I wrote this after blowing up on the 29th of Oct, I drank, blacked out, woke up in the hospital screaming for the cops to just shoot me. I knew I had tossed it all away, the car was totaled, my defered prosuction was toast. A mental health guy talked to me at lenght before they would let me out of jail to be sure i wouldnt kill myself and also said "you need some meds NOW". I got out, got on my antidepressents and when my mind started to clear I took the bull by the horns. This is a long piece, you can skip to the end if you like, but there is some good stuff along the way.
Remission not Recovery
A personal plan for remission.
(You recover from a broken bone. You can go into remission with chronic disease and only if you stay on your meds.)
People drink for lots of reasons, mostly to feel elated, for some like me it is a blast of euphoria, and that blast was and is very seductive. Booze just lifted all the stress, depression, boredom, everything right off my shoulders. I for a long time could “handle” (abstaining) it after admitting my problem, going through IOP and being aware. I generally could just tough it out, but that snapping point is out there somewhere and when you hit it “old reliable” is right there to take it all away with disastrous results. I guess that is why the recidivism rate is so high. I hit my snapping point, depression, time of year, family situation, work stresses, it all became too much.
I did extensive research and it appears that a combination of both Wellbutruin XL and the Naltrexone is an effective treatment for my diseases. The real interesting thing is this; I have used both in the past but never together. How these drugs work is that the Naltrexone acts as a “stop sign” or “waste gate” and from personal experience, I can say it worked like a charm. The effect was if I did have a drink, it was “ho humm, that’s nice, no, thanks no more for me.” It was easy not to have two, or even one as there is no euphoria blast like before. It is that euphoria blast that makes binge drinking so hard to stop and it is just such a short steep slippery slope from a “buzz” to having your higher brain functions off line.
This system is also called the Pennsylvania model of treatment.The Pennsylvania Model is a medical model, in which a full range of empirically tested treatment options is offered to individuals who are dependent upon alcohol. The foundation for the Pennsylvania Model is fully researched and documented. Dr. Joseph Volpicelli, MD, PhD of the University of Pennsylvania is one of the key members of the team that formulated the model.
Dr. Volpicelli recognized that alcohol dependence is indeed a disease, albeit a very complicated disease with distinct Biological, Psychological and Social components.
He came to believe that treatment should be more broad-based and include such new developments as pharmacotherapy, for example, the utilization of Naltrexone as an important component of the treatment processes. The protocols of the Pennsylvania Model fully integrate pharmacological and psychosocial support in the recovery process.
Naltrexone and Alcoholism Treatment. The Treatment Improvement Protocol (TIP) Series appears to be one of the most comprehensive documents on the use of this combined treatment protocol[1]. One of the findings were “Although established data are currently lacking, some animal studies (e.g., Reid et al., 1996) and a recent open-label clinical study (Kranzler et al., 1997) suggest that after an established course of daily treatment, Naltrexone may be effective on an intermittent or as-needed basis. In certain circumstances, continued Naltrexone treatment may be considered as prophylaxis for patients who anticipate a high-risk situation or who undergo major stressors or lifestyle changes that increase the risk of relapse”.
I started on the Naltrexone and the Wellbutrin combination on Nov 3rd because my research and from personal experience indicated that it might be very effective. To quote from a recent study[2] "The findings from the COMBINE Study should be of great interest to primary care physicians treating patients with alcohol dependence. Patients who decline an offer of pharmacological treatment to reduce their drinking can be referred for intensive behavioral treatment. "Notably, however, the beneficial effects of Naltrexone were seen in the context of medical management similar to what is routinely available in primary care practice. This offers the prospect that an efficacious treatment for alcohol dependence can be made as widely available as are current treatments for smoking cessation and major depression." Naltrexone[3] is an opiate antagonist with its effect so dynamic that a medic alert bracelet letting emergency services that you are on it is recommended. The reason is any opiate will NOT work for pain reduction and has the same effect with alcohol, preventing the high.
