Naltrexone/Alcoholism, Sinclair Method

Letter from the Publisher

Is It Time to Steer Alcoholics into Medical Treatment and Away from 12-Step Programs?

For more than 70 years treatment for alcoholism has focused on counseling and 12-Step programs. Although alcohol addiction was known to cause medical pathology, such as cirrhosis and pancreatitis, habitual drinking was thought to be a problem of moral weakness. Something in the individual’s character debased one’s will, causing the individual to drink to excess. Up until the 1940s teetotalers beseeched drinkers to pull themselves up by their bootstraps and simply stop drinking. Around that time period an alcoholic, Bill Wilson, developed a prototype of a step program that asked individuals to admit their powerlessness, seek help from a higher power (usually God), search and find their hidden faults and weaknesses, ask God to dispose of them, apologize to those they have hurt, and seek to maintain their improved morality by staying attuned with God. Wilson’s 12-Step program became the backbone of Alcoholics Anonymous (AA). Individuals who participated ardently and fastidiously agreed to stop their drinking and were empowered to remain abstinent. Similar 12-Step programs were established for other addictions such as Narcotics Anonymous.

However, despite the moral and spiritual cleansing that members achieved or sought to achieve by participating in such programs, addictive craving for alcohol and drugs did not disappear for a majority. In fact, cravings for alcohol and drugs were persistent despite the strongest of will power. By one estimate, 95% of individuals who joined AA in January of a given year were no longer participating in December. It is not that the 12-Step program is unworkable or intolerable (although some complain about its dependency on a higher power). It is that counseling and 12-Step work does not banish alcohol or drug cravings. The cravings are mediated by one’s neurochemistry—if the neurochemistry is abnormal, cravings continue and cannot be stopped by will power.

In the 1980s a drug was developed that had opioid-receptor antagonist activity. That drug was naltrexone. Naltrexone’s anti-opioid activity made it an early treatment for opioid addiction. Other drugs have been shown to be more effective in treating opioid dependency. However, naltrexone was a very effective agent in decreasing the craving for alcohol. Extensive research in Europe and the US during the 1990-2010 has found that naltrexone very effectively curbs the craving for alcohol in a majority of treated alcoholics. The use of naltrexone to treat alcohol dependency has been popularized as the Sinclair Method (TSM). Naltrexone has essentially no major adverse effects and the craving for alcohol is substantially curbed enabling the drinker to reduce alcohol consumption 50-100% without difficulty.

What is shocking is that despite the success of this treatment approach, the Sinclair Method is largely ignored in the addiction community. It is not encouraged by AA, alcoholism counselors, and even alcoholism treatment centers. The medical profession is largely ignorant of it, and it is “below the radar” for public seeking answers. The time has come for the medical profession to declare that alcohol dependency should be treated medically and not by 12-Step or counseling. Addiction deserves to be approached medically just like any other physical condition.

It’s a Small World: Making Every Child Obese and Diabetic

Like many of you I was enchanted when I saw the “It’s a Small World” exhibit at the 1964 New York World’s Fair. The ride accompanied by the song of the same name is a mainstay at all of Disney’s entertainment parks. Too bad that world strife, disease, and poverty casts a dissonant image to the theme park’s exhibition and tune. And while we argue over the cause of the world’s steadily rising average Fahrenheit, nature or man, there can be little argument that processed, sugary, trans-fat foods are making children worldwide fat and pre-diabetic. It’s a small world, indeed, one that will suffer and need medical care that is largely of our own creation. For once, when one asks what caused this illness and condition, there can be no confusion—it’s what we put into our mouth.

One would hardly think that junk food has made its way into the backwaters of the Amazon, but, yes, it’s there. Closer to the Brazilian coast a woman, aged 29, is one of many street vendors hired by Nestle, the international food conglomerate, to sell and deliver packaged foods to families. She took a turn at selling Avon but her clients were not able to pay her. “Food” from Nestle is something everyone wants, especially sugary puddings, chips, and other candied foods, and everyone has the money for food. While processed foods have had sales plateau in the US and Europe, the developing world is ripe for new market share. And young women, mothers, know when families receive their paychecks or government allowances, selling packaged foods to women in their communities. It’s a win-win: the women vendors (and Nestle only allows women to be vendors) bring home income to buy a refrigerator and other appliances while Nestle has a profitable increase in their bottom-line worldwide. Too bad that processed foods are making children and adults obese and diabetic. But one has to eat, right? Despite efforts by government agencies to reign in the consumption of sugar and trans-fat, the price is right, and families are not interested in spending hours cooking traditional meals. So, in Brazil the fast-food network is not only carried out at storefronts like McDonald’s but also through direct sales at the house. And business is most definitely booming.

