Wake up. Take blood pressure, baby aspirin, and cholesterol pills with your morning orange juice. If you are an addict, add your anti-craving pill/s as well. A Naltrexon (Trexan) to stop your alcohol cravings, a Subutex (Buprenorphine) to stop your opiate cravings, and one of the many new medications currently in development to reduce your desire for marijuana, cocaine or methamphetamine.
That, in part, is how Tom McLellan, PhD., outgoing Deputy Director of the Office of National Drug Control Policy sees the future for many, if not most, addicts. He spoke recently at a panel discussion hosted by “Intervention TV” and "Hollywood, Health & Society" at the Writers Guild of America for a small group of treatment providers and industry insiders. The Obama Administration, he says, is committed to expanding the use of effective “medication-assisted therapies” which are currently limited because the FDA has approved far fewer pharmaceuticals to help in addiction treatment than other chronic medical disorders.
Our clients say that synthetic opiates like Methadone, Suboxone or Subutex get into their bones, and detoxing from is much more painful, and takes much longer, than getting off heroin.
But the subject seems worth investigating because McLellan is an impressive guy -- a psychologist and professor of psychiatry who has been in the field of addiction for more than three decades. His achievements are too numerous to list here but they include authoring more than 400 articles and chapters on addiction treatment, developing the Addition Severity Index, founding the Treatment Research Institute (TRI) and serving as Editor in Chief of the Journal of Substance Abuse Treatment.
At his Senate Confirmation hearing in June 2009 he told members of Congress that despite his vast knowledge about addiction, he was personally unable to save either his brother or son from the disease, and had experienced first hand the same wreckage 20 million other American families suffer each year – car accidents, arrests, lost jobs and relationships due to substance abuse.
Small wonder that when former Seattle police chief Gil Kerlikowske was appointed “Drug Czar” by the Obama Administration, and announced he was bringing on board as an equal partner McLellan - personally recruited by Vice-President Joe Biden who he reports to -- the addiction community was hopeful. Many felt that McLellan could help the Obama government set priorities more in concert with current thinking of scientists and addiction professionals about prevention, treatment and recovery. Kerlikowske pledged to spend less money on the costly and ineffective War on Drugs launched by President Nixon four decades ago.
President Obama’s recently inaugurated National Drug Control Strategy still allocates more billions to chasing Columbian, Mexican and Afghani drug lords than to prevention and treatment. But it places new emphasis on prevention, early-stage intervention, enhanced medical and nursing school educational programs, prescription drug monitoring programs, informing the public of the risks of prescription drug abuse and overdose, and working with physicians to achieve uniform standards on opiate painkiller prescribing.
And it allocates funding for “medication-assisted therapies.”
In his June 2010 Congressional Testimony, McLellan stated: “For approximately 23 million Americans, substance use progresses to the point that they require treatment. This is roughly the same number of American adults who suffer from diabetes. In the U.S., the only disease that affects more people is heart disease. Particularly problematic is the fact that of these 23 million, only 10 percent receive any type of formal treatment for their disorders. This represents the lowest treatment penetration rate of any illness. For addicted individuals and their families, modern treatment can be a critical, even lifesaving resource, but only if it is readily available and of high quality.
“The most effective method of treating substance use disorders requires a holistic approach that incorporates both pharmacological and behavioral treatments. Medications, when combined with evidence-based behavioral therapies selected to best meet an individual’s needs, create the optimal approach to treat persons with substance use disorders.”
It’s not going to be that quick or that easy. First of all, the existing pharmaceuticals are not fail proof. Secondly they tend to have nasty side effects. I polled our current clients, counselors and those in recovery who were visiting the day I completed this blog, about anti-cravings pills. The results weren’t encouraging:
Two of the alcoholics continued to drink while taking Campral. The most recent client who came to us through "Intervention TV" had to be detoxed form both methadone and heroin. A counselor said that while taking antibuse, he sprayed himself with cologne (which happened to contain alcohol) and got fatally ill. A counselor whose mother is a prescription pill addict said she takes a maintenance dose of suboxone daily but wants to stop because she goes into withrawal whenever she can’t afford to renew the prescription.
Maybe 25 years from now, thanks to new government funding of science and research, "medication-assisted therapies" will be effective and safe, and it will be hard to remember a time when addicts died from their addictions. In the meanwhile, I vote we continue to raise dopamine levels with a healthy diet, yoga breath work, food supplements, all kinds of therapy and membership in the 12-Step Fellowship.