Repositioned Anti-Inflammatory Drug Shows Promise for Alcohol Use Disorder and Pain Relief

A recent study conducted by scientists at Scripps Research has revealed that an FDA-approved anti-inflammatory drug may be effective in treating alcohol use disorder (AUD) and alleviating associated pain. The research, published in the journal JCI Insight, focuses on apremilast, a phosphodiesterase-4 (PDE4) inhibitor traditionally used for inflammatory conditions.

AUD impacts approximately 400 million individuals globally, and chronic pain is often a significant factor driving relapse among those struggling with this disorder. Many individuals with AUD experience mechanical allodynia, a condition where even mild stimuli are perceived as painful. This heightened sensitivity can persist during periods of abstinence, leading to challenges in recovery.

According to the lead researchers, the findings indicate that apremilast could serve as a dual treatment option for individuals suffering from both AUD and pain issues. The drug has already demonstrated efficacy in reducing alcohol consumption in previous studies involving both animal models and human participants. The current research aimed to evaluate whether apremilast could also reduce pain linked to alcohol consumption.

In the study, the researchers administered apremilast to genetically predisposed rats with a propensity for higher alcohol intake, alongside a standard strain. Results indicated that apremilast significantly decreased alcohol consumption across both strains and biological sexes. Additionally, the drug lowered pain sensitivity in most groups, demonstrating its potential for pain management both immediately following alcohol use and during withdrawal periods.

Notably, the effects of apremilast on pain reduction varied based on biological sex and genetic strain, highlighting the necessity of considering these factors in future research. In some male rat subjects, the expected pain-relieving benefits were not observed, underscoring the complexity of individual responses to the drug.

Another key finding from the research was that apremilast enhanced GABAergic transmission in the central amygdala, a brain region involved in both addiction and pain regulation. This effect, however, was only noted in standard genetic strains of rats, suggesting that the drug's efficacy may be influenced by genetic background or individual vulnerability to AUD.

Furthermore, the study noted that alcohol exposure led to increased expression of PDE4 genes in the brains of male rats, reinforcing the connection between inflammation, pain, and compulsive drinking behavior.

While the results are promising, the researchers emphasize the need for further clinical studies to confirm the drug's effectiveness in treating AUD and pain in human subjects. Future research will also explore whether apremilast can address anxiety and emotional distress often associated with alcohol withdrawal, as these factors significantly contribute to relapse risk.

Overall, this study highlights the potential of repurposing existing medications to treat complex disorders such as AUD and related pain, paving the way for more personalized therapeutic approaches.