Tuesday, August 26, 2008

Addiction is Individual; Treatment is Individual

Here are some bullets on today's briefing on alcoholism. The discussion was expanded to include other types of addiction.

*Dr. William Haning from the John A. Burns School of Medicine led off with a summary, and clarified what he said yesterday on the addictive quality of various substances. The chances of an individual getting hooked on a particular substance will vary significantly, of course, but the likelihood after the initial induction is 90% for cigarettes, 80-85% for crystal meth, and 10% for alcohol and marijuana.

*Gary Allen, Hawaii Business Health Council, said that his organization offers a counseling program for employees and employers for both alcohol and cigarette addiction.

*The Department of Health representative, Dr. Yamamoto, emphasized that while programs are available, many people can't afford them, and that private insurers need to step up and offer coverage for substance abuse programs and services. It all comes down to money.

Alan Johnson (left) and Dr. William Haning

*Alan Johnson, Hina Mauka, did a joint power point presentation with Dr. Haning. They covered the purpose of medication, which can help manage addiction but it is never enough.

*There are several drugs on the market for alcohol addiction, but they work in different ways. Naltrexone, taken orally or by injection, is also known by its brand name Vivitrol. It works to decrease the craving for alcohol. The injection is taken once a month, 300 mg. Disulfiram (Anatabuse) taken orally, works in the same way. Acamprosate (Campral) suppresses craving by making you deathly ill if you take it in conjunction with alcohol.

*The cost factor is significant; one shot of Vivitrol costs about $700-900 per shot/per month.

*One of the challenges is that the human brain naturally resists any chemistry changes. Every individual will react differently to medication. There are currently about 200 new medications that are being tracked and may be available in the next 5-10 years.

*The bottom line is that medication is no magic bullet, that physicians have found something that helps, but it's pricey.

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