Susan Hochstedler, RN, CADAC, is a nurse at Addison Gilbert Hospital in Gloucestor, MA. She works full-time with substance abusers in The Discovery Program, an addictions day treatment program.
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Dr. Gitlow, let's get right into the issue of benzodiazepines. A typical scenario for many of us in office practice is that we will see a patient recently out of detox who will say, "Well doctor, I have always had terrible anxiety whether I have been drinking or not, I have tried this and I have tried that, and if I can't take something that will help my anxiety, I am sure I am going to start drinking again."
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By now, it is clear that the most effective treatment for alcoholism is consistent attendance at AA (Alcoholics Anonymous) meetings. Not only have outcome studies shown that AA attendance promotes abstinence, but in addition, therapy aimed specifically at encouraging AA attendance has been shown to robustly increase the chances that patients will actually go to meetings and get sponsors (Alcohol Research and Health, 1999;23:93-98).
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Guess what: Antabuse (disulfiram) is back in fashion, over a half century after its initial approval by the FDA. You have probably seen some of the infomercials funded by Odyssey Pharmaceuticals and published as supplements by the usual journals.
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Reviewing the new medications for alcoholism brings us into a pharmacologic netherworld. Nothing is very clear, and when you think you've finally come to a conclusion, a new study comes along to cast a fresh fog over everything.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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