More people are addicted to drugs now than any time in our nation’s history. Addiction has become public enemy number one, and the search is on for new treatments. Surgeries, pills, vaccines – we’re willing to try anything if it means putting an end to the suffering. But has science gone too far?
Here are five of the most controversial addiction treatments that beg the question, “Is this the best we can do?”
Methadone and Suboxone are opioids that have been well-studied and widely used to minimize withdrawal symptoms and cravings in opiate addicts. By removing addicts from the junkie lifestyle, these medications have been marketed as a solution to a life of crime, sickness, unemployment and poverty, with minimal side effects and a more affordable price tag than rehab.
Why the Controversy: Once believed to be a “cure” for opiate addiction, the drawbacks to these medications have become clear over time. Both medications are addictive and difficult to wean off of because of severe withdrawal symptoms. Although Suboxone is generally preferred over methadone because it reduces the risk of addiction and overdose and blocks the effects of other opiates, neither medication addresses the complex underlying causes of addiction. This means that counseling, self-help groups and other treatments are still essential for long-term success.
Maintenance therapy, or using Suboxone or methadone for months or years on end, is another source of controversy. Suboxone is revolutionary as an aid in short-term detox but should not be considered a long-term therapy except in the most severe cases. Most opiate addicts can be successful in recovery without prolonged methadone or Suboxone use, and maintenance therapy robs the addict of the opportunity to be drug-free.
When methadone and Suboxone fail, some believe the safest and most effective treatment for hard-core heroin addiction is heroin itself. As a treatment of last resort, some studies suggest that daily injections of medical heroin can stabilize patients, reduce the risk of overdose, HIV and criminal activity, and improve compliance rates.
Why the Controversy: Heroin is illegal in the U.S. and has been classified as a Schedule I controlled substance, meaning it has high potential for abuse and no legitimate medical purpose. It poses serious side effects such as overdose and seizures. Continuing to use any addictive substance, but especially one as potent as heroin, is unlikely to curb heroin addiction and could actually exacerbate it.
Ibogaine, a hallucinogen that is derived from a West African shrub, has been studied as a treatment for addictions to opiates, methamphetamine and other drugs. Some users have reported a dream-like state that gives them insights into their addictions and visions that help them overcome negative emotions and fears. In rat studies, Ibogaine reduced alcohol consumption and opiate withdrawal symptoms.
Why the Controversy: Ibogaine has been illegal in the U.S. since the 1960s. Because of severe side effects such as hallucinations, seizures, and fatal heart arrhythmia and brain damage in patients with other health problems, the drug has been classified as a Schedule I substance and clinical studies have been limited.
LSD is a powerful hallucinogen that has been examined for decades as a potential treatment for alcoholism. In recent studies, some alcoholics reported having a transformative experience that gave them a new appreciation for their addiction as well as motivation to do something about it. The effects lasted up to six months.
Why the Controversy: Like other hallucinogens, the effects of LSD can be unpredictable. A “trip” can last 12 hours or more and can cause nightmarish hallucinations, panic, flashbacks and long-term psychosis. Because the risks outweigh the potential benefits, LSD is classified as a Schedule I substance.
Deep brain stimulation is a surgical procedure wherein a small device is placed in a specific region of the brain and emits electrical pulses to disrupt activity in the targeted area. It has been used to treat Parkinson’s disease and epilepsy and is being studied for addiction and other mental health issues. Rat studies have suggested that the procedure may reduce cocaine addiction.
Why the Controversy: Deep brain stimulation is an invasive surgery that poses a significant risk of complications such as hallucinations, depression, brain hemorrhage and infection. As an experimental procedure, there is no track record of success and no clear guidelines for use.
Science has confirmed that addiction is a brain disease, but that doesn’t mean the only way to treat a drug problem is with high-risk drugs or surgeries that fail to address the addiction itself. These controversial treatments say less about scientific advancement than how desperate we’ve become to beat this disease.
We need something better than what we’ve got – but not just anything, and certainly not a treatment that threatens more harm. Controversial treatments can compromise our efforts at full rehabilitation and some head us in the wrong direction – toward untenable solutions that give false hope to addicts and their families and away from what we know works: comprehensive, long-term treatment that addresses the physical, emotional and social roots of addiction.
David Sack, M.D., is board certified in Psychiatry, Addiction Psychiatry, and Addiction Medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment centers that include Promises Treatment Centers in Malibu and Los Angeles, The Ranch near Nashville, The Recovery Place in Florida, and The Sexual Recovery Institute.
Heroin addict photo available from Shutterstock.
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Last reviewed: 28 Jun 2012