A similar scenario is unfolding in India, the Philippines, in West Africa, China and elsewhere. It may not be female vendors working for Nestle, but packaged sugary foods are being distributed throughout the world. The rate of obesity has notably exploded in the US in the last 30 years. Similarly, obesity is escalating in Europe as well as in South America, Africa, and Asia. We have succeeded in becoming a junk-food nation, now we are a junk-food world. As Julia Ross writes in the cover story for this issue we now crave junk food as much if not more than any other drug. We need a solution to the craving and Ross’s work offers a strategy we must incorporate into our practices to curb our obsession with sugar and fat. It may very well be that Ross’s approach is what we need to make our world smaller!

Bioenergetic Medicine Diagnostics and Grounding to Reduce Pain!

Of all the aspects of integrative and holistic medicine the area that has always given me the most trouble appreciating and understanding has been bio-energetic medicine. We use this term as a rubric for many different techniques and methods. At the crudest level many practitioners and even more patients employ “muscle testing.” Using a variety of techniques, some testing assesses muscle strength changes, some captures movement changes like a pendulum–“kinesiology” is used to test whether a supplement should be taken or a food eaten. The question that often arises is whether the testing may be interfered with by an unsuspected bias of the examiner. Some practitioners use sophisticated energetic devices such as EAV, Electroacupuncture According to Voll, or similar instruments to make “energetic” diagnoses and/or therapeutic decisions. There is a certain degree of impartiality or lessened bias when electronic devices are employed—to a large degree the bias of the practitioner and patient is removed from the signaled energy field that is deemed to be problematic. However, the question remains as to how verifiable energetic diagnoses are especially when specific viruses and toxins are identified.

Many practitioners are concerned about such biases that show up in crude testing techniques. Subsequently “refined” methodologies have been developed to counter and minimize false bioenergetic diagnoses and treatments. In this issue Dr. Reimar Banis, MD, PhD discusses “20 Years of Psychosomatic Energetics.” Bannis, a Swiss physician who has had extensive experience in bioenergetic medicine, developed Psychosomatic Energetics in 1998. A unique aspect of Psychosomatic Energetics (PSE) is its focus unblocking emotional conflicts. Such an approach is critical for restoring not only mental health but also physical well-being. Banis and colleagues have also reviewed, in previously published articles in the Townsend Letter, the effectiveness of PSE.

While grounding is not a diagnostic technique its methodology appears to be the quintessential bioenergetic medicine. At its most basic level grounding is walking or sitting on the ground permitting energy from the earth to come into the body unimpeded by shoes and flooring. Grounding investigators believe that it is the free flow of electrons into the body that acts as a healing process necessary to counter the free radicals that build up, living as we do in our houses, offices, and cars. The key symptom that most individuals experience when nature’s electrons are not free to neutralize our internal stagnant energetics is pain. We use pharmaceuticals and physical methods to reduce pain but drugs, particularly opioids, fail to resolve chronic pain issues.

In this issue James Oschman, PhD, Stephen Sinatra, MD, Gaetan Chevalier, PhD, and Martin Zucker write about grounding. Of course, most individuals do not have the time nor the wherewithal to take 45 minutes to walk around barefoot outside. Fortunately, grounding can be done quite comfortably and easily while we are asleep. The strategy requires that we need to be able to create a flow of energy from the earth outside to our bodies. Pads, mats, and sheets can be connected to properly grounded electrical plugs, and grounding can be accomplished. Such a simple technique deserves a trial, especially in any individual experiencing chronic pain!

CBD and THC Efficacy in Pain Management

Marijuana has long been touted as being an effective natural remedy for pain. Long standing illegality of its use has prevented more widespread appreciation of its pain-relieving benefit. Additionally, there has always been a trade-off between its symptomatic benefit versus a generally non-desired cognitive, disorienting euphoric “high.” Nevertheless, THC has been remarkably effective in a wide number of medical conditions justifying medical use of marijuana. In this issue, Robert Gorter, MD, PhD, an immune system expert at the UCSF, reports on the role of “Cannabis in Pain Management.” Gorter has observed that a cohort of HIV patients who succeeded in staving off the ravaging of AIDS had the common use of smoking marijuana at least three times weekly. Gorter’s work ultimately focused on cancer and here too marijuana has been very effective in lessening the need for opioids, reducing the nausea and emesis associated with chemotherapy, and providing better pain control compared to opioids alone. Gorter reviews the research supporting marijuana’s use in pain management.

Chris Meletis, ND, and Kimberly Wilkes examine “Endocannabinoids, Phytocannabinoids, and Palmitoylethanolamide’s Role in Pain Management” in this issue. Meletis and Wilkes describe the physiology of the endocannabinoid system and pain. THC and CBD operate on endocannabinoid receptors differently and that difference provides a reason for combining THC and CBD treatment in managing pain. Meletis and Wilkes provide the rationale for deciding how to use both.

Jonathan Collin, MD