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Stepping Away from 12-Step Programs

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Several doctors and researchers view addiction as a disease and urge addicts to take a more medical approach to detox and recovery than 12-step programs, which are not very effective treatment plans for addicts.

About 21 million Americans have a substance-abuse disorder that requires specialty treatment, according to statistics from the 2010 National Survey on Drug Use and Health. Ninety percent of people addicted to drugs other than nicotine do not receive treatment, and most of those who do seek treatment participate in unproven programs organized by people who do not have medical training, according to a report released in June by Columbia University. Conclusive data on the effectiveness of 12-step programs, the most popular recovery approach, are lacking, the report stated.

Director of the Office of National Drug Control Policy and President Barack Obama's top adviser on drug policy Gil Kerlikowske said in a speech given in June that addiction "is not a moral failing on the part of the individual. It's a chronic disease of the brain that can be treated."

Dr. Nora Volkow, chief of the National Institute on Drug Abuse, agrees that addiction is a chronic disorder, and she believes it requires multiple rounds of therapy to not only reduce the risk of relapse but also to lengthen periods of sobriety.

"Addiction is a very aggressive disease," she said. "We need to treat it aggressively. We do that for other diseases."

Several drugs to treat addictions have recently been approved, adding to the few already in use, including methadone for heroin addiction and Antabuse for alcoholism.

These new medications will encourage doctors to treat their patients' substance abuse problems as they would treat high blood sugar or high cholesterol. "You are killing two birds with one stone—giving tools to improve outcomes for the patient and giving tools to the physician, increasing the likelihood they will incorporate substance abuse disorders into their practice," Volkow said.

New Medications and Vaccines

Naltrexone, a pill for the treatment of alcoholism, was reformulated into a monthly injection called Vivitrol in 2006 and was approved for the treatment of opioid addiction in 2010. In studies, 36 percent of the opioid-addicted patients on Vivitrol were able to stay in a treatment program for its six-month duration, compared with 23 percent of the patients receiving a placebo injection—a significant improvement, according to experts.

A pharmaceutical company in San Francisco plans to seek FDA approval of an implant that would provide continuous delivery of the drug buprenorphine—known as Suboxone in its pill form—for six months to people recovering from addiction to heroin or prescription painkillers.

The National Institute on Drug Abuse is in the process of developing vaccines to fight addiction to nicotine, cocaine, heroin, and methamphetamine. The vaccines are designed to trigger an immune response to a specific substance so that it is unable to reach the brain and elicit a pleasure response, causing cravings to lessen over time.

Source: Medical Xpress