Fighting Fire With Fire

Does an unproven treatment that combats drug addiction with drugs promise more than it can deliver?

"She had this problem I didn't understand, and I had this problem she didn't understand," Steve says.

After she discovered him smoking meth in his office yet again and he moved out, his wife researched treatments online and came across the Prometa Web site. Steve called Murray Hill. He began seeing the center's therapist, and Dr. White recommended Prometa because she had found it to be most useful for meth addiction. Steve was determined not to touch the drug again, so for 20 days until his treatment began, he struggled with withdrawal.

"I was depressed about everything. It all looked very bleak," he says. "I got tired early at night, couldn't get up in the morning, missed days at work. I had to fight tooth and nail to get through every day." His body, having been kept in a hyper-alert state for so long, was crashing. A host of receptors in his brain, suddenly unoccupied, were signaling him to alleviate the exhaustion by using.

Laurry Michlin, a retired salesman who was addicted to cocaine for more than 3 decades, says the Prometa treatment program was the key to his getting clean and sober six months ago. "It doesn't cure all of life's ills," he says. "I've got plenty of problems, but I don't want that crap anymore."
Morrey Taylor
Laurry Michlin, a retired salesman who was addicted to cocaine for more than 3 decades, says the Prometa treatment program was the key to his getting clean and sober six months ago. "It doesn't cure all of life's ills," he says. "I've got plenty of problems, but I don't want that crap anymore."
Callie Liles, clinical director at Murray Hill Recovery, says that even though Prometa'sefficacy hasn't been proven in a series of double-blind, placebo-controlled trials,the clinic's results speak for themselves.
Morrey Taylor
Callie Liles, clinical director at Murray Hill Recovery, says that even though Prometa'sefficacy hasn't been proven in a series of double-blind, placebo-controlled trials,the clinic's results speak for themselves.

Steve's wife, though angry about his continued drug abuse, was committed to holding their marriage and family together. On May 31, 2007, she took him to Murray Hill, near Northwest Highway and Preston Road, for his first injection of flumazenil. He received additional injections in the following days, plus oral doses of hydroxyzine, which White says helps relieve flumazenil's side effects such as agitation and anxiety.

Steve says he felt the difference immediately. "I no longer had a mental craving. It was gone," he says. "I was elated. My wife was elated."

Free of the persistent longing for meth, the obsessing and resisting that had held him hostage for so long, Steve wholeheartedly embraced his recovery. "On the second day, I believed it was an end all, be all, a cure," he says. "But you can't get caught up in that—then you end up back where you were. You have to do the work [therapy and changing behavior patterns]." Within a month he'd moved back home and given his wife permission to randomly test his urine for drugs. "I felt good about that," he says. "It was a positive reinforcement for me."

For the next nine months Steve attended one-on-one therapy sessions twice a week and a small men's group each Wednesday night. Through therapy, he discovered that his insatiable overachieving had fueled his drug use. He'd grown up in a high-powered oil family, and no matter how much he accomplished, he wanted more. "Before, I had high expectations and zero patience," he says. "For years I prayed for patience for my New Year's resolution, and each year I broke it. I was never happy with my accomplishments. It was always something more, and I could never get to where I wanted to be. Therapy teaches you what will drive that mechanism up—high stress, et cetera—and how to avoid falling into it."

Steve acknowledges that part of his success staying sober is likely related to more effective counseling this time around. The first time he underwent therapy, it was in a group of some 30 people, many of whom he couldn't relate to because they were homeless or just out of jail. He ignored his problem by convincing himself that he was fine compared with "those people." He insists, however, that the key to his Murray Hill recovery was suddenly being free from the relentless desire for meth that had plagued him for six years.

"Those other times I quit, I always knew I was eventually gonna use again," he says. "When I did Prometa, that went away. It's like having two little guys talking on your shoulder, one telling you to use. That guy shut up."

————

The fMRI scanner looks like something out of 2001: A Space Odyssey. White and round and about the size of a small SUV, the magnetic tube brings to mind a massive donut and takes up most of a small lab room at UT Southwestern Medical Center. On a July morning, a 40-year-old man from North Dallas lies on his back inside the machine as it creates images of his brain on a computer screen in the next room.

Three of Dr. Adinoff's assistants huddle around the monitor. They're helping with an experiment that seeks to identify what causes relapse among addicts. The scientists make weekly visits to local shelters and rehab clinics like Homeward Bound and Nexus Recovery Center, looking for addicts who are willing to have their brains monitored within four to six weeks of their last drug use.

The man in the scanner today isn't an addict; he's a control subject. As he lies inside the scanner punching buttons on a videogame control box, the machine makes a chugging noise and clicks away as it rapidly snaps images. In just one second, the machine captures the entire volume of the brain in 36 different "slices."

Adinoff designed the experiment to test his hypothesis that addicts' brains have a hard time reversing or stopping habits based on certain cues. While in the scanner, people play a videogame in which they choose a sequence of shapes likely to win them money. When the cues are switched—meaning the shape combinations that win money versus lose money are reversed—the subjects must switch their choice accordingly. The process is based on the misfiring reward-response process of addicts, who continue to abuse drugs even when the pleasant payoff of getting high is replaced by negative consequences.

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