Addiction in Society

Addiction—the thematic malady for our society—entails every type of psychological and societal problem

The Disease Theory Succeeds by Failing Part 2: Drug Cures

Telling people that a pill will cure their addiction is (a) wrong, (b) misunderstands the nature of addiction and recovery, (c) hurts people's chances of recovering. Philip Seymour Hoffman died with one such drug, buprenorphine, in his possession. Read More

Not a true cure, but one of the best tools around

Although heavy drinking is not a disease and so cannot have a "cure" as such, sometimes medication is helpful. An approach called pharmacological extinction (popularly known as the Sinclair Method) has great results. It's 90% successful in clinical trials and about 70% successful in the field.

The gist is that the drinker takes an opioid blocker (usually naltrexone) before drinking, and only before drinking. The pleasure/reward of alcohol is thus blocked, and the drinker unlearns the conditioned behavior of drinking to get an opiate rush. At the end one is left not with terror of a "cunning, baffling, powerful" inanimate liquid but with indifference toward it.

It's not magic and does not miraculously turn people into those fabled "normal drinkers." It does bring active addiction to a halt, so that addicts can set about repairing their lives and dealing with whatever led them into addiction in the first place.

http://naltrexonekey.blogspot.com/2014/01/what-naltrexone-is-and-isnt.html

There is no miracle drug which will make people stop drinking or drink less, but once heavy drinking has been thoroughly learned (and likely strengthened by misguided so-called treatment), extinction of that learning is a huge help in moving into a post-addiction life.

I would not go so far as to say that pharmacological extinction saved my life, because I am not a crazed cultist, but it was the best tool I ever found.

90% successful!

Wow! It's all over -- that's the answer! No more need for any other therapy, I'd say -- wouldn't you?

Naltrexone in the Treatment of Alcohol Dependence

John H. Krystal, M.D., Joyce A. Cramer, B.S., William F. Krol, Ph.D., Gail F. Kirk, M.S., and Robert A. Rosenheck, M.D. for the Veterans Affairs Naltrexone Cooperative Study 425 Group

N Engl J Med 2001; 345:1734-1739December 13, 2001DOI: 10.1056/NEJMoa011127

http://www.nejm.org/doi/full/10.1056/NEJMoa011127

Although naltrexone, an opiate-receptor antagonist, has been approved by the Food and Drug Administration for the treatment of alcohol dependence, its efficacy is uncertain.

We conducted a multicenter, double-blind, placebo-controlled evaluation of naltrexone as an adjunct to standardized psychosocial treatment. We randomly assigned 627 veterans (almost all men) with chronic, severe alcohol dependence to 12 months of naltrexone (50 mg once daily), 3 months of naltrexone followed by 9 months of placebo, or 12 months of placebo. All patients were offered individual counseling and programs to improve their compliance with study medication and were encouraged to attend Alcoholics Anonymous meetings.

There were 209 patients in each group; all had been sober for at least five days before randomization. At 13 weeks, we found no significant difference in the number of days to relapse between patients in the two naltrexone groups (mean, 72.3 days) and the placebo group (mean, 62.4 days; 95 percent confidence interval for the difference between groups, –3.0 to 22.8). At 52 weeks, there were no significant differences among the three groups in the percentage of days on which drinking occurred and the number of drinks per drinking day.

x x x x x x x

90% successful in clinical trials, you say -- that's fantastic, fantastic. (By the way, the first sign that you are a BSer is in reporting an absolute outcome, rather than an advantage over a comparison or a control group. In this case there was no advantage -- they both most have been 90% successful!)

Read a little more closely

You're looking at one study of *daily* naltrexone administration. I'm speaking of *targeted* naltrexone usage.

No, it's not baloney.

Wow

You actually deleted the comment in which I pointed out that you hadn't seen the main point of the previous comment?

I thought better of you. I really did. Back in the 80s, you were an inspiration with your well-researched polemics against 12-Step hegemony. In the 90s, you made a strong case for REBT and related therapies to give addicts better choices (we even corresponded for a while).

Now, in 2014, when our positions are reversed and I have information to share with you, all you can do is mock me without even examining the evidence?

No, I'm not a "BSer." I'm an aware human being who realizes that learned behavior can be unlearned and that some means of unlearning are faster and more helpful than others.

As for the "no need for any other therapy" ridicule -- no, I would not say that at all. Aside from the 10% whose addiction works via some other mechanism, there are those who bail from the process once they realize they'll no longer be getting high. Those people will need to grapple with whatever's driving them to get blasted, as has always been true. We're fortunate that we now have tools to kill the actual addiction, but that doesn't mean that there's no need for anything else, and I never said or implied that.

I'm sorry

I see now that you did not delete the previous comment, and that it was some sort of server caching problem. I do apologize for concluding that you had knowingly deleted it.

What about baclofene?

here in France it is being touted as the miracle pill, with propogandists claiming something like 85 percent success rate. Either abstinence or low to moderate drinking rates.

Some alcologists, pyschiatrists and all claiming the state is not helping people in danger by not fully autorising it's use.

Seems to me baclofene is the new prozac, abilify, seroquel et al all supposed miracle products, but the reality leaves a nast hangover, pun intended.

High-dose baclofen has issues

Baclofen research is still in its early days. It looks promising, but a lot of things look promising at first without panning out later. Still, research marches on, and some things do pan out.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540966/

Baclofen seems to provide a tremendous boost for some people, but it has to be used at a high dosage. For some people, it's a frighteningly high dosage. This leads to side effects and also to nasty problems if the supply is interrupted suddenly.

Some people on My Way Out were contemplating drinking their own urine to taper more gradually, when their supply of the drug was interrupted. *shudder* I'm personally glad that I didn't go the baclofen route.

My Way Out is probably the best place to find baclofen users and learn from their stories.

Thanks Unchained mouse

Had to laugh when they had self reports about drinking in there, we all know addicts never lie right...

Rejoins what i have seen in France, inadequate studies, over zelaous addicts with their over zealous psychiatrists alcoligists etc talking in absolutes about a product that somehow is a damn miracle and one size fits all!! hallelujah

Amisien himself was on tv here and lied through his lying front teeth how everyone could be cured with baclofen and there were no side affects!!!

Wait and see, i am not against the product, but caution is needed.

I don't think he's lying. I

I don't think he's lying. I think he believes what he's saying. He could be wrong, but that doesn't mean he's lying.

a

Mitragyna speciosa aka kratom resolved a morphine dependency thanks to a professionally derelict pain management doctor, and I have read it also works well with heroin cessation. It is not too pleasant tasting, however, but that is also a good thing as you would have to drink so much of the stuff in juice or eat it in yogurt, or take so many capsules to get a high from it, well, remember all the bowls of cereal in the colon blow commercial from snl? Yeah, that many. And even then very little bang for your buck, so abuse potential in my opinion is nearly non-existent. It also has great pain relieving qualities for some people. Everything in moderation, however, it is important to keep up with pain and not numb it too much, as pain is a sign something needs to change.

50 bags sounds like a lot, but how much per bag?

One story said he had recently withdrawn $1200 from a nearby ATM, which works out to $24 per bag. This is a street level amount, like a tenth of a gram or two. This doesn't even add up to half an ounce.

The larger circumstance was that his (common law) wife kicked him out and out of his kids lives rather than supporting him when he probably needed it most, so in a way this is actually a fairly common post-divorce (or post-separation) suicide, though a lot of focus is being spent on the particular means for some reason.

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Stanton Peele, PhD, JD, is the author of Recover! and developer of the online Life Process Program. He has been a pioneer in the addiction field since publication of Love and Addiction in 1975.

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