The End of My Addiction by Olivier Ameisen M.D. Read Free Book Online Page A

treatment and recover.”

3. Under Treatment and “In Recovery”
    PHYSICIANS ARE NOTORIOUSLY BAD PATIENTS who often inhibit their recovery by trying to run their own cases. In the last days of August 1997, as I recuperated in New York Hospital from massive seizures suffered during acute alcohol withdrawal, I wondered if I had been adding to my problems in that way, despite my best efforts not to do so.
    For the previous nine months, despite recurring denial of the extent of my drinking problem, I had been trying to find someone who could run my case and manage my treatment for anxiety and alcohol dependency. A daisy chain of referrals sent me to a number of highly regarded and credentialed specialists, none of whom ever proposed a comprehensive treatment plan, although some of them did not hesitate to criticize the way my referring psychiatrist treated me. By default, I was forced to coordinate my care as best I could on my own.
    From my psychopharmacologist I received prescriptions for tranquilizers, benzos like Valium and Xanax. Saying they were helpful for anxiety as well as depression, the psychopharmacologist also prescribed selective serotonin reuptake inhibitors, or SSRIs, like Prozac and Zoloft. We tried them at various dosages alone and in combination. None of the permutations were effective, and all of them had unpleasant side effects.
    The psychiatrist I was seeing for alcohol dependency knew I was taking these medications, and he also prescribed Antabuse (disulfiram). Antabuse, which stays active in the body for five days, blocks the liver from breaking down alcohol, so that if you drink on it you almost immediately experience the nastiest symptoms of severe intoxication: accelerated heart rate, flushed skin, shortness of breath, nausea, and vomiting. Keep drinking and you could die. Taking Antabuse is a form of aversion therapy, the idea being that the fear of becoming very ill or dying will scare the patient enough not to drink.
    Aversion therapy with Antabuse has not worked well in general, because it does not affect the craving for alcohol and patients know that if they stop taking Antabuse for five days it will clear their systems and they can drink again safely, so to speak. It has been shown effective only in a minority of patients. Very few problem drinkers can stick to an Antabuse regimen, and I was not one of them. Instead, like many people who try Antabuse, I played games with it. When I was looking forward to attending a party on the weekend, I stopped taking it at the beginning of the week so that it cleared my system. In one instance I simply succumbed to mounting craving and drank even though I had the medication in my bloodstream, which flushed my face and made my heart pound. When I reported this to my psychiatrist and said I thought it was dangerous for me to be on Antabuse, he agreed and immediately took me off it.
    I tried acupuncture and hypnosis therapy, both of which had zero effect, and I consulted a highly recommended specialist in cognitive behavioral therapy (CBT), which I was told could help me avoid and resolve emotional experiences that triggered drinking. He seemed more interested in turning me from a binge liquor drinker into a moderate wine drinker.
    Progressively, I increased my attendance at Alcoholics Anonymous meetings, read about AA’s history and philosophy, and tried unsuccessfully to advance through the famous twelve steps. I always found benefit in the wisdom of AA, but fearing that my religious agnosticism might keep the program from working for me, I also tried Rational Recovery (RR).
    RR appealed to me greatly. Its central premises are that alcoholism is not a biological disease but a voluntary behavior and that the individual can overcome it with his or her own intellectual resources. In my experience, however, the “power within” celebrated by RR and the “higher power” of AA both proved puny in the face of the overwhelming power of my anxiety-driven craving