Naltrexone (Part 3) – Why the Alcohol Pill Doesn’t Work

(Neltrexone Parts 1 and 2 were posted in November and December of 2010)

Our lives are filled with alcohol and we are very well trained at accepting the good things about it, while turning our embarrassed eyes away from the bad things. When compared to obese people and smokers, alcoholics don’t get much encouragement to change because they threaten our own reliance on social drinking. Even if everybody knows about him, an alcoholic can be avoided and played down. “A drink never hurt nobody” is still the way most adults think. But what do younger people think now with more drunk-driving reports and evidence in their families of the bad side of booze?

The stigma about alcohol that young people learn is that it is necessary in our social lives because it gets us accepted into groups of friends who like to have fun. Old people teach us that, like our parents, who we “rebel” against. Then advertisers, “who sell us stupid shit,” keep teaching us more.

The other stigma about alcohol is that it will turn you into an outcast when you “hit rock bottom.” People who can’t handle alcohol are not acceptable anymore. Help for alcoholics comes with a lot of baggage. Although it has surfaced on TV with shows like Celebrity Rehab and Intervention, help for alcoholism scares people. Aside from support groups like old Alcoholics Anonymous, we are still in uncharted territory.

I never completed the 3-month Neltrexone treatment because I knew that the pills didn’t stop me from getting drunk. It doesn’t work like a nicotine patch or a diet pill that suppresses cravings. Instead, it is supposed to block the effects of alcohol and opiates after you ingest them.

When you become aware that alcohol is hurting your life, not just your body, and you are ready to do something about that; a pill won’t change your life. Its effect on your body chemistry may help you, but it didn’t help me much. Perhaps it is too early in the stages of Neltrexone research to tell.

THE FOLLOWING INTERVIEW WITH DOCTOR HECTOR CASTILLO, WHO TREATED ME WITH NELTREXONE HAS BEEN SENT TO HIM AND WILL BE POSTED SOON:

When regarding Neltrexone, please report on similar treatments, unless they are too different.

1. Do you think Neltrexone should be made available over the counter?

2. According to your observations, how did Neltrexone or similar prescription treatments affect your patients?

Tell me about physical short and long term changes:

Tell me about any mental changes similar to the effects of anti-psychotic or anti-depressant treatments:

Tell me about changes in their attitudes:

Tell me about side effects they have reported:

3. How effective is Neltrexone? Is the chemical bond to nerve receptors that blocks opiates and alcohol the best chemical effect that you know about?

Tell me your estimated success rate:

temporary:

long-term:

4. Considering the behavioral aspect of alcohol addiction, do you consider Neltrexone a primary or supplementary treatment?

Can it be a primary treatment?

What specific resources have you suggested for behavioral support?

5. The information supplied by Neltrexone reads that for a good outcome of the treatment, the patient should use “community-based support groups.” In our recent history, I was not informed enough to ask you about any other support networks besides AA. When I was prescribed Neltrexone, why was I not supplied with a list or a direction to find any other specific resources?

Is it generally difficult to find community-based support groups?

6. What is your best advice to an alcoholic who wants to quit drinking?

Dr. Castillo believes in a support program for patients who seek help with alcohol. However, he failed to provide me with options when he prescribed Neltrexone to me. Although attending Alcoholics Anonymous meetings was a condition for me to live at home, I was not attending them anymore because I didn’t have faith in the program or trust in its members. I wanted to take a time out and go to a “respectable” rehab, away from the city to fix whatever was wrong with me.

In 2008 a roommate introduced me to AA, and I tried the program. Drugs were a part of my past, recreationally and socially, but I always looked down on drunks and could never accept myself as one. When I became aware that I was relying on drinking more than anything else for a good time, I realized that I was not special at all. Despite producing original work as an artist and writing original stories for publishers, I saw myself as the most unoriginal drunk. This important idea about who I was self-motivated me to try AA then, and continue to look for help in other places later.

In my experience with AA, the program very quickly became bullshit. The first sponsor who was supposed to coach me through it betrayed my trust by only wanting to have sex with me. Later I discovered that in the AA 12-step program, having sex with your sponsee is something commonly known as “13 stepping.”

When I moved to LA, the next sponsor I tried still binged on booze and drugs and showed little interest in going through the steps with me. I stopped talking to him after an occasion when he repeatedly asked me to score ecstasy so we could have sex with a girl together. My belief in all the AA terminology and “programming” always left me feeling detached from life and from myself. My trust in AA and the people in the program suffered from the start.

