Category Archives: Alcohol

A Different Path to Fighting Addiction

When their son had to take a medical leave from college, Jack and Wendy knew they — and he — needed help with his binge drinking. Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and in order to stay alive, he’d have to attend A.A. meetings and abstain from alcohol for the rest of his life, they said.

But the couple, a Manhattan reporter and editor who asked to be identified only by their first names to protect their son’s privacy, resisted that approach. Instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change.

The center, known as the C.M.C., operates out of two floors of a 19th-century building on 30th Street and Fifth Avenue. It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users.

Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take.

And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.”

When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Nicole Kosanke, a psychologist at the C.M.C. Tough love might look like an appropriate response, she said, but it often backfires by further damaging the frayed connections to the people to whom the child is closest.

The center’s approach includes motivational interviewing, a goal-oriented form of counseling; cognitive behavioral therapy, a short-term form of psychotherapy; and harm reduction, which seeks to limit the negative consequences of substance abuse. The psychologists also support the use of anti-craving medications like naltrexone, which block the brain’s ability to release endorphins and the high of using the substance.

A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, which are often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of A.A. and other “TSF” — for 12-step facilitation — programs. Results of an updated study have not yet been released.

Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group, reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.

Jack and Wendy’s son, who is in his early 20s, began drinking to alleviate crippling anxiety and ease persistent depression. His drinking, while worrisome, was not an entrenched pattern, his parents believed. Some of Jack’s friends suggested that if their son did not attend A.A. of his own volition, the only thing Jack and Wendy could do was attend Al-Anon.

“The implication was that there was no other solution,” Jack said. “There was a great deal of sadness on their part, empathetic sadness, which in some ways was frightening in itself.”

“A lot of people credit A.A. with saving their lives,” he added. “It’s understandable that they can’t dissociate themselves from a program that worked for them. But it’s an all-or-nothing commitment for life. That really freaked me out.”

In A.A.’s literature, “alcoholism” is defined as “a progressive illness that can never be cured.” Members describe themselves as being “in recovery,” which translates to lifelong abstinence and adherence to the 12 steps mapped out in the Big Book, published four years after the organization was founded in 1935. First among them is the obligation for members to admit their “powerlessness” over alcohol. It also relies heavily on faith; God is mentioned in five of the 12 steps.

On a warm evening last month, about a dozen parents gathered to hear Dr. Kosanke describe the center’s program for families, which goes by the acronym Craft, for Community Reinforcement and Family Training. It rejects, she said, the use of three words: “addict,” “alcoholic” and “enabling,” a term often used to describe the acts of loved ones that help perpetuate unhealthy behaviors.

Instead of addict or alcoholic, she prefers the terms favored by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or the DSM-V, which says that patients suffer from “alcohol use disorder” or “substance abuse disorder,” terms that convey a spectrum of severity.

“Substance use takes on a lot of different shapes and sizes,” Dr. Kosanke said. “There are real downsides to labeling a child with a lifetime identity, when that truly may or may not turn out to be the case.”

And calling caring behavior enabling, she said, has a way of turning even acts of kindness into something negative. “Our field hasn’t done a good job of defining it in a narrow way that’s appropriate,” she said. “If you give your kid money knowing he will go buy pot, that’s enabling. If you take your kid to soccer practice, you’re encouraging healthy behavior. That’s not ‘enabling.’ ”

Part of the Craft approach has parents take care of themselves, too, said Lorraine McNeill-Popper, who volunteers for the parent hotline at the Partnership for Drug-Free Kids, a nonprofit group devoted to recovery for young people. “If you are sleep-deprived and stressed out, how can you think clearly?” she said.

Ms. McNeill-Popper has her own family history of drug abuse. Her twin brother died of an overdose, and she adopted his son, who later became a heavy marijuana user and ended up in rehab. “I tell parents, ‘It’s like when you’re on an airplane, and they tell you to put the oxygen mask over yourself first. That way you can help with the others.’ ”

The center’s approach is controversial in the recovery world. David Rotenberg, executive vice president of treatment at the nonprofit Caron Treatment Centers, a large drug and alcohol rehabilitation provider with branches in several states, cautioned against approaches that do not set abstinence as a goal.

“The majority of people who are chemically dependent would love to be able to drink and drug in a more moderate fashion,” Mr. Rotenberg said. “Most drug addicts and alcoholics would love to drink just a couple of drinks, and they try to do so, with poor results.”

The C.M.C. doctors say treatment for young people needs to be tailored for them, since teenagers and young adults are neurologically, psychologically, socially and legally different from adults, and have different treatment needs.

