Important program updates 
Updated Recommendations for the My Way Out program

Copyright 2006 Capalo Press and Health Sciences

March, 2006
Overview from Roberta Jewell: one year later

March 28 will mark My Way Out’s official one year anniversary. We are delighted and overwhelmed with the success of this program over the past 12 months. We’ve heard from thousands of individuals from all over the world, many of whom have finally broken the bonds of addiction. They have found a program that fits their lifestyle and comfort level and can be done in the privacy of their own homes. A program that allows a choice of moderated drinking or abstinence. And a program that provides a community of enthusiastic support—often online—offering strength, fellowship, and inspiration.

Now, one year later, we present information to make the program even better. We’ve learned so much from the patients, physicians and researchers with whom we’ve worked and we are eager to share it with everyone involved in the My Way Out program. Like any good medical therapy it will continue to evolve, to be enhanced, and provide even greater efficacy.

Here is an overview of modifications and updated recommendations to My Way Out:

Nutrition

We have made our first official recommendations for modifications the My Way Out nutritional program for those who may wish to adopt them. As many of you know, this therapy allows a great degree of individual tweaking. We learn, through many of our patients and MWO members, what works best and how others may incorporate similar practices. We follow a tremendous amount of research, including a number of ground-breaking studies in addiction medicine. And we work closely with highly regarded specialists; they include physicians, researchers, nutritionists, herbalists and others who help ensure our program is safe, effective, and cutting edge.


We consider our original supplement schedule to be extremely effective. It works very well for most individuals, so if you are on the program, you may simply choose to continue using your supplements at the existing doses. However, we have proposed several potential modifications you may wish to consider based on data and observations over the past year. If you're currently using the My Way Out program—or considering it—and would like more information about specific changes in our supplement program please see our MWO 2006 update sheet.

For feedback from MWO members about supplements and nutrition and as they relate to My Way Out, visit
http://www.mywayout.org/community/showthread.php?t=2724

Medication

When we first published My Way Out, the anti-craving drug of choice was Topamax (topiramate), an anti-seizure mediation used off label. As I mentioned in the book, which was published in March, 2004, newer drugs would soon become available, including Campral (acamprosate), which many of our members now use. It is often the medication of choice for those who select complete abstinence over moderated drinking. Other pharmacological solutions are also being introduced, including the oral medications Baclofen or Vivitrex, the latter of which is a reformulation on naltrexone and delivered in a monthly injection. Other medications—and combination of medications—are under development to help balance neurotransmitters in the brain and blunt the craving for alcohol. New research has also brought to light data about drinker sub-types, including early and late onset drinkers.

Our experience suggests the following:

Topiramate is the medication of choice for those who select controlled drinking. However, some individuals have difficulty obtaining a prescription because their health care providers are unfamiliar with its application to addiction treatment or do not wish to prescribe an off-label medication.
Many individuals find they need not titrate their Topamax does up to the full 300 mg recommended in the Physician’s Desk Reference and reprinted in My Way Out. The dosing scale follows original research published in the groundbreaking 2003 Lancet study. We now recommend patients hold steady at the dose that works best (due to potentially bothersome side effects at higher levels) and continue to actively engage in the other elements of the My Way Out program.
A significant number of individuals have selected Campral as their anti-craving medication of choice. Campral requires a few day of abstinence before administration and the effects of the drug may be lost if one begins drinking while on it. It does not appear to have the same level of side effects as Topamax.
Some people use these medications for the duration of the 12-week program (typically longer with Campral) and then discontinue; but it appears a majority of individuals opt to continue taking the drugs much longer, sometimes indefinitely.
Others titrate off the medication completely, but commit themselves to a long-term maintenance plan that incorporates other facets of the program (such as occasional use of the hypnotherapy and daily administration of L-Glutamine, Kudzu and All One).
For feedback from MWO members about medication as it relates to My Way Out, visit http://www.mywayout.org/community/showthread.php?t=2723
Hypnotherapy

The self-hypnosis, visualization, meditation and relaxation techniques incorporated as part of My Way Out remain core to the program. We believe this explains why individuals who practice the hypnotherapy often experience a craving reduction so soon—much sooner than those in studies who used medication alone. Hypnotherapy is a gateway to powerful behavior modification and is critical to the program, particularly for those who opt out of taking any medication.

