We know that alcohol can adversely affect the microbiome and that alcohol is associated with various GI cancers.
Naltrexone is an opioid blocker that is used in treating various substance use and behavioral/eating disorders including alcohol use disorder, opioid use disorder, binge eating disorder in combination with bupropion, and in small studies for gambling disorder.
We see that craving for alcohol may diminish and appetite may diminish with the use of naltrexone however some patients choose to use naltrexone as a tool for abstinence while others continue to drink with naltrexone using it more to enable moderation in use.
What we don’t know is why naltrexone works for some and not for others in either being effective in abstinence or decreased use, and how it may affect the microbiome differently and whether or not these differences yield difference outcomes in abstinence and diminished use.
I would like to study the following:
1) how naltrexone is absorbed in those being treated for moderate to severe alcohol use disorder—all study subjects have baseline microbiome analyzed, then microbiome evaluated after the start of naltrexone
2) how naltrexone is absorbed in those who continue to drink with naltrexone vs. those who abstain while taking naltrexone—analyze microbiome while drinking vs. those subjects who do not drink while taking. If drinking amounts change over time analyze if there is change in absorption of naltrexone and in the microbiome
3) the correlation between decreased cravings, abstinence and naltrexone absorption if any, and if any change in microbiome
4) the correlation between decreased appetite, absorption of naltrexone
5) Nausea is common side effect of naltrexone that eventually resolves, to see if there is a marked difference in the microbiome in those who have severe nausea that does not relent vs. in those who do not have this side effect
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