Excellent article re: new treatment approaches
Bumping this old 2007 thread.
Its interesting (at least to me) for a number of reasons:
1 I hadn't seen the 2006 NYT Magazine article before now. It is a pretty comprehensive review of what was known about addiction and medical treatment for addiction at the time. Here's the link:
An Anti-Addiction Pill? - New York Times
2 Baclofen therapy was barely known at that time. But in many ways not much has seemed to change. The GABA link was not much discussed. The article focusses more on the connection between dopamine and craving.
3 One speaker said: "In 5 or 10 years, we will be treating addiction very differently," predicts Nora Volkow, a psychiatrist and the director of the institute on drug abuse, who attended the M.I.T. conference and presented a lecture, 'Addiction: The Neurobiology of Free Will Gone Awry...' " Well? Five years have passed...How much progress has been made? It seems that most alcoholics still must find their way through the maze to a place like mwo if they are seeking a medical/pharmacological solution. And then use off shore pharmacies and internet support instead of professional care.
4 A sponsor of the conference was the "Picower Institute" at MIT. I believe Mr Picower was an early investor with Bernie Madoff and if memory serves he (or his family) reached an enormous settlement with the Madoff trustee. So Picower may not be in a position to fund more conferences.
5 The thread contains a post from Roberta Jewell, who, I guess, was more actively involved in mwo back in 2007.
6 The article also refers to a company called Hythiam which back in 2006 had a potential cure called Prometa. Here's what it says:
"Hythiam, a Los Angeles-based health care services management company that made national news in the spring when it plastered Chris Farley's face — with the words "It Wasn't All His Fault" — on a series of Los Angeles billboards, is particularly interested in GABA's role in addiction. The company is aggressively marketing its Prometa protocol for cocaine, alcohol and methamphetamine addiction, which involves therapy and medications, both oral and intravenously injected, not usually used to treat addiction: flumazenil, approved by the F.D.A. to treat overdoses of Valium and Xanax, and gabapentin, approved to relieve neuropathic pain".
"While no double-blind placebo studies have tested Prometa's effectiveness (two are under way), addiction-medicine doctors around the country who have administered the protocol report encouraging results. Prometa appears to reduce anxiety and craving by enhancing the brain's GABA receptors, says David Smith, the former president of the American Society of Addiction Medicine and now the director for medical affairs at Hythiam and the head of a Prometa treatment center in Los Angeles. Sanjay Sabnani, Hythiam's senior vice president for strategic development, says: 'It's all hypothesis at this point, because we haven't sliced open anyone's brain yet, but it seems that normalizing the GABA receptor takes away the craving and anxiety that one would typically experience in the absence of the drug. And it doesn't appear to be happening because of will power, love, God, discipline, family support or anything else. It seems to be happening because the protocol resets a faulty mechanism in the brain.' Yet, several addiction scientists told me they were skeptical that Prometa works, and some criticized Hythiam for promoting it before it has been rigorously tested".
Hythiam is still around, as is Prometa (link: Prometa - Wikipedia, the free encyclopedia), but the company is now called Catasys, Inc. Here's a link to the Catasys website:
Specialized Health Management Services
7 Hythiam/Catasys/Prometa got a lot of hype around 2008 including a story on 60 Minutes. Here is a link to the 60 Minutes story:
Prescription For Addiction - CBS News
Apparently, Hythiam's stock price soared and then crashed amidst allegations of conflict of interest and uncertain effectiveness. Prometa is still around but there doesn't seem to have ever been solid proof of efficacy and, notwithstanding Hythiam's purported interest in GABA at the time of the NY Times Magazine article, its website and literature is absolutely silent on baclofen...presumably because baclofen treatment is not patentable. So much for commercial solutions...
Interestingly, I had urged 60 Minutes last summer to do a story on baclofen. They turned me down on the grounds that the evidence of efficacy is still "anecdotal". But it may also be that they were burned by the Hythiam story and are now reluctant to get out in front on another "pill" story until there is more "scientific" evidence.
Anyway... I am mainly bumping the thread for informational purposes to remind us all of the enormous and well-understood potential for good in medical treatment of alcoholism and how complicated and elusive the goal of bringing that treatment into the mainstream seems to be.
