Four weeks ago, Lyn, an Atlanta resident, began putting the last 20 years of his life behind him. Like millions of Americans, Lyn was a long-time alcoholic who had tried a series of treatment programs to kick his addiction, but without any lasting success. “Lots of programs will just tell you not to drink and to come back tomorrow,” Lyn said. “But it’s But now, Lyn (who has asked that his last name be withheld) and many others like him are winning their battles against alcoholism with the help of Naltrexone, a drug that virtually eliminates the cravings that cause many alcoholics to relapse into their drinking habits.
“I haven’t had any cravings to drink,” says Lyn, now in his fourth week on Naltrexone. “I still have thoughts about drinking sometimes, but they’re not as gnawing as they were.” While few clinics administer the drug, Lyn was prescribed it as part of a program at Advanced Treatment Solutions (ATS) in Atlanta.
ATS combines behavioral and cognitive therapies with administration of Naltrexone. The clinic’s methods treat alcoholism and other addictions as problems of biology, not problems of self-restraint. “We hope that in the future, alcoholism will be treated like any other medical problem, with no social stigma,” says Rebecca Olson, a Licensed Clinical Social Worker and director of the Atlanta Treatments at ATS cost up to $15,000 (some programs charge as much as $28,000) and operate on an outpatient basis, consisting of daily intake of Naltrexone, individual and couples counseling, and evening group sessions, all of which are customized to each patient’s individual needs.
Naltrexone is a critical part of the clinic’s medical approach to the disease. From the beginning of detoxification, patients are given daily doses of the drug. This medication prevents alcohol from stimulating the networks of the brain that produce feelings of pleasure, which allows alcoholics to . Patients who take Naltrexone experience no relapses 50 to 80 percent of the time, versus the 10 to 12 percent who don’t relapse using a traditional 12-step or 28-day program to recover.
Such success rates cause many to wonder why every alcohol treatment program in the nation doesn’t integrate Naltrexone into their recovery processes. Olson explains Naltrexone’s minimal presence in treatment clinics as a lack of understanding of the drug itself, as well as the most effective way to “Some clinics have never used it and they don’t know how well it works. Others have used it, but the doses they have given have been too small and not as effective,” Olson said. “We use an assertive amount of Naltrexone to get rid of the cravings right away.” Others who are familiar with the drug believe that ignorance is not the only reason for its currently limited use. Darryl Neill, Ph.D., a professor of psychology and pharmacotherapy at Emory University, believes that some patients may find it difficult to continue taking Naltrexone. “As is too often the case with pharmacotherapy, Naltrexone has side effects which can vary with the individual,” Neill says. “They can be noxious enough for the person to not tolerate the drug These side effects can include nausea, headache, dizziness, fatigue, insomnia, anxiety, and sleepiness. If alcoholics experience these side effects and “simply stop taking the drug, the effect is gone,” Neill says. “And, of course, some people might just like the booze more than the Naltrexone.” Olson also believes that a certain mindset about the nature of alcoholism prevents many patients from wanting to take the drug for treatment. “Some alcoholics will say ‘I want to be completely clean, with no medication at all.’ But they don’t understand the biological components (of alcoholism) and that it’s a medical condition,” Olson said.
“They see it as a problem with a person’s strength of character.” But while Olson and other treatment professionals laud the success of Naltrexone, they emphasize that treatment with the drug alone can only go so far. Some sort of behavioral or cognitive therapy should supplement the use of Naltrexone to help patients get to the roots of their drinking problems and Another patient, Keith, was an alcoholic for many years and had several unsuccessful attempts at treatment before he came to ATS. Now, after three weeks of the program, he recognizes the benefits “They’re helping me deal with myself,” Keith said. “Naltrexone takes the physical parts of it away, and that opens the door to let the healing process begin.” But while Naltrexone may have all the appearances of a miracle drug, Neill cautions against getting “While it’s useful, it should not be viewed as the long-sought ‘magic bullet’ for alcoholism, but simply one arrow in the quiver of possible treatments for the problem,” Neill said.
But, Naltrexone or not, Olson believes that altering the biological and behavioral basis of alcoholism “This is the frontier of addiction. We will no longer will ourselves to be healthy,” Olson said.
“Treating these problems medically is the way of the future.”


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CASE REPORT MASTERING TASKS OF ADOLESCENCE: THE KEY TO OPTIMUM END -OF- LIFE CARE OF AN ADOLESCENT DYING OF CANCER. Suriati Mohamed Saini* and Susan Mooi KoonTan.* *Department of Psychiatry, Faculty of Medicine, UKM Medical Centre, Jalan Yaacob Latif, Abstract Objective: This case report highlights the optimum end-of-life care of an adolescent dying of cancer. Method:

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