Rehabilitation: A New Perspective
The war against drugs, now well into its third decade, is faltering. The disturbingly high rate of recidivism, even after repeated treatments, has been unchanged by the panoply of strategies implemented at federal and state levels. The fact that they have failed to prevent a majority of drug users from returning to their addictive behavior has led some experts to conclude that addiction is incurable.
A review of the literature regarding existing drug rehabilitation techniques reveals many uncertainties. In fact, none of the prevalent approaches to treatment has been conclusively established to be reliable. Success rates as low as 33%, not substantially higher than those anticipated from no treatment at all or treatment with placebos are generally considered to be very good.
In view of this, it is surprising that such hazardous measures as electric shock, drug-induced nausea, and chemically-introduced respiratory failure continue in current use. The application of such "aversion therapy" techniques has been particularly discouraging "Behavioral Therapies for Substance Abuse." Published in 1985 in the International of the Addictions. Examined more than two decades of research in the use of behavioral interventions for the treatment of drug and alcohol abuse. The authors concluded, "none of the studies using chemical or electrical stimuli with drug abusers has demonstrated physiological evidence of conditioned aversion."
FASE Associate Dr. Bernard Rimland (see "Associated Update"), himself a psychologist, is convinced that psychotherapy has proved equally ineffective as a means of resolving drug abuse. "Psychotherapy has not demonstrated value in any sort of disorder," he says. "Not depression, not delinquency, not schizophrenia, not neurosis, not phobias, nothing. It's absolutely worthless, as far as all the research goes, and yet it's a very common component of so many drug and alcohol treatment programs."
The use of comparatively "benign" drugs as a means of breaking an addiction to dangerous drugs has also proved to be frustrating, as the journal citings referenced above illustrate. Repeatedly the intended medicine has itself become a substance of abuse.
For example, the usefulness of methadone in reducing drug cravings remains questionable. A study completed this year by the General Accounting Office (GAO) found that between one-third and one-half of the patients at 15 methadone clinics continued to use heroin, cocaine, and other illegal drugs while receiving methadone. Nonetheless, the insistence on the use of chemicals to handle chemical abuse is so ingrained that the National Institute on Drug Abuse (NIDA) currently defines drug detoxification as "planned withdrawl from drug dependency supported by the use of a prescribed medication."
More than 6 million Americans are estimated to require treatment for drug abuse problems. New approaches to treatment are urgently needed.
An increasing number of researchers are moving away from a reliance on Pavlovian conditioning techniques such as aversion therapy, and questioning the advisability of using drugs to combat drugs. They have begun to examine the biochemical imbalances, which are created by drug abuse, and to develop means of treating them with nutrients rather than further medication. Promising research is also being done regarding the use of detoxification - in a more complete and accurate sense of the word, the elimination of accumulated drug residues from body tissue - as a treatment approach.
Dr. Rimland is convinced that a nutritional approach will prove to be as effective in treating drug problems as it has been found to be in resolving disorders such as autism and schizophrenia. "If there's any approach that's going to work," he says, "it's going to be changing the body chemistry using original equipment, like vitamins and fatty acids, amino acids, minerals and so forth."
Although not always widely acknowledged, support for the use of nutritional supplements to combat drug and alcohol dependence has been accumulating for several decades. The use of the amino acid glutamine in the treatment of alcoholism was described in the literature as long ago as 1957. Nutrients such as niacin ( vitamin B3 ), zinc, magnesium, and vitamin B1, among others, have also been reported to be effective means of treating substance abuse. Bill W. the founder of Alcoholics Anonymous advocated the use of vitamin B3 in the treatment of alcoholism.
FASE Associate Dr. Joseph Beasley is a member of the American Medical Society on Alcoholism and Other Drug Dependencies, and Medical Director of Brunswick House, the largest private alcoholism treatment facility in New York State. "A wide-ranging treatment protocol, with a strong nutritional component, results in comfortable abstinence for more than 70% of our patients with very low attrition," he says, "We have observed this kind of success even in patients cross addicted with drugs, a condition we find in 40% of those we treat.
The accumulation of drug residues in the adipose tissue is a consequence of drug use, which is not addressed by most treatment programs. Once lodged in fatty tissues, drug residues may subsequently be released into the blood. Some researchers believe that this ongoing exposure could be the basis for the "flashback" phenomenon, and contribute to continue cravings for drugs.
To examine the phenomenon of drug storage and to determine the extent to which true drug "detoxification" is possible. FASE associates have endeavored to track body burdens of commonly used drugs. A 1982 study examined the presence of THC (the active ingredient in marijuana) and its metabolites in the blood, urine, fat, and sweat of persons undergoing treatment with the Hubbard detoxification method. (It is noteworthy that although a number of studies have demonstrated the method to be an effective procedure for reducing body burdens of commonly encountered environmental compounds, its developer, L. Ron Hubbard, originally conceived it to alleviate problems associated with drug accumulation.)
Analysis of samples taken before and after detoxification verified the presence of the compounds, as well as their reduction at the completion of detoxification. Body fat was shown to be the major storage compartment for marijuana, with levels in fat tissue up to 80 times the level in the blood. An additional finding was that among the components of THC found, the hydroxy-metabolite was the most predominant. Earlier studies have demonstrated the hydroxy-metabolite to be many times more potent than THC itself, and more likely to enter the brain.
Additional research suggests strongly that cocaine, diazepam (Valium), and PCP ("Angel Dust") also store in fat deposits of the body, resulting in a slow, prolonged release of drug residues into the plasma long after the discontinuation of drug use. (Fate and Distribution of Cocaine, Diazepam, Phencyclidine (PCP) and THC (Marijuana) A Technical Review, FASE. August. 1985.)
In order to further investigate the relationship between the reduction compounds accumulated in body fat and future drug use, a survey was recently made of persons with known histories of drug abuse that have undertaken treatment with the Hubbard program to assist in the recovery from addiction.
"This survey has disclosed some intriguing information, says Scientologist Director Dr. Shelley Beckmann. The success rate - as measured by continual abstinence from drug use for greater than a year after detoxification - appears to be surprisingly high. We were able to contact 45 of the 79 patients treated specifically for drug abuse over the last six years. Of the 45, none now use cocaine, heroin, amphetamines, antidepressants or hallucinogens, though 41 of them had used such drugs prior to treatment
"The alcohol recovery rate is difficult to assess due to occasional social drinking," Dr. Beckmann says. "Twenty-three of those surveyed no longer use alcohol, of the other 22, 13 commented that they drink infrequently. The two patients treated specifically for alcohol," Significant improvements in family relations were reported, with many of the patients recommending the program to others with like difficulties.
These findings are of particular interesting as current treatments for drug abuse do not employ methods designed to actively remove drug residuals. "Although the persons interviewed for this survey would be characterized as moderate drug users, neither crack cocaine users nor heavy heroin users were included - the fact that such a large number had not returned to drugs is significant." Says Dr. Beckmann. "The findings definitely warrant further study to determine to what extent the pattern will be duplicated among heavier users. If a correlation can be established between reduction of adipose levels of drug residues and lowered recidivism rates it may help to explain the failures of programs that do not include detoxification as a component of rehabilitation.
(For a summary of FASE studies regarding the use of the Hubbard methods in the reduction of tissue levels of foreign compounds. See "Detoxification A Retrospective" in FASE Reports Vol. No. 2. Winter 1988)
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