Tuesday, December 21, 2010

Naltrexone: Part 2 of the Alcohol and Drug Pill



In the beginning of October 2010, I asked a public doctor to prescribe Naltrexone to me in order to support my decision to stop drinking. Naltrexone is a medicine that is used to treat narcotic or alcohol addiction. Because the treatment lasts for three months, I wrote the first part of this series at the end of October, and am following up now with part two at the end of November.
In part one; I described the effect of Naltrexone when mixed with alcohol as something like a sinus headache. I never felt anything physical that would have kept me from drinking. But experiencing a weird unpleasantness after I consumed alcohol reminded me daily that I was making an effort to drink less.
In November, I went ahead and drank heavily, and became very intoxicated. I felt a light euphoric “buzz” after about four strong consecutive drinks. After eight drinks, the alcohol affected me very suddenly and powerfully.  The pill’s mechanism to bind nerve receptors and block the chemicals in alcohol has a limited strength, and I consumed beyond that.
Death and coma are listed as warnings for people who are specifically taking Naltrexone to block opiates like heroin. The information supplied by the manufacturer states that if you insist on administering large doses of an opiate, you can go too far and overdose.
It does not state anything about administering large amounts of alcohol. But in my case, the effects are abnormally powerful.
Though I continue to take the pill daily, I don’t trust it anymore to physically stop me from getting drunk. My doctor, Dr. Castillo, warned me that an extra painful hangover is a side effect of drinking while on Naltrexone, but I do not experience that either. While in treatment, I do not detect any physical effect that stops me from wanting to drink.
However, on our follow-up appointment at the end of November, Dr. Castillo explained that Naltrexone does more than block alcohol. It also supplies a chemical that acts like a substitute for alcohol in the sense that it produces a calming effect over time.
After a night of heavy drinking, I used to wake up with an overwhelming hangover and obsession in my mind to go to the liquor store and buy more alcohol. But right now, even after becoming very intoxicated I do not wake up that way anymore.
I believe that the calming effect of Naltrexone helps reduce the physical craving on the following morning. For people who drink in the mornings and go on binges, this effect blocks those physical cravings.
The mental craving for alcohol is a social matter, where the presence of alcohol is expected and usually provided at gatherings. It is also a personal matter, based on individual choices that lead to drinking alone.
Relying on alcohol socially is a learned family tradition where there is some adult control. The acceptance of it in family parties leads to young people experimenting with it in order to form their own bonds. They often prove themselves as the “big partiers” who receive validation that way.
Socially, alcohol consumption is a marketing weapon that is unchallenged and extremely present in alcohol ads. Before 1996, liquor ads were banned for 50 years from broadcast media. Since then, they have made their way into major TV networks with some of the most iconic ad campaigns like Budweiser’s “wazzzuuuup.”
Unlike anti-cigarette smoking ads, there are no broadcast ads on any TV networks that warn against the unhealthy effects of alcohol. There are some ads that warn against driving drunk, and recently, few ads that promote community support groups like Alcoholics Anonymous.
According to the website for the Center for Science in the Public Interest – Alcohol Policies Project (www.cspinet.org/booze), ads for Smirnoff Ice began to air in the year 2000 on popular youth-oriented shows including “Dark Angel” and “Saturday Night Live.” Bacardi and Anheuser-Busch soon launched Bacardi Silver to compete with that.
Today, online alcohol ads and complete websites for alcohol products are the latest marketing tools. According to The New York Times article, Shaken and Stirred: For Liquor Campaigns, the Web’s the Thing (Elliot, June 22, 2007), MSN creators of shows like The Office are building websites for products like Chivas Royal.
In the article, new-brand marketing director for vodka products, Elwyn Gladstone, at Grant in New York, stated that the online target consumer is 25 to 35 years old and uses the internet more than TV. But in the same article, George A. Hacker, director for the Alcohol Policies Project at the Center for Science in the Public Interest states that Web alcohol advertising is “troublesome, given that the online world is frequently traveled by underage young people.”
Engine searches for Naltrexone will produce many results, including recent news reports on major networks like CNN. But getting introduced to Naltrexone through any advertising medium does not occur. Patients who are featured in news reports share a similar introduction to the treatment: through a personal friend or unconventional suggestion by a doctor. 
Naltrexone is not introduced through social self-help groups like AA. There are very few opportunities to study new options that can support someone who decides to stop consuming alcohol. Though alcohol is listed on many websites as one of America’s top legal deadly substances, the stigma over getting treatment and the competition against the social acceptance still won’t allow for many advertisements about its negative effects, or promotional information about new treatments.
My doctor mentioned AA when he prescribed Naltrexone in October. I told him that I did not attend AA meetings, and he did not suggest anything else. The manufacturer’s information states that “appropriate management of comorbid conditions, use of community based support groups, and good medication compliance” are factors that lead to success. However, there are no suggestions for support groups or one-on-one therapy.
Again, through a friend, I found a therapist in November and began seeing her weekly. I mentioned this to Dr. Castillo in our last appointment, and he said that therapy is a longer-term treatment that should be used after the Naltrexone treatment ends. 
My therapist is an intern at Fuller Seminary in Pasadena, who operates under the supervision of accredited psychologists, and only costs $35 per visit. I see her for the specific reasons to understand my past reliance on alcohol, and to explore my personal causes that lead to impulses and cravings to drink today.
After a month of visits, I am learning to foresee the kind of stress that builds up in my life, and use exercises that she provides to calm down and remain focused. I have taken on many professional and personal challenges on my own, and traveled to large cities including Los Angeles, San Francisco, Paris, and New York City. I have led the kind of life where opportunities have been more important than long-term friendships; and that has sometimes been very stressful and lonely.
I have been a very independent artist, writer, manager and entrepreneur. Using alcohol does not fit in with the original man who I see myself as. My therapist reminds me to maintain a congruency with how I identify myself.
Naltrexone is worth trying for anyone who also can’t identify with themselves as a drinker or drug user, but nevertheless, still experiences strong physical cravings. There are many new options today for people who have decided to drink less, but they are not popular; not even at Alcoholics Anonymous meetings. 
In this century, it would be brave to see young adults change the social and personal patterns of alcohol and drug use. I never had a preventive counseling program when I was young. I think a personal therapist is a great form of support now, and wonder how much more of an impact this kind of psychology can have earlier in young adults today.