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Drinking May Raise Cancer Risk in Women

Posted by Roberta Jewell
Categories: Medications and research

New research from Georgetown University supports the existing theory about a relationship between drinking alcohol and increased risk of breast cancer. For women predisposed to a specific type of breast cancer (estrogen or progesterone receptor positive) this may mean that drinking moderate amounts of alcohol is hazardous.

In the study over 184,000 post menopausal women were followed for an average of seven years. The research team found that those who had less than one drink a day had a seven percent increased risk of breast cancer compared to non-drinkers. According to study results, women who drank one to two drinks a day had a 32 percent increased risk and those who had three or more glasses of alcohol a day had up to a 51 percent increased risk.

Researchers agree that results are preliminary and more studies are needed to prove a cause and effect link. But women with a familial history of breast cancer may want to take heed and weigh the benefit and risk of moderate drinking.

To learn more click here.

Our experience with Chantix to reduce alcohol cravings

Posted by Roberta Jewell
Categories: Medications and research

We’re following research on the prescription drug Chantix (varenicline) with great interest because it seems to be effective in curbing cravings for alcohol. Chantix was approved by the FDA for smoking cessation in May 2006 and is sold under the name Champix in Europe.

Chantix works by blocking specific activity in the brain associated with nicotine acetylcholine receptors, or nAChrs, which play an important role in both nicotine and alcohol dependence.

I’ve been getting a lot of information in about this medication over the past year or so. Doctors with whom I work have reported that their patients, when prescribed the medication for smoking, consistently lose their appetite for alcohol. And, as expected, we’ve had a bit of discussion about this drug on the My Way Out forum, where members post questions and feedback about all facets of our program, including ant-craving meds.

To see those post, visit the links below. Keep in mind, messages are unmoderated and represent the opinion the members who write them. However, anecdotal information is often a good starting point for gathering information.

Chantix messages at My Way Out forum:
Has anyone tried Chantix for alcohol?
Chantix may cause psychiatric risks
Chantix, not just for smoking cessation
Anyone on Chantix, anti smoking pill?

Anti-craving meds can be extremely beneficial in interrupting reward circuitry in the brain that drives people to drink excessively. Used in conjunction with a multi-faceted therapy to include counseling, support, nutritional improvements and other lifestyle changes, these drugs can provide a powerful jump-start to a successful recovery program. Chantix is not approved for alcohol dependence, but many people urge their physicians to prescribe medications off-label when compelling evidence is presented about their efficacy. However, it’s critical that anyone considering Chantix for a drinking problem tell their health care provider about past psychiatric issues if they exist and be monitored carefully for changes in behavior once they start taking it.

Exciting developments are underway in the field of addiction medicine, but many of the drugs now prescribed are new to the market As with any medication, you’ll want to evaluate potential side effects and keep a careful eye on how you’re feeling once you begin taking them.

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Addendum: This recent article by New York Magazine writer Derek deKoff serves as an important lesson in how Chantix affects some individuals.

Advice from the addiction doc

Posted by Roberta Jewell
Categories: Medications and research

Dr. Linda Garcia, Medical Director, My Way OutDr. Linda Garcia, MD, Medical Director of My Way Out, specializes in addiction medicine and has provided treatment to hundreds of alcohol dependent patients. As we move into New Year’s weekend she offers specific tips about how to prevent relapse in the face of holiday triggers.

Look here for her five minute audio interview and associated article.

Consider this when depression hits

Posted by Roberta Jewell
Categories: Diet, nutrition and exercise

Treatment for dual diagnosis is often necessary when someone is affected by both chemical dependency and an emotional illness. We see a lot of this within our drinking population because so many people suffer from both depression and alcohol dependence. In fact, the question often arises: which came first?

Regardless of the answer, we find many alcoholics are prescribed anti-depressants or mood stabilizing medication.

