"If you drink more alcohol than you want to or should youre not alone. A nationwide survey httpspubs.niaaa.nih.govpublicationsRethinkingDrinkingRethinking_Drinking.pdf by the National Institutes of Health found that  percent of adults in the U.S. are heavy drinkers or drink more than is recommended. Yet most heavy drinkers dont get the help they need. The biggest problem we have in the field is that less than  percent of individuals with an alcohol use disorder get any treatment whatsoever says George Koob https director of the National Institute on Alcohol Abuse and Alcoholism. Part of the challenge researchers say is that many drinkers dont realize that a medicine long used to help people addicted to opioids quit their drug habit can help alcoholics and other heavy drinkers cut back too. I thought my only option was AA John tells NPR. Weve agreed to use only his middle name disclosing his trouble with alcohol publicly he says would jeopardize his business. Hes a yearold professional who says he started out as a social drinker  a few beers with his softball team after a game. But he sank into a deep depression after several deaths in his family and sought solace in the bottle he says. I wanted to numb my thoughts says John. Hed often start with hard liquor in the morning John says and it wasnt uncommon to have eight drinks or more before the end of the day. He worked from home so he was able to mask the problem for a while. But eventually his wife confronted him. Article continues after this message from our sponsor She had come home and I was rushing to hide a glass and she was furious with me he recalls. Just absolutely furious. He went to see Paula DeSanto httpmnalternatives.comaboutus.html a therapist and director of Minnesota Alternatives in Spring Lake Park Minn. The center provides outpatient mental health and substance use treatment services. I would say Johns story is not unique DeSanto tells us. A lot of people are reluctant. Sometimes traditional treatments  such as residential rehab or a step program like Alcoholics Anonymous  can lead to a significant disruption in their lives she explains. Theres stigma shame and embarrassment. DeSanto suggested a different approach to John. To help work through the loss and grief he was feeling counseling can help she told him. She also recommended he try naltrexone https a prescription drug. Naltrexone is an effective medication for the treatment of alcohol use disorders says Koob. He points to a recent metaanalysis published https in the journal Addiction that concluded that naltrexone helped reduce heavy drinking and cravings for alcohol. The analysis included data from  clinical trials in which people were given either the medication or a placebo pill to test the effectiveness of the treatment. The analysis also found that another drug acamprosate https is effective at helping people who have already stopped drinking to maintain abstinence perhaps partly by easing the physical and emotional cravings experienced by heavy drinkers who quit. So how does naltrexone work The drug seems to curb the euphoric and sedative effects of opiates in the brain. Alcohol is known to activate some of the same receptors in the brain that opioids do and studies find that by tempering the pleasure https from alcohol naltrexone can help people drink less. It blunts the effects of alcohol says Koob. People who use naltrexone will say they have a drink and its not doing much for them. That was exactly Johns experience. After taking the naltrexone pill he didnt get the buzz he was used to getting so didnt want to keep drinking. I actually didnt feel the alcohols effects he says. It was startling. Its now been about five months since he started taking the medication. He has not stopped drinking completely but says he has cut way back. This is helping me John says. I can go out with friends and not worry that Im going to end up inebriated or sloppy. According to the findings https of a recent review both naltrexone and acamprosate are safe costeffective and efficacious. But they are substantially underused according to the review. Many physicians are unaware that there are medications to treat alcohol use disorders says Koob. His institute is stepping up efforts to work with the medical community on that front he says and is also touting Rethinking Drinking https a website aimed at consumers that offers the latest researchbased information on a range of treatment options. Any health care provider who is licensed to prescribe medicine can prescribe naltrexone  not just mental health professionals or addiction specialists. As as long ago as  a published study showed  https treatment of alcohol dependence with naltrexone by primary care doctors can be effective followup research has confirmed that the primary care approach not only works but makes treatment much more accessible. According httpspubs.niaaa.nih.govpublicationsRethinkingDrinkingRethinking_Drinking.pdf to the NIAAA patients can now receive effective alcohol treatment from their primary care doctors or mental health practitioners by combining the newer medications with a series of brief office visits for support. Naltrexone is certainly not a cureall researchers say. And it wont help everyone who has a drinking problem  especially if the disorder is severe. I use these medications as an adjunct to therapy and group sessions and step meetings says Dr. Jeffrey Hsu http a psychiatrist at Johns Hopkins University who is certified in addiction medicine. He says that when used alone the medicines are only modestly effective. But theres good evidence that the combination of counseling and drugs such as naltrexone can help people cut back on drinking or move toward abstinence."