I know I was very depressed, and according to lots of studies[4], many alcoholics are undiagnosed depressives and/or seasonal ones. The Pennsylvania model show’s that both need to be treated with targeted medicines to be optimally effective. Clinical depression is patient monster, it slowly ratchets up. It is like you are a frog in a pan of water, oblivious that the water is getting hotter until it is too late. The evidence of my depression obvious to any one that has known me for any period of time, it is also obvious that I have Seasonal Effective Disorder[5] (depression intensified by shortening days and longer nights); the evidence is in my medical files. A further piece of evidence that is clinically based is that Wellbutrin has little effect on people that are not biologically depressed (it was part of the drugs testing) and it had a huge and noticeable effect on me with in hours.
People like me do not have a “stop sign” the euphoria is there from the first drink and sweeps you away. The Naltrexone however put that in place, no euphoria, no blast, just like other people its “oh that’s nice, no thanks no more for me”. Naltaxone has a long history of very good results, however in the past the treatment was for x time (12 weeks, 6 months) at which time that the behavior has been changed. It is a good plan, but if you do not take the Naltrexone, the “euphoria block” does fade away with it your last safety net. All it takes are other biochemical problems (depression) or life just blowing up on you that “old reliable” is right there waiting, the slippery slope all greased up.
Some people have just decided to stay on Naltrexone forever, keep the stop sign in place and why not, its not expensive $3.50 daily, and it WORKS. Knowing that if you do slip, you are not going to go off on the black out express train and that is huge load off your shoulders. According to the published information at 50 mg, a day showed no long-term negative health effects but a liver function test every 6 months is recommended. There is a time release shot available, it is good for 30 days but currently cost almost $800.00 a shot[6] . The injection has advantages, no nausea, cannot forget to take your pill and the injection is more track able for the courts, and employers. Me, I will just take my pill, every day just as millions of other people do, after all it is my lifeline.
Naltrexone alone does not solve the whole equation, it is the waste gate or circuit breaker on the system but why do we “load” the system in the first place. This loading of the system often is because of mood, in my case depression and stress. There are good meds for depression, with Wellbutrin a serotonin reuptake inhibitor being one of the best. It appears that in some people like me the combination of not enough serotonin receptors, too many opiate ones make for a nasty combination, and that combination has to be attacked from both sides. Wellbutrin is often prescribed for treatment of major depression and seasonal effective disorder[7].
Wellbutrin XL is the first and only medication approved to prevent seasonal major depressive episodes. Seasonal affective disorder is a serious and often under-diagnosed form of depression that affects millions of people each year in the United States, said Norman E. Rosenthal, M.D., clinical professor of Psychiatry at Georgetown Medical School and medical director of Capital Clinical Research Associates. "The FDA approval of Wellbutrin XL for the prevention of seasonal major depressive episodes in adults diagnosed with SAD is exciting. For the first time, it may be possible to prevent the predictable onset of SAD with medication by beginning treatment in the autumn season, prior to experiencing depressive symptoms."
Drugs can interact in funny ways, reinforcing, or canceling each other out. I started out on the Wellbutrin XL 150 mg (strongly recommended by Joe Beckett the person that interviewed me in jail about my suicidal mindset) and after even 1 day the fog of depression was lifting, a huge weight off my guts, but with all the stress I still wanted and needed to smoke. I started the Naltexone in combination with my Wellbutrin on the 3rd day and a really odd thing happened, I did not need to smoke. Naltrexone and Wellbutruin have both been used in anti smoking treatments, to limited success, and this effect may be unique to me, but I am grateful nonetheless. The only down side with this combo is that it kills your appetite, and this combo was used to treat chronic binge eaters to some success. I don’t need to loose more weight, but its far easier and safer to address that issue rather than the other, after all few people go insane, crash their car and ask to be killed because of eating too many French fries.
