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Suppressing the compulsion to steal

April 01, 2009

An opiate receptor blocker shows promise in treating kleptomania

If a drug took the fun out of stealing, would it reduce crime? A new study scheduled for the April 1st issue of Biological Psychiatry, published by Elsevier, suggests that this may be so.

Kleptomania is a type of impulse control disorder characterized by persistent and recurrent patterns of stealing, where afflicted individuals often experience an irresistible urge to steal items they often don't even need. In a rigorous study design, researchers at the University of Minnesota School of Medicine recruited individuals with kleptomania who were actively experiencing urges to steal and randomized them to receive treatment with either naltrexone or placebo. Naltrexone is a drug that blocks the effects of endogenous opiates that may be released during stealing; in other words, it blocks the part of the brain that feels pleasure with certain addictive behaviors. They found that after eight weeks of treatment, naltrexone was able to reduce the urges to steal and stealing behavior in people with kleptomania. Its side effects were generally mild.

Corresponding author Dr. Jon E. Grant further discusses the findings: "These individuals had long histories of stealing, reported urges to steal, and described a 'rush' or thrill from the behavior. Naltrexone's efficacy in treating the symptoms of kleptomania suggests that kleptomania in particular, and impulse control disorders in general, may be related to substance addictions and share a common brain circuitry." Dr. John Krystal, Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, concurs, noting that "this work extends the findings in alcoholism, opiate dependence, smoking, and other addictive disorders where naltrexone has shown evidence of reducing the abuse of substances."

The prevalence rates of kleptomania in the general population are hard to come because these individuals don't usually seek treatment and/or are simply jailed, but billions of dollars worth of items are stolen from retailers every year. That naltrexone appears to be an effective treatment is an important step forward in understanding this disorder and in helping those who suffer from its effects. Further research is now needed to evaluate the long-term effects of naltrexone treatment.

Elsevier