Colorado Drug Rehab....Naltrexone and Alcoholism
Naltrexone...Another Attempt to Sell Drugs to Addicts
On May 21, 2010 we attended a conference on innovations of treatments for addiction disorders. Like all licensed professionals, we are required to attend continuing education classes to keep abreast of "advances" in the field. After the many years in this field, we have found that most of the "advances" are actually the same disappointments of the past being re-packaged and pushed as revolutionary. This is definitely the case with one of the lectures on Naltrexone as a necessary adjunct for the treatment of alcohol addiction and alcoholism.
First of all, we know centers that CURE this problem, so we weren't interested in giving any of our patients an old drug that is now being pushed to help reduce cravings for alcohol.
Secondly, Naltrexone, by definition, is an opioid receptor antagonist and since there isn't any research that documents that alcoholism has anything to do with the mu receptors in the brain that are the centers of pleasure for opiate addicts, I couldn't see how Naltrexone could have any value other than placebo effect.
Chemically, Naltrexone, is shown to block the effects of heroin and other opiates at the opioid receptor level, based on the logical assumption that if you block the receptors for heroin and, therefore, a user doesn’t get any “rush” or “high” or any response from taking the opiates, then the addict would not be tempted into relapse.
Naltrexone, is a long-acting opioid antagonist that blocks these opioid receptors, supposedly reducing the craving while diminishing tolerance for both opiates and alcohol. Naltrexone will cause an opiate addicted to go into severe withdrawals, but why would this drug also act to block alcoholic cravings when alcohol does not have target receptors sites and there is no evidence that the high from alcohol is biochemically similar to the opiate reaction.
Naltrexone is being pushed by researchers at the University of Pennsylvania and by most government agencies as an adjunct to help reduce the severity of alcohol consumption by alcoholics.
In an attempt to sell this drug in Australia for heroin addiction treatment, the pharmaceutical company generated widespread enthusiasm for its generic use and encouraged family doctors to prescribe and promote it as a cure, or at least an adjunct to a cure.
Once it was widely used, researchers in Australia stated: “We have enough research in Australia to say Naltrexone is of limited value for opiate addicts”. The evidence suggest that about 10 percent do well on Naltrexone and that is hardly any proof that the drug is the reason for their improvement any more than the placebo.
We have always felt that the use of an opiate blocker is essential to save a life when someone has overdosed on heroin or another opiate, but we have never seen the wisdom in giving Naltrexone as a prophylactic to curb cravings or opiates and certainly not for drugs that are unrelated to opiates.
It has always been our contention that the use of Naltrexone is actually hindering the recovery of an opiate addict because this opiate blocker will block the receptor sites in the brain that are the targets for feelings of pleasure. These are are "circuits" where the feelings of love and laughter are communicated through to the being. If you block these channels, then you are leaving a person with a lack of highs, and perhaps lows, but you are hindering one's ability to feel normal. Any addict can tell you that they are seeking drugs that will help them feel normal, therefore, there is no wisdom in prescribing an opiate blocker to help an opiate addict stay off of opiates.
In fact, after being on Naltrexone for some time, most addicts will admit that they quit taking the drug so that they can get high on heroin or other opiates. A good treatment program will bring them to a place where they will feel "normal" without drugs, but via their on good health and nutrition. Once this happens to someone that has suffered with all of the other feelings that come from opiate addiction, they want to keep their bodies clean of drugs and secure that "normal" feeling in normal ways.
Since we have learned that this has been the reaction of most opiate addicts that have tried to use Naltrexone to stop their cravings, then what logic would tell the treatment professionals that this drug would be beneficial for alcohol cravings.
In addressing this same issue, Dr. Stanton Peele wrote the following about Naltrexone and the research in Australia:
"Obviously, a drug that reduced the likelihood of alcoholic relapse, even after drinking, has a place in treatment. But, I strongly suspect early enthusiasm about naltrexone in alcoholism treatment will quickly fade.
This has already occurred in heroin addiction treatment, and especially in the country (Australia) where its use was most quickly and widely embraced (for use by general medical practitioners). Of course, naltrexone has been used for decades in heroin treatment. There was widespread enthusiasm for its generic use in Australia, and GPs were given prescribing privileges for it. There has now been considerable retrenchment. James Bell, in Australia, indicated, "We have enough research in Australia to say Naltrexone is of limited value [for opiate addicts]. Overseas evidence suggests only about 10 percent do well on it." Of course, any improvement with Naltrexone has to be matched with the improvement shown by untreated addicts."
Around 1999, Mallinckrodt, a pharmaceutical company that manufactures most of the methadone in America as well as the hydrocodone and other pharmaceutical opiates, started promoting this idea that Naltrexone was effective for curbing the cravings of alcohol in alcoholics.
As a business decision, this concept had efficacy since hardly anyone was using this drug any longer to reduce opiate cravings and since Naltrexone is out of patent and is cost very little, profits would be high if some of the same patients that are taking methadone daily could add Naltrexone to their regimen.
You also have methadone maintenance clinics as a target audience to market your drug since many patients on methadone maintenance abuse alcohol and these clinics are not teaching their patients to be "drug-free" but are under the idea that addiction is a "brain chemistry" problem, so the use of Naltrexone fits perfectly with their philosophy. Anyone familiar with methadone clinics can tell you that profits are the first motivation in their practice and adding another profit center would appeal to their management, who in turn could use the "weak" research data on Naltrexone to get patient to add this drug to the methadone cocktail each day.
Colorado Drug Rehab hopes that someone that is considering the use of Naltrexone will read about our experience and will do further research before they introduce another "toxic" chemical into their bodies. The largest majority of those persons that are free from alcohol and opiate addiction have done so by returning their biological chemistry back to a natural equilibrium and are continually protecting their systems for contamination with opiates or opiate blockers, but are using vitamins and minerals to support their recovery.
Disclaimer: This article on Naltrexone is written as an editorial from the 35+ years of experience in watching how this drug and others have been providing false hope to patients, and proftis to others. Colorado Drug Rehab fights against the exploitation of those in need of alcohol and drug treatment and our opinions are one point of view that we feel needs to be noticed and considered.