EUROPEAN DRUG MAY HELP CURB ALCOHOLICS

A drug widely available in Europe that may reduce the urge to drink is being
tested in the United States, which has an estimated 13.7 million alcoholics.
Its French maker hopes to have it on the U.S. market in 2000.

Many experts on dependency say the drug--acamprosate, which would be sold in
the United States as Campral--is badly needed. Only two other medications
can treat alcoholism and both can have unpleasant or potentially dangerous
side effects.

Doctors say prescribing acamprosate to help alcoholics remain sober could
possibly save thousands of people from painful relapses while reducing the
cost of rehabilitation, which was $5 billion last year.

But acamprosate's expected arrival has ignited a controversy in the
health-care field, pitting specialists who argue that alcoholics should be
treated with counseling alone against doctors who insist that drugs are
crucial tools.

The debate has become rousing at times, with acamprosate's champions
deriding opponents for their "medieval" outlook. Advocates of drug-free
treatments say their approach has worked for decades; why take chances?

Acamprosate's maker, Lipha SA, a subsidiary of the German drug maker Merck
KGaA, is undeterred. It plans to take on a U.S. marketing partner and
emphasize acamprosate's success rate.

In 11 clinical trials with 3,338 alcohol-dependent patients in Europe, 50
percent of the patients using acamprosate abstained for three months--the
period when alcoholics are most likely to regress--compared with 39 percent
of those using a placebo.

A U.S. trial, with 600 alcohol-dependent patients at 21 sites nationwide,
should be completed early next year.

"Acamprosate has been shown to help prevent relapse," said Dr. Karl Mann, a
professor of medicine at the University of Tubingen, who conducted the trial
in Germany. "Once patients give up alcohol and go on with their lives, they
see it, smell it, dream about it. Acamprosate helps them get through all that."

Doctors hope acamprosate will become popular because it is inexpensive and
simple to take. In France, the average cost is $1.94 a pill. Patients take
two 500-milligram pills in the morning and two at night. The main side
effect is mild diarrhea, which usually goes away after several days.

By contrast, American Home Products' Antabuse can be toxic if the patient
drinks enough alcohol, while naltrexone, made by DuPont Merck
Pharmaceutical, can cause liver damage if taken in too high a dose.

Many experts call the synthetic drug a therapeutic breakthrough. Invented by
Lipha in 1980, acamprosate, also known as calcium acetylhomotaurine, is
thought to work by restoring normal activity on certain neurotransmitters in
the brain that become overexcited by the withdrawal of alcohol.

"There is still a stigma that alcoholism is a moral weakness," said Dr.
Richard Fuller, director of clinical and prevention research at the National
Institute on Alcohol Abuse and Alcoholism. "Alcoholism has a biological
basis like hypertension. We treat that with medications. Why can't you treat
alcoholism the same way?"

That argument, however, does not sit well with some clinicians. "Alcoholics
should not be given drugs, unless it is to treat an organic illness like
diabetes," said Dr. Joseph Pursch, who treated Betty Ford and Billy Carter
for alcoholism.

"All these drugs--Xanax, Valium--that doctors prescribe for alcoholics can
be addicting. What good is it to switch dependence from one drug to another?"

Checked-by: Melodi Cornett