Our blended program of nutritional supplementation, dietary changes, exercise, hypnotherapy–and medication, if appropriate–addresses chemical imbalances in the brain. Patients who adopt our therapy are often surprised at how quickly their depression lifts. One of advantages of our approach is that it is highly customizable and allows individuals to focus on problem areas. Some people look to renew their bodies (e.g. liver health or brain function) while others wish to improve their mental and emotional well being. The body’s entire system, both mental and physical, is compromised by excessive drinking and we find a multi-faceted approach is most effective when tackling an action plan for long term sobriety.

Sometimes a simple supplement can make a world of difference. Take Omega-3 fatty acid oils. They are often overlooked as a mood enhancer, but we’ve gotten some really great feedback about how well they work. Clinical trials are now underway to follow up previous studies and determine more precisely their mechanism of action. You’ll find info here.

We also have some excellent links in our Health Store regarding the many benefits of omega oil supplementation (it’s excellent for heart health) including the following overview:

“A now famous Harvard study (Stoll et al., 1999) determined that individuals suffering from manic and mood disorders collectively exhibit low levels of EPA and DHA. During this double-blind, placebo-controlled study, nearly 75% of the subjects treated with omega-3 experienced relief from their symptoms. According to Dr. Stoll, “Our study results indicate that fish oil does possess the elements needed to stabilize mood.”
Source: Now Foods Health Professor

Omega-3 supplements are generally easy to find, inexpensive and safe. However, consumers must be diligent about purchasing a high quality brand that’s been tested for contaminants such as peroxide, mercury, PBCs and dioxins. Best also to select one that meets or exceed FDA safety standards.

Six Ways to Avoid Holiday Booze Blunders

Posted by Roberta Jewell
Categories: This 'n that

Newsweek reporter Temma Ehrendfeld shares tips about how to make it through the holidays. We’re proud that My Way Out was mentioned as a resource to help those in need of support. They’ll find it in our anonymous online forum.

Six Ways to Avoid Holiday Booze Blunders

‘Tis the season for uncomfortable moments if you don’t drink alcohol or are hosting someone who doesn’t. Here are our tips on teetotaler etiquette.

You’ve made a resolution and you’re starting now. Or maybe you or one of your guests made a no-alcohol pledge years ago. Either way, you plan to be merry with the best of them—but without the mulled wine, spiked eggnog or champagne punch. Happily, in these health-conscious times toasting the New Year with a fizzy cider or an alcohol-free wine is more acceptable than ever before, abstainers say. Still, the rules of festive sobriety aren’t always obvious. READ MORE…

Baclofen a promising and safe anti-craving medication

Posted by Roberta Jewell
Categories: Medications and research

We’ve been following the drug Baclofen with some interest. The research reported below is very promising, especially for anyone who’s concerned about taking an anti-craving medication like Naltrexone, which is contraindicated for those with impaired liver function. You may remember reading earlier research about an MD who self prescribed baclofen and went on to publish his findings. That article is here.

Baclofen Aids Abstinence in Alcoholics With Cirrhosis
Study finds drug’s anti-craving action, safety could play role in liver treatment

Posted 12/7/07 FRIDAY, Dec. 7 (HealthDay News) — The drug baclofen promotes alcohol abstinence in alcoholics with cirrhosis of the liver, says an Italian study in this week’s issue of The Lancet.The study included 84 alcohol-dependent patients with liver cirrhosis who received either oral baclofen (42 patients) or a placebo (42 patients). Total alcohol abstinence and duration of this abstinence were assessed during outpatient visits. Relapse was defined as alcohol intake of more than four standard drinks per day (a standard drink defined as equal to 12 grams of absolute alcohol) or overall consumption of 14 or more standard drinks per week over a period of at least four weeks. Among those taking baclofen, 71 percent (30 of 42 patients) achieved and maintained alcohol abstinence, compared to 29 percent (12 of 42) of those who took the placebo. The study also found that patients taking baclofen abstained from alcohol for more than twice as long as those taking the placebo — 62.8 days vs. 30.8 days. More…  

What the Wiki??