My mom was convinced that AA was the only way to change because she wasn’t informed about other options. Even after telling her my experience with past sponsors, she told me that I should forget about them and not let anything interfere with my sobriety. She didn’t have all the answers, but she really pushed me to help myself, and I wouldn’t have come too far without that attitude.

My family knew nothing about alternative community support groups or one-on-one therapy. My older sister had no advice. Nobody gave me any advice, and I didn’t advise myself.

But still, my mom found a one-on-one therapist at Fuller Seminary in Pasadena. My instincts knew that this was a better solution. It cost $35 per session, once a week for one hour. Mom was so concerned, hopeful, and confident that she could help, that she agreed to pay.

My therapist and I worked on “congruency” between the man who I see myself as, and the man who I am. We were working on my identity, but the word identity never came up. In my way of thinking, I was working on problems, and did not explore the idea of who I was at this point in my life.

Later, she also introduced the idea of “integration,” where I should work on integrating all aspects of my life: school, relationships, art, health, etc.; but I was still thinking too literally. I was focusing on daily activities and situations. Drinking was still an aspect of my life – so how did that fit or not fit in? My therapist and I were on the right track, but I wasn’t able to bring myself together right away. I was white knuckling it and sometimes I just didn’t care about myself enough to stay dry.

During this time, I returned to college at LACC with the educational plan to transfer into

Cal State LA.

My confidence shot up, but I still binged throughout Winter and Spring semesters. Despite working full-time during finals week and achieving great grades, I would still disappoint myself – back and forth constantly. I didn’t know how to use what I was getting out of therapy because it was new to me, and I was so attached to behavioral patterns and living in a constant survival mode. My therapist warned me at the beginning of treatment that she would leave in June, and she did.

Alcohol still remained a nasty setback in my life, so I returned to AA and found a new sponsor. She was great, but she moved away, so we stopped working the steps. Not as vulnerable as I was when I entered the program, I was able to access a more mature message without relying on the other members too much. But I needed to believe in myself again, not in AA. I wanted something like my therapist, but more intense. I needed peace, and I still imagined that rehab in the mountains somewhere.

I could have informed myself more about rehab, but I always thought it was a luxury for people who could take time off work. I was ashamed of being a financial burden, so I didn’t even try to investigate. But soon, I discovered that local community rehab centers offer a variety of affordable programs, including inpatient and outpatient, with accountable therapists.

Again, my mom came through with a phone number for Aurora Las Encinas, a rehab center in Pasadena. I didn’t even want to call because I thought it would cost too much and I felt hopeless just thinking about it. But once I connected to them, they connected me to a couple of other places. There are many centers – not in the mountains – but in local communities. I found one nearby called BHC Alhambra Hospital in the city of Rosemead (626-286-1191). With a minor insurance policy, and a financial agreement with the facility, rehab was very affordable.

The program I was admitted into at BHC was for high-functioning adults with different mental and emotional problems. It was not full of drunks and junkies and didn’t resemble the AA model. The group of about ten people spoke freely about their problems and tried to confront their feelings.

Our therapist, Mark Smith, M.A., was very skilled at accessing our thoughts, encouraging group discussions, and confronting us with what he saw as behavioral or mental patterns triggered by emotions. We met with Mark for three hour-long sessions, and with one of the other staff therapists on our last hour-long session. With BHC-arranged travel and a cafeteria lunch voucher, I spent six hours a day in this focused environment. I made an effort to repair myself and got a lot more than I expected in a short amount of time.

During my first group session, a very simple message regarding identity reached me: There are the things that you do, and then there is who you are. In an instant, I felt relieved of the non-stop guy who was looking for the best job, drinking too much, and trying to make new friends; and I felt myself in my heart again.

Though I have always looked to myself for honesty, I learned a lot more during that intense period of time. I realized how years of taking care of others who didn’t care too much for me was more than a compromise for some acceptance into a family I could call my own. I was still affected by memories of my past that I had not confronted. Over the years, for some temporary happiness, my idea of a good time slowly replaced my instinct toward a more fulfilling life.

With group therapy, I saw myself in others when they spoke of anger, sadness, frustration, and shame. We saw each others’ defenses and tried dodging painful truths, but eventually trusted enough to speak about them. The level of trust and acceptance was profound because it came from a totally no bullshit source – our hearts. I accept myself again, more powerfully than ever before. I am very proud that I am different and I want what is best for me.