Here we are getting deeper into Recovery Month. As I said last week, the whole purpose of Recovery Month is to focus on the fact that alcohol and drug addiction exists, and yet, it is very treatable. I think of Recovery Month as a time to showcase all of the great advances and treatments that have been discovered by scientific research over the last two decades. Why are these research findings important to promote? Because these scientific breakthroughs create a great deal of hope for the patients and families that this life-threatening disease affects. Just to make sure that you are aware of all of the Recovery Month activities in your area, here is the website that you can browse for activities both nationally and in your area (searchable by zip code) - http://www.recoverymonth.gov/
So last week, I left you hanging about the issue of celebrity deaths from alcohol and drug addiction. Sorry about that, but I wanted you to have some time to really think about this issue, as it is critical for our country to get “its act together” in regards to fixing our current alcohol and drug addiction treatment system – which as I said last week is woefully broken !!
So, if we pick up from last time, I stated that with the recent “leak” of some of the coroner’s toxicology results and the search warrants, the facts demonstrate that Michael Jackson did have the disease of drug addiction, at least to sedatives (e.g. sleeping medications, and a class of substances called benzodiazepines – like Valium or Ativan.) To restate my main point from last week’s blog, because it is so critically important to our country and the world, Michael Jackson’s tragic death can actually save thousands, even tens of thousands of lives and families across the U.S. and around the globe. That is, if we can focus the media on what is important here – drug and alcohol addiction is treatable with a very high chance of success when treated correctly– and that is what everyone should learn from this tragedy. However, I can see many people reading, listening and watching all of the different stories about his death and then drawing the conclusion (thinking) that, “if Michael Jackson, as rich and as famous as he was can’t beat this drug addiction thing, then what chance do I have?” They will go on to think, “my situation is hopeless. Nothing is going to help me! He had millions and still died – my chances of staying sober and beating this disease are about zero- why even try and stop?” Similarly and maybe even more tragically, the family member of an addict or an alcoholic may think, “… boy if he could not beat it with all of his money and resources, there is no way my husband can stop his alcoholism (or his addiction to pain pills).”
So enough about last time! My belief is that alcohol and drug addiction is very treatable, now in 2009, and with the right science-based treatment tools and medications, Michael Jackson would have still been alive today. The fact is that we have great anti-addiction medications for alcohol and opiate addiction. We know that he was taking some narcotics, and so one medication that he should have been on is called Suboxone, which is an amazing, almost miraculous tool to help effectively manage opiate addiction. (I will talk specifically about Suboxone in a future blog entry, but for now understand that this medication should have been a key part of his comprehensive addiction treatment program.)
So with all of his money, fame and influence, why didn’t Michael get the most effective addiction treatment? Well the fact is that celebrities do not have all of the secrets to success. Having a lot of money and having this disease does not necessarily mean that you will beat it, because almost every addiction treatment program in the U.S. uses basically the same approach, which only partially treats this illness. What do I mean by that? Well, because alcohol and drug addiction is a chronic brain disease, you have to treat it like a chronic medical disease to be able to stay sober. (see my previous blog entries to understand this concept.) Unfortunately, most treatment programs are only using the 12-step approach with their clients. Now, I strongly believe that the 12-step component is an essential part of any good treatment program, but the problem is that by itself, it is not sufficient to treat this disease in most cases (meaning at least 75%). So then, why do most addiction treatment programs only use this approach?
Well, my answer to that questions is that most treatment programs in our country were started and are run by people in recovery, meaning that they have the chronic brain disease of addiction themselves. When they went through treatment over 20 years ago, whether just AA/NA, residential or outpatient programs, they stayed sober – in other words they were part of the lucky 25% who were able to stay sober with just the AA approach. Before 20-25 years ago, we did not know that much about the brain and how this illness affected it. Sadly, the field only really had that one treatment option – the 12-step approach. I say sadly because the other 75% of the patients did not respond to that approach and continued to use and then died much earlier than they were supposed to. I call this process reverse Darwinian selection.- It is not survival of the fittest, but rather survival of the “lucky.” Since only the lucky lived, they now think that, “Hey, AA worked for me so therefore it should work for everyone. If it doesn’t work , then they (the new patients in the program) are just not trying hard enough or they just need to go to more meetings!” Sadly, this reasoning is woefully inaccurate in most (75%) of the cases. (Note: this would be like telling someone with diabetes to just go to groups that help them stay on their diet and not eat sugar. Yes, that would help, but these patients also do not have enough insulin in their blood, they need other treatments than just talking about the disease in groups. In today’s diabetic treatment environment only going to groups to talk about not eating sugar would definitely constitute malpractice!)
But because these lucky 25% are still sober, and are convinced that the 12-step approach will work for everyone, if they only “hunker down” and get with the program, , they are very resistant to any new ideas or techniques! I know this sounds ludicrous, today in September 2009, when science has made so many advances in the area of both neuroscience and addiction treatment – but sadly what I just described is the current “state” of 95% of our treatment programs in the U.S.. The addiction treatment industry in our country is just so very resistant to integrating the latest science into its treatment centers, because of the reasons that I mentioned above, which can be summarized in the statement that I hear from the treatment field over and over, “Well, I didn’t need anything but my AA meetings to get me sober, so why does anyone need those new medicines or other treatments?”
So often when I am discussing the newest scientific research breakthroughs with therapists, I hear the statement, “Why are you treating drug addiction with “drugs?” My reply to this ridiculous question is, “Why do you treat diabetes with Insulin or why do you treat high cholesterol with Lipitor?” I just want to bring the latest scientific breakthroughs to my patients to give them the best chance of success. Basically, I hear these intense levels of resistance to progress in our field whenever I am lecturing to therapists across the country – a fact which implies that our current addiction treatment system is broken. The system–is using only 40-50 year old technology (specifically 12-step programs) to treat a life threatening, chronic brain illness.
When you look at our current addiction treatment system this way, you can see why even celebrities who are paying $100,000 per month for the “best” programs (all of which are only 12-step based) continue to relapse. If they are not part of the “lucky” 25%, they are going to relapse just like the rest of the unlucky 75%, and in many cases die, because alcohol and drug addiction is a dangerous illness that needs to be taken very seriously.