Posted by Roberta Jewell
Categories: This 'n that

I love the Wikipedia concept: an online encyclopedia developed as a collaborative effort, editable by any and all Internet users. Because of its large number of volunteer editors and rather stringent policies, Wikipedia is generally considered as accurate an encyclopedia as any other. One of the benefits of this ‘living’ encyclopedia is that new information can be added continuously. Or so I thought. As it turns out, I had an opportunity to see the Wiki sausage being made and I’ve got to tell you, it was not very pretty. Here’s what happened:

Several months ago, I submitted an article explaining My Way Out to Wikipedia. I wanted to supplement existing entries about alcohol recovery treatment, most of which described traditional, mainstream programs like 12-step and inpatient care. I figured it made sense to add information about ours, as it is now considered a valid, stand-alone therapeutic approach. By this time, thousands of people around the world had adopted it. Many clinicians within the medical community had embraced it. We were finishing up work on a utility patent for the program. And last year, one of the largest media conglomerates on the planet attempted to acquire rights to our book because of their interest in the unique nature of our approach. I’m not bragging, I’m simply stating why I felt there was adequate interest and justification in placing a simple article in Wikipedia about this new alcohol recovery option. So I wrote and posted an overview, attempting to match in style and tone entries on similar topics.

A few weeks later I checked in and noted my entry had been deleted. I was new to Wikipedia but soon learned that because My Way Out might be considered controversial or commercial, someone (a “competitor” or an individual opposed to the approach) may have lobbied an editor to have it removed.

Commercial I could almost understand–we do have an online store; it’s our primary means of selling and distributing our book. But anyone familiar with our program knows we have always urged individuals to purchase products from whatever source they wish–to find the highest quality goods at the best price possible. I had certainly not promoted the health store in my article; in fact, I had taken painstaking efforts to write the piece in the most objective manner. The point in explaining the program was to encourage alcohol dependent individuals to consider a multi-faceted approach because it had not been formally introduced prior to our program. In a nutshell, we promote a blended therapy that includes a specific regimen of nutritional supplements (vitamins, minerals, amino acids and herbs); anti-craving medication if appropriate; self-administered hypnotherapy; light exercise; and a change in diet. It’s a powerful, comprehensive system and it tackles alcoholism much like you do diabetes, with medicine, nutrition, and behavior modification. In addition, we believe support is important–it can take place in face-to-face meetings or online, whichever an individual prefers. The program is highly customizable and that’s one of the things that makes it very popular. Some drinkers adopt My Way Out to achieve total abstinence while others seek moderated drinking.

So I had tried to explain the program, but perhaps I hadn’t done so with proper objectivity. Or I hadn’t adequately addressed the controversial aspects. However, isn’t that the nature of much new science? Our program is founded on the work of some of today’s most respected specialists in addiction research; men and women whose work has been published in prestigious medical journals. Didn’t we deserve an opportunity to share this? Were other innovative medical treatments excluded from books of learning or was ours somehow different because of the stigma associated with alcoholism?

This seemed the ultimate irony to me. This was the public’s encyclopedia, yet our voice was not to be heard. Nor was I allowed to share a program with those who most needed help–those who had suffered for so long but could not find help and would not find help if Wikipedia had anything to say about it.

So I started over. I assumed I must have done something wrong and that it was simply too difficult for me to be objective. Perhaps I was not able to describe without passion a program for which I felt so passionately. I decided I must hire an expert. I searched until I found a writer and designer (yes, you “design” the articles) who were well versed in–of all things–writing for Wikipedia. They told me, that indeed, Wikipedia had become a fickle task master but they were confident given the legitimacy and success of our program we’d have no problem.

Several days later, after much back and forth, the writer presented me with a brilliant article. It was Wiki dry, objective, and rife in citations, sources, and references–many more than my original–plus a design to match that of the respectable Alcoholics Anonymous entry that had clearly gained immediate access upon entry. I could not have been more pleased. The designer went to work and submitted our article the following day.

The next morning I receive her email. “You won’t be happy to hear this,” she wrote. “The Wikipedia editor deleted the article. They consider it spam.”

Just like that.

I have come to believe that Wikipedia has made its redress process so incredibly cumbersome and painful to an average user that they understand you will simply give up and go away when your article is rejected. But I had to know why this had happened. Again. Why?

