9/28/2015

Op-ed homework #1

http://www.nytimes.com/2014/01/02/opinion/cold-turkey-isnt-the-only-route.html?_r=0


  B Rose
English/ Assignment #2
Draft


   In a recent op-ed titled “Cold Turkey Isn’t the Only Route”, writer Gabrielle Glaser talks about the lack of promotion for methods of treating alcoholism outside of Alcoholics Anonymous (AA). Her article cites that women are on the sharp edge of alcoholic drinking in America, the failings of the traditional method of going cold turkey and abstinence for quitting drinking and the growing body of science behind programs that teach tools to implant moderation in place of binge drinking.
   Gabrielle Glaser could be seen as an expert in alcoholism amongst women. She has published a few books on the subject and she writes about the topic often. This particular op-ed is not specifically about women but they do make up the lion’s share of content. She explains women are increasingly needed more help for more drinking. Drunk driving among women has increased by women has increased over the last 20 years in America. She also say that of the 856 million gallons of wine sold in the US, women are buying more of it than men.
   Also mentioned in the article is the perceived shortcomings and failings of AA for helping women get sober. In her books she talks about some of the safety issues that woman are subject to inside the AA program. She states that programs like AA are kept in existence by doctors and the multibillion dollar treatment industry. She cites that the 12 steps that are used by the multibillion dollar treatment industry were created by chronic inebriate men in the 1930s.
   Gabrielle Glaser quotes research by Bankole Johnson, a consultant to pharmaceutical companies and the chair of University of Maryland School of Medicine’s Psychology Department. Johnson recommends a program of abstinence, helping women to reach a point of no more than 9 drinks a week and no more than three in any one sitting. A program like this with a drug intervention using Naltrexone (an opiate antagonist) has shown promise in reaching the goals of these moderation programs.
   I feel that there is more to say about the idea of moderation in drinking and the treatment options available to both men and women. The biggest gaps in this op-ed that I can see are the idea of moderation and how it is defined, the linking of twelve step programs to the multibillion dollar treatment industry and the idea that Bankhole Johnson is a consultant for the makers of Naltrexone which he recommends as an answer to the 12-step/ multibillion dollar treatment industrial complex.
   The possibility that we can help people arrest their drinking problems in any way is great news. I am a big fan of short term drug interventions as treatment options for all kinds of physical and mental illnesses. I think it is important to recognize ongoing research also, it is the brightest spot on the horizon of treatment for alcoholism. I do worry that the outcome for success mentioned by Gabriel Johnson is 9 drinks a week or less and no more than three per sitting. The conversation should include the fact that the CDC defines 4 drinks in one sitting as binge drinking for women. If the program slows drinking to manageable levels that is a victory but are we ok with defining manageable levels just shy of binge drinking three times a week? The CDC defines moderate drinking for women as 1 drink a day and for men just 2 drinks per day. The plan of moderation here is an 80% increase over what the CDC recommends. I think this conversation should reconcile the difference between what Moderation Management LLC recommends with what the CDC recommends, the gap is too large considering what is at risk.
  In America and around the world, 12 step programs have not only been the most successful over the last 70+ years but also the most accessible. Twelve step programs such as AA and NA (Narcotics Anonymous) have always been free. They are located in nearly every country around the world and they represent languages from all over the world. These programs have always been the the one place anyone can turn to. A person in crisis, someone who wants to help someone with a problem or someone who feels they have a problem can always walk through the doors to a meeting and find an accepting fellowship. Because there is no money involved with the 12 steps anybody can use their literature and ideas. Many large treatment facilities have used the 12 steps to help people get help for addiction. Hazelton is an example of a money making treatment center that uses the twelve step, but it would be unfair to say the 12 steps are part of a multibillion dollar industry. If a hospital recommends sun and fresh air as part of its treatment, we wouldn’t label sun and fresh air as part of a multibillion dollar healthcare industry. Along those same lines, Gideon’s bibles are not responsible for the billions of dollars the hotel/ motel industry makes each year, they are just the free literature included with the room.
  The last thing that we need to keep in mind when we discuss this is the idea that the twelve steps are part of a multibillion dollar treatment industrial complex and thus untrustable but Bankhole Johnson is beyond reproach as merely a consultant for the company that makes the drug used in the therapy being recommended here. I don’t want to say that Mr. Johnson is corrupt in anyway, but his position makes him unusable as a source the way he is relied upon here. Regardless of his actions and involvement, there is certainly to easily a line drawn to Teva Pharmapsudicals for him to beyond question, his involvement in this op-ed is a conflict of interest to be sure.
   I am go into the future kicking and screaming about moderation as a treatment for drug addiction and alcoholism but I see the writing on the wall, there is a dearth of promising research available with more coming in the future. I am a proponent of drug interventions and drug therapies when used properly. Because of my feelings about the inevitability of moderation therapies I feel we need to be extra diligent about our recommendations. When we have these conversations it is important to cover all the point and keep both eyes open, the idea of “learning moderation” is too close to a blank check for the alcoholic mind to be taken lightly.




   

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