I wrote a detailed letter to the editor about this but I'll only post part of it here.
I've been sober for 13 years and I'm a Licensed Mental Health Counselor. Who currently has some clients that are in recovery.
Naltrexone, Methadone, and Suboxone aren’t news. They are drugs that are commonly used all across the United States and have been in widespread use for at least a decade. It is rare that I have a client in a dedicated substance abuse treatment program who isn’t prescribed one of these medications. So, the ignorance shows through immediately here. Podcast hosts aren’t addicts, they’ve never been through recovery themselves, they have never worked in a recovery program, or bothered to talk to anyone who has, and quite frankly, it shows. If you are going to your PCP expect to be disappointed. PCP’s are responsible for knowing every little thing about the human body, which is an insane amount of information to cover. Needless to say, they aren’t very good at any of it. They just have a basic understanding of everything. I frequently have to correct the inaccurate mental health diagnoses that PCP’s issue to patients. They never spot Bipolar disorder and very dangerously put bipolar people on SSRI medications. This is why people need to be in a substance abuse treatment program and not just go to their PCP. Most PCP’s will tell you to enter one, but people ignore it.
You’re already off base in the whole premise of your podcast episode. Next, you mention a study of 150 participants that had a stunning 75% success rate in lowering drinking. I literally put my face into my palm when I heard this. Journalists should not cite research that they do not understand. Journalists don’t understand statistics very well or how these studies are constructed. The podcast host even stated 150 participants as though it were a large number. That number is so small to the point of being meaningless. When studies are that small you need to wait for enough research to be published for there to be a meta-analysis on the subject. The smaller a data set is, the more prone it is to random variations in the data. Thus, it becomes extremely important to know who those 150 people were and how the researchers found them.
There was a Cochrane review of AA’s effectiveness in which there was a meta-analysis of over 10,000 participants, and they found AA to be an effective intervention.
They found AA led to a 42% success rate in participants being sober after one year.
Also, Katie sounds like she has a comorbidity, a dual diagnosis, with how she describes obessing over alcohol. That stuck out to me even as someone who has spent time in AA and worked with many addicts.
The difference is what The Sinclair Method proposes - to take Naltrexone AND continue drinking. When alcoholics are prescribed meds at clinics or by doctors they are told to STOP drinking.
In the podcast, they stated that Naltrexone is uncommon and little known. I don't have a problem per se with the Sincliar method. Often alcoholics can't stop drinking cold turkey since alcohol withdrawals can kill you.
It is WIDELY unknown - everyone knows what AA is, but unless you have sought out help for alcoholism (which majority of alcoholics don't), you would not have heard of Naltrexone. You work in this field, so it's well known to you, but not the general public.
It is relatively unknown to general practitioners, especially the Sinclair Method of using it. Right after I heard this story (it's been available for a while), I reached out to 3 family practice doctors, and while they had a vague understanding of the drug, none of them had ever prescribed it, and they all had to do some research on it.
Doctors who work as addiction specialists know naltrexone very well - but if a person just goes to see their GP, they might have to do some convincing!
If someone wants to get sober they need to get into a treatment program with competent professionals. PCP's aren't addiction recovery specialists and probably should not be prescribing naltrexone anyway since they aren't familiar with it.
Think back to what the doctor said in the podcast about PCP's prescribing naltrexone incorrectly and it being ineffective. Addiction recovery is a specialty, its unreasonable to expect a PCP to be able to do everything.
I wrote a detailed letter to the editor about this but I'll only post part of it here.
I've been sober for 13 years and I'm a Licensed Mental Health Counselor. Who currently has some clients that are in recovery.
Naltrexone, Methadone, and Suboxone aren’t news. They are drugs that are commonly used all across the United States and have been in widespread use for at least a decade. It is rare that I have a client in a dedicated substance abuse treatment program who isn’t prescribed one of these medications. So, the ignorance shows through immediately here. Podcast hosts aren’t addicts, they’ve never been through recovery themselves, they have never worked in a recovery program, or bothered to talk to anyone who has, and quite frankly, it shows. If you are going to your PCP expect to be disappointed. PCP’s are responsible for knowing every little thing about the human body, which is an insane amount of information to cover. Needless to say, they aren’t very good at any of it. They just have a basic understanding of everything. I frequently have to correct the inaccurate mental health diagnoses that PCP’s issue to patients. They never spot Bipolar disorder and very dangerously put bipolar people on SSRI medications. This is why people need to be in a substance abuse treatment program and not just go to their PCP. Most PCP’s will tell you to enter one, but people ignore it.
You’re already off base in the whole premise of your podcast episode. Next, you mention a study of 150 participants that had a stunning 75% success rate in lowering drinking. I literally put my face into my palm when I heard this. Journalists should not cite research that they do not understand. Journalists don’t understand statistics very well or how these studies are constructed. The podcast host even stated 150 participants as though it were a large number. That number is so small to the point of being meaningless. When studies are that small you need to wait for enough research to be published for there to be a meta-analysis on the subject. The smaller a data set is, the more prone it is to random variations in the data. Thus, it becomes extremely important to know who those 150 people were and how the researchers found them.
There was a Cochrane review of AA’s effectiveness in which there was a meta-analysis of over 10,000 participants, and they found AA to be an effective intervention.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012880.pub2/full
You don’t want to fight me when it comes to my occupation. I am very good at what I do, and you should take the time to talk to people like me.
This link is more succinct the first one links to the full study:
https://www.cochrane.org/news/new-cochrane-review-finds-alcoholics-anonymous-and-12-step-facilitation-programs-help-people
They found AA led to a 42% success rate in participants being sober after one year.
Also, Katie sounds like she has a comorbidity, a dual diagnosis, with how she describes obessing over alcohol. That stuck out to me even as someone who has spent time in AA and worked with many addicts.
The difference is what The Sinclair Method proposes - to take Naltrexone AND continue drinking. When alcoholics are prescribed meds at clinics or by doctors they are told to STOP drinking.
In the podcast, they stated that Naltrexone is uncommon and little known. I don't have a problem per se with the Sincliar method. Often alcoholics can't stop drinking cold turkey since alcohol withdrawals can kill you.
It is WIDELY unknown - everyone knows what AA is, but unless you have sought out help for alcoholism (which majority of alcoholics don't), you would not have heard of Naltrexone. You work in this field, so it's well known to you, but not the general public.
In the podcast, they were stating it was unknown to medical professionals which is false. This podcast isn't simply about raising awareness.
It is relatively unknown to general practitioners, especially the Sinclair Method of using it. Right after I heard this story (it's been available for a while), I reached out to 3 family practice doctors, and while they had a vague understanding of the drug, none of them had ever prescribed it, and they all had to do some research on it.
Doctors who work as addiction specialists know naltrexone very well - but if a person just goes to see their GP, they might have to do some convincing!
I said that in my original post.
If someone wants to get sober they need to get into a treatment program with competent professionals. PCP's aren't addiction recovery specialists and probably should not be prescribing naltrexone anyway since they aren't familiar with it.
Think back to what the doctor said in the podcast about PCP's prescribing naltrexone incorrectly and it being ineffective. Addiction recovery is a specialty, its unreasonable to expect a PCP to be able to do everything.