Craving is an intense and sometimes overwhelming desire to consume the item to which a person is addicted, whether it is drugs and/or alcohol. Craving is also an essential aspect of an addiction (also known as dependence) to drugs or alcohol.

When an individual is addicted to a substance, the craving builds up to a high level until the substance is consumed, after which the craving temporarily abates, only to return and increase in intensity again until the substance is consumed yet again. Even after a person has undergone detoxification in a rehabilitation program and has successfully ended the addiction, often the cravings for drugs or alcohol return and persist, and this is why many individuals relapse into using addictive substances.

Self-help programs such as Alcoholics Anonymous and Narcotics Anonymous are very helpful to many individuals who are combating their craving for alcohol and drugs. However, some individuals need medication as well.

Some physicians use medications to combat the craving for drugs or alcohol. For example, Naltrexone is a medication approved by the Food and Drug Administration to treat alcoholism, and it helps to reduce the craving for alcohol. According to Charles O'Brien in his 2005 article in the American Journal of Psychiatry on anticraving medications, studies have shown that subjects who received naltrexone had lower craving levels than those who took a placebo. Alcohol was also made available to the subjects in one study. The study subjects were given either naltrexone or a placebo as well as one "priming drink" of alcohol.

O'Brien reports:

Participants had the choice of more alcoholic drinks or money instead of each drink after the priming drink. The placebo group chose to drink significantly more than the naltrexone group, resulting in a progressively increasing blood alcohol level, whereas the naltrexone group reported less craving during alcohol availability, consumed fewer drinks, and drank them more slowly when they did drink. This human laboratory study was remarkable in that it produced results consistent with both animal models and clinical trials.

Other drugs have been tested for their efficacy in reducing the craving for illegal drugs. Buprenorphine (Subutex, Suboxone) is approved by the FDA to treat drug cravings for heroin, and in some cases, to treat narcotic addiction, such as an addiction to hydrocodone (Vicodin), oxycodone/acetaminophen (Percocet), or oxycodone controlled release (OxyContin). Methadone is also commonly used to treat patients addicted to narcotics.

Other anticraving drugs are being studied. For example, modafinil (Provigil), a drug that is approved by the FDA to treat narcolepsy, has also been found to be effective at reducing both the euphoria from cocaine as well as the craving for this drug. It also reportedly reduces the withdrawal symptoms from cocaine dependence. Modafinil is under further study for the treatment of cocaine addiction as of this writing.

Other drugs are under study to treat cocaine addiction, such as Disulfiram (Antabuse), a drug used to treat alcoholism that causes violent vomiting if any alcohol is consumed. Topiramate (Topamax), propranolol (Inderal), and baclofen (Lioresal) are also under study for the treatment of cocaine addition. Rimonabant (Acomplia) is under study to treat both alcoholism and cocaine addiction. In addition, ondansetron (Zofran) is being studied for the treatment of alcohol addiction.

Acamprosate (Campral) is a delayed-released medication that is used to treat alcoholism, first used in the United States in 2005 after its FDA approval in 2004. Campral was the first new antialcoholism drug to be introduced into the United States in about 10 years. It is used to decrease the craving for alcohol and helps to reduce the risk for relapse.

Another medication, vigabatrin (Sabril), which is an antiseizure medication, has been shown to reduce craving in a preliminary study of cocaine addicts. However, trials have been suspended in the United States because the medication may cause visual problems. Some research has shown that topiramate, another antiseizure medication, can help individuals addicted to crack cocaine.

References:

O'Brien, Charles P., M.D. "Anticraving Medications for Relapse Prevention: A Possible New Class of Psychoactive Medications." American Journal of Psychiatry 162 (2005): 1,423-1,431.

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