A new preclinical study from scientists at Scripps Research suggests that an existing drug, already approved for treating inflammatory diseases, might help reduce both alcohol use and pain — two problems that often occur together in people with alcohol use disorder (AUD).
Published on April 22, 2025, in JCI Insight, the study found that the drug apremilast may be useful as a dual-acting treatment for AUD, especially for individuals who experience physical pain during and after drinking.
Apremilast is currently approved by the U.S. Food and Drug Administration (FDA) to treat psoriasis and psoriatic arthritis, which are chronic autoimmune conditions.
The new findings are important because they offer a potential way to target two major challenges in AUD: excessive drinking and chronic pain.
According to the World Health Organization, about 400 million people aged 15 and olderworldwide are affected by AUD. For many, chronic pain is a major trigger for relapse, and it’s often not addressed in current treatment strategies.
People with AUD commonly suffer from mechanical allodynia, a condition where even light touches feel painfully intense. This heightened pain sensitivity can last even during alcohol abstinence and may drive people back to drinking in an attempt to self-medicate.
“Our findings highlight the therapeutic value of apremilast to reduce co-occurring drinking and mechanical allodynia in long-term abstinence — a critical component of harmful drinking and AUD psychopathology,” said senior author Marisa Roberto, professor of neuroscience at Scripps Research.
In this study, researchers tested apremilast in two types of rats: one strain genetically prone to heavy drinking and a standard genetic strain. Both strains, including both male and female rats, were given alcohol and then treated with either apremilast or a placebo.
The results were promising:
- Alcohol intake dropped significantly in all groups treated with apremilast.
- Pain sensitivity also decreased during drinking and in abstinence periods ranging from 24 hours to four weeks after stopping alcohol.
However, the effects weren’t identical across all groups. First author Bryan Cruz, a postdoctoral fellow at Scripps, noted that “the patterns of reduction differed between males and females, as well as between strains.” For instance, some male rats didn’t show the same level of pain relief, suggesting that biological sex and genetic background can influence the drug’s effectiveness.
In another part of the study, researchers explored how apremilast affects the brain. They found that the drug increased GABAergic transmission in the central amygdala, a region involved in both addiction and pain processing.
GABA is a brain chemical that calms neural activity, which can reduce stress and discomfort. This brain effect was only seen in one of the two rat strains, again highlighting the importance of individual differences in response to treatment.
In both strains of male rats, alcohol exposure boosted the activity of PDE4 genes in the brain — the very enzyme that apremilast is designed to block. This supports the idea that inflammation, pain, and alcohol use may be closely linkedat a biological level.
Other PDE4-blocking drugs have been studied for pain unrelated to alcohol, but apremilast might be uniquely suited for treating people who struggle with both drinking and pain. However, these results come from animal studies, so more research is needed to see if the same effects occur in humans.
The team now plans to investigate whether apremilast can also reduce anxiety and emotional stress during alcohol withdrawal. These symptoms are also powerful triggers for relapse.
“For over a decade, it’s been well-established that withdrawal-induced anxiety is a major driver of relapse,” said Roberto. “Many individuals use alcohol to cope not only with physical pain but with emotional distress as well. Addressing all parts of the addiction cycle is essential.”
In summary, this study opens the door to repurposing apremilast — a safe, already-approved anti-inflammatory drug — as a possible treatment for both alcohol use disorder and chronic pain. If future clinical trials in humans confirm these findings, it could lead to a more personalized, holistic approach to treating AUD and helping people avoid relapse.
If you care about alcoholism, please read studies that your age may decide whether alcohol is good or bad for you, and people over 40 need to prevent dangerous alcohol/drug interactions.
For more information about alcohol, please see recent studies about moderate alcohol drinking linked to high blood pressure, and results showing this drug combo shows promise for treating alcoholism.
The research findings can be found in JCI Insight.
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