Perhaps I’m jumping to conclusions, but it seemed fairly easy to figure out. I looked at the name of the editor who so quickly dismissed the article and read his bio. As luck would have it, our submission landed on the virtual desk of an editor who happens to be–of all things–a physician from the UK. (He boasted, as well, about his status as a bureaucrat.) But when I learned he was a doctor I thought of the many dozens of messages and emails I’d read from members of our online community posting from the British Isles. Patients excited about the prospect of overcoming their drinking problem with My Way Out, but who had left their doctors’ offices in despair. They were not given anti-craving medication upon requesting it; they were often told the program was without foundation; they were provided little to nothing in terms of help or support. This happens all over the world, of course, and I know there are many caring, compassionate and enlightened British physicians. But I have noted what appears to be a disproportionate number of patients in the UK who are simply unable to find help. There, where alcoholism rates continue to soar. I have even heard from some who tell me they have actually lied to their doctors, claiming to suffer from migraine headaches, so desperate are they to receive an off-label prescription for the anti-craving medication, Topamax.

So what to do. Wikipedia encourages authors to contact individual editors in cases like this. So I did and I pled my case. Dr. Bureaucrat never wrote back. I emailed another editor, asking him to override the decision. Again, nothing. I wrote to a third requesting my article be temporarily re-instated so it could be reviewed by a supervisory team. It was not–instead I received an esoteric message in support of the original decision.

I have come to reassess my opinion of Wikipedia and must wonder how many other articles arrive DOA or are colored by the opinions of the selecting editors.

There is a silver lining to this story, however. As I looked around, I found a new resource called “Wiki How”. It’s unrelated to Wiki. The format is less formal and it presents itself as a “how-to” manual. Interestingly, some articles posted there are ranked even higher on a Google search, at least this week. Which means it may be easier for those who are looking for information about our program to find it.

So I decided I’d cut my losses and write yet another article. A number of entries already existed, including “How to Quit Drinking”, “How to Quit Drinking without AA” and “How to Get Sober with a 12 Step Program”, so I focused on “How to Quit Drinking Alcohol Using Anti Craving Medications“. I figured I could write about an important component of our program and one we are often asked about, while including many of the same citations I listed in the original article.

Do me a favor: go check it out and provide some feedback. I invite you to participate in the discussion, add links if you like–you may even edit the article if you have valid content to offer. By contributing, you honor the true collaborative concept upon which Wikipedia was founded–but to which it apparently no longer subscribes.

We’ve come a long way in two years

Posted by Roberta Jewell
Categories: Medications and research

It’s been interesting, this past week, watching the plethora of news stories roll in about Topamax and its potential for treating alcohol dependence. Patients of the My Way Out program have known about this for over two years. I based my book and the therapy I developed around Dr. Bankole Johnson’s 2003 clinical trial as published in The Lancet. It’s always puzzled me that outside of our program and the esoteric work of addiction specialists, his original breakthrough study didn’t gain more notoriety among physicians and their alcoholic patients. We’ve found it to be an extremely effective medication for many alcohol dependent individuals, particularly when it’s used in the context of a multi-faceted program with nutritional supplementation, exercise, behavior modification and support.

So…fast forward four years and here we are. Topamax, does indeed curb the desire to drink. In the meantime, other medications including Campral, Revia, Acomplia, Baclofen and Chantix have also been introduced and found helpful.

Research takes time. I get that. I understand it’s important we adopt rigorous standards when testing new meds. We need to ensure objective results and safeguard those who will eventually trust their health to those remarkable little pills that dance on the receptors of our mid-brains.

But like many people, I wanted results faster than science was willing to offer. It’s one of the reasons I grabbed the research at hand and ran with it. I mixed it up with some rather non-traditional strategies–at least at the time–and incorporated elements from the far East, including kudzu, an herb known by practitioners of Traditional Chinese Medicine. They’d used it for hundreds of years to blunt alcohol craving, so I did too. It has since been proven effective in human studies in the west and is only one of several important nutritional supplements to help detoxify and heal the body while addressing addiction.

