Natural treatments for alcoholism
Natural treatments for alcoholism encompass a variety of approaches aimed at supporting individuals in their recovery journey from alcohol dependency. These treatments often include nutritional support to address the depletion of vitamins and minerals caused by excessive alcohol consumption. Key natural remedies proposed include milk thistle, which is believed to protect the liver, and S-adenosylmethionine (SAMe), although evidence supporting their effectiveness remains inconclusive. Other suggested natural interventions include acupuncture, various herbal supplements like kudzu and passionflower, and even practices such as yoga and mindfulness exercises, which may offer psychological support during recovery.
While some studies indicate potential benefits of these treatments, results are often inconsistent, and further research is needed to establish their efficacy. Importantly, certain herbs and supplements should be avoided due to their potential liver toxicity, particularly in individuals with a history of alcohol abuse. Overall, while natural treatments can complement traditional methods, they should be approached with caution and ideally under the guidance of healthcare professionals. Individuals seeking to address alcoholism may benefit from a holistic approach that combines these natural options with established therapeutic practices.
Natural treatments for alcoholism
DEFINITION: Treatment of addiction to alcoholic beverages.
PRINCIPAL PROPOSED NATURAL TREATMENTS: General nutritional support, milk thistle, S-adenosylmethionine
OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, honey, kudzu, passionflower, phosphatidylcholine, prickly pear cactus (Opuntia ficus indica), trimethylglycine
HERBS AND SUPPLEMENTS TO AVOID: Arginine; beta-carotene (excessive doses); kava; kombucha; prepackaged Chinese herbal combinations; vitamin A (excessive doses); white willow
Introduction
Alcoholic beverages present a perfect example of the ancient virtue of moderation. While small amounts of alcohol on occasion may not harm one's health and can enhance well-being, excessive consumption of alcohol wreaks gradual havoc throughout the body. The liver is often the first organ to show injury, followed by (in no set order) the brain, circulatory system, pancreas, stomach, and throat.
Conventional treatment of alcoholism involves nutritional support and various means to induce and maintain abstinence. The twelve-step program Alcoholics Anonymous (AA) is an effective abstinence-promoting method that has benefited more than two million people, but other programs and techniques are also in use. The drugs acamprosate (Campral) and naltrexone (ReVia) have shown considerable promise. Disulfiram (Antabuse) is also approved by the US Food and Drug Administration to treat addictions to alcohol. For the best chance of success and positive treatment outcomes, it is recommended that these drugs be combined with therapy, a twelve-step program, a rehab program, or another method of treatment to address the underlying mechanisms of the addiction. Other proposed medications for individuals with an alcohol addiction include Topiramate (a seizure medication), Ondansetron (a nausea medication), Nalmefene (an opioid receptor antagonist), and Baclofen (a skeletal muscle relaxant).
Principal Proposed Natural Treatments
The herb milk thistle and the supplement S-adenosylmethionine (SAMe) have been recommended for protecting the liver from alcohol-induced damage. However, none of these treatments have been conclusively proven effective; abstinence has proven more effective than any treatment.
In addition to damaging the liver, alcoholism causes a general depletion of nutrients. People who drink to excess—either because they have not quit drinking or because they are in the process of quitting—may benefit from supplementation.
Milk thistle. The herb milk thistle has been proposed to protect or heal the human liver damaged by alcohol abuse. The herb's main active ingredient, silymarin, is a combination of flavonoids called silibinin, silidianin, and silicristin, which have properties linked to liver health. However, numerous double-blind, placebo-controlled studies enrolling several hundred people have evaluated whether milk thistle can successfully counter alcohol-induced liver damage. Most of the studies, however, were flawed in design and reporting, and their results were less than consistent. A review of published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials, and even in these trials, milk thistle did not show more than a slight benefit. A subsequent review of nineteen randomized trials drew a similar conclusion for alcoholic liver disease generally, although it did find a modest reduction in mortality for persons with severe liver cirrhosis. It is not possible to draw firm conclusions about milk thistle’s usefulness for people who consume too much alcohol.
