To start out this rant, let me tell you what naltrexone does. It decreases an alcoholic’s craving for alcohol, and if an alcoholic drinks when on naltrexone, it blocks the part of the brain that provides the buzz. You drink and you feel just like if you haven’t drunk. Now to be sure your body will still react in the same way. You will still slur your words and lose your motor skills and be a bad driver, but you won’t get the high or buzz you are looking for. Now to be totally honest, if you drink enough to put yourself in a coma or kill yourself, you will eventually reach a point where you start to feel the buzz maybe just before you become comatose.
Naltrexone was originally developed for use in combating heroin and other opioid addictions. Like with alcohol, it blocks the brain receptors which provide the high from opioids. In fact, if you’re on naltrexone or Vivitrol, like A is, you need to wear a wrist band or carry a card which indicates that you are on the medication because if you are in an accident and require surgery, in order to use an anesthetic, they must first give you a shot to block the effect of naltrexone. For history on the development of naltrexone see http://www.lowdosenaltrexone.org/gazorpa/History.html. I suggest you check that link out. You’ll find that the US government was instrumental in getting this medication developed and approved by the FDA and marketed.
If you go to http://www.lowdosenaltrexone.org, you will see that it is presently being evaluated for a large number of purposes.
So if what you say is true Curmudge (and it is) why haven’t I heard of it. The answer is twofold. First and foremost, the AA Kool-Aid drinkers consider any medication to help alcoholics as an anathema.
From the American Council on Alcoholism website, 2005:
“Many physicians and non-physicians in treatment programs are unaware of the usefulness of naltrexone or how to use it. In other areas of medicine, it is highly probable that the development of such an efficacious medication would prompt physicians to use it readily. The biggest obstacle to using naltrexone for the treatment of alcoholism is the ‘pharmacophobia’ of many alcoholism-treatment professionals. This near-hysterical resistance to medication for treating alcoholism (or other substance-abuse disorders) has deep and tangled roots. Many recovering professionals learned in their recoveries that MDs and their prescription pads were evil purveyors of pharmacological lies and temptations. This attitude is often accompanied by a deeply rooted and strongly held belief that recovery has only one successful formula (usually the 12-step program) and that any modification to that approach is unethical. Scientific evidence is irrelevant to these individuals. They believe they have the ‘truth’ about recovery and don’t want to be bothered with other points of view.” http://www.lowdosenaltrexone.org/gazorpa/History.html.
It is incredible to me that a group with what they consider the answer for alcoholics, would oppose medication that really helps those they profess to want to help. Could it be they want to protect their monopoly? And they know, as Dr. Dodes points out that there is no scientific or medical evidence to support the 12 step program, so they would naturally want to block any medical solutions.
The truth of the above can be confirmed by any of you who watch TV. How many commercials have you seen for shaky leg disease or other “illnesses” urging you to get your doctor to write a prescription for “getbetterol” or something, but you’ve never seen a commercial for naltrexone – a drug that could save lives! I heard from two friends yesterday that had actually heard a commercial on the radio for Vivitrol, so maybe there is hope the word will eventually get out and a significant number of people can greatly improve their lives and the lives of those around them.
I have personally experienced this phenomenon. During A’s second stay at the rehab facility in NC, after 2 weeks I was allowed to visit him on Sunday, but only after listening to an hour of AA speak. At one point the woman giving the spiel began to talk about the changes alcohol made to brain function, and I asked is this where naltrexone comes into the picture? She turned and gave me a look like I had just peed on her cornflakes. After a long pause, she scowled, “Well that’s very expensive.” Not when compared with the cost of unsuccessful after unsuccessful rehab attempts! How many times has Lindsey Lohan been to rehab?
For a little background on this subject, let me tell you that at one point in my career in the federal agency, I was the attorney responsible for advising our labor, EEO, and human resources offices. One result of this was that I conducted training of agency employees on the Rehabilitation Act, which is the federal equivalent of the Americans with Disabilities Act. The training often dealt with how to deal with alcoholics under the act and usually involved me discussing the legal obligations and our alcohol abuse counsellor talking about alcoholism. The counsellor was always someone who had gone through AA. The point here is that as part of the counsellor’s speech, it was always stated that it was expected that alcoholics would relapse after rehab, perhaps several times.
Now I know some or maybe all of you are thinking, I know people or know people who know people who have benefited from AA, so how can it be true that AA is not effective. This is because the 12th step commands converts to go forth and proselytize. What you don’t understand is that for every person you know who “recovered” there are 13 or 14 who didn’t recover, but they’re not going around bragging about their failure.
The second reason you probably haven’t heard about naltrexone is because the rehab industry is a multi-billion dollar industry. Cadillac rehabs like the Betty Ford or Hazelton or Promises Palisades and others charge $50,000 to $90,000 for a one month ineffective stay. Can you imagine a better business model? We’ll convince you to come here at great expense, do a bunch of ineffective meetings, and then you’ll come back multiple times to pay us again and again, and it’s your fault if you don’t get better. WOW that is genius! As Deep Throat once said, follow the money! Now these facilities do usually provide counselling and I’m sure psychological evaluation and counselling, but at their core they are just fancy 12 step programs that offer additional goodies like horseback riding.
Earlier I indicated that I prefer Vivitrol, an expensive 30 day shot over a much cheaper daily dose of naltrexone. The reason is simple. If you’re a parent or a spouse or significant other, you can go to the doctor with the alcoholic and make sure he/she takes the shot. It is a lot more difficult to make sure someone takes a pill every day. And if you’ve ever lived with or were concerned about an alcoholic, you know the constant fear that the disease will rear its ugly head again. That’s why having them get the shot gives you peace of mind.
I don’t profess to be any kind of professional in this area, but from what I’ve seen and heard, and from what A’s last counsellor told me, naltrexone and Vivitrol are the best bets for treating alcoholism at present. If you know someone with a problem and rehab and AA are not working for them, I suggest you try to get them to a physician who deals with naltrexone treatment and give it a try. You can find a list of such professionals on the Vivitrol website. Www.vivitrol.com. I am not a paid spokesman for these medications. I am simply someone who has seen the results they produce after having suffered through the nightmare of having children with alcoholism.
In my last rant on this subject, I will be discussing what needs to be done to fix the situation. The need to rethink how we deal with the problem. The ineffectiveness of the mandatory DUI laws brought on by MADD and how they can have the opposite effect from what’s intended. It will be up next week because I want to take a little more time to properly present it.