I have decided, given the all the evidence, web and personal that I will just take the Naltrexone and Wellbutrin daily for the rest of my days, as there is currently no cure for alcoholism or chronic depression. There is reliable, tested and cost effective medical treatment available for both, with aggressive research on more by many companies[8]. All the evidence point that this combination of medications is mine. There are many parts to this disease, and you need to deal with all aspects effectively to succeed both biological ones as well as the emotional ones.
There is one more component, support and understanding from your loved ones, that’s one that until this time I more or less ignored. It was shame on my part, stupid really, as it is obvious that these are diseases just like diabetes and I would not be ashamed to admit that I was a diabetic to them or somebody I was dating. This time it is all out in the open, lovers, family, friends, and business partners I told them all. It surprised the hell out of me that not one cut and ran for the hills, they are all behind me. Now some of them have a bit better understanding the stresses I am under and that I should talk more not just smile and say, “It’s all ok”.
My Personal life will change, but the story out here is pretty much written, a continuation of what has been going on the last 5 years. I am the caregiver, simple as that, and nothing really will stop the slow decline my mother is experiencing. I see it daily she will continue to lose function, require more care and understanding. It is damn hard to watch but her quality of life is about as high as we all can make it and we owe her that. In time, she will pass, I will move on, but I will move on knowing that I did the right thing. I will move ahead if not having conquered my diseases at least put them into remission.
I continue to work for my future, I have a new product about to go to license with a good company that could pay off well, not rich but comfortable. I have some other projects, continue to build prototypes for others so my life will be as it has for 30 years a roller coaster. I know that the roller coaster will now only be in the financial arena, because with the medications and support of my loved ones I will not fail again on sobriety.
[1] http://www.ncbi.nlm.nih.gov/books/bv....chapter.51510
[2] Study Defines Most Effective Alcoholism Treatments
[3] Naltrexone - Wikipedia, the free encyclopedia
[4] http://www.depression-guide.com/alco...depression.htm
[5] Seasonal affective disorder and its prevention by ...[Biol Psychiatry. 2005] - PubMed Result
[6] http://www.fda.gov/cder/drug/infopag...ne/default.htm
[7] FDA Approves Wellbutrin XL(R) (bupropion HCl Extended-release Tablets) For The Prevention Of Seasonal Major Depressive Episodes
[8] http://stanford.wellsphere.com/bioet...oholism/404017
Remission not Recovery
A personal plan for remission.
(You recover from a broken bone. You can go into remission with chronic disease and only if you stay on your meds.)
People drink for lots of reasons, mostly to feel elated, for some like me it is a blast of euphoria, and that blast was and is very seductive. Booze just lifted all the stress, depression, boredom, everything right off my shoulders. I for a long time could “handle” (abstaining) it after admitting my problem, going through IOP and being aware. I generally could just tough it out, but that snapping point is out there somewhere and when you hit it “old reliable” is right there to take it all away with disastrous results. I guess that is why the recidivism rate is so high. I hit my snapping point, depression, time of year, family situation, work stresses, it all became too much.
I did extensive research and it appears that a combination of both Wellbutruin XL and the Naltrexone is an effective treatment for my diseases. The real interesting thing is this; I have used both in the past but never together. How these drugs work is that the Naltrexone acts as a “stop sign” or “waste gate” and from personal experience, I can say it worked like a charm. The effect was if I did have a drink, it was “ho humm, that’s nice, no, thanks no more for me.” It was easy not to have two, or even one as there is no euphoria blast like before. It is that euphoria blast that makes binge drinking so hard to stop and it is just such a short steep slippery slope from a “buzz” to having your higher brain functions off line.
This system is also called the Pennsylvania model of treatment.The Pennsylvania Model is a medical model, in which a full range of empirically tested treatment options is offered to individuals who are dependent upon alcohol. The foundation for the Pennsylvania Model is fully researched and documented. Dr. Joseph Volpicelli, MD, PhD of the University of Pennsylvania is one of the key members of the team that formulated the model.
Dr. Volpicelli recognized that alcohol dependence is indeed a disease, albeit a very complicated disease with distinct Biological, Psychological and Social components.
