Can presence of ‘sweet tooth’ predict effectiveness of alcohol treatment?

In an alternative to AA, self-empowering approaches to recovery incorporate living a sen life. This includes proper nutrition, exercise, and rest. Maintaining good mental health is an important aspect of long term abstinence and nutrition, exercise and adequate rest, play a significant role here. Good health in recovery is an important aspect to achieving a greater quality of life.

Existing evidence suggests that response to sweet taste reflects the activity of the endogenous opioid system, which is also involved in the pleasure response to alcohol consumption. Response to sweet taste is heritable and can be measured; the phenotype is identified as either sweet-liking (SL) or sweet-disliking (SDL). Naltrexone is an opioid receptor antagonist often prescribed in alcohol treatment. Naltrexone reduces the pleasurable response to alcohol. Some individuals respond strongly to naltrexone treatment while others do not respond as well. Since the sweet-liking phenotype is thought to reflect activity of the opioid system (upon which naltrexone works), a team of researchers set out to investigate the relationship between the phenotype, alcohol craving, and response to naltrexone treatment among alcohol dependent individuals (Garbutt et. al., 2009).

The researchers enrolled 40 alcohol dependent individuals in a 12-week open-label study which combined 50 mg of naltrexone with four sessions of motivational enhancement therapy. Before alcohol treatment, participants completed a sweet taste preference test as well as the Penn Alcohol Craving Scale. Participants were categorized as either SL or SDL based on the results of the standard sweet tasting paradigm. Participants and staff were blinded to the results of the sweet taste preference tests. The researchers examined the sweet-liking phenotype, pre-treatment craving, and their interaction as predictors of abstinent days and heavy drinking days during alcohol treatment with naltrexone.

SL and SDL individuals achieved similar reductions in percent of heavy drinking days during treatment. SDL participants had 48 percent abstinent days during treatment, compared to 30 percent for SL subjects. Pre-treatment craving predicted neither percentage of abstinent days nor percentage of heavy drinking days. However, the researchers found an interaction between the sweet-liking phenotype and pre-treatment craving: “An interaction effect was found between the SL/SDL phenotype and pretreatment craving such that SL subjects with high craving demonstrated higher rates of percent abstinent days whereas SDL subjects with high craving demonstrated lower rates of percent abstinent days, P < 0.001.” The results of this study suggest that the SL/SDL phenotype may predict response to alcohol treatment, especially when interaction with craving is considered.

“In summary,” the authors conclude, “we have found preliminary evidence that the SL phenotype predicts fewer days of abstinence in alcohol-dependent patients who are treated with naltrexone and counseling. Furthermore, we also found that the SL/SDL phenotype interacts with craving for alcohol such that SL patients who have high levels of craving are more likely to achieve abstinence whereas SDL patients with high levels of craving are less likely to achieve abstinence. These findings require confirmation and extension but support the hypothesis that the SL phenotype may be useful in advancing understanding of the biological heterogeneity of alcohol dependence and its relationship to naltrexone and treatment response.”

Garbutt JC, Osborne M, Gallop R, Barkenbus J, Grace K, Cody M, Flannery B, Kampov-Polevoy AB. Sweet liking phenotype, alcohol craving and response to naltrexone treatment in alcohol dependence. Alcohol and Alcoholism. 2009; 44(3): 293-300.

http://alcalc.oxfordjournals.org/cgi/content/full/44/3/293