🚀 go-pugleaf

I have been following the interesting discussion about biological
predisposition toward alcohol dependence, research, and treatment. I am
a doctoral student at Antioch New England. I have also been a therapist,
clinical instructor, and researcher at the Alcohol Research Center at
the UCONN School of Medicine for the last seven years. Some quick
comments: (1) It is becoming clear from double-blind placebo controlled
research that naltrexone (an opioid blocker) may be as effective with
alcohol dependence as antidepressants are for depression. Intervening
with the endogenous opioid pathway is a promising area for addiction
(and maybe someday for parasuicidal behavior). Medications don't work
independent of well-delivered psychosocial treatment. It seems that
something is different about the brains of addicts. We can't say if that
is a cause or effect. There is one group for whom there seems to be a
biological marker that can be identified even in kids (before the first
drink). The P3 wave (EEG) marker has been shown only in males (so far).
(2) I really don't think anyone involved with this discussion is being
flip about safety. I am not being critical, honest. Please be very
careful recommending controlled drinking for clients with addiction.
There seems to be some evidence that people with addiction histories can
sometimes drink without totally undoing their lives. IMHO, there is a
ton of evidence that alcohol kills these people. Seeing someone who has
not curtailed their drinking die in the hospital is a highly instructive
experience. I recommend doing this before recommending drinking to
anyone. I am currently involved in a study that puts the client in
control of their goal (abstinence vs. low levels of drinking) and even
their medication (naltrexone). We do NOT do this with alcohol dependent
clients! Only with people who have signs of developing a problem (one or
two psychosocial criteria). Even with these people, we are very clear
that it's safest not to drink. While I share the concern that
researchers can be biased against controlled drinking, I don't want to
look someone in the eye and make the recommendation that ends up killing
him/her. I look forward to the further comments of others.

Chris Penta
penta@snet.net