Dr. Wilkens founded the center with a fellow psychologist, Jeffrey Foote, in 2003. The two had worked together in larger hospital-based treatment centers where they struggled to introduce evidence-based treatments, she said. When it opened, the C.M.C. was one of the few centers in the nation that were not tethered to the 12-step model, she said.

“It was our strong belief that you can work with people at any stage of change, ranging from ‘I’m not even sure I have a substance problem’ all the way to ‘I just got out of rehab and want to go to A.A. meetings every day,’ ” Dr. Wilkens said. “We don’t have a judgment on how you address your substance use problem. Maybe A.A. is helpful to you and you find everything you need there. If it’s not, we genuinely believe there are many strategies for helping to resolve them.”

In fact, a majority of college binge drinkers do not go on to become alcohol dependent, said Stanton Peele, a Brooklyn psychologist who has studied substance use for decades and is a longtime critic of the A.A. model. While binge drinking and other drug use are risky, multiple studies show that most people “mature out” of such recklessness when they begin to have increased responsibilities.

A federally financed study of 43,000 randomly selected Americans, called the National Epidemiologic Survey on Alcohol and Related Conditions, or Nesarc, found that 75 percent of those who are heavy drinkers eventually regain control without rehab or A.A., Dr. Peele said. The survey, which was conducted in the early 2000s and was designed to be representative of the larger United States population, was aimed at helping researchers understand high-risk drinking patterns, design better-targeted treatment programs and monitor recovery. It found that over half of those who recover managed to cut back instead of abstaining, Dr. Peele said.

“Isn’t it more encouraging to know that most people are going to outgrow these habits than to think they’re going to have a disease for the rest their lives?” Dr. Peele asked. “The data show that the odds are in your favor.”

Dr. Wilkens is familiar with that pattern. She was a college binge drinker herself and also struggled with bulimia. Once she left her home state of Kansas for New York City, where she attended Hunter College, she felt culturally stimulated and intellectually challenged, she said, and the drinking and disordered eating disappeared.

“When you focus on building up the world around you, you find stimulation and rewards that are very different from using drugs and alcohol. You find other ways of soothing yourself, and things can get better,” she said.

That is precisely what L.S. learned five years ago. L.S., a Manhattan lawyer in his early 30s who asked to be identified only by his initials to protect his privacy, spent nearly a decade as an episodic binge drinker. He began drinking as a student at his large Midwestern university, where he played rugby and where many of his best friends belonged to fraternities. Alcohol, he said, flowed freely through both subcultures. L.S. said he thought his drinking — weeks of no drinking followed by serious binges of a few dozen drinks over several days — would end after college. Yet the behavior did not fade. The morning after his wedding, he awoke with a hangover that lasted a day and a half.

His father, who drinks socially, told him that people either were alcoholics or were not. But L.S. was unprepared to accept that label and began researching moderation on his own. He found a New York branch of Moderation Management, or M.M., a secular, peer-led support group that takes a cognitive behavioral approach.

In contrast to A.A., which stresses a drinker’s lack of power in the presence of alcohol, M.M. encourages personal responsibility for drinking. The group, founded in 1993, encourages members to start with an alcohol-free month, and then allows for the reintroduction of moderate amounts of alcohol. (Critics note that one of its founders, Audrey Kishline, was involved in a fatal accident while driving drunk. She left the group in January 2000 with the intention of joining A.A., and three months later, crashed head-on into another vehicle, killing the driver and his 12-year-old daughter.)

L.S. now attends hourlong meetings once a week at which he and about a dozen others discuss their goals for moderate drinking, as well as tips, challenges and progress on avoiding triggers. Since he began attending, L.S. limits himself to about five drinks a week, well below the 14 drinks M.M. advises as a safe limit for men.

L.S. is convinced that there is no single approach for all problem drinkers. “M.M. doesn’t profess to work for everybody. It has a scientifically based approach that works for some people,” he said.

The C.M.C. psychologists are blunt about the reasons many teenagers and young adults use drugs: When it comes to decreasing anxiety and relieving depression, substances tend to work for the short term. “Kids aren’t crazy for using them,” Dr. Wilkens said. “They have an effect that is reinforcing in some way. If you understand that, you can strategically work to support and reinforce other healthy, competing behaviors.”

That approach runs through the book she wrote with Dr. Foote and Dr. Kosanke, “Beyond Addiction: How Science and Kindness Can Help People Change.” It was published in February, just as the death of Philip Seymour Hoffman from a heroin overdose struck fear in the hearts of many parents whose children use drugs. It landed Dr. Wilkens on several talk shows and drew scores of calls to the center. (In addition to its New York office, the group has opened a residential treatment center in the Berkshires.)

