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Can We Use Drugs to Treat Addiction?

Are we in the middle of a cultural and medicinal shift in how we both view and treat people with addiction? Will addiction have that Prozac moment?

Radiolab is a dazzling radio show and podcast originating from WNYC in New York and syndicated across many markets on local NPR stations. It is an auditory adventure that tackles topics in science and philosophy and blends interviews, storytelling and excellent production to create a thoroughly entertaining and interesting broadcast. A recent episode entitled “The Fix” (click to listen to this interesting episode) uses three separate stories to look at addiction and the possibility of using different drugs to treat addiction.

The first story speaks with a former Radiolab producer who is now the editorial director at Upworthy. She discusses a relationship with an alcoholic and how that experience led her to read The End of My Addiction, a book by a French cardiologist that had his career and life ruined by alcoholism. This doctor read a small article where a cocaine addict used muscle relaxers for an injury and found that they ended his cravings for cocaine. The doctor experimented on himself by gradually increasing the dose of baclofen until his desire for alcohol ceased.

Radiolab hosts go on to ask, “We see addiction as this thing we have to morally conquer - like a spiritual calamity. What if drug addiction is just a switch in your brain that got stuck in the on position and you can use a pill to switch it off?”

Dr Anna Rose Childress, addiction researcher at University of Pennsylvania, used baclofen to treat crack addicts. This began when she happened upon a patient taking baclofen to help with muscle spasms. He was a cocaine addict that was shot several times and left in a wheelchair. This patient found on his own that when he doubled the dose of the muscle relaxer he had no desire for cocaine. He tried to use it, but didn’t want to. When he lowered the dose of medication the cravings for cocaine came back strong. Despite lack of study. doctors are now prescribing baclofen and other drugs off-label because of the positive effects on those suffering with addiction.

Apparently there are a slew of drugs that are being used. These drugs either target the high or the urge. By blocking the good feelings someone would get from heroin or alcohol it renders the drug useless.

In fact, naltrexone has a 78% success rate in helping heavy drinkers reduce their drinking to normal levels. These drugs are out there, and they have been around for awhile. How is it possible in our prescription crazy, big pharma fueled society that these aren’t prevalent and helping people fight the disease of addiction? In the US, maybe 1% of alcoholics are given the choice of medication. The answer is somewhere along the way, addiction medicine was completely separated from the rest of medicine. Essentially, Radiolab presents the question; is addiction a purely biological problem or a reflection of a personal crisis of the mind and soul?

Next, they weave in the topic of Alcoholics Anonymous. They begin with the history. As tuberculosis is defeated, the space that was once TB wards opens up. Just prior to this a group of mostly men got together to form what is now known as AA. These AA members begin to ask if the can use the vacated TB wards as alcoholism units. Since doctors are flummoxed by the issue they agree to let them use the space. Writer, Gabrielle Glaser, marks this as the beginning of the separation between traditional medical practice and addiction medicine. So the division between the medical approach and the AA tactics is codified. Her article for The Atlantic, The Irrationality of Alcoholics Anonymous, takes a deeper look at the 12-step process and approach –including using total abstinence and religion–its failures, and the need to embrace the medical approach to treatment of addiction as a disease.

Radiolab opens this topic up to the public via The Brian Leher Show in New York. They ask to hear from people that struggle with substance abuse; what is their story, what were they given to treat it? You can see how the topic polarizes the recovery community. The idea here is that if pills work to cure addiction the people are simply sick, not bad people.

This is an intriguing listen because the medicinal treatment of addiction supports Runwell’s mission to address addiction as a disease and fight the stigmas associated with substance abuse. Will the medical approach to treating addiction, coupled with the networking and support of groups like AA, be the answer to defeat addiction?

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