(Update, Jan 15 2009. This post was written in response to one from Stanton Peele entitled "Lies that addiction experts tell us part 3......". The title of Stanton Peeles post has subsequently been changed to "Addiction myth #3.......". I tell you this to explain the numerous references to "lies" and "lying" that appear here).
Unfortunately the biggest and most damaging lie from Stanton Peele's post is the one he announces in his title. The idea that addiction is not "treatable" is, at best, simply untrue and at worst will mislead sufferers of addiction into thinking that modern medicine can do nothing for them. For people to believe this lie would be a tragedy.
Naltrexone (ReviaTM) and acamprosate (Campral TM) are both medications that are prescribed to addicts to will help reduce their symptoms, most notably craving. Both are indicated for the treatment of alcoholism.
Any actual "addiction expert" will freely admit that neither drug works especially well and that their effects are moderate, but they do work. A recent, very large study, called the "Combining Medications and Behavioral Interventions for Alcoholism" (or COMBINE) study attempted to fully address whether naltrexone works in the treatment of alcoholism. They found that it did. So in fact, does behavioral therapy. The findings were published, by Anton and colleagues, in the Journal of the American Medical Association (JAMA).
The moderate overall effect of medications like naltrexone may be explained by them working for some people and not others, so that the averaged effect appears small. This variation in individual responses to naltrexone has long been thought to have a genetic explanation and follow-up analysis of subjects in the COMBINE study revealed this to be true.
Naltrexone works by blocking the mu-opioid receptor. The gene for the mu-opioid receptor, like almost all genes, is slightly different from one individual to another (as I discussed recently for social anxiety disorder).
Anton and colleagues performed a genetic analysis on their subjects and found that patients carrying one particular variant of the mu-opioid receptor gene, a variant called Asn40Asp, were significantly more responsive to naltrexone, raising the possibility that sufferers of alcoholism could undergo a simple genetic test to determine if they might benefit from naltrexone treatment.
As I stated earlier; these addiction treatments are not perfect, but they do help some patients and form the basis of further research aimed at developing more effective treatments. Anything which is proven, in clinical trials, to help addicts overcome their disease has to be a good thing. To claim that scientists who think that "addiction is a treatable disease" are somehow lying is a to willfully seek to deny patients of an opportunity to get better.