Dr. Wilkens’s message struck a chord with Wendy. Her son had just left school, and the couple was exploring treatment options. Wired in the evenings with extreme anxiety, he drank excessively to get himself to sleep. Once in bed, he’d stay there till 5 p.m.

Before she read the book, Wendy said, she would stomp upstairs hourly to announce in an exasperated voice, “It’s 2 o’clock. You’ve got to get out of there.”

“I’d do that three or four more times and then be fuming,” she said. “I’d be fuming all day, at home doing my work and knowing he was upstairs sleeping off whatever he’d been drinking the night before.”

After learning the Craft approach, Wendy said, she stopped nagging, changing her negative, accusatory tone to a more pleasant one by asking open-ended questions.

Today, Wendy and Jack’s son is working with his psychiatrist and getting help for his depression and anxiety. He seems to be bingeing much less. When the family went out to dinner on a recent night, the parents each ordered a beer or a glass of wine and sipped slowly through dinner. “How will he learn moderation if he doesn’t see it modeled?” Wendy asked.

Ellie hopes her daughter, too, will be able to change her drinking patterns. Ellie is a New York editor, who asked that her last name be withheld to protect her family’s privacy. Her daughter, 23, has struggled with binge drinking since she was 16. While her daughter graduated from college and holds a responsible job, she still binges on weekends. “It’s so much a part of the culture, it’s everywhere,” Ellie said. “She says she’d have no social life if she stopped drinking.”

Ellie, who grew up in a home in which many relatives attended A.A., at first tried Al-Anon. “They talk about ‘disengaging,’ ” she said. “But it’s your child, and I’m not one of those people who can put her out on the street.”

While their daughter has resisted treatment so far, Ellie and her husband have begun seeing a therapist at the C.M.C. to better navigate their relationship.

“My child is much more than a label or a diagnosis,” she said. “She’s not a problem to be solved, but a child to be loved and guided toward a better life.”

Source:  The New York Times

Starbucks Adding Alcohol to Evening Menu

Popular coffee chain Starbucks is expanding its evening menu with bacon-wrapped dates and Malbec wine. The rollout of new products to almost all of Starbucks’ thousands of locations will take several years, according to Chief Operating Officer Troy Alstead.

“We’ve tested it long enough in enough markets – this is a program that works,” Alstead said. “As we bring the evening program to stores, there’s a meaningful increase in sales during that time of the day.”

The addition of wine to its stock is part of a campaign to increase the chain’s market value to $100 billion, a plan that includes more non-coffee items such as alcohol, juice, food, and an app that will allow customers to order ahead from their smartphones for pickup.

Starbucks first sold alcohol in October 2010 at a Seattle location and expanded the program to Chicago, Atlanta, and Southern California in 2012.

The new evening menu is in about 40 locations now, but won’t be expanding to all of its stores. The company has seen the menu succeed in urban areas where people are out at night, said Alstead, and the menu’s availability will follow suit.

Starbucks has over 20,100 locations worldwide, with 11,500 stores in the United States.

Zombie Beer Brewed With Real Brains

This brainy brew contains cranberries for carnivorous color and smoked goat brains for grisly flavor.

If you fancy yourself a zombie and would like to drink like one, then Dock Street Brewing Company has a beer for you. Their new brainy brew, Walker, is made with cranberries and real, actual brains.

Being fans of The Walking Dead, the brewing company wanted to pay homage to their favorite mindless hordes with a beer that’s infused with carefully roasted brains – goat brains, of course, since we aren’t real zombies yet – for a savory undead twist. The beer is also brewed with cranberries to give it a bloody hue to really help drinkers get in touch with their inner mindless cannibal.

The beer runs at about 7.2 percent alcohol by volume – about 50 percent more potent than most American beers – meaning it will turn drinkers into brainless, shambling shells of themselves in no time. Geek.com has pointed out that this is possibly the worst beer to drink during a zombie apocalypse, as it can put you in a slumped-over stupor rather quickly and leaves your breath smelling like roasted brains, an aromatic meal that will attract the zombie hordes.

The company is set to premiere their “smartest beer” at their own screening of The Walking Dead finale at the end of this month.

Brain Restoration for Addiction & Disease: Too Good to be True?

Could mega doses of energy-giving NAD—which allegedly relieves withdrawal symptoms, flushes out stored drugs in the body and replenishes balance in the brain—really be the cure-all for addiction as well as many other diseases and mental health disorders?

When Paul decided again it was time to do something about his drug addiction, he knew the usual routes wouldn’t work. While using a variety of substances for at least two-thirds of his life – injecting heroin in the last 20 years of it – he also became a veteran of just about every traditional rehab/detox program in the book. Twelve to be exact; with no permanent results or positive outcomes to speak of.

