An essential component of our program is the use of safe, approved and effective medications that have been shown to effectively improve treatment results.
Medications use by Y.E.S. are not "cures" in themselves but they do level the playing field, so to speak.
Currently the anti-alcohol medications recommended by Y.E.S. include: Naltrexone and Campral(r), these medications are available only by a prescription from a licensed physician and you can get them in our program through our medical consultants, physicians licensed in addiction medicine.
One of the primary investigators of medication assisted treatment for alcohol dependence is Joseph Volpicelli, MD, PhD, associate professor of psychiatry at the University of Pennsylvania. He explains that one of the reasons humans like to drink is for the endorphin "high" that alcohol causes. "When you drink, your brain releases these morphine-like compounds called endorphins," he says. "These... create the need to have another drink and cause the pleasurable effects of drinking."
Opiate antagonists, such as naltrexone, bind to the endorphin receptors in the brain -- the same parts that are stimulated by endorphins -- but do not activate them, Dr. Volpicelli explains. As a result, cravings are reduced, and if the alcoholic drinks, the sense of "high" is greatly reduced -- in some patients, by half. "When an alcoholic is taking naltrexone, if he doesn't drink, he doesn't feel anything," says Dr. Volpicelli. "But if he does drink, it tastes different in a way he can't describe; it just doesn't hit the spot anymore. He will start sipping the drink and will do something he has never done before: leave the drink on the bar half-empty."
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Conquering the Craving:
Pharmacotherapies Treat Alcohol Addiction
by Leah Shafer
Rx.com Magazine, 2000
Overcoming the enormous hurdle of alcohol addiction usually means a period of white-knuckled craving during which the goal is simple, though not easy: to make it moment-to-moment without a drink. Of the one million Americans treated each year for alcoholism, almost 50 percent start drinking again in the first few months of sobriety. But naltrexone, among a class of medications called opiate antagonists, appears to offer hope to alcoholics and has garnered the attention of the medical community. When compared with a placebo in clinical trials, naltrexone consistently reduced the rate of relapse to heavy drinking as well as the frequency of drinking. Opiate antagonists have been used for more than 20 years to help people kick addictions to drugs such as heroin and morphine. Researchers express excitement about the potential of these medications to treat alcohol addiction as well.
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Naltrexone: Not a Magic Bullet, But Still Pretty Darn Good
By Dr. Edward W. Wilson, Clinical Director, Y.E.S.
As the treatment of alcohol-related conditions has become more sophisticated, the use of medications has too. Until recently the only commonly prescribed adjunct was disulfiram (Antabuse), an aversive drug whose use resulted in violent illness when combined with even trace amounts of alcohol. That worked for those willing to risk the results and fit well with the frequently punitive nature of many treatment regimens.
Currently, however, a preferable alternative has appeared. Naltrexone (ReVia) affects drinking behaviors in two non-aversive ways. First, it functions in somewhat the same way nicotine patches do for smokers, it cuts the craving for alcohol. Second, it interferes with the brain's feeling of wellbeing that is associated with drinking. Simply put, one has less desire to drink and none of the usual rewards from drinking.
Because of its two-pronged, but non-aversive, effects, Naltrexone has also been found to be effective in helping some people moderate their alcohol use. Obviously, with cravings gone and effects muted, many drinkers will find their consumption declining. Less drinking tends to free up time for other activities and some find themselves easing back out of alcohol abuse and dependence in much the same way they fell into it.
But it isn't a magic bullet.
The usual problems associated with any medication occur with Naltrexone too. Many people will take the meds for a period of time then stop, with the result that the old behaviors reassert themselves. Obviously, if the effects of drinking are curtailed, then the choice is to do something else or rekindle the effects. Most people find it easier to stop taking their meds than to develop new interests.
Consequently, Naltrexone, like Antabuse and Campral, works best as a support in conjunction with competent professional counseling whether the goal is abstinence or moderation. Generally speaking, this will involve short-term cognitive behavioral therapy (CBT) in an outpatient setting. Ideally, the Naltrexone phase in a person's behavioral change program should last from three to six months with a gradual phase-out. The actual time will, of course, vary with different individuals, but the timing is flexible and can easily be tailored to preferences or needs.
The establishment of real change takes about a year (see Prochaska, Norcross, and DiClemente: Changing For Good) and a gradual transition away from medical and therapeutic support is usually most effective. The success that people achieve is, after all, usually based on motivation, support, knowledge, and the assumption of responsibility for one's own continued wellbeing. All of these components are most effectively created with accountability and insight, along with the introduction of new and rewarding social and recreational activities.
No, Naltrexone isn't a magic bullet but it does help create a window of opportunity - a window that will close unless it is used. Opportunity with planning, activity, support, and, yes, good humor, will make change possible. It won't always be fun. It will be frustrating and difficult at times - just ask any ex-smoker - but a renewed life can also be a tremendous gift both to oneself and everyone around them.
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