several methods — often used together — to treat alcohol use disorder. They include:
- Inpatient treatment programs: The patient stays at a residential treatment center for an integrated treatment approach.
- Outpatient treatment programs: The patient commutes to a local treatment center, but still resides at home.
- Medications: Medications used to aid recovery include Disulfiram, which inspires vomiting and heart palpitations at first sip of alcohol; Naltrexone, which disables the high many sufferers feel with drinking; and Acamprosate, which helps reduce a patient’s cravings for alcohol.
- Individual therapy: One-on-one counseling options can help a patient recondition themselves and inspire healthier habits.
- Group therapy and community guidance: Peers can provide patients with validation and support in ways that non-addicts cannot.
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Doctors also use barbiturates such as benzodiazepines to help patients cope with the detox process, which can be very traumatizing to the body. Anticonvulsants can serve in this function as well. Generally, barbiturates should be used with caution as they also have addictive properties. They are generally prescribed short-term during detox only.
Similarly, doctors have had success using psilocybin, which derives from hallucinatory mushrooms. Like barbiturates, these substances are addictive and should be used with caution.
Some doctors also prescribe antidepressants and SSRIs. This happens when alcoholism is not the dominant condition, but a secondary condition or symptom of mood disorders or other mental health concerns and trauma. Common antidepressants prescribed include Imipramine, ritanserin, citalopram, and fluoxetine.
The first step in treating alcohol use disorder is detox, which is one of the more painful and difficult steps. Before a patient could begin stem cell therapy, they would have to complete detox. Detox allows the patient’s body to remove alcohol from itself, but the dependency is already set. Patients will hallucinate, experience seizures, and shake. For this reason, detox should be supervised.
Through this process, it’s best to support a patient and set expectations for lifelong recovery. Even if a patient had a drink yesterday, it’s vital to provide support for improvement.