CAPA Responds to the New York Times Article

This posting is in response to the recent New York Times article titled: Drugs to Aid Alcoholics See Little Use, Study Finds, which was published in the Health section on May 13, 2014.

All of the CAPA leaders were going to send a letter to the NYT expressing our concerns about this article with all of our names attached. After getting recommendations from experienced journalists, a much smaller response was sent. According to the NYT, about 98% of letter sent to them do not get published. They recommend a very small offering of about 150 words, which is not much when you are mad and want to argue a larger point!

Below is our original letter, which after reviewing the NYT submission requirements, would have never been published. However…because we have our own outlet – this website/blog – we basically have no limits related to word count.

Her it tis!

Dear NYT editor,

This letter is in response to the recent New York Times article titled: Drugs to Aid Alcoholics See Little Use, Study Finds, which was published in the Health section on May 13, 2014.

The reason we are responding to this article is to ensure readers of your paper as well as the community at large are best informed about addiction issues. The article raised some concerns for us. First we agree that people who need alcoholism treatment rarely seek it or receive it. There are a number of issues at work for this gap, which is beyond the scope of this response.

We want to raise awareness around the most important statement in the article, “The new research looked only at the effectiveness of the medications in combination with behavioral interventions like counseling and therapy.” When it comes to treating alcoholism, most interventions work in combination with behavioral interventions. Unfortunately, our medical model values pharmaceutical-based solutions to health and wellness problems.  The medical industry’s prescribe-first approach to treating addiction has not held up under rigorous study.

Also, the majority of clients entering addiction treatments across the U.S. do not limit their use to only alcohol, which is the focus of this article. The typical person needing treatment ingests multiple drugs, including alcohol. A large proportion of clients also enter treatment with multiple mental health problems. There is currently no scientific support to quickly provide these recommended drugs in community-based real world treatment settings. Along with the stated side effects “…nausea, dizziness and headaches,” there are no scientific outcome studies related to other possible side effects when mixing acamprosate and naltrexone with other prescribed medications.

Finally, the most alarming quote comes at the end from Dr. Bradley who is a senior investigator at the Group Health Research Institute in Seattle; she states, “Historically, treatment for alcoholism and other addictions has been relegated to support groups, rehabilitation centers and similar programs…But that is beginning to change as more doctors view addiction as a chronic illness that should be treated in a health care setting.”

What doctors are just beginning to learn – addiction is a chronic illness – “support groups, rehabilitation centers and similar programs,” have known for decades. We in CAPA and the larger addiction treatment field would strongly recommend against addiction being primarily treated in health care setting directed by MDs. Being guided by science, it is behavioral counseling and therapy that should be at the core of treatment followed by other empirically supported treatments, like medication assisted activities. If addiction treatment is relegated to health care settings, which Dr. Bradley recommends and has been attempted in the past, it will be pharmaceuticals first and therapy maybe.  The better recommendation is a collaborative approach where health care professionals and addiction specialists work together – led by science.

Community Academic Partnership on Addiction (CAPA)

David A. Patterson Silver Wolf (Adelv unegv Waya), PhD, Assistant Professor, Washington University in St Louis, Brown School

Mike Morrison, CEO, Bridgeway Behavioral Health

Bart Andrews, PhD, Director of Clinical Services, Behavioral Health Response

Howard Weissman, Executive Director, National Council on Alcoholism & Drug Abuse

Tom Etling, CEO, St Patrick Center

Lara Pennington, Executive Director, Queen of Peace Center

Tom Wickenhauser, CEO, Harris House

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