I looked also at what holistic medicine had to offer and added hypnotherapy to the program. It’s a powerful tool in overriding old habits while overpowering drinking triggers. Exercise and nutrition were equally important as elements of this newfangled system.

Then came the technology. The online forum. The place to meet for those lab rats brave enough to try all this out. It’s also where much of the magic happens. Even a traditional alcohol recovery counselor will tell you that success in sobriety is very much dependent on a support system. Thousands of people from around the world have found that very thing at My Way Out’s message board and I’m very proud of what happens there each and every day. The support, camaraderie and information sharing are unparalleled.

Our members are often individuals who will not attend face-to-face 12-step meetings. For them, we offer a safe, anonymous and supportive alternative. That is not to say our site is mutually exclusive of local meetings or sponsors. Those are often lifelines for individuals in recovery and in fact, our members sometimes encourage others to seek help at a community AA or Women For Sobriety meetings. We are all about choice.

So what’s next? I certainly have no shortage of ideas. The same is true of Dr. Linda Garcia, MD, the Medical Director of My Way Out, who is called upon to speak about the program, and does so throughout the United States. We have found that health care providers are eager to learn about effective new strategies in addiction treatment, particularly those that are inexpensive and easily managed. This is certainly the case for MWO, which can be administered by any prescribing clinician.

I’ve learned much since writing My Way Out, and to be honest, I do not aspire to write another book (having never aspired to write the first!) because the process simply takes too long. But I do have much to say.

My goal is to continue to refine the MWO program to help ensure individual success for everyone who seeks help by it. I want to provide specific resources in terms of research, motivation, products, and guidance that will not only give people hope that they can overcome their alcohol dependence, but will guarantee their success. We don’t use that word–guarentee–in this “industry”. It’s not allowed. But I don’t care. Because I think we have to continue breaking rules if we want to win this battle. We have to see ourselves healthy and know it will happen before we take that very first step. In my heart, I am convinced that is just as important as any pill that any company will ever develop.

If you don’t believe me, just go to the forum and read the posts of those who have followed the program, or modified it to their needs, and take note of those who are now posting about their success. Notice their user names. Observe their “mood” icons. Read those messages. Feel that energy. You’ll see a pattern, I promise.

That’s not something I wrote about in my book. But it’s equally important. Those individual teach all of us something. And they reminds us of just how far we’ve really come.

It’s time to change the label

Posted by Roberta Jewell
Categories: Medications and research

labelLabeling someone is usually not politically correct, but occasionally it can help debunk an old stereotype. Take alcoholics for example. Until now, conventional treatment for alcohol dependence has been centered around 12-step programs, in-patient care, or a drug that makes you throw up. These strategies have been considered the most effective in helping the typical alcoholic — that middle aged, late stage drinker — in overcoming his or her battle with the bottle. Problem is: most alcoholics don’t fit that mold.

New research from the National Institute on Alcohol Abuse and Alcoholism has identified five alcoholic subtypes. It turns out chronic, late stage alcoholics represent less than ten percent of the overall alcoholic population. In a nutshell, here’s what researchers found:

“The young adult subtype accounts for about 32 percent of U.S. alcoholics. They’re young adults who rarely seek help for alcohol dependence. About 24 years old, they became alcoholics by age 20, on average. They drink less frequently than other alcoholics, but they tend to binge drink when they drink. This is the largest subtype.

The young antisocial subtype comprises 21 percent of U.S. alcoholics. They are 26 years old, on average. More than half have antisocial personality disorder. They tended to start drinking at 15 and became alcoholics by 18 — earlier than other subtypes. They are more likely to smoke tobacco and pot. The young antisocial subtype and the young adult subtype don’t overlap, Moss tells WebMD.

The functional subtype accounts for about 19 percent of U.S. alcoholics. They’re generally middle-aged, working adults who tend to have stable relationships, more education, and higher incomes than other alcoholics. They tend to drink every other day, often consuming five or more drinks on drinking days.