SAMe. The supplement SAMe has been proposed for the treatment of alcoholic liver disease, but there is no meaningful evidence that it is effective. A two-year, double-blind, placebo-controlled study of 117 people with alcoholic liver cirrhosis found that treatment with SAMe reduced mortality or the need for a liver transplant (or both) in those with less advanced disease but not in the group as a whole.
Nutritional support. Chronic overconsumption of alcohol may lead to improper metabolism or outright deficiencies of numerous vitamins and minerals. For this reason, the use of a general nutritional supplement may be advisable.
Other Proposed Natural Treatments
In a double-blind study of sixty-four people, the use of an extract made from the skin of the fruit of the prickly pear cactus Opuntia ficus indica significantly reduced hangover symptoms compared with placebo. The greatest improvements were seen in symptoms of nausea, loss of appetite, and dry mouth. Overall, the rate of severe hangover symptoms was 50 percent lower in the treatment group compared with the placebo group. The researchers involved in this study hypothesized that hangovers are caused by inflammation and that the herb reduced inflammation.
Artichoke leaf is much better known than prickly pear cactus as a means of preventing hangover symptoms. However, the one double-blind study on the subject failed to find artichoke any more effective than placebo. The supplement trimethylglycine stimulates the formation of SAMe and might be helpful for alcoholic liver disease. However, no meaningful double-blind, placebo-controlled clinical trials have been reported. The supplement phosphatidylcholine has been advocated as a treatment for early alcohol-related liver damage (especially fatty liver), but the results of preliminary studies have been inconsistent. One study in baboons even found evidence of increased liver toxicity.
Other herbs and supplements that have been proposed for protecting the liver, but only on the basis of extremely weak evidence, include Andrographis, barberry, beet leaf, boldo, dandelion, inositol, licorice, lipoic acid, liver extracts, N-acetylcysteine, Picrorhiza kurroa, Schisandra, taurine, thymus extract, and turmeric.
The herb kudzu (Pueraria montana) has been widely advocated as an aid for quitting alcohol, based on studies using hamsters or rats. Overall, small double-blind studies in humans have yielded inconsistent results, but a mid-2010s study found that even one dose of kudzu extract aided in lowering the amount of alcohol one consumes.
Acupuncture has also been proposed as an aid to alcohol withdrawal. However, study results have been contradictory, and the largest trial failed to find any benefit. This three-week, single-blind trial study of 503 individuals with an addiction to alcohol failed to find any difference between actual ear acupuncture and placebo ear acupuncture. In addition, a ten-week, single-blind, placebo-controlled study of seventy-two individuals addicted to alcohol found no difference in drinking patterns or cravings between sham acupuncture and real acupuncture groups. Negative results were also seen in a similar trial of fifty-six participants and in one in forty-eight people. A study of 109 people compared acupuncture with aromatherapy (intended by these researchers as a placebo) and failed to find that acupuncture was more effective. However, a single-blind trial of fifty-four people did find acupuncture more effective than a placebo, as did a single-blind trial of eighty people.
The herb passionflower has been proposed as an aid to alcohol withdrawal, primarily on the basis of the study of people addicted to opiates. Another study suggests that honey consumption might increase the body’s ability to metabolize alcohol, thereby limiting intoxication and more rapidly reducing blood alcohol levels to a safer (or legal) zone.
Psilocybin, sometimes called magic mushrooms, has also been proposed as a treatment for individuals with addictions to alcohol. In a study combining two doses of psilocybin with psychotherapy, over 80 percent of the participants decreased their drinking habits. Additionally, compared to the placebo group's 24 percent abstinence rate, 48 percent of those who received the mushrooms stopped drinking alcohol entirely.
In addition to supplements, various types of therapy—art, music, massage, animal, acupuncture, and horticulture—and several types of mindful exercise practices—yoga and tai chi—have been shown to work in their own ways in different people. Each treatment will not be a perfect fit for every individual, so it is important to find a therapy or practice that offers benefits to the individual.
Herbs and Supplements to Avoid
High doses of the supplements beta-carotene and vitamin A might cause alcoholic liver disease to develop more rapidly in people who abuse alcohol. Nutritional supplementation at the standard daily requirement level should not cause a problem.