Our experience suggests the following: 
The recommended schedule for listening to the hypnotherapy CDs is highly flexible; people can listen to them less than the recommended schedule and still receive significant benefit
Individuals do well to listen to the CDs in the recommended order, particularly as it relates to the Clearing and Hypnotic title
The hypnotherapy CDs seem to encourage better sleeping patterns, particularly during the withdrawal phase in which sleep or dreams may be significantly affected
Those who incorporate the CDs into their program—particularly the first 30 days—tend to note an increased reduction in craving over those who use them sporadically
Individuals often enjoy variety and customization, especially in listening to the Hypnotic title, so often opt to add the “Controlled Drinking in Social Events CD” to their program
Some individuals have mentioned they are bothered by specific wording or pronunciation in the CD recordings but tend to overcome barriers to relaxation and the hypnosis by simple continued use
A small number of individuals have found they are simply unable to use the CDs successfully for one reason or another. They are generally still able to achieve their overall goals if they seek alternative behavior modification techniques.
A number of individuals have created customized subliminal CDs using their private music collection
Visualization techniques and positive affirmations are highly individualistic, but many people find it is best to focus on one particular suggestion per session
Those who engross themselves in more “sensory” experiences seem to note increased effectiveness in craving reduction. This may include suggestions about taste, smell, or sounds.
For feedback from MWO members about hypnotherapy as it relates to My Way Out, visit
http://www.mywayout.org/community/showthread.php?t=2722

Exercise

Exercise is a critical part of the My Way Out program and we find that a little goes a long way. We continue to promote its use in controlling alcohol craving and depression. Exercise sessions provide an endorphin boost, which helps support recovery and reduces the chance of relapse.

Our experience suggests the following:
Many individuals in the MWO program already incorporate a program of exercise in their weekly schedule, making for an easy transition
Exercising at an aerobic range to burn fat is recommended; it also helps mid-brain receptors release dopamine which provides a sense of well being
Many individuals incorporate music into their regular workouts
It’s best to work out earlier in the day, so as not to disrupt evening sleep patterns
Short workouts, even 15 minutes, are very beneficial, particularly in accommodating busy schedules
For feedback from MWO members about hypnotherapy as it relates to My Way Out, visit
http://www.mywayout.org/community/showthread.php?t=2721

Additional Information
Individuals have most success with the program when adopting all elements of it
Support of other members on the My Way Out message board, including chat, has been instrumental in helping many people achieve goals related to re-establishing their relationship with alcohol
A number of individuals start the program with moderation as a goal but come to realize abstinence may be a more realistic outcome. Others are successful in their goal of moderated drinking
Those who start the program with a positive frame of mind, visualizing success and committing to positive change, seem to do very well
Some individuals have reported doing quite well for a time, then suffer a relapse. They find it helpful to continue the program and re-commit themselves to all facets of it rather then dwell on “the slip”.
It is often helpful to break established patterns (particularly in the evening) when time is no longer spent drinking—or drinking excessively—by engaging in new activities
Many other programs and online tools have been effective in helping to support success. These include the Moderation Management, AA, and Women for Sobriety websites.
People are often surprised that once withdrawal and physical cravings are behind them, psychological ones remain. This is best addressed by continued involvement in the discussion forums, individual counseling, fellowship based meetings, and other solutions which help address the fundamental cravings and personal issues associated with them.
Many individuals tend to be actively involved in message board and chat activities early in their recovery; they often post less frequently as they reach their goals and then simply move on
A number of alternative and holistic approaches have been helpful to program participants. These include auricular (ear) acupuncture, EFT, and Zen meditation.
For feedback from MWO members about other issues related to My Way Out, visit
http://www.mywayout.org/community/
Copyright © 2006 Capalo Press, All Rights Reserved | fax: 800-877-5680