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Intolerance As Treatment, Revulsion As Resolve

Probably around 8% of the global population, around 560 million humans, are allergic to or intolerant of alcohol, making this “one of the most common hereditary disorders in the world.” Whether or not an individual will suffer from this depends on aldehyde dehydrogenase (ALDH), an enzyme that turns alcohol into vinegar.

Another information source carefully delineates the difference between allergy and intolerance:

[A]lcohol allergy is an immune system response triggered by specific ingredients in alcoholic beverages, such as chemicals, grains, or preservatives. Allergic reactions can cause symptoms such as difficulty breathing, coughing, runny nose, or stomach upset.

Meanwhile, alcohol intolerance, which is both genetic and metabolic, originates in the digestive system. A person who has it is stuck with it, which leads to unintentional dry humor:

Alcohol intolerance is a lifelong condition that won’t go away, although symptoms can be managed by avoiding alcohol consumption.

Of course, it might be argued that this is not a disorder, but a benefit, because of the extreme potential for harm that could come to anyone who develops a liking for alcohol. To experience a bad reaction like gut pain from drinking could be the salvation of a vulnerable person. That thought leads to another one: What about purposely induced intolerance, as treatment?

Whole generations grew up believing that if they needed to avoid alcohol, the doctor could prescribe pills that would, if they drank a drop of it, make them nauseated. This started as far back as the late 19th century. In 1897, the Journal of the American Medical Association published a letter to the editor from a gentleman named H. G. Norton. He described the “tonic” used in contemporary rehab centers, where patients apparently were told that the potion they were served curative nutrients or something of the kind. Actually, it contained ipecac:

The more ipecac the more nausea. This will in time disgust a patient and produce a dislike for liquor. The ipecac is added after drinking [alcohol], without the knowledge of the patient.

Next, the correspondent explains about the drug apomorphia, which is a bit harder to get into a person because it needs to be administered intravenously:

One-tenth grain, a short time after drinking [alcohol], will produce excessive vomiting. The patient must not know the cause of the vomiting.

Not know the cause? To be unaware of a hypodermic needle jab, wouldn’t the patient need to be pretty far gone? But this too is handled, with an explanation of how to lull and befuddle the patient, for his or her own good:

These things can be worked in the tonic without arousing the patient’s suspicion; thus the trick of these institutions. The hypodermic is used when a tonic is given hypodermically, on some pretext, after drinking.

Returning to the present, a Reddit.com group has formed around Myalgic Encephalomyelitis, or ME, also known as Chronic Fatigue Syndrome. Member “Bucket_McGraw” describes alcohol intolerance caused by ME. When he came down with the condition, he started to have “mammoth hangovers after more than 2 small beers, and lately it seems to be getting even worse. Now one beer is enough to crash me within half an hour.”

He also experiences an ocular migraine, a previously rare occurrence. Also, the pseudonymous “Love2LearnwithME” reported on the same ailment:

I go straight to the hang over feeling from even a partial glass of wine. It’s taken all of the fun right out of it… Alcohol intolerance is a known and common ME/CFS symptom. In fact I saw one ME specialist quoted as saying that alcohol intolerance is so common in ME that she questions whether the diagnosis is correct if alcohol intolerance is NOT present.

Another person reported experiencing almost instant hangovers in the form of severe headaches or migraines “within just an hour or two of having even one drink.” It is a cruel fate, but perhaps more merciful than full-blown alcoholism would be.

What if the same effect that ME causes could be accomplished with a prescription? Upfront, it sounds like a very simple question: If the GLP-1 meds can cause people to cut down on food, might they cause people to cut down on alcohol? The notion is so basic, that it is possible to imagine one faction scoffing, “What are you talking about? That’s absurd.” — while another contingent exclaims, “Brilliant! Why didn’t we think of that?”

GLP-1 makes people food-intolerant by artificially inducing a sensation of fullness, which convinces the body to reject food. The post “Balance is Key” noted that the drug semaglutide seems to somehow keep some people from becoming alcoholics, and to prevent others from relapsing if they are trying to sober up.

Tatyana Meshcheryakova reported that semaglutide might be able to mend alcohol-related liver disease, for which testing is in progress. These are no small accomplishments, for a medication that started out treating type 2 diabetes and went on to be useful in obesity prevention and long-term weight management. And it might do more.

Now being explored is the question, if it stops food consumption by making people sick, would that work in the case of alcohol? And if not, why not? One possible answer is that “big pharma doesn’t see an easy path to profitability with addiction treatment like it does with obesity treatment.”

If ipecac is already available for the same purpose, and at a much smaller cost, why even bother? Also at some point, the question must be: What are we going for here? The reduction of craving, or the cultivation of revulsion? As previously noted, the key apparently lies in making the person just sick enough to quit the original, addictive substance, but not sick enough to abandon the cure.

Written by Pat Hartman. First published July 26, 2024.

Sources:

“Are you allergic or intolerant to alcohol?,” BBC.co.uk, August 2022
“Alcohol Intolerance: Symptoms & Health Risks,” Lotusbh.org, May 8, 2024.
“The Tonic for Alcoholics,” JamaNetwork.com, November 27, 1897.
“ME-induced alcohol intolerance… is this an actual thing?” Reddit.com, 2022
Image Copyright: Zohre Nemati/Unsplash

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