Hearing the remarkable claims from a Brain Restoration Therapy outpatient clinic immediately sent him into skeptic mode: This is too good to be true. How can I kick drugs with just an infusion of some concoction? What about withdrawal? Side effects? And, if it really works, will it last? Sounded far too simple for this jaded, somewhat cynical, pushing-60 drug addict.

Figuring he had nothing to lose, he called and arranged a free consultation. After listening to details of their success rate and impressed with assertions of little or no withdrawal symptoms, he signed up for the treatment – albeit with some reluctance. His wife’s divorce threat had something to do with enrolling, but it was more about life hitting bottom one more time.

Groggily arriving at the crack of 9 am the next day, a warmly friendly nurse in navy blue scrubs hooked him up to an IV. Told that all he needed to do was relax, he settled into the oversize leather lounge chair. If nothing else he’d be able to listen to music, watch a few videos, and read a bit, he thought. Observing the slow drip of clear liquid entering his veins, he listlessly wondered what he would do next if this latest treatment failed.

At the end of the first eight-hour treatment, Paul says he already felt different. He couldn’t quite explain it, he recalls, but his mind was clearer. He felt energized. More alive. And definitely more present.

Returning daily for nine more treatments, he noticed a growing list of undeniable and rather dramatic changes. His outlook was more positive and he was optimistically able to imagine a future for himself, one he’d stopped envisioning years ago. His mind was as sharp as it had been prior to years of drug use.

The best part, he says, true to the claims, there were few or no withdrawal symptoms therefore no need for a replacement drug to get him through yet another grueling detox. He also realized he had no cravings, the primary cause of his continued bouts of relapse. His disbelief completely gone, he recalls, he concluded he was drug free.

But would it last?

Ann Rodgers, the Director of Brain Restoration Therapy, meets me at the door of the Center for Health and Wellbeing in San Diego, CA., where the clinic operates under medical supervision. It’s difficult to not get caught up in her animated explanation of the benefits of this program. “The treatment utilizes a mega dose of NAD [Nicotinamide Adenine Dinucleotide is a co-enzyme of niacin that is the key fuel for energy production in every cell of the body] in an IV form, and it’s clinically proven with a 90% no-craving statistic,” she excitedly offers.

Listening quietly as she rapidly fires glowing statistics in my direction, my skeptical mind revs into full gear. “With literally no reported side-effects,” she says, “the protocol reduces withdrawal symptoms by 70-80% without using replacement drugs, and restores the patient’s clarity and well-being to pre-use levels. Six to ten days of treatment is like a seven or eight month jump-start to recovery.” All this expounded with the tone of a bragging parent.

Rodgers tells me that although relatively new to America, NAD treatment has been successfully used in South Africa since 1961, with centers there reporting more than 22,000 people treated. [Rodgers could not provide any research report from South Africa to confirm this, only a report from individual clinicians who treated patients with NAD. Separately, I could not confirm the 22,000 figure.]

The first NAD clinic to open in the States was in Springfield, Louisiana, founded by psychotherapist Paula Mestayer, M.Ed, LPC, FAPA, along with her psychiatrist husband Richard. The couple discovered the treatment when their 16-year-old adopted daughter became addicted to alcohol and found her way into NAD treatment. Thrilled to see her positive results, they conducted their own research and in 2001, putting aside their cumulative years of treating addicts with therapy, they opened the Springfield Wellness Center on a private 500-acre estate. They claim to have treated more than 1,000 patients since then with NAD.

Springfield Wellness Center’s ten day addiction detox, Mestayer asserts when I contact her, has been used successfully on people hooked on prescription drugs, alcohol, opiates, benzos, stimulants, cocaine, marijuana, suboxone, and methadone.

Mestayer noted in our interview that “like a thumb print, all brains are unique, so this protocol is more like an art than a science.” Each patient, she pointed out, responds differently to NAD, with one factor being their type of addiction. She therefore adjusts the dosage and prescribes booster NAD treatments when necessary, especially when a patient feels vulnerable or if any cravings return. “I always emphasize that there may be a period of time where they need maintenance, either by an occasional booster or other means of support. Some patients have gone nine years without needing a booster, but many do.” Mestayer generally prescribes oral NAD as a supplement to the IVs, on the grounds that the more NAD that builds up in an addict’s system, the less prone he or she is to succumbing to cravings

Mestayer emphasizes that the treatment is “not a cure, but rather maintenance,” and notes that it remains a mystery as to why NAD works more successfully on some addictions than others. “The highest success rate is on alcohol and opiate users,” she says. “The only failures are people who were using during the treatment or not committed to their maintenance.” Even so, she like Rodgers encourages all patients to seek therapy and support groups to address underlying psychological issues.

