alcohol use disorder

The Dangers of Self-Diagnosis and AUD (Alcohol Use Disorder)

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Using naltrexone to cut back on drinking isn’t new, says Sarah Wakeman, a senior medical director for substance use disorder at Mass General Brigham. The approach dates back to the 1980s with the Sinclair method, which pairs drinking with naltrexone to blunt alcohol’s pleasurable effects. In parts of Europe, Wakeman adds, people have long used a “pill-in-the-pocket” strategy, taking the medication only when they anticipate drinking. A decades-old drug is helping people drink less alcohol—without giving it up completely – https://www.nationalgeographic.com/health/article/naltrexone-drink-less-alcohol? (Paywall article)

The Provider Individual who is not a doctor will see you after you answer the questionnaire (this is the self-diagnosis part).

Oar Health is an online service offering naltrexone subscriptions to those with alcohol use disorder (AUD). Users can fill out a brief assessment which is reviewed by a medical professional, then be given a naltrexone prescription if appropriate. After a one-time $50 fee, subscriptions cost $297 for three months of medication, which comes out to $99 monthly. It’s currently available in 42 US states. Beyond the naltrexone prescription, Oar Health offers ongoing access to the support of a medication prescriber, a health coach, a Facebook group for community support, and extras like educational articles and guided reflections.Oar Health Review: Pros & Cons, Cost, & My Experience – https://www.choosingtherapy.com/oar-health-review/

Health coaches who are “naltrexone experts”! And The Sinclair Method might not work for everyone. https://drugfree.org/article/sinclair-method/

Depending upon the online service you choose you may get naltrexone prescribed when trying to get your doctor prescribed GLP-1 filled out even when you don’t have alcohol use disorder.

Telehealth companies such as Vida Health and its rivals offer lifestyle support so people taking drugs like Wegovy and Zepbound can have the most success on the drugs. But the companies often have another job: limiting obesity drug costs for employers.

The Vida Health nurse said he was a good candidate for Zepbound but insisted he try two generic drugs first: naltrexone, a drug used to curb alcohol and opioid use, and bupropion, an antidepressant. Neither drug is approved for obstructive sleep apnea. Primary care doctors raise alarm as telehealth companies get involved in obesity drugs – https://www.npr.org/2026/06/14/nx-s1-5805984/glp1-telehealth-weight-loss-drugs

Yikes.

Drive By Truckers 2.0

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Total drug violations reported into the clearinghouse in 2022, including positive tests and refusals to take a drug test, increased 18% to 69,668 compared with last year’s 59,011, according to the most recent statistics released this week by the Federal Motor Carrier Safety Administration. That rate almost doubled the 9.2% annual increase in drug violations reported in 2021. Much of the increase can be attributed to violations related to marijuana, the substance identified most in positive tests. Marijuana violations increased 31.6% in 2022 compared with 2021, to 40,916. That compares to a 5.3% increase between 2020 and 2021.

Truckers’ positive drug tests up 18% in 2022 — https://www.freightwaves.com/news/truckers-positive-drug-tests-up-18-in-2022

At least binge drinking prevalence is just 19%

Truck drivers have been reported as a highly vulnerable working population due to different risk factors [16,17,18] including hypertension, fatigue [19], obstructive sleep apnea (OSA) and sleep deprivation [20,21], and insufficient physical activity [22]. Other risk factors are exposure to diesel exhaust and risk of developing lung cancer [23], poor diet, obesity, dyslipidemia, and other metabolic disorders [24]. Furthermore, they are prone to risky behaviors and lifestyles such as smoking, drinking, using psychoactive substances, and having casual sexual contacts [25].

Patterns of Harmful Alcohol Consumption among Truck Drivers: Implications for Occupational Health and Work Safety from a Systematic Review and Meta-Analysis — Int J Environ Res Public Health. 2018 Jun; 15(6): 1121.
Published online 2018 May 30. doi: 10.3390/ijerph15061121

I ask them why the industry has a 90 percent attrition rate within the first year. All instantly respond: “No money.” They describe a predatory apprenticeship system that conspires against new drivers seeking to enter the profession. The industry is made up of thousands of mostly small-fleet owners—95 percent of them with 20 trucks or fewer—but dominated by about two dozen giant companies that serve as its gatekeepers. These megacarriers often house schools where some 400,000 new truckers receive commercial driver’s licenses annually. The companies entice people with promises of financial plenty, even as they ensnare them in “training contracts”—binding agreements that require them to drive for the company at below-market wages for a year in exchange for training or else be hit with an exorbitant fee for that training, to be paid off at high interest. Many drivers stick around for the full year to avoid those fees, enduring what amounts to debt peonage. 

“I have panic attacks,” he says. “That’s why I drink.”


Life as a 21st-Century Trucker — https://www.wired.com/story/life-as-a-21st-century-trucker/

For the first post in this series see Drive By Truckers.

People with family history of alcoholism release more dopamine in expectation of alcohol

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People with a family history of alcohol use disorder (AUD) release more dopamine in the brain’s main reward center in response to the expectation of alcohol than people diagnosed with the disorder, or healthy people without any family history of AUD, reports a new study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

This explains a lot.

Read about this small interesting study here.