Has anyone tried Vivitrol?
naltrexone package insert/integrated neuroscience
DuPont authored the package insert, which is the prescribing info for doctors. DuPont's patent on naltrexone has since expired, but of course that insert is still the same for all brand-name and generic naltrexone.
The insert is set out in the chapter For Medical Professionals in Eskapa, pp. 209-231, and includes comments/explanation/rebuttal by Eskapa. Without Dr. Eskapa's comments, the insert is murky and confusing as to how naltrexone supposedly works for alcoholism, except to say that some clinical trials reported a reduction in consumption and relapse after twelve weeks, which is the recommended course of treatment. So the clear implication is that, according to the package for alcoholism treatment, nal is an anti-craving med to aid as part of a comprehensive program in achieving abstinence. How sad.
There's a fascinating back story here, set out in Eskapa's book (at 61-62 and App. C). Sinclair got a patent on his research in behalf of his employer (a Finnish gov't agency), mainly to try to work w/ DuPont to have input into the prescribing information. Dupont ended up end-running him and his patent by using prescribing info based on research other than Sinclair's -- in other words, the anti-craving instructions we see now. That left Sinclair to wonder whether his patent strategy -- calculated to spread the word about TSM -- backfired. Dupont evidently felt it could sell more of its then-patented med without havig to also sell such an unconventional alcoholism treatment.
There are high-priced treatment modalities that use naltrexone. This is a shame, since the COMBINE study showed naltrexone, used properly (i.e. TSM), works WITHOUT counseling beyond minimal counseling focused on compliance.
Here is a New York Times article describing how naltrexone now may be prescribed by primary care physician, as primary and not adjunct treatment for alcoholism. Primary Care for Alcoholics - New York Times
And here is a great FREE self-administered CBT program, shown to be effective, for those who feel they could use it. MoodGYM: Welcome Its language is sort of geared toward the younger set but is has been shown effective for all ages.
Of course, many of us have co-occurring mental health issues and if you have been in treatment for them, then by all means continue. But many of us developed mental health issues arising out of our struggle with alcohol, and these tend to resolve as our drinking and our lives get under control. Sinclair found that his subjects, administered the Beck Depression Inventory at the onset of treatment and again after three months, showed vast improvement with naltrexone the only modality. (Note: naltrexone itself has no psychoactive properties)
Of course there is the exception that proves the rule. Some on this board have said naltrexone works for them as an anti-craving med. No med is 100 % ineffective. Many have also said it has "worn off" after a while. We all have choices to make for ourselves. Hopefully they are based on accurate information.
LoOp is correct: Any study showing even low efficacy of naltrexone for traditional alcoholism treatment is one in which the subjects, long-term, were initially non-compliant with directions to abstain but eventually improved. In other words, they inadvertantly followed TSM.
As with baclofen, many of us are starting to get the result we expected with TSM, for the cost of a paperback book and a generic prescription medication.
naltrexone package insert/integrated neuroscience
DuPont authored the package insert, which is the prescribing info for doctors. DuPont's patent on naltrexone has since expired, but of course that insert is still the same for all brand-name and generic naltrexone.
The insert is set out in the chapter For Medical Professionals in Eskapa, pp. 209-231, and includes comments/explanation/rebuttal by Eskapa. Without Dr. Eskapa's comments, the insert is murky and confusing as to how naltrexone supposedly works for alcoholism, except to say that some clinical trials reported a reduction in consumption and relapse after twelve weeks, which is the recommended course of treatment. So the clear implication is that, according to the package for alcoholism treatment, nal is an anti-craving med to aid as part of a comprehensive program in achieving abstinence. How sad.
There's a fascinating back story here, set out in Eskapa's book (at 61-62 and App. C). Sinclair got a patent on his research in behalf of his employer (a Finnish gov't agency), mainly to try to work w/ DuPont to have input into the prescribing information. Dupont ended up end-running him and his patent by using prescribing info based on research other than Sinclair's -- in other words, the anti-craving instructions we see now. That left Sinclair to wonder whether his patent strategy -- calculated to spread the word about TSM -- backfired. Dupont evidently felt it could sell more of its then-patented med without havig to also sell such an unconventional alcoholism treatment.
There are high-priced treatment modalities that use naltrexone. This is a shame, since the COMBINE study showed naltrexone, used properly (i.e. TSM), works WITHOUT counseling beyond minimal counseling focused on compliance.
Here is a New York Times article describing how naltrexone now may be prescribed by primary care physician, as primary and not adjunct treatment for alcoholism. Primary Care for Alcoholics - New York Times
And here is a great FREE self-administered CBT program, shown to be effective, for those who feel they could use it. MoodGYM: Welcome Its language is sort of geared toward the younger set but is has been shown effective for all ages.
Of course, many of us have co-occurring mental health issues and if you have been in treatment for them, then by all means continue. But many of us developed mental health issues arising out of our struggle with alcohol, and these tend to resolve as our drinking and our lives get under control. Sinclair found that his subjects, administered the Beck Depression Inventory at the onset of treatment and again after three months, showed vast improvement with naltrexone the only modality. (Note: naltrexone itself has no psychoactive properties)
Of course there is the exception that proves the rule. Some on this board have said naltrexone works for them as an anti-craving med. No med is 100 % ineffective. Many have also said it has "worn off" after a while. We all have choices to make for ourselves. Hopefully they are based on accurate information.
LoOp is correct: Any study showing even low efficacy of naltrexone for traditional alcoholism treatment is one in which the subjects, long-term, were initially non-compliant with directions to abstain but eventually improved. In other words, they inadvertantly followed TSM.
As with baclofen, many of us are starting to get the result we expected with TSM, for the cost of a paperback book and a generic prescription medication.
nfire:
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