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Controversial Program Works For Some Drug Addicts

By Balzafire, Aug 6, 2010 | |
  1. Balzafire
    SAN FRANCISCO (CBS 5) "It felt like a near-death experience. No energy, complete lifelessness, no appetite, sweating, chills. You know, just no motivation. Your will is sucked out of you."

    That's how a young man we'll call "Mark" describes giving up oxycontin after eight months of taking the prescription painkiller to get high.

    "It started with anywhere from 5 to 15 milligrams at the beginning to probably around 240 milligrams at the end," he explains.

    Mark lost his job. He was scared he'd lose his life. So he investigated some abstinence-based treatment programs.

    "All of those options required, you know, to be absolutely clean - no drug use of any kind whatsoever, no drinking, no smoking, anything."

    Dr. Carolyn Schuman says that's just not the way to go for everyone.

    "All the evidence has show that in the last fifty years that that approach doesn't work," she says.

    Schuman is Medical Director at the Reliance Center, a drug treatment program that opened eleven months ago on San Francisco.

    "Models that really emphasize abstinence only are sort of the perfectionists of the treatment world," she says. "It would be wonderful if all my patients were able to comply with everything they wanted. Unfortunately, it's not realistic."

    The Reliance Center uses a model called "harm reduction" - zeroing in on a patient's most dangerous habit, while putting the non-life-threatening behaviors on the back burner. Executive Director and co-founder Jerry Bayer says he agrees total abstinence is the standard, but he says some addicts may not even seek treatment if they know it means giving up all those behaviors at once.

    "Our feeling is let's get people on the road. Let's get them started," Bayer says. "Everybody can't do it all immediately. There are some people who need to be lead step by step to a healthier, safer place."

    We talked to several representatives of abstinence-based programs who didn't want to appear on camera. But they all expressed concern that the harm reduction method would fail in the long run; that patients who don't stop things like drinking and smoking while kicking an opiate addiction will be more likely to fall back into dangerous habits.

    Mark found the approach unique: "It was very different from the help I had tried to find at first."

    When he met Dr. Schuman at the Reliance Center, he got the ok to continue his occasional drinking and marijuana use.

    "We and Mark together opted to address the oxycontin use and work on giving him a medication that would help him get over his withdrawal, that would absolutely eliminate his craving," Schuman remembers.

    Now with that medication and support at Reliance, Mark is off oxycontin. He says the idea of returning to it is "repulsive." And he's not the only Reliance client to defeat his body's constant clamoring for drugs. Bayer says they've seen most patients hit the road to success:

    "People come to us and within a month or two, we find that the majority of those patients are not using opiates on a daily basis."

    Mark adds, "I think I'm headed in the right direction. I know I am."

    Joe Vazquez
    Aug 5, 2010


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