The intermediate familial subtype makes up nearly 19 percent of U.S. alcoholics. Nearly half have close relatives who are alcoholics. Alcoholics in this subtype typically began drinking by 17 and became alcoholics in their early 30s.

The chronic severe subtype is the rarest subtype, accounting for about 9 percent of U.S. alcoholics. This subtype mainly includes men, has the highest divorce rate, and frequently includes users of illicit drugs.”

Study author Howard Moss, M.D., agrees that in all cases, “alcohol dependence must be viewed as a severe disease with a significant adverse impact on health and well-being.”

We’re glad to see these distinctions identified so appropriate care can be provided. Many young adult, middle age, and highly functional alcoholics visit our website and join our program. As a general rule, they have refused conventional treatment because they don’t feel they fit the stereotype of a traditional alcoholic. Many categorically reject existing options which force them to quit drinking completely or attend meetings that offend their sensibilities. So the downward spiral continues.

Interestingly, once those same individuals begin a course of customized therapy, many ultimately decide they want to eliminate alcohol from their lives forever. They gain control, insight, and support on their path to health. Some even follow up with fellowship based meetings in addition to the free online support we provide. But they’ve begun a program of healing with a therapy tailored to their needs. No more cookie cutter assumptions about what defines an alcoholic or how best to treat them.

Vivitrol continues to perform

Posted by Roberta Jewell
Categories: Medications and research

Vivitrol

John started drinking as a teenager, stealing booze from his parents’ liquor cabinet. Once he became an adult, his problem only worsened, ultimately wreaking havoc on his personal and professional lives.  

“I was staying out late, coming home drunk,” said John, 62, a married Bergen County, N.J., businessman who requested that his last name not be used.

Today, John says, he hasn’t touched a drink in almost six months. And he points to his backside while making that declaration of sobriety.

Once a month, John receives a shot in his buttocks that seems to turn off his craving. Vivitrol is the first-ever injectable medication for alcohol dependence.

Approved by the federal Food and Drug Administration in April 2006, Vivitrol is an injectable version of an oral medication — naltrexone — which has been used for more than a decade.

Doctors think Vivitrol works by blocking neurotransmitters in the brain associated with alcohol dependence.

Some patients who have tried to drink while taking the injections no longer report a “buzz.”

It’s not right for everyone

“One of my patients said it was like drinking lemonade,” said Sharad Wagle, chief of psychiatry at Holy Name Hospital in Teaneck, N.J.

Raye Litten, associate director of the Division of Treatment and Recovery Research at the National Institutes of Health, said that though Vivitrol won’t work for everyone, “it gives clinicians a greater menu of medications to choose from.”

Some addiction specialists are giving it even higher marks.

Because the shot is given in the privacy of a doctor’s office and the effects in the body last the entire month at an accepted therapeutic range, the social stigma associated with being an alcoholic is virtually removed, they say.

“It legitimizes the disease, and you don’t have to feel demoralized,” said Hugo Franco, a staff psychiatrist at the Carrier Clinic, an addiction treatment facility in Belle Mead, N.J.

Even when people do reach out for help, they can still be resistant to treatment, said Jeffrey Berman, president of the New Jersey Society of Addiction Medicine. “Patients might fill the prescription, but then it winds up sitting in the medicine cabinet.”

Of 24 patients he has treated with Vivitrol, 12 have remained off alcohol.

Six others relapsed and are no longer in treatment.

Six others “binged” but immediately got back into treatment, he said.

“It’s not a silver bullet,” Berman said.

Tempting environments

Since John started getting his shots, he reports, he has been in plenty of situations where he might have been tempted to drink. He even admits he has a “burning desire” to try it just to see what happens, but he doesn’t yet feel he’s strong enough. 

“I have been in bars and at parties where I talk it (Vivitrol) up while I’m drinking club soda and lime,” he said.

One day, John hopes to stop the injections.

“I’m almost over the hump,” he said.

John’s doctor, family physician and addiction specialist Aleksandr Martirosov, who practices in Fair Lawn, N.J., says most of his patients are giving him positive feedback: “They say it’s working.”