In California, I asked Rodgers if the treatment is just a substitute “high.” Rodgers countered with “it’s a state of well-being that allows the client to feel content with their life, so many don’t even consider going back to being an addict, no desire for that miserable life anymore. It’s as if they become themselves again, back to their natural state, seeing themselves as a different person, separate from being an addicted person. It’s not just a detox; it’s a total state of sobriety.”

With only a handful of other U.S. clinics in existence, the technology has yet to become familiar to most of the recovery community. Even so, Ann Rodgers says she is certain that once knowledge of NAD spreads, it will be seen as a revolution in addiction treatment. “[Members of] the AA community have been resistant to it at first, but once they read the evidence and witness the results, they embrace it,” she claims.

Her San Diego clinic is modern, serenely comfortable and well-appointed. Located on the first floor of the larger health center, it’s been open for over three years and has treated nearly 40 patients. Rodgers recently opened another facility in Los Angeles, CA, at the Center for Optimum Health.

HOW THE TREATMENT WORKS

Dr. Janette Gray, a California licensed internist and a pioneer in combining allopathic and holistic medical approaches, is the center’s medical director. Board certified in Holistic Integrative Medicine, she worked for years in the prison system helping inmates get off drugs and has extensive experience with the agonies of drug withdrawal. “Seizures, nausea and vomiting, intense sweating and physical pain are standard, but that is greatly minimized with this program,” she tells me. “The most common withdrawal symptom is feeling a little bit flu-ish…[which] passes quickly.”

Gray rattles off to me a scientific explanation behind the BR treatment. The protocol, she says, employs a proprietary NAD formula administered by IV. NAD is an element that reacts with oxygen in the cell’s mitochondria in order to create energy for movement, breathing, heartbeat, blood pumping, digesting food, brain functions, and generally living life. It is available in low doses over the counter.

Studies have found that those with extremely low NAD levels (which can be present even at birth) are far more vulnerable to addiction as well as other diseases and to chronic physical conditions. There is a preponderance of low levels of NAD present in Western society as it is mostly lost in cooking and food processing. What little remains is broken down by stomach acid, degraded before it’s absorbed from the digestive tract.

When the clinic’s all-natural NAD is received directly through an IV, the nutrients bypass the stomach and go directly to the receptors in the brain, Gray tells me. According to Gray, this immediately produces palpable positive results as the nutrients bathe the brain in a continuous pool of natural and highly therapeutic co-enzymes.

Since NAD is a detoxifier, it takes days (rather than weeks or months), to flush out stored drugs from the body and its organs, replenish balance in the brain, and reverse damage. Results can be mental clarity, cognitive function increase, focus and concentration returns, more energy, better mood, positive outlook. And this happens cold turkey.

“We find that one of the big reasons this treatment works is because it’s so rapid,” Gray says. The majority of drug addicted individuals, she claims, need about ten days of infusions, sometimes less. “It keeps people inspired when they see fast results,” she adds, “especially when they feel better than they did before, or perhaps ever in their life.”

Based on each individual, Gray like Mestayer sometimes recommends a periodic “booster” which can be one or two days of IV to support the results achieved in the initial treatment. She also prescribes a co-enzyme that, she says, helps maintain higher levels of NAD in the body. If a client relapses, she claims, one or two treatments can quickly get them sober and craving-free again.

The clinic also offers a four day “Tune Up” treatment for those suffering from stress, anxiety, irritability, low energy, PTSD and depression. The clinics also address other non-substance related addictions such as gambling.

NAD was first discovered in 1936, but World War II stopped the research. It was patented for treatment of drug addiction and schizophrenia in 1961 based on an 11,000 patient study. Sloughed aside with the discovery of methadone – a far more lucrative choice at the time for drug companies – NAD went “underground.”

Research has shown that NAD increases the synthesis of certain neurotransmitters in the brain known to be effective in correcting specific chemical imbalances. Some of these chemical imbalances underpin addiction, mental illness, anxiety, aggression, depression, despair and hopelessness. Fatigue is often the first signal of NAD deprivation; other clues may include depression and anxiety in children. Almost any chronic disease, including Parkinson’s, can also be indicative of deficiency.

There is some research and other reports indicating that NAD might be effective treatment for a host of other ailments including schizophrenia, PTSD, chronic fatigue, weak immune system, memory disturbance, sleep problems, concentration defects, blood pressure, poor cholesterol levels, sugar metabolism and diabetes, muscle pain and weakness, joint pain and stiffness, headaches, fevers, sore throats and swollen lymph glands. Clinical research has shown it is a potent biological antioxidant which can aid in preventing cell damage and a variety of diseases, cancer included.

