Scientists have found that a medicine already approved for inflammatory diseases may one day help people with alcohol use disorder by reducing both heavy drinking and chronic pain.
The study, led by researchers at Scripps Research, was published in JCI Insight and suggests the drug apremilast could treat two major problems that often occur together.
Alcohol use disorder, also called AUD, is a long-term medical condition in which people find it difficult to stop or control drinking even when it causes harm.
According to the World Health Organization, around 400 million people aged 15 years and older live with the condition. Many also experience ongoing physical pain, which can make recovery much harder.
People with AUD often develop a condition called mechanical allodynia. This means even a light touch can feel painful. The pain can continue after a person stops drinking, leading some people to return to alcohol in an attempt to ease their discomfort.
Apremilast is already approved by the U.S. Food and Drug Administration to treat psoriasis and psoriatic arthritis.
Because its safety has already been studied in people, researchers believe it could be a promising candidate for a new use if future studies confirm its benefits.
In the new preclinical study, the scientists tested apremilast in two different strains of rats, including one that is naturally prone to heavy drinking. Both male and female animals received alcohol and were then treated with either apremilast or a placebo.
The results were encouraging. Rats given apremilast drank much less alcohol than those receiving the placebo. The drug also reduced pain sensitivity while the animals were drinking and during periods of alcohol withdrawal that lasted from one day to four weeks.
The researchers found that the effects were not exactly the same in every group. Differences were seen between males and females and between the two rat strains, suggesting that genetics and biological sex may influence how well the treatment works.
The team also examined how the drug affects the brain. Apremilast increased the activity of GABA, a calming brain chemical, in the central amygdala, an area involved in both addiction and pain. This effect was seen in one rat strain, showing that responses to the drug may vary.
The researchers also found that alcohol increased the activity of PDE4 genes in the brain. Apremilast works by blocking the PDE4 enzyme, supporting the idea that inflammation, pain, and alcohol addiction are closely connected.
The researchers stress that these findings come from animal studies, so it is still unknown whether the same benefits will occur in people.
They now plan to investigate whether apremilast can also reduce anxiety and emotional stress during alcohol withdrawal, which are common causes of relapse. If future clinical trials are successful, the drug could offer a new and more complete way to treat alcohol use disorder.
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