He came to believe that treatment should be more broad-based and include such new developments as pharmacotherapy, for example, the utilization of Naltrexone as an important component of the treatment processes. The protocols of the Pennsylvania Model fully integrate pharmacological and psychosocial support in the recovery process.
Naltrexone and Alcoholism Treatment. The Treatment Improvement Protocol (TIP) Series appears to be one of the most comprehensive documents on the use of this combined treatment protocol[1]. One of the findings were “Although established data are currently lacking, some animal studies (e.g., Reid et al., 1996) and a recent open-label clinical study (Kranzler et al., 1997) suggest that after an established course of daily treatment, Naltrexone may be effective on an intermittent or as-needed basis. In certain circumstances, continued Naltrexone treatment may be considered as prophylaxis for patients who anticipate a high-risk situation or who undergo major stressors or lifestyle changes that increase the risk of relapse”.
I started on the Naltrexone and the Wellbutrin combination on Nov 3rd because my research and from personal experience indicated that it might be very effective. To quote from a recent study[2] "The findings from the COMBINE Study should be of great interest to primary care physicians treating patients with alcohol dependence. Patients who decline an offer of pharmacological treatment to reduce their drinking can be referred for intensive behavioral treatment. "Notably, however, the beneficial effects of Naltrexone were seen in the context of medical management similar to what is routinely available in primary care practice. This offers the prospect that an efficacious treatment for alcohol dependence can be made as widely available as are current treatments for smoking cessation and major depression." Naltrexone[3] is an opiate antagonist with its effect so dynamic that a medic alert bracelet letting emergency services that you are on it is recommended. The reason is any opiate will NOT work for pain reduction and has the same effect with alcohol, preventing the high.
I know I was very depressed, and according to lots of studies[4], many alcoholics are undiagnosed depressives and/or seasonal ones. The Pennsylvania model show’s that both need to be treated with targeted medicines to be optimally effective. Clinical depression is patient monster, it slowly ratchets up. It is like you are a frog in a pan of water, oblivious that the water is getting hotter until it is too late. The evidence of my depression obvious to any one that has known me for any period of time, it is also obvious that I have Seasonal Effective Disorder[5] (depression intensified by shortening days and longer nights); the evidence is in my medical files. A further piece of evidence that is clinically based is that Wellbutrin has little effect on people that are not biologically depressed (it was part of the drugs testing) and it had a huge and noticeable effect on me with in hours.
People like me do not have a “stop sign” the euphoria is there from the first drink and sweeps you away. The Naltrexone however put that in place, no euphoria, no blast, just like other people its “oh that’s nice, no thanks no more for me”. Naltaxone has a long history of very good results, however in the past the treatment was for x time (12 weeks, 6 months) at which time that the behavior has been changed. It is a good plan, but if you do not take the Naltrexone, the “euphoria block” does fade away with it your last safety net. All it takes are other biochemical problems (depression) or life just blowing up on you that “old reliable” is right there waiting, the slippery slope all greased up.
Some people have just decided to stay on Naltrexone forever, keep the stop sign in place and why not, its not expensive $3.50 daily, and it WORKS. Knowing that if you do slip, you are not going to go off on the black out express train and that is huge load off your shoulders. According to the published information at 50 mg, a day showed no long-term negative health effects but a liver function test every 6 months is recommended. There is a time release shot available, it is good for 30 days but currently cost almost $800.00 a shot[6] . The injection has advantages, no nausea, cannot forget to take your pill and the injection is more track able for the courts, and employers. Me, I will just take my pill, every day just as millions of other people do, after all it is my lifeline.
Naltrexone alone does not solve the whole equation, it is the waste gate or circuit breaker on the system but why do we “load” the system in the first place. This loading of the system often is because of mood, in my case depression and stress. There are good meds for depression, with Wellbutrin a serotonin reuptake inhibitor being one of the best. It appears that in some people like me the combination of not enough serotonin receptors, too many opiate ones make for a nasty combination, and that combination has to be attacked from both sides. Wellbutrin is often prescribed for treatment of major depression and seasonal effective disorder[7].