There is also some evidence that NAD therapy can help with aging. Dr. David Sinclair, professor of genetics at Harvard Medical School, in a paper published in the journal Cell, describes a compound naturally made by young cells that is able to revive older cells, allowing them to be energetic and youthful again. With adequate amounts of NAD, aging can theoretically be reversed, he asserts. “When we give the molecule, the cells think oxygen levels are normal and everything revs back up again,” Sinclair wrote.

Pondering these claims raises the un-researched theory of whether NAD deficiency might be an unrecognized epidemic disease of our time.

THE BIOCHEMICAL PATH TO PERSONAL DEFICIENCY

Before I interviewed patients of the two clinics to determine whether they validated the positive assertions of Rodgers, Gray and Mestayer (they do, as you will read below), I decided to research more carefully the biology of the NAD process to determine whether there is a basis in science for their claims even in the absence of double-blind long-term studies. What I learned is relevant to the health, mental vitality and even possibly, as Sinclair asserts, to the aging of each of us, not only to addicts.

I learned that a range of vitamins, minerals, carbohydrates, proteins and fats from our diet provide the building blocks to create what medicine refers to as the “Citric Acid Cycle,” which names the energy it takes to produce NAD and link it with hydrogen (NADH). NADH enters the electron transport chain in the mitochondria and is sparked with oxygen – and the outcome is energy. This in turn fuels the 86,000 daily beats of the heart, enabling muscles to contract, and provides the cellular energy requirements of the 100 trillion cells of the body. The brain consumes about one-third of all the energy produced, so if the NADH is low, brain functions suffer. If any of the nutritional factors that produce NAD are low, energy production is weakened.

Often NAD deficiency is first evident in brain-related symptoms of poor concentration, difficulty focusing, and attention deficit disorders. If the energy shortage lasts long enough, brain neurons cannot synthesize neurotransmitters. When this occurs, the molecules of consciousness (such as serotonin, dopamine, and noradrenaline) are affected. Anxiety, depression, sleep disturbance and other mood changes can then arise.

Also important to know is that the crucial enzymes that catalyze the Citric Acid Cycle are inhibited or destroyed by chemical toxins that create oxidative, or free radical damage. Sources of the damage include cigarette smoke, drugs, chronic stress, sedentary living, as well as the accumulation of the myriad toxins found in daily life such as in pesticides.

Along with acquired NAD deficiency, there may also be a genetic disorder that is present at birth. Symptoms can appear in young children as difficulty sleeping, behavioral problems, hyperactivity, impaired concentration, academic stress and underachievement.

Moreover, NAD deficiency that induces fatigue and depression increases a propensity to use drugs and alcohol in order to improve energy and mood – simply to feel better. The self-medicating cycle is a common story reported by many addicts, and leads to even lower NAD. A vicious cycle ensues.

There is some history to using megavitamins as potential cures for addiction, including dating back to Bill Wilson’s (aka “Bill W.” the revered co-founder of Alcoholics Anonymous) ideas and experience. In 1960 Wilson underwent a major shift in his beliefs about the value of nutrition in achieving sobriety when he met Dr. Humphry Osmond who introduced him to the concept of megavitamin therapy. Curious, Wilson became a guinea pig, taking 3,000 mg of niacin daily. Within a few weeks, fatigue and depression (symptoms of low NAD) which had plagued him for years, were gone.

Seeking to share this exciting discovery, Wilson gave the same doses to 30 of his close friends in AA, hoping it could be replicated. Of the 30, 20 he later reported became free of anxiety, tension and depression in one or two months. This dramatically reduced their alcohol consumption.

Wilson wrote a detailed report called “The Vitamin B 3 Therapy” and distributed thousands of copies as a pamphlet. Because the information was controversial, way ahead of its time and ran counter to the precepts of the 12-Step Program, Wilson became unpopular with the board of directors of AA International and the information was squelched

THE PATIENTS HAVE THEIR SAY

Unfortunately, newer in-depth scientific studies in the U.S. on the long-term benefit of NAD treatment on addiction and alcoholism have never been financed. That leaves largely the claims of clinic operators and their patients to bear out the assumption that, by virtue of its catalytic role in the body, NAD might in fact be an effective agent in addiction and alcohol treatment.

