Posted on 12/09/2007 9:37:09 PM PST by bd476
Costly treatment for drug addiction spurs heated debate
...The treatment, called Prometa, is not approved by the Food and Drug Administration as an addiction therapy, nor has it undergone extensive scientific testing...
[ Snip ]
David Smart turned to Prometa when he hit rock bottom eight months ago. Smart had lost everything -- his wife, his family, his job and his home...
[ Snip ]
"I had tried everything and nothing worked for me," said Smart, 41, of suburban Tacoma, Wash. "But Prometa has."
Mario Acosta Jr. also tried Prometa but relapsed within days of completing treatment... ... He took out a $5,000 loan to help pay for it. "What a waste of money that was," he said.
[ Snip ]
"I don't think Prometa is a drug treatment for addiction; I think it's a marketing scheme," said Dr. Alex Stalcup, a California-based expert on methamphetamine addiction.
[ Snip ]
"People are dying [from drug abuse], and this [treatment] seems to be making a dramatic difference," said Dr. Matthew Torrington, medical director of the Prometa Center in Santa Monica, Calif., one of four such treatment centers.
[ Snip ]
Last year, an estimated 23 million Americans abused or were dependent on alcohol, illegal drugs or prescription medication, according to the federal Substance Abuse and Mental Health Services Administration...
[ Snip ]
Hythiam has opened treatment centers in Santa Monica, San Francisco, New Jersey and Florida... ... Alcoholism treatment costs $13,000; cocaine and meth treatment costs $15,000.
[ Snip ]
The company also is seeking public funding to cover treatment of Medicaid patients, parolees and others..."
(Excerpt) Read more at chicagotribune.com ...
Note: In the excerpted article above, I have highlighted the positive points in blue and the negative aspects in red.
The controversy surrounding Prometa, at least in part revolves around:
- the high cost of Prometa;
- the intense marketing campaign done by Hythiam, the company selling the treatment protocol. Last year Hythiam advertised Prometa on a billboard showing comedian Chris Farley, whose death was caused by his drug addiction;
- the anecdotal success rate of Prometa may be colored in part by some of the prescribing physicians reporting the success rate of Prometa as a treatment for addiction. Supposedly some of the physicians have a monetary interest in Prometa, including Dr. Matthew Torrington (quoted in article above and whose bio I've included below);
- the FDA has not approved Prometa for addiction treatment; and
- the big ticket item upcoming for taxpayers as I have highlighted from the article above:
"The company also is seeking public funding to cover treatment of Medicaid patients, parolees and others..."
All of the above are weighed against the long term implications and inherent high cost to society caused directly and indirectly by alcohol and drug addiction, which in short are
- increased crime rate affecting all communities;
- cost of law enforcement;
- court costs, public defenders, etc.;
- cost of imprisonment of addicts and drug dealers;
- cost of medical care for addicts in and out of prison;
- medical and legal costs for the victims of addicts' criminal behavior;
- cost of social services and medical care for affected children within addicted families, etc.
Prometa has not yet been approved by the FDA. A double-blind clinical study on Prometa has not yet been published. However there are anecdotal reports from addicts who claim that Prometa completely stopped their addiction.
Legally, Prometa can be prescribed by physicians for addiction because Prometa was approved by the FDA for another medical condition.
I searched for more information on Dr. Matthew Torrington, Medical Director of a Prometa treatment center in Santa Monica, California quoted in the article.
One site was temporarily unavailable and another site had shut down completely. Finally I was able to pull up his bio in cache: Matthew A. Torrington, MD Integrated Substance Abuse Programs
Matthew A. Torrington, MD
Integrated Substance Abuse Programs
University of California, Los Angeles
Dr. Matthew Torrington is an addiction medicine physician and clinical research fellow with the Integrated Substance Abuse Programs (ISAP) at UCLA. UCLA’s ISAP is one of the foremost substance abuse research groups in the U.S. and worldwide. Dr. Torrington attended Jefferson Medical College, in Philadelphia, Pennsylvania, and completed his residency training at Christiana Care in Wilmington, Delaware. Dr. Torrington is a board certified family medicine physician, is certified by the American Society of Addiction Medicine, and is a certified medical review officer. He is licensed to practice in the state of California and is involved in inpatient and outpatient research in addition to his private practice. Dr. Torrington has a clinical focus on the treