Monday, May 7, 2012
PHARMACOTHERAPY HAS ITS PLACE
When working on recovery with my patients, I often recommend that they attend AA/NA/GA, go to meetings, join a home group and pick a sponsor. This is very therapeutic, but it is not therapy- it is adjunctive. Yet, I know that the more positive support a patient has, the better off he or she will be in long-term recovery. Whatever works is the prescription I adhere to. The patient's success is paramount. What puzzles me is the negative reception many of my patients receive when they go to AA/NA and members find out that they are on medicines to assist their recovery. Abstinence may work for many people but it is not the only way to enter recovery. Pharmacotherapy, or the use of medication to cut down on urges or cravings, is another method. We often find people who have relapsed numerous times when attempting abstinence. These are the folks who are better off taking medication to help manage their lives, then to chronically feel like a failure. Revia helps with Pathological Gambling. Suboxone works with Opioid Dependence. And both Vivitrol and Campral help with Alcohol Dependence. If folks are suicidal, we recommend their PCP use an anti-depressant. All of these of course should be combined with substance abuse treatment on a weekly basis and frequent contact with the prescriber. Folks in AA/NA/GA adhere to the abstinence model. They learn about acceptance, gratitude and surrender. What they need to learn as well is tolerance and a non-judgemental way of accepting others who struggle with addiction.