Rodger’s California centers are too new to have meaningful data on the long-term effects of NAD treatment based on follow-up interviews with patients, though Rodgers says she intends to set up a formal study of her patients in the near future. Mestayer’s Louisiana clinic did collect data for some years which was lost when their clinic was hit hard during hurricane Katrina. She has been collecting more recent statistics on the long-term effects of the NAD formula her clinic uses which, she claims, show an even higher success rate than the earlier formula.

In fact, the statistics if true are astounding, with some earlier participants in the Louisiana clinic achieving, according to Mestayer, nine years of sobriety.

“Statistically,” Rodgers claims, “70% of patients are craving-free by day five; 90% by day ten.” She adds that some reported having no physical memory of how drugs even felt, clearing their desire for them.

As testimonials, Rodgers provided me several video-taped former patients, each boasting tremendous success. One was from a man who claimed he had been taking 30 Oxycontins a day for 12 years. Another was from a woman who had been suicidal, shot speed for 20 years. Another woman reported a personal trauma that threw her into deep depression. Each claimed to have maintained a drug free life since their treatment.

I inquire about Paul who went through treatment three years ago: Is he still clean and sober?

“Not only is he clean and sober, he paid for two of his friends to do the treatment,” Rodgers tells me, with tears in her eyes. “He no longer defines himself as an addict since his thought patterns have shifted and he sees life so differently.”

Separately, I interviewed four people who have gone through treatment at either the San Diego or Springfield, Louisiana centers. Their stories:

• Doug, a health-conscious personal fitness trainer who experienced CTS (Chronic Traumatic Encylopathy) from several football injuries, would drink copious amounts of vodka at night to allow his amped-up body and mind to relax and shut down. He tried exercise and nutrition to get past anxiety-based insomnia; nothing worked. He knew that a 12-step program or therapy that dealt with past history wouldn’t work for him given that his issue was clearly a chemical imbalance. After just 20 minutes with his first NAD IV, he experienced a state of well-being he hadn’t felt in his entire adult life. His angst was gone, and the neuro-transmitters that lay dormant in his brain felt alive again. After the first day of treatment he was able to sleep soundly, and he told me he’d been craving-free for more than four months. He takes an NAD supplement and goes back monthly for a booster.

• After several tours of duty in Iraq, Patrick, a Marine, became a heavy heroin user after trying many other ways to self-medicate his PTSD and resulting insomnia. He admitted himself to two traditional inpatient treatments, one lasting 57 days. The first day out of each, he relapsed. After day four of the NAD treatment, during which he experienced no withdrawal symptoms, he felt completely clear and now sleeps without nightmares. He gets boosters once a month and has been drug free for several years.

• Steve, also an Iraq veteran, had nine neck surgeries in five years. He used pain pills and opiate drugs to deal with constant physical pain as well as intense PTSD. He entered the NAD program out of a desperate desire to be free of his addictions in that he has children and perceived a good life ahead of him. Starting the NAD program with a pain scale of eight, within ten days the pain eased down to a one. On bad days, he says, it now goes up to a two, but is easily managed with a couple of Aleve. With only slight withdrawal symptoms, he told me he is now 100% craving free and his PTSD is also gone. He continues to take the oral NAD supplement but has not needed any booster treatments. He did the program in November, 2013.

• Sandy is a young woman whose addiction to pain killers and amphetamines spiraled from recreational use to a full-on necessity. For three years she was not able to get out of bed without drugs, the lowest point of her life. She researched various other programs and told me she was baffled by the concept of replacing one drug addiction with another as a “cure.” After eight days of NAD treatment, she no longer thinks about using at all. Her mood is good, her energy is up, and she’s happy, she reported. Clean for a year and a half, she believes it was the combination of the in-home IV treatment she received and the warm caring from the clinic staff that made the difference. She has had two boosters and believes she won’t need any more to remain addiction free.

I ask Ann Rodgers if the treatment works for everyone and if not, is there a typical profile of who it doesn’t work for? “No, it doesn’t work 100% of the time,” she replies. “Interestingly, sometimes it doesn’t work for young heroin addicts. It could be because they aren’t emotionally mature enough to deal with their issues, or perhaps they don’t have a good support system in place yet.”

One young man, Rodgers notes, went through the program a year ago and did extremely well until he entered an intimate relationship. “That triggered emotional issues,” Rodgers says, and he returned to the arms of heroin. The Center then refused to treat him again as he refused to enter rehab, an essential aftercare resource in which BR+ patients are encouraged to participate.

“Patients often feel like a fish-out-of-water when out of the drug culture they are accustomed to, and they need to find a structure to help them live drug free,” Rodgers explained. Accordingly, patients are informed of the importance of addressing any long-standing psychological issues and of re-learning how to live life as a non-addicted person, and they are encouraged to enter after-care programs that provide such support. “Rehab programs work so much better after doing NAD therapy since the person is so clear, more willing to make it work in their lives,” Rodgers says. “Their confidence allows them to make significant shifts in other areas of life so they are far less likely to relapse when they re-enter society.

“We really see ourselves reversing the customary order of mind/body to body/mind… by addressing the bio-chemical issues first it makes it so much easier to shift other areas of an addict’s life.”

Although the clinic runs its own therapeutic center, the staff advocates follow-up support groups that can include 12-step programs and/or conjunctive therapies such as outside psychological and spiritual counseling. As part of one of the largest integrative medicine centers in California, the Center for Health and Wellbeing, the clinic itself offers intensive psychotherapy along with a recovery coach. Patient options include an IOP, sober living, or simply going home. The center also offers a full menu of complementary programs including massage therapy, cranial sacral therapy, naturopathic, nutritional counseling, acupuncture, marriage and family therapy and chiropractic, all of which Dr. Gray prescribes on an individual basis.

Separate from after-care, could NAD itself turn out to be something of a miracle cure or at least pre-cure for addicts? As more people go through the programs, there will be more statistics on permanency of results but no fully authenticated research until some serious independent and double-blind studies are undertaken by scientists, medical professionals or companies who can attract the funds to finance research. Meanwhile, NAD figures to remain something of a blip on the treatment scene attracting people like Paul who said simply: “There is just nothing to lose.”

What is Alcohol Tolerance?

What is alcohol tolerance  — and how quickly does it change?

With St. Patrick’s Day around the corner, many revelers are already busily coordinating their green outfits and drinking plans. But there’s a difference between enjoying one green beer (or perhaps something similarly festive but a little bit healthier) and losing all control. St. Patrick’s Day undeniably owns one of the top spots on any list of the drunkest holidays — and tolerance (or lack there of) may never be so publicly on display.

So why can some people handle their liquor better than others? First, it’s important to define what, exactly, tolerance is. There are two ways of thinking about it, says George F. Koob, Ph.D., the director of the National Institute on Alcohol Abuse and Alcoholism. Developing tolerance to alcohol — or any drug — means it takes more of that drug to produce the same effect — or, looked at another way, the same amount of the drug produces less of an effect.

Some people are born with the ability to go round for round, showing minimal effects. A growing body of research from the University of California, San Diego among families with history of alcoholism has pinpointed low-sensitivity to alcohol in some people, or what Koob calls inherent tolerance. “These are basically individuals who drink everybody under the table and they’re born that way,” he says. “It’s an intriguing neurobiological question as to why, but it still remains somewhat of a mystery.” Ironically, this low-sensitivity actually seems to make someone more likely to become an alcoholic, he says.

But other people simply become more tolerant as they drink more. “In effect, to me, tolerance is the brain adapting to the drug,” says Koob. There are different pathways by which the brain adapts, but the end result is that more alcohol is required to feel the same buzz.

There’s likely a Pavlovian-esque learning response involved, he says. The brain learns the effects of alcohol and triggers a response to counter those effects. Then, the next time you throw a few back, your brain has already learned how to react. When we drink, our brains are constantly working to return our bodies to baseline. “When you remove the alcohol, that system is exposed as being overactive,” says Koob. “That’s what we call withdrawal.”

On a day-to-day basis, you might have a different name for that withdrawal: hangover. What’s called acute tolerance can develop over just a few hours, says Koob. Take your average picnic, he says. One beer might make you feel relaxed and sociable, but the third or fourth beer out on the lawn has much less noticeable of an effect. Technically, that’s a form of tolerance building throughout the afternoon, he says. The more you drink at that picnic, the greater tolerance you develop — and the worse you can expect to feel the next day.

Among people who are dependent on alcohol, adaptations can also take place elsewhere in the body, says Koob. Drinking a lot may cause liver enzymes that break down alcohol to become more active. “An alcoholic person could metabolize perhaps twice as fast and twice as much in a given amount of time as a non-alcoholic,” he says.

The exact rate of building or decreasing your tolerance will vary greatly depending on how much you’ve been drinking and for how long, but you’ll likely lose your tolerance at the same speed you gained it. A period of time spent teetotalling “will reverse a lot of the tolerance but not all of it,” says Koob. That’s because those pathways in the brain that adapted to the effects of alcohol show traces that changes have occurred forever. Pick up the bottle again and they’re reactivated much more quickly. It’s similar to riding a bike: Hopping back on after a hiatus takes a little re-learning when it comes to steering and balance, but it’s infinitely easier than learning that first time. “The system is forever changed,” says Koob. “Your response is not quite the same ever again.”