Wellbutrin XL is the first and only medication approved to prevent seasonal major depressive episodes. Seasonal affective disorder is a serious and often under-diagnosed form of depression that affects millions of people each year in the United States, said Norman E. Rosenthal, M.D., clinical professor of Psychiatry at Georgetown Medical School and medical director of Capital Clinical Research Associates. "The FDA approval of Wellbutrin XL for the prevention of seasonal major depressive episodes in adults diagnosed with SAD is exciting. For the first time, it may be possible to prevent the predictable onset of SAD with medication by beginning treatment in the autumn season, prior to experiencing depressive symptoms."
Drugs can interact in funny ways, reinforcing, or canceling each other out. I started out on the Wellbutrin XL 150 mg (strongly recommended by Joe Beckett the person that interviewed me in jail about my suicidal mindset) and after even 1 day the fog of depression was lifting, a huge weight off my guts, but with all the stress I still wanted and needed to smoke. I started the Naltexone in combination with my Wellbutrin on the 3rd day and a really odd thing happened, I did not need to smoke. Naltrexone and Wellbutruin have both been used in anti smoking treatments, to limited success, and this effect may be unique to me, but I am grateful nonetheless. The only down side with this combo is that it kills your appetite, and this combo was used to treat chronic binge eaters to some success. I don’t need to loose more weight, but its far easier and safer to address that issue rather than the other, after all few people go insane, crash their car and ask to be killed because of eating too many French fries.
I have decided, given the all the evidence, web and personal that I will just take the Naltrexone and Wellbutrin daily for the rest of my days, as there is currently no cure for alcoholism or chronic depression. There is reliable, tested and cost effective medical treatment available for both, with aggressive research on more by many companies[8]. All the evidence point that this combination of medications is mine. There are many parts to this disease, and you need to deal with all aspects effectively to succeed both biological ones as well as the emotional ones.
There is one more component, support and understanding from your loved ones, that’s one that until this time I more or less ignored. It was shame on my part, stupid really, as it is obvious that these are diseases just like diabetes and I would not be ashamed to admit that I was a diabetic to them or somebody I was dating. This time it is all out in the open, lovers, family, friends, and business partners I told them all. It surprised the hell out of me that not one cut and ran for the hills, they are all behind me. Now some of them have a bit better understanding the stresses I am under and that I should talk more not just smile and say, “It’s all ok”.
My Personal life will change, but the story out here is pretty much written, a continuation of what has been going on the last 5 years. I am the caregiver, simple as that, and nothing really will stop the slow decline my mother is experiencing. I see it daily she will continue to lose function, require more care and understanding. It is damn hard to watch but her quality of life is about as high as we all can make it and we owe her that. In time, she will pass, I will move on, but I will move on knowing that I did the right thing. I will move ahead if not having conquered my diseases at least put them into remission.
I continue to work for my future, I have a new product about to go to license with a good company that could pay off well, not rich but comfortable. I have some other projects, continue to build prototypes for others so my life will be as it has for 30 years a roller coaster. I know that the roller coaster will now only be in the financial arena, because with the medications and support of my loved ones I will not fail again on sobriety.
[1] http://www.ncbi.nlm.nih.gov/books/bv....chapter.51510
[2] Study Defines Most Effective Alcoholism Treatments
[3] Naltrexone - Wikipedia, the free encyclopedia
[4] http://www.depression-guide.com/alco...depression.htm
[5] Seasonal affective disorder and its prevention by ...[Biol Psychiatry. 2005] - PubMed Result
[6] http://www.fda.gov/cder/drug/infopag...ne/default.htm
[7] FDA Approves Wellbutrin XL(R) (bupropion HCl Extended-release Tablets) For The Prevention Of Seasonal Major Depressive Episodes
[8] http://stanford.wellsphere.com/bioet...oholism/404017
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