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.

Alcoholism in Hawaii

The House Health Committee will hold an informational briefing on Alcoholism in Hawaii and the reasons why Hawaii has one of the highest rates of drunken driving in the nation.

The focus will be on options to reduce alcoholism in the areas of prevention, treatment and recovery. The committee will also review the efficacy of Vivitrol, a promising new medication taken by injection once a month, which may be used in conjunction with a treatment program.

WHEN: Tuesday, August 26, 2008 - 10:00 a.m.

WHERE: State Capitol, Conference Room 309

WHO: The following organizations/representatives have been invited to participate:

William Haning, M.D. John A. Burns School of Medicine
Alan Johnson, CEO, Hina Mauka
State Department of Health
Honolulu Police Chief
Cephalon, Inc.
Hawaii Business Health Council

Rethinking the Drinking Age; Health Committee Reviews Vivitrol

Did we hear right? Six college presidents in Maryland, including the president of Johns Hopkins University, say the drinking age of 21 is not working and that it's time to consider lowering the age. Or, at least rethink it. Their logic is that trying to enforce the age limit is impossible and only serves to drive kids to binge drink.

While each state has the authority to set its own drinking age, Congress passed a National Minimum Drinking Age Act in 1984 which penalizes states that lower the drinking age below 21. States that do will lose 10% of their federal highway monies. Since then, no state has lowered their drinking age. Here's the Hawaii statute.

According to this article in the Baltimore Sun, the Maryland college presidents will work toward repealing that law as part of next year's transportation authorization bill.

Meanwhile, here locally, the House Health Committee will hold an informational briefing next week on the issue of drunk driving and the efficacy of the drug Vivitrol. According to the hearing notice, a single monthly dose of Vivitrol, given by 300 mg intramuscular injection, is purported to reduce the craving for alcohol. A pilot program for employers, which includes retaining employees while in treatment and using Vivitrol, will be discussed.

When: Tuesday, August 26, 2008, 10:00 a.m.
Where: State Capitol, Room 309