Unique treatment for alcohol abuse gaining traction

A drug called Naltrexone is delivered through an implant.
Thursday, May 15, 2014
A unique treatment for alcohol abuse is gaining traction in the Bay Area. It relies in part on a small implant placed inside the body to deliver the medicine.

That implant helped reverse a painful slide for actor Jeremy Miller, from a starring role on the television sit-com Growing Pains, through a battle with alcoholism that lasted years.



"It got worse and worse over a 14 year period. Not all day, but 4-5 drinks a day, then kept growing," Miller said.

He says he tried myriad rehab programs. But after little success, he turned to a program called Start Fresh. It combines the familiar counseling model with an anti-addiction drug, delivered in a unique way.

"I could not have been more skeptical when I heard about Start Fresh program and the implant. The idea that some magic pill was going to make this all go away was unfathomable to me," he said.

Rather than a pill, the drug called Naltrexone is actually delivered through an implant. In a short procedure, doctors place the time-released dosage beneath the skin on the lower right hand side of the stomach.

Dr. George Fallieras is a physician with the program, which has a treatment center in Walnut Creek.

"Naltrexone attaches itself and blocks receptors in the brain. The impulsive desire to drink is mediated by that pathway," Fallieras explained. "So by blocking these receptors, it prevents that cascade, that euphoric feedback loop that addiction provokes."

He says once in place, the implant is designed to disrupt the pathway for a period ranging from six months to a year, depending on the patient's metabolism. Naltrexone itself has been available for more than two decades for alcohol treatment, but until recently it was mainly in pill form, which was a hurdle for many struggling alcoholics.

"If you take alcoholics, the most notorious of non-compliant patients, they're not going to take their medications. Even if they're very dedicated and do, after three months doing pretty well, they delude themselves into thinking I don't need this," Fallieras said.

Todd McMenamin began working in patient outreach after graduating from the program. He believes the Naltrexone implant was key to his completing the rehab counseling.

"I believe that's such a strong component-- enough period of time to get the demon off your back," he said.

Side effects from the drug can include nausea, dizziness, and anxiety. And success isn't guaranteed. Jeremy Miller says he suffered a relapse after dropping out of counseling the first time.

"They let me start from the beginning. From then on I've been completely sober," MIller said.

Since that time, Miller has been entertaining acting offers, while also beginning work as a patient advocate with the program he now credits with turning his life around.

As for cost, the treatment program can run into the thousands of dollars. The Affordable Care Act now requires insurers to provide coverage for substance abuse, but specific benefits can vary.

Written and produced by Tim Didion
Related Topics:
health alcohol prescription drugs Walnut Creek
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