Cassander
Bumping this old 2007 thread.
Its interesting (at least to me) for a number of reasons:
1 I hadn't seen the 2006 NYT Magazine article before now. It is a pretty comprehensive review of what was known about addiction and medical treatment for addiction at the time. Here's the link:
An Anti-Addiction Pill? - New York Times
2 Baclofen therapy was barely known at that time. But in many ways not much has seemed to change. The GABA link was not much discussed. The article focusses more on the connection between dopamine and craving.
3 One speaker said: "In 5 or 10 years, we will be treating addiction very differently," predicts Nora Volkow, a psychiatrist and the director of the institute on drug abuse, who attended the M.I.T. conference and presented a lecture, 'Addiction: The Neurobiology of Free Will Gone Awry...' " Well? Five years have passed...How much progress has been made? It seems that most alcoholics still must find their way through the maze to a place like mwo if they are seeking a medical/pharmacological solution. And then use off shore pharmacies and internet support instead of professional care.
4 A sponsor of the conference was the "Picower Institute" at MIT. I believe Mr Picower was an early investor with Bernie Madoff and if memory serves he (or his family) reached an enormous settlement with the Madoff trustee. So Picower may not be in a position to fund more conferences.
5 The thread contains a post from Roberta Jewell, who, I guess, was more actively involved in mwo back in 2007.
6 The article also refers to a company called Hythiam which back in 2006 had a potential cure called Prometa. Here's what it says:
"Hythiam, a Los Angeles-based health care services management company that made national news in the spring when it plastered Chris Farley's face — with the words "It Wasn't All His Fault" — on a series of Los Angeles billboards, is particularly interested in GABA's role in addiction. The company is aggressively marketing its Prometa protocol for cocaine, alcohol and methamphetamine addiction, which involves therapy and medications, both oral and intravenously injected, not usually used to treat addiction: flumazenil, approved by the F.D.A. to treat overdoses of Valium and Xanax, and gabapentin, approved to relieve neuropathic pain".
"While no double-blind placebo studies have tested Prometa's effectiveness (two are under way), addiction-medicine doctors around the country who have administered the protocol report encouraging results. Prometa appears to reduce anxiety and craving by enhancing the brain's GABA receptors, says David Smith, the former president of the American Society of Addiction Medicine and now the director for medical affairs at Hythiam and the head of a Prometa treatment center in Los Angeles. Sanjay Sabnani, Hythiam's senior vice president for strategic development, says: 'It's all hypothesis at this point, because we haven't sliced open anyone's brain yet, but it seems that normalizing the GABA receptor takes away the craving and anxiety that one would typically experience in the absence of the drug. And it doesn't appear to be happening because of will power, love, God, discipline, family support or anything else. It seems to be happening because the protocol resets a faulty mechanism in the brain.' Yet, several addiction scientists told me they were skeptical that Prometa works, and some criticized Hythiam for promoting it before it has been rigorously tested".
Hythiam is still around, as is Prometa (link: Prometa - Wikipedia, the free encyclopedia), but the company is now called Catasys, Inc. Here's a link to the Catasys website:
Specialized Health Management Services
7 Hythiam/Catasys/Prometa got a lot of hype around 2008 including a story on 60 Minutes. Here is a link to the 60 Minutes story:
Prescription For Addiction - CBS News
Apparently, Hythiam's stock price soared and then crashed amidst allegations of conflict of interest and uncertain effectiveness. Prometa is still around but there doesn't seem to have ever been solid proof of efficacy and, notwithstanding Hythiam's purported interest in GABA at the time of the NY Times Magazine article, its website and literature is absolutely silent on baclofen...presumably because baclofen treatment is not patentable. So much for commercial solutions...
Interestingly, I had urged 60 Minutes last summer to do a story on baclofen. They turned me down on the grounds that the evidence of efficacy is still "anecdotal". But it may also be that they were burned by the Hythiam story and are now reluctant to get out in front on another "pill" story until there is more "scientific" evidence.
Anyway... I am mainly bumping the thread for informational purposes to remind us all of the enormous and well-understood potential for good in medical treatment of alcoholism and how complicated and elusive the goal of bringing that treatment into the mainstream seems to be.
Cassander
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