All forms of vitamin B3, including niacin, niacinamide (nicotinamide), and inositol hexaniacinate, may damage the liver when taken in high doses. Again, nutritional supplementation at the standard daily requirement level should not cause a problem.
One animal study suggests that the herb kava may have value as an aid to alcohol withdrawal. However, people who abuse alcohol should probably not take kava. Even in healthy people, the herb has caused severe liver damage.
Numerous herbs and supplements have known or suspected liver-toxic properties, including barberry, borage, chaparral, coltsfoot, comfrey, germander, germanium (a mineral), greater celandine, kombucha, mistletoe, noni, pennyroyal, pokeroot, sassafras, and various herbs and minerals used in traditional Chinese herbal medicine. In addition, herbs that are not liver-toxic in themselves are sometimes adulterated with other herbs of similar appearance accidentally harvested in a misapprehension of their identity (for example, germander found in skullcap products). Other forms of contamination also are possible. Blue-green algae species, such as spirulina, may sometimes be contaminated with liver-toxic substances called microcystins (for which no highest safe level is known).
Some articles claimed that the herb echinacea is potentially liver-toxic, but this concern was based on a misunderstanding of its constituents. (Echinacea contains substances in the pyrrolizidine alkaloid family. However, while many pyrrolizidine alkaloids are liver toxic, those found in echinacea are not believed to have that property.)
Whole valerian contains liver-toxic substances called valepotriates. However, valepotriates are thought to be absent from most commercial valerian products, and case reports suggest that even very high doses of valerian do not harm the liver. Herbs and supplements with the potential to irritate the stomach, such as white willow and arginine, should be used only with caution by people who consume excessive alcohol. Other studies found that liver toxicity was caused in a few cases of individuals taking whole valerian with other supplements that interact.
Bibliography
"Alcohol Use Disorder." Mayo Clinic, 18 May 2022, www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250. Accessed 20 Sept. 2024.
Celik, Muhammet, et al. “A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder.” Brain Sciences, vol. 14, no. 3, 20 Mar. 2024, p. 294, doi:10.3390/brainsci14030294.
Kunz, S., et al. “Ear Acupuncture for Alcohol Withdrawal in Comparison with Aromatherapy.” Alcoholism: Clinical and Experimental Research, vol. 31, 2007, pp. 436-442. doi: 10.1111/j.1530-0277.2006.00333.x.
O’Keefe, J. H., K. A. Bybee, and C. J. Lavie. “Alcohol and Cardiovascular Health: The Razor-Sharp Double-Edged Sword.” Journal of the American College of Cardiology, vol. 50, 2007, pp. 1009-14.
Onyesom, I. “Honey-Induced Stimulation of Blood Ethanol Elimination and Its Influence on Serum Triacylglycerol and Blood Pressure in Man.” Annals of Nutrition and Metabolism, vol. 49, 2005, pp. 319-24.
Penetar, David M., et al. “A Single Dose of Kudzu Extract Reduces Alcohol Consumption in a Binge Drinking Paradigm.” Drug and Alcohol Dependence, vol. 153, 2015, pp. 194-200. doi:10.1016/j.drugalcdep.2015.05.025.
Rambaldi, A., and C. Gluud. “S-adenosyl-L-methionine for Alcoholic Liver Diseases.” Cochrane Database of Systematic Reviews vol. 19, no. 2, 2001, p. CD002235.
Rambaldi, A., B. Jacobs, and C. Gluud. “Milk Thistle for Alcoholic and/or Hepatitis B or C Virus Liver Diseases.” Cochrane Database of Systematic Reviews vol. 4, 2007, p. CD003620.
Saller, R., et al. “An Updated Systematic Review with Meta-analysis for the Clinical Evidence of Silymarin.” Forschende Komplementärmedizin, vol. 15, 2008, pp. 9-20.
"10 Types of Holistic Treatment for Alcoholism." New Directions for Women, 3 Mar. 2022, www.newdirectionsforwomen.org/10-types-of-holistic-treatment-for-alcoholism. Accessed 28 Aug. 2023.