Drinkers Decide What Constitutes Unhealthy Drinking

Andrew Sullivan is concerned that the new DSM-V psychiatric classification system will define the 40% of college students who sometimes binge drink as alcoholic. He links to an angry critique by Russell Blackford, who sees the potential over-extension of the alcoholic label as misguided and oppressive.

As I outlined a few days ago, and Dr. Deni Carise elaborates on today at Huffington Post, the alarming 40% figure that keeps being quoted is misleading. If criteria were broadened, the purpose would be specifically to identify problem drinkers who are not what is commonly understood as alcoholic. Continue reading “Drinkers Decide What Constitutes Unhealthy Drinking”

The Rise and Fall of a “Miracle Cure” for Drug Addiction

Dr. Walter Ling, one of the world’s most respected addiction treatment researchers, has completed the first long-term placebo-controlled trial of PROMETA. This alleged miracle cure for methamphetamine addiction proved completely ineffective. I have a short commentary in the journal Addiction (pdf here) describing the rise and fall of this heavily-promoted treatment protocol.

60 Minutes did some investigative reporting on PROMETA a few years back, noting that the treatment protocol was never FDA-approved and that a suspicious number of its advocates were discovered to have a financial stake in the product. The whole story is worth watching as a cautionary tale:

As someone who has worked with addicted patients, I am struck by the moment when journalist Scott Pelley asks the creator of PROMETA (a former junk bond salesman named Terren Peizer) about the need for evidence before an addiction treatment is marketed. Peizer responds as follows:

If you had a son. If you had a son or a daughter, and maybe you do. If he’s strung out on meth. And he’s going to kill himself. Would you, if you had the opportunity. And I said to you, will you treat your son with Prometa?…Would you take that option for your son?”

The answer to this question is yes for many people, but this undermines rather than supports Peizer’s contention that it’s wrong to wait for evidence. Rather, it is *because* people are so desperate for a cure to addiction that we have a responsibility to rigorously research putative cures before they are marketed to the public. Otherwise, vulnerable, frightened people may spend thousands of dollars on ineffective treatments instead of pursuing other options that have a greater chance of restoring them to health.