If Addictions Can Be Treated, Why Aren’t They?

Charles P. O’Brien, M.D., PhD., University of Pennsylvania Perelman School of Medicine

Comments

alcoholism naltrexone
Stephen M Cox MD

9/1/2012 12:50:47 PM

 I’m the President of the National Anxiety Foundation and a longtime supporter of the DANA Foundation. We have jumped the fence of anxiety disorders to include in our website the Sinclair Method of using naltrexone extinction of excessive alcohol consumption. This is because alcoholism can quite often be a resultant, co-morbid consequence of poorly treated anxiety disorders; it has been for thousands of years. The simple process of taking a cheap pill of generic 50mg Naltrexone one hour before drinking alcohol has been resolving the plague of alcoholism in my private patients at a rate of 75% or better at a one year follow-up for the past three years! I was fortunate to learn how to do this by my friend David Sinclair PhD of Finland who did the naltrexone research there and by his friend Roy Eskapa PhD author of The Cure for Alcoholism. I too was hesitant to try it, “This can’t work. It is too easy. It’s too good to be true.” My resolve in using this treatment was later steeled by Dr. Anton’s COMBINE research attesting to the validity of the treatment as well as the US federal government’s TIPS publications vouching for the effectiveness of the approach. So I tried it hesitantly at first. It DID work. And robustly so over 3-9 months. And, at no expense of hospitals, specialty counseling, or time consuming meetings. I encourage my psychiatric colleagues and primary care physicians to read Dr. Eskapa’s book which clearly explains how the medication needs to be prescribed in order to work. You see, naltrexone will not work for your patients if they take it as the package insert instructs. There’s a finesse in naltrexone’s use that Dr. Sinclair discovered years ago. I’m not against AA at all. We still absolutely need traditional alcoholism treatment as there is a 12% failure rate and a dropout rate of 10%. But the Sinclair Method of using naltrexone should be the first choice due to being 300% more likely to resolve alcoholism; and, doing so for about $900 instead of tens of thousands of dollars. We need both the Sinclair Method and traditional treatments. Hats off to the DANA Foundation for bringing direly needed attention to this breakthrough miracle which is sitting in the corner of our modern medicine world, nearly ignored!

alcohol treatment
Edward W Wilson, Ph.D.

7/27/2012 10:29:05 AM

 My colleague, Dr. Mary Ellen Barnes, and I use all of the effective and research proven methods currently available, including Dr. Jane Loevinger's Sentence Completion Test which identifies those for whom AA is a viable option from those it harms, to provide custom tailored treatment. But as long as "alcoholism" -- or "addiction" -- is seen as a chronic "disease" rather than a symptom, treatment is doomed. Of course it's important to note that traditional treatment providers don't want anything to do that interfers with the current 95% failure rate and the extremely luicrative revolving door that fuels those profits. Again, follow the money and the answers appear - ineffectual and/or counterproductive approaches, unskilled and untrained (read cheap) staff, and a vested interest in client failure. That's the real reason why treatment isn't being done.

Addiction treatment(3)
Steve Castleman

7/17/2012 1:26:03 PM

 A thoughtful commentary, thank you. I have nothing against using drugs to treat addiction. Indeed, antabuse helped save my life. It foreclosed drinking as an option for this alcoholic and taught me that I could withstand the circumstances that led to cravings, which I was previously unable to deal with without relapsing. However, addiction is a chronic disease that requires substantial behavioral changes to manage on a day-to-day basis. So in my experience drug therapy alone wasn't sufficient. Both psychotherapy and participation in Alcoholics Anonymous were instrumental in learning how to live sober, eventually making antabuse unneccessary for my continued (now 13+ years) sobriety. Thus, in my (humble) opinion, addiction treatment should be holistic. Drug therapies can be helpful, especially in dealing with cravings, but they aren't sufficient. Treatment should include behavioral/psychosocial components as well. The best treatment strategies combine science (doctors, psychotherapists, etc.) and the experience of addicts who have learned how to stay sober, whether through 12-Step programs or others like Smart Recovery, etc. Too often doctors discount the experience of sober addicts and sober addicts discount the knowledge and experience of doctors. That's a shame, as the knowledge and experience of both groups should be integrated for the best chance at success. Education and treatment which integrates the wisdom of both groups is key. For a not-for-profit website that does that, discussing the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don't; how treatment works; how well treatment works; why relapse is common; what family and friends can do; etc.) please click on www.AddictScience.com. Steve Castleman AddictScience.com