Alcohol use disorder, often called alcoholism, is a serious medical condition that affects millions of people around the world.
People with this disorder have difficulty controlling their drinking, even when alcohol is causing problems in their health, relationships, work, or daily life. According to the World Health Organization, around 400 million people aged 15 and older worldwide are living with alcohol use disorder.
Treating alcohol use disorder can be extremely challenging. Many people go through repeated cycles of drinking, quitting, and then relapsing. One major reason is that alcohol addiction often comes with other problems that are difficult to manage. One of the most common and overlooked issues is chronic pain.
Many people with alcohol use disorder experience increased sensitivity to pain. Even a light touch may feel painful, a condition known as mechanical allodynia.
This abnormal pain sensitivity can continue even after a person stops drinking. Some people may return to alcohol because they are trying to relieve both their physical discomfort and emotional distress.
Scientists are therefore searching for treatments that can address several aspects of addiction at the same time. A new preclinical study from researchers at Scripps Research offers encouraging evidence that an existing medication may be able to do exactly that.
The findings were published in the journal JCI Insight.
The researchers studied a drug called apremilast. This medication has already been approved by the U.S. Food and Drug Administration to treat psoriasis and psoriatic arthritis, which are long-term inflammatory diseases caused by abnormal immune activity.
Because the drug is already approved and has an established safety profile for other conditions, researchers are interested in whether it can be repurposed for entirely new uses.
The scientists tested apremilast in two different strains of rats. One strain was genetically prone to heavy alcohol drinking, while the other represented a more standard genetic background. Both male and female rats were exposed to alcohol and then received either apremilast or a placebo.
The results were promising. Rats treated with apremilast drank significantly less alcohol than untreated rats. At the same time, they became less sensitive to pain. The improvement in pain was seen both while the animals were still drinking and during periods of abstinence that lasted from one day to four weeks after alcohol exposure ended.
The researchers also found that the drug did not work exactly the same way in every animal. The patterns of improvement differed between males and females and between the two genetic strains of rats. Some male rats, for example, did not experience the same degree of pain relief as others.
These findings suggest that biological sex and genetic background may influence how people respond to treatment. This could eventually support more personalized approaches to treating alcohol use disorder.
The researchers also wanted to understand what was happening inside the brain. They discovered that apremilast increased GABA-related signaling in the central amygdala, an area of the brain involved in both addiction and pain processing.
GABA is a brain chemical that generally reduces the activity of nerve cells. By calming neural activity, it may help reduce stress, discomfort, and some of the processes involved in addiction. Interestingly, these brain effects were observed in only one of the two rat strains, again emphasizing that individual biological differences may play an important role.
The study also uncovered evidence linking alcohol use, inflammation, and pain. In both strains of male rats, alcohol exposure increased the activity of PDE4 genes. Apremilast works by blocking the PDE4 enzyme. This finding suggests that inflammation-related pathways may contribute to both excessive drinking and pain sensitivity.
The researchers emphasize that these findings come from animal studies. More research is needed before scientists can determine whether apremilast has similar benefits in humans with alcohol use disorder.
The team plans to continue investigating whether the drug can also reduce anxiety and emotional distress during alcohol withdrawal. These symptoms are powerful triggers for relapse and are major obstacles to recovery.
The findings are important because they point toward a more comprehensive approach to addiction treatment. Rather than addressing alcohol use alone, future therapies may target drinking behavior, physical pain, anxiety, and emotional distress at the same time.
If future clinical trials confirm these results, apremilast could potentially become an affordable and practical treatment option that helps people stay sober and improve their quality of life.
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