Monday, April 20, 2009

Anti-addiction pill? Buyers beware...

CNN posted a story at the end of last week about naltrexone, an anti-craving drug. Dr. Mark Willenbring had this quote: "There will be a 'Prozac moment', when primary care doctors start handling functional alcoholics."

Here's another quote, this the response from Hazelden's medical director: At Hazelden in Minneapolis, Minnesota, a small proportion of patients receive anti-addiction drugs, but medical director Dr. Kevin Clark says the traditional model -- based on intensive therapy and the 12 steps popularized by Alcoholics Anonymous -- is still best. "It is a disease of the brain, but it's a multifaceted disease. It has a spiritual component, a behavioral component to it," says Clark. "Our experience tells us that having the network of support and recovery is what really makes the difference."

I lean towards the Hazelden response- I am in recovery and I believe that simply taking medication without a sufficient support network would lead to an unhappy life. There's a difference between stopping drinking and actual recovery. Until we develop a medical treatment that can do something besides simply reducing craving, then we still need to work with addicts and alcoholics to find recovery through 12-step programs, therapy, and supportive rehabilitation centers. However, I do think this is huge medical progress- and I'm happy that we're making strides to find other solutions which may increase successful outcomes.

Here's a video about placing naltrexone under the skin of heroin addicts:

And here's something funny.

As always, find me on LinkedIn and Twitter. Take care.

Monday, April 13, 2009

Methadone: A blessing or a curse?

Methadone maintenance has been around for years- it's development stemmed from predictions in Nazi Germany that the war would cause shortages in opiates being able to cross into Germany's borders. In 1947 Eli Lilly's company started producing methadone stateside, and off we went. The drug was first published as a pain reliever, and now is mostly used in harm reduction around addiction.

I'm torn on the effectiveness of this methodology. What I've heard in anecdotes from members of 12-step programs is that their lives only really started to get better once they were able to detox off of the methadone, which creates a physical dependence of it's own. What is difficult to discern is that most of the people I've spoken with bout this have had resources for private addiction treatment- for those without resources, methadone seems to be a good start.

Methadone can be a start towards a path to a new life; however, it is not the be-all, end-all solution. Without therapy, a recovery program, and a plan to eventually remove oneself from a mind-altering substance, the chances of someone really recovering from addiction are slim. When planned correctly, methadone can be an important component in helping an individual get better.

The problem is in the profits- methadone maintenance is one of the most profitable businesses today, and I worry that clinics don't attempt to taper people off solely to make their numbers work on the bottom line. We need to respect the quality of life of our patients, and the easiest way to do this is to make a long term plan when someone begins a methadone maintenance plan. With all of the tools and resources available to us, we can put a plan together that allows methadone to be an active part of recovery.

Here's a link to the HBO special "Methadonia," a documentary regarding people who are hooked on methadone:

And here's a video on methadone and the consequences of not managing it correctly:

And, as always, here's something funny.

Find me on Twitter and LinkedIn. Looking forward to your feedback!

Wednesday, April 8, 2009


With the T V show Intervention creating such a huge following and awareness, we've been able to see more resources put into the hands of struggling families. The effectiveness of such an approach can be shown in multiple ways- the addict going into treatment, the family setting boundaries, etc. What many people may not realize is that intervention is generally for the family- regardless of whether or not the identified individual enters treatment. The most important part of the intervention is recognizing the problem- a drug addiction, a compulsive behavior, or a behavioral problem- and addressing it from the viewpoint of the family.

Once the family is able to understand that they can make changes within their own family dynamic WITH OR WITHOUT A COMMITMENT FROM THE IDENTIFIED INDIVIDUAL, then the interventionist has made lots of progress. Of course, it's hard at the outset for a family to see that the intervention is a success when an individual chooses not to seek help. However, should the family hold the boundaries the interventionist helped them set, they'll often see a change in the individual and the family system. Following the intervention with participation in a program of recovery such as Al-Anon is essential for family members to continue their healing process. The most important thing- DOING SOMETHING. When a family chooses to move forward with an intervention, they are creating a bottom for the addict- therefore, allowing an individual a chance to get well before things get worse.

Interventions are the greatest gift a family can give.

Here's some clips from the Intervention TV Show:

And here's some of my favorite interventionists:

Gallant and Associates
Addiction Intervention Resources
Surrender Interventions
Crisis Case Management
Bayer and Associates

And here's a video for the song Intervention by Arcade Fire. I just thought this was cool.

Here's something funny.

As always, find me on LinkedIn and Twitter. Have a great day.

Thursday, April 2, 2009

Obama says NO to legalization

In his first internet town hall, President Barack Obama said he is against the legalization and taxation of marijuana. Since the majority of the questions for this town hall came from individuals via the internet, the response was instantaneous. Twitter users reacted swiftly with their disapproval (check it out on the previous article).

The tough part for politicians and businesses today is the quick reaction by bloggers, Twitter users, and Facebookers to write about what they see wrong. I trust that Obama has worked with experts to come to this decision for now- what's nice is it seems Obama isn't completely adverse to change and is willing to admit he was wrong and not have to stick to his guns. If a good argument is economically and scientifically presented, I'm sure he'd change his stance based on the evidence.

Once again, I'm torn on this issue. I'm wondering what my friends over at Faces and Voices of Recovery would have to say about this; I can say that there hasn't been a lot of uproar about this issue besides some Twitter feeds from Vaughn Howland.

It's really interesting to watch people in the industry start to get into social media, like blogging, Twitter, LinkedIn and Facebook. I'm still working on ways to make all of this work better and would welcome any ideas to help use social media to help our cause. Make sure to check out the All About Addiction blog as well.

Here's a good argument pro-legalization.

Here's an interesting video from Lou Dobbs:

Here's something funny.

As always, find me on LinkedIn and Twitter. See you later this week.