The right medicine for alcoholics

  • Article by: Markus Heilig  , Special to the Washington Post
  • Updated: September 9, 2013 - 8:12 PM

With about 80,000 Americans dying each year, excessive alcohol use remains the third most-preventable cause of death in the United States, topped only by smoking and obesity.

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mlbnelsonSep. 9, 13 9:13 PM

I myself am an alcoholic and am greatful for my many years of sobriety. That being said,. Using scientific technology's or not, it's hard for me personally to believe someone with a M.D or PhD truly has a grasp of the diseases if he or she is not alcoholic. I'm not apposed to research but it my humble opinion that we alcoholics have an allergy of the body and the obsession of the mind and must learn to live life on life's terms. Alcohol is simply a symptom of the disease.

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RankenFyleSep. 9, 13 9:55 PM

Some very good points for consideration. With a 30% success rate at AA,its definitely time to consider medical options. No one treatment or cure fits everyone, particularly when it comes to understanding addiction.

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sntenbenselSep. 9, 13 9:58 PM

mibnelson, I respectfully disagree. The notion that an individual who has studied addiction and been involved with the recovery of many individuals is somehow not in a position to further the treatment of addiction because they themselves are not addicted is not helpful. Does a doctor have to have diabetes in order to treat it? Does an orthopedic surgeon have to break many bones in order to repair a break? Sure it adds to compassion but does not exclude what they bring to the discussion.

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bikiesterSep. 9, 1310:10 PM

This is a poorly written piece in which the author cherry-picked anecdotes and data to support his claim while ignoring (or not knowing about) conflicting information. One might expect more from the clinical director of the National Institute of Alcohol Abuse and Alcoholism. The only part I'm on board with is that alcoholism is devastating and there ought to be adjuncts to or better options than AA. But there aren't, so I use the parts of AA that I find useful--parts that have been more effective in treating my alcoholism than 6 treatment centers, naltrexone, every SSRI and anti-anxiety med, and medical detox. As a recovering alcoholic with over 5 1/2 years of continuous sobriety and a PhD in neuroscience I can attest to two important points: 1)The neuroscience of compulsive drug and alcohol use does not currently support continued drug/alcohol use as a good option, and 2) the big book of AA explicitly states that there is a role for doctors and medicine in recovery for an addict. I'm going to go out on a limb and say that the idea that people can permanently recover from alcoholism is attractive, but not bourne out by any studies at this point, so his use of such an anecdote is questionable. There are many examples of treatment centers prescribing naltrexone and acamprosate so I'm not sure about his contention on this point. The numbers the author throws around may be found in clinical literature, but they are out of context. For instance, the best studies of naltrexone show that it moderately improves the abstinence rate for a select subset of individuals tested. I got blasted on gin while taking the stuff--it's no silver bullet. I'm not a believer in the "harm-reduction models"--I had a therapist who had me cut back to 6 beers a day for a while when I was drinking. It didn't work. What we really need is for the director of NIAAA to spend a year with gutter drunks, high-functioning drunks, house-wife drunks, and any other type of drunks he can find and go to 365 AA meetings. Listen to the stories of the folks with long-term recovery. Some of them take medicines that their doctors prescribe. I firmly believe the best treatment modern medicine can provide for alcoholics is distance from the drink (30 days in a treatment center) and therapy (both pharmacological and talking) to address such underlying neuro-psych conditions such as anxiety, depression and any other "dual-diagnosis" co-morbid disorders. Until there is a true anti-craving pill that also fixes all of the psycho-social problems many alcoholics face the aforementioned approach will likely be more effective than the pharmacological intervention alone.

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west336Sep. 9, 1311:28 PM

They need to invent a Suboxone for alcohol. I take Suboxone for opioid addiction and it both curbs most cravings and blocks the ability for a person to get high off of opiates. It's also a very strong drug itself and it's a complete pain to get off of -- almost as bad as regular opioid withdrawal (which is to say very bad). It's not a "miracle drug" though in that you can take it and live the rest of your life normally. No. In fact, without AA (or NA) and/or continued counseling with a psychiatrist and/or psychologist it is very likely that most patients who use Suboxone will not stay sober indefinitely. I'd know.....I've tried it and it doesn't work. In my mind there is no "cure" for addiction, just like you can't "cure" diabetes or "cure" rheuamatory arthritis. Acceptance of who and what you are and being willing to work within any confines that presents you is vital to staying sober and living a mostly-normal life.

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rlwr51Sep. 9, 1311:49 PM

Not a very well written article from someone who is supposedly so well educated. He also doesn't seem to have that good of an understanding of alcoholism.

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tupelohoneySep. 10, 13 7:18 AM

I find the line that studies show that some alcoholics can resume a normal drinking behavior questionable. I've never known an admitted alcoholic who could return to drinking and not resume alcoholic behavior. But, what do I know other than I am an alcoholic who has 8.5 years of sobriety under my belt, has attended thousands of meetings and known hundreds who thought they could pick up another drink and then couldn't put it down.

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mnborn2Sep. 10, 13 7:33 AM

But studies also show that others are able to return to social alcohol use.............. One week studies show that coffee drinking is bad for us. The next week studies show coffee drinking has benefits. Lets remember that these are just studies. Would a recovering alcoholic really want to give up their sobriety based on a study and take this type of a chance? Not this "recovering" alcoholic with 26+ years of sobriety.

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twspt7Sep. 10, 13 8:04 AM

@tupelohoney "I find the line that studies show that some alcoholics can resume a normal drinking behavior questionable" I agree. Perhaps science will find an alcohol-use equivalent to Suboxone, mentioned by west336 above, but 'til then, as an alcoholic in recovery with over twenty years of sobriety under my belt, I know I cannot use alcohol. I've seen those that have tried to use it responsibly in recovery, and I have seen that, in most cases, it leads to relapse.

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gemie1Sep. 10, 13 8:22 AM

I will have 21 years from my last drink on Sept 16th. For people like myself, we have to change our lifestyle, stay away from people, places and things that trigger our use and get outside our own heads by helping others. Alcoholic and drug addicts have always searched for the magic pill. We have also always searched for an easier and softer way to stop using and have recovery, but it just does not work for most of us. I am not against medication for anxiety, depression, bi-polar, and other axis I disorders, but I have seen people come into recovery with a diagnosis of borderline personality, anti-social, etc. Many of these people do great with the 12 steps and turn things around. The steps also helps people reduce their anxiety by learning healthier coping skills and by interacting with others, it has helped reduce depression.

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