I woke up early this morning and was enjoying my coffee while waiting for the Sunday paper to be delivered.  I turned on the TV, watched the news and then started flipping through the program guide.  I found an infomercial that was coming on Court TV in a few minutes called “The Addiction Cure”.  Being involved in the treatment industry as well a recovering alcoholic, I was immediately curious.  I read a book by a gentleman named Chris Prentiss a couple of years ago called “The Alcoholism and Addiction Cure” and wondered if this paid infomercial might have some affiliation. 

As the program started, the host displayed a copy of the aforementioned book.  He gave a brief overview and then introduced Mr. Prentiss.  Chris Prentiss is the co-founder and co-executive director of Passages Malibu, a very expensive and upscale treatment center located in Malibu California with his son Pax.  Passages treats addictive behavior by addressing underlying psychological issues.  Their treatment is quite lengthy and very involved.  According to their website, they have a host of therapist with different specialties.  Among them are marriage and family therapist, hypnotherapist, chemical dependency counselors, spiritual therapist, continuing care counselors, acupuncturist, doctors, nurses, and client supervisors.  The facility is located on the Pacific Ocean and features a very upscale environment with manicured grounds and gourmet meals.   The cost of treatment at Passages is rumored to exceed $50,000 per month and is private pay.

The infomercial touts this book as a definitive permanent cure for addiction.  Mr. Prentiss states in his interview that by simply reading his book and applying it’s teachings that you can cure any addiction, regardless of the severity or peculiarities of the problem.  He says that it works for gambling, sex, drugs, alcohol, tobacco, dietary and any other addiction or compulsive behavior. 

He also tells the television audience that you can read the book and cure yourself.  He says that the book can be used by people that might be too busy at work or can’t find a babysitter so that they can go into treatment for their addiction.  I sat and watched all twenty eight minutes in total disbelief.  Why would someone with a high profile treatment facility like Passages resort to an infomercial to sell books?  I thought at first that it might be a genuine effort to help people defeat their chemical dependency but as the program progressed I was left with the impression that this was not the case but rather was designed to sell books at an inflated price.  At the end of the infomercial, the book was offered for $24.95 plus S&H.  It is listed as a $29.95 value.  I checked on Amazon and indeed the list is $29.95 but Amazon sells it for $19.77 in hardback and $10.85 in paperback.   

As I said earlier, I read the book a couple of years ago.  I consider it a very good and informative book with a non-traditional approach to recovery.  It is entertaining and an easy and compelling read.  The first few chapters describe in detail the addiction issues that Pax, the son, dealt with for a number of years.  Pax was cross addicted to several drugs during his youth and his particular problems culminated in Heroin addiction.  The remainder of the book talks about his recovery and the underlying reasons that were driving his addiction. 

“The Alcoholism and Addiction Cure” is an interesting book but it is far from a “cure” for alcoholism or addiction.  Chris Prentiss states in his infomercial that alcoholism is not a disease and that it was classified that way only to make it coverable by insurance companies.  If it is not a disease, how did he come up with a cure?   

Passages Malibu states on their homepage that they have the “highest success rate in the world” but they also employ “continuing care” counselors.  There is also an outpatient alcoholism treatment center in Atlanta that states that their program is eight times more effective than the national average.  They bill themselves as “The Nations Leading and Most Effective Alcoholism Counseling Alternative to 12 Step Alcohol Addiction Treatment and Counseling Programs”.  After completing their program and attaining one year of sobriety you are rewarded with a coveted “Gold D” for your efforts.  They say that after attending their program you are not in recovery, but “recovered”.

One would have to assume that neither of these facilities has any clients that relapse or returned to dependency.  I seriously doubt that this is the case.  I also have no idea how either of them can legitimately make the success claims of being “Number One.”  There are no ways to measure themselves against other treatment centers or programs.  Most treatment centers are not aware when a client relapses after an extended period of time because contact is usually lost.  I went through three treatment centers for alcoholism and never heard a word from any of them after I left the program.  AA keeps no records, nor do most other non-12 step support groups.

There are many treatment centers, programs and philosophy’s available to deal with addictions.  Some are very effective and some are not.  12-step or AA style of treatment works for some and is totally ineffective for others.  One must remember that AA has a phenomenal success rate when you consider that it is free and run by a group of recovering addicts with no psychological or professional training.  Most effective treatment centers that utilize the12-step treatment philosophy also provide counseling, medical, psychological and after care elements.  It is my belief that there is no definitive or perfect way to treat the disease.  Our treatment has many components and is individualized for each person.  All clients have different needs and it is our belief that there is no “one size fits all” answer.

You cannot permanently “cure” alcoholism or drug addiction.  Once you have crossed the threshold into chemical dependency several things occur both physically and psychologically.  It is not possible for an alcoholic to drink casually or responsibly, a Heroin addict to take pain pills, a gambler to go to Vegas or a sex addict to go to a brothel without returning to the dependency.  Addictive patterns can be altered, psychological issues can be addressed and dealt with, chemical substances can be removed from the system, the body can heal and a happy productive life can be resumed but alcoholics and addicts can never be totally cured.  If resumed, alcohol and drug consumption may be controlled for a short time but will eventually end up with the addict resuming the addictive behavior and again being fully involved in dependency. 

Many people who complete treatment for alcohol dependency blame relapses on unbearable cravings for alcohol.  The dependent person has usually been drinking for a reasonably long time and has a conditioned response to the alcohol cravings.  When actively drinking, the cravings were easy to deal with but what do you do now that you have been detoxed and treated for alcohol abuse?  One drink will virtually always culminate in a full blown relapse.  Some are short in duration and are caught prior to redeveloping physical alcohol dependence, others land the person back in the hospital for yet another detox. There are many tools available to help with cravings.  This article will discuss some of the methods and products available.   

Therapy – Traditional treatment rarely includes any therapy to modify behavior other than the twelve steps of Alcoholics Anonymous.  More contemporary and progressive treatment centers use psychotherapy and incorporate cognitive behavioral therapy.  Much of the alcohol dependence mechanism is controlled by repetitious or habitual behavior.  Most alcoholics have specific drinking conditions where the reward of alcohol has been used daily.  Modifying these conditions and helping the brain to learn a new behavior is extremely effective in remaining sober.  Cognitive Behavioral Therapy is used to help the dependent person learn new ways to react and behave that do not include alcohol. 

Medications – There are pharmaceuticals available which are effective in helping deal with alcohol cravings.  Among them are Naltrexone, Vivatrol, Campral and there are some early indications that Chantix may also be an effective anti-craving medication.  All of these drugs are used to occupy specific neuro-receptors that are responsible for the cravings.   

Naltrexone is an oral medication that occupies the opiate receptors in the brain and is also available in an injectible form known as Vivitrol.  This drug has proven very effective in helping reduce cravings in the majority of problem drinkers.  Many report that substantially all cravings have been abated but a small percentage of the people who have tried these medications report that they notice no reduction. 

Campral (acamprosate calcium) is another oral medication available to help reduce cravings.  The manufacturer states that the mechanism of Campral is not totally understood.  Alcohol inhibits activity of receptors called NMDARs (N-methyl-D-aspartate receptors) in a way which overproduction of these receptors is caused by excessive and prolonged alcohol consumption.  When alcohol is suddenly not present, these NMDARs become more active than normal.  Withdrawal from alcohol creates a surge in the release of neurotransmitters such as glutamate.  Campral is believed to help reduce this glutamate surge.  Again, it is effective in reducing cravings in some and in others it seems to have no effect. 

Some recent studies have indicated that promise is shown for a tobacco cessation medication called Chantix in treating alcohol cravings.  Chantix (varenicline) is a nicotinic receptor partial agonist that reduces the cravings and pleasurable effects of nicotine.  This drug is not currently indicated for alcohol cravings.  

Education – Most alcoholics have no idea what is going on with their body and brains as a result of their continued alcohol consumption.  Every attempt should be made to educate these individuals on the neurochemistry of alcohol addiction.  The more one knows about the effects that the abuse creates the more likely they are to make the difficult decision not to resume drinking. 

Nutrition – Nutrition plays a critical part in recovery from alcoholism.  Alcoholics tend to neglect nutritional needs in favor of alcohol.  The caloric content of alcohol often satisfies hunger and the dependent individual drinks rather than eating.  Alcohol contains no nutritional value and the body immediately converts any alcohol consumed into sugar.  The rapid introduction of sugar into the system raises blood sugar levels and gives the alcoholic a feeling of well being.  Rather than consuming protein and carbohydrates that are more gradually metabolized, the alcoholic drinks.  The alcohol burns rapidly and blood sugar drops dramatically causing the dependent person to feel weak, anxious and shaky, similar to the feeling a normal person gets when they are extremely hungry.  The metabolism of alcohol also depletes many vitamins and minerals.  Most alcoholics that enter treatment are severely deficient in many areas that are necessary in normal bodily functions.  Many are also pre-diabetic or hypoglycemic.  During early sobriety it is critical to address these deficiencies and resume a diet high in quality nutrients.  Supplements are also recommended to aid in the healing process.  Blood sugar irregularities are often confused for alcohol cravings. 

After accessing the individual’s specific needs, we use a combination of any or all of these components in early sobriety.  Psychotherapy, cognitive behavioral therapy, medications, education and nutrition can all play critical parts in recovery.  Often Campral and Naltrexone are used in combination to deal with cravings.  Pharmaceutical intervention and being nutritionally sound can virtually eliminate physiological cravings.  Psychological factors such as changing destructive behavior, dealing with issues that drive the addiction and understanding what is happening with your brain and body are the other often to frequently overlooked components.  Long term sobriety is rarely achieved by pharmaceutical intervention alone and must be accompanied by physiological and cognitive behavioral therapy.