Treatment Abuse, Behavior Modification, Thought Reform > The Troubled Teen Industry
Memorial Hermann Prevention & Recovery Center
woodbury reports:
Prometa - A Promising Treatment for Alcohol and Stimulant Dependence
by Matt Feehery
As new and updated treatments are integrated into the array of services offered for persons with chemical dependencies, it is imperative that treatment professionals educate themselves about them. We need to become familiar with these new technologies for many reasons, one reason being that consumers themselves are spending more time researching their treatment options before engaging a treatment service or program.
Matt FeeheryA second and equally important reason is that people want to know what their options are. A knowledgeable treatment professional can help guide the potential patient or inquiring family member in the decision making process. In this publication, a variety of treatment approaches and models are regularly presented: food for both thought and individual research.
In the medical arena, we know there have been recent advances in the treatment of opiate dependence and that there are many new medications that can reduce alcohol cravings during the early stages of recovery. Another treatment that is gaining wider acceptance is a program marketed under the name Prometa. Prometa is designed to assist persons dealing with alcohol, cocaine, and methamphetamine dependence.
The most remarkable aspect of the treatment is the way it can help restore mental clarity and significantly reduce cravings. Crack cocaine and methamphetamine dependent persons, as well as some alcoholics, have an extremely difficult time dealing with substantial cravings both during withdrawal and post withdrawal. Combine with that the inability of some addicts to focus on the behavioral aspects of their treatment or follow through with treatment recommendations and it is easy to see why this treatment can offer some hope of relief.
The key to Prometa is the drug Flumazenil, a benzo antagonist that restores the function of the brain’s GABA receptors, the same receptors that are altered by exposure to alcohol or stimulant abuse. Flumazenil has been traditionally used to treat benzodiazepine overdose, such as Xanax and Valium, and this use is off-label for addictions. (Many of the medications commonly used for treating withdrawal symptoms and addictions were developed for other purposes, hence their “off-label” use.)
Prometa treatments are administered intravenously in a series of treatments targeted to the specific drug of use. Both start with a series of treatments over a three day period and the treatment for stimulant dependence is enhanced by two follow-up treatments three weeks later. It is the dosing schedule and administration cycle that makes the treatment unique and effective.
From my perspective and anecdotal experience with the treatment, Prometa affords some individuals with a quicker start to their recovery program, especially in the area of craving reduction. It is not a cure nor is it touted as one. It is not, in my opinion, a stand alone treatment. The person choosing Prometa must address the behavioral aspects of their disease and engage in a program of recovery to achieve the desired results over the long term, which is true of all treatment approaches. Prometa highlights the behavioral treatment component and also addresses the nutritional aspects of recovery health.
Hythiam, Inc., the publicly traded parent company of Prometa, has spent years and millions of dollars developing the program and funding research. Prometa has also gone through many marketing campaigns and missteps since its introduction over four years ago. With a lack of US-based clinical studies to support the claims and the perception of an overly aggressive marketing approach, clinicians and treatment centers were wary of the company’s intentions and its business structure. But marketplace acceptance may be more forthcoming as clinical studies are being completed and reported.
The effectiveness of Prometa medical treatments for alcohol dependent subjects is currently being evaluated in open label and double-blind placebo-controlled studies under the direction of Jeffrey Wilkins, MD at Cedars-Sinai Medical Center in Los Angeles. A similar clinical study testing efficacy for treatment of methamphetamine dependence is being conducted by Walter Ling, MD at UCLA’s Integrated Substance Abuse Program.
Results of these and other clinical studies are expected beginning in the fall of 2008. A previous open-label study conducted by Research Across America and released in 2007 dealt with the safety and efficacy of the pharmacological component and showed cravings reductions among methamphetamine users.
The Prometa treatment program can be accessed in both residential and outpatient settings and can be incorporated into other treatment modalities at almost any time during the treatment process. The medications are non-addictive and use is obviously short term. Prometa treatment program costs start around $13,000 and are offered by licensees in all areas of the country. To find a lincensee in your area go to http://www.prometainfo.com.
In a positive development, Prometa treatment programs, which have only been available on a private pay basis, will be covered through some of Cigna’s insurance plans in the near future. A number of other managed care providers are also in the process of considering the addition of Prometa to their covered treatments, which should improve accessibility and ultimately drive down the cost. In the last legislative session, the State of Texas approved funding for offering Prometa through some probation and parole programs.
The primary drawback has been its high cost, but even that argument can be countered when you consider the number of repeat treatment episodes that many chemically dependent persons experience or the low success rates achieved with methamphetamine dependent persons. Sometimes we need to try different approaches if we wish to achieve different results.
A secondary drawback involves consumers looking for a “quick fix” and that is not what Prometa is. Counseling patients prior to treatment is an important step in preparing them for the potential benefits and realities. People can and will relapse, so we must do our best to educate and prepare them, no matter what treatment they consider.
Memorial Hermann Prevention and Recovery Center (PaRC) Houston was the second Prometa licensee in the US and has nearly four years of experience with it. Prometa was initially recommended on a limited basis to people experiencing severe cravings post withdrawal, people who had been treated multiple times (chronic relapses), and people whose cognition was heavily impaired by substances. With these types of cases, valuable time in treatment is often lost due to the patient’s inability to engage in treatment sooner.
Over time, the treatment has become more widely recommended for others.
Prometa is another important treatment tool available to treatment professionals and their patients. That is what drew me to inquire about it at an American Society of Addiction Medicine (ASAM) conference over four years ago. I was intrigued by the medical and scientific aspects of Prometa and chose to investigate it. We are treating a brain disease and we need to have better medical tools to deal with it. No single treatment approach is entirely effective for all populations. If we commit ourselves to the bio-psycho-social-spiritual model of treatment and recovery, then we need to be aware of the new medicines and protocols that will enhance and improve the recovery process. When the physical aspects are better managed it is easier to address the behavioral aspects.
Matt Feehery, LCDC is CEO of Memorial Hermann Prevention and Recovery Center (PaRC) in Houston, 713-329-7300 http://www.mhparc.org Matt has worked in the treatment field for over 29 years and currently serves as a director on the TAAP State Board.
woodbury reports:
Contact PaRC
Speak with a knowledgeable PaRC representative at 713-939-7272 to learn more about how our comprehensive range of alcohol and drug rehab for adults and teens can help you. Or, complete the form at the right and we will contact you within the next business day.
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Houston, TX 77080
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http://www.orange-papers.org/orange-effectiveness.html
At the beginning of every Alcoholics Anonymous meeting, someone reads out loud a plastic-laminated document that says, among other things, that this Twelve-Step program has rarely been known to fail, except for a few unfortunate people who are "constitutionally incapable of being honest with themselves":
RARELY HAVE we seen a person fail who has thoroughly followed our path. Those who do not recover are those who cannot or will not give themselves completely to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way.
A.A. Big Book, 3rd & 4th Editions, William G. Wilson, page 58.
Nothing could be further from the truth. Even the most ardent true believers who will be honest about it recognize that A.A. and N.A. have at least 90% failure rates. And the real numbers are more like 95% or 98% or 100% failure rates. It depends on who is doing the counting, how they are counting, and what they are counting or measuring.
A 5% success rate is nothing more than the rate of spontaneous remission in alcoholics and drug addicts. That is, out of any given group of alcoholics or drug addicts, approximately 5% per year will just wise up, and quit killing themselves.6 They just get sick and tired of being sick and tired, and of watching their friends die. (And something between 1% and 3% of their friends do die annually, so that is a big incentive.) They often quit with little or no official treatment or help. Some actually detox themselves on their own couches, or in their own beds, or locked in their own closets. Often, they don't go to a lot of meetings. They just quit, all on their own, or with the help of a couple of good friends who keep them locked up for a few days while they go through withdrawal. A.A. and N.A. true believers insist that addicts can't successfully quit that way, but they do, every day.
Every disease has a spontaneous remission rate. The rate for the common cold is basically 100 percent — almost nobody ever dies just from a cold. People routinely just "get over it", naturally. Likewise, ordinary influenza — "the flu" — has a very high spontaneous remission rate, greater than 99%. Yes, some old people do die from the flu every year, but not very many. Most people just get over it.
On the other hand, diseases like cancer and Ebola have very low spontaneous remission rates — left untreated, they are very deadly and few people recover from them.
Alcoholism is in the middle. The Harvard Medical School reported that in the long run, the rate of spontaneous remission in alcoholics is slightly over 50 percent. That means that the annual rate of spontaneous remission is around 5 percent.
Thus, an alcoholism treatment program that seems to have a 5% success rate probably really has a zero percent success rate — it is just taking credit for the spontaneous remission that is happening anyway. It is taking the credit for the people who were going to quit anyway. And a program that has less than a five percent success rate, like four or three, may really have a negative success rate — it is actually keeping some people from succeeding in getting clean and sober. Any success rate that is less than the usual rate of spontaneous remission indicates a program that is a real disaster and is hurting the patients.
Continue reading article at: http://www.orange-papers.org/orange-effectiveness.html
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http://www.peele.net/lib/diseasing3.html
The actual scientific evidence, however, strongly contradicts the contentions of the alcoholism movement. or example, the standard wisdom is that AA is unmatched in effectiveness for dealing with alcoholism and that alcoholism would be licked is only everyone joined AA. Certainly, many people who belong to AA tell us that AA stopped them from drinking. However, this no more demonstrates the general effectiveness of AA than testimony that some people decide not to kill themselves after they discover Christ is evidence that Christianity is the cure for suicide. In fact, research has not found AA to be an effective treatment for general populations of alcoholics. Consider the following summary by researchers at the Downstate (New York) Medical Center Department of Psychiatry:
The general applicability of AA as a treatment method is much more limited than has been supposed in the past. Available data do not support AA's claims of much higher success rates than clinic treatment. Indeed, when population differences are taken into account, the reverse seems to be true.2
Not one study has even found AA or its derivatives to be superior to any other approach, or even to be better than not receiving any help at all for eliminating alcoholism when alcoholics are assigned to different kinds of treatment. At the same time, other methods that have regularly been found to be superior to AA and other standard therapies for alcoholism have been completely rejected by American treatment programs. To preview the startling proposition that therapies that are universally advocated have already been shown to be ineffective and that more effective approaches are available, consider the prevailing approach to drunk-driving convictions in America—remanding drinking drivers for treatment. Advocates of a humane, informed approach to the problem continually plead for more referrals and bemoan primitive programs that simply arrest, imprison, or place on probation those caught driving while intoxicated (DWI). Meanwhile, comparative studies of standard treatment programs versus legal proceedings for drunk drivers regularly find that those who received ordinary judicial sanctions had fewer subsequent accidents and were rearrested less.3
Continue reading article at: http://www.peele.net/lib/diseasing3.html
woodbury reports:
Your Teen Can Recover from Substance Abuse
http://parc.memorialhermann.org/drug-al ... ehab/teen/
"Each time we visit the PaRC we can see signs of our son – our true son – returning. It is in his eyes mostly.” - Veronica M., August 2010
Alcoholism and drug addiction are family diseases…and they are treatable. Your teen can recovery from substance abuse. You and your family can recover from the effects of the substance abuse.
PaRC’s specialty is substance abuse treatment. Our adolescent treatment program is respected, well-rounded, and aims to treat your teen and your family. Your teen receives comprehensive, individualized attention and treatment. You and your family receive the education, treatment, and guidance you need to remain healthy and focused while dealing with your teen’s alcohol or drug use.
Drug addiction and alcoholism are diseases that get worse and worse without treatment. Don't let your teen's disease progress any further. We urge you to take action and get help for your teen and your family now. The PaRC welcomes you. Come by our campus, take a tour, and get all the information you need to make an informed decision. Or simply speak with a knowledgeable PaRC representative at 713-939-7272 to learn how we help teens and their families each and every day.
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