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Betel nut addiction could be treated by the same, simple drugs used to wean people off cigarettes, a study has found.

Research on the stimulation caused by the popular custom of chewing betel nuts shows the nut’s psychoactive chemicals affect the same brain regions as nicotine. According to lead author Roger Lee Papke, a pharmacologist at the University of Florida in the United States, this means betel nut addiction could be treated with existing drugs.

“This is the first time that there’s even a potential avenue for treating this dependence.”

Roger Lee Papke, University of Florida 

“Without knowing why people become dependent, there was no way to help them get over the dependence,” he says. “[Our findings] raise the possibility that prescription drugs like varenicline and cytisine currently used to break nicotine dependence, could also be effective against betel nut addiction.” 

Despite the nut being estimated to be the fourth-most-used stimulant after caffeine, alcohol and tobacco, there has been little research on how betel nut addiction relates to the nut’s active ingredient, arecoline, says Papke.

“This is the first time that there’s even a potential avenue for treating this dependence,” he says.

Betel nut is used by around 200-600 million people around the world, mainly in South-East Asia. Chewing the betel quid — a mixture of the nut, spices and slaked lime wrapped in betel vine leaves — is a tradition that goes back many centuries.

Ingesting the nut’s juices produces a cheap, quick high, but is also highly addictive. Long-term use can result in lethargy and greatly increases the risk of oral diseases. The World Health Organization says chewing the nut causes cancer.

Papke’s paper, published on 21 October in PLOS One, says the link between nicotine and betel nut addiction treatments is particularly important as tobacco is increasingly being added to betel nut mixes, producing a double addiction.

Other researchers working to combat betel nut addiction say the findings might provide opportunities to offer wider treatment for betel nut cravings. Thaddeus Herzog, a cancer researcher at the University of Hawaii in Honolulu, says betel nut is often overlooked in healthcare and intervention planning, even though it causes oral cancer and other diseases.

“There is far more assistance available for smokers as compared to betel nut chewers,” he says. “Users of both substances show similar patterns of dependence and smokers and chewers both generally want to quit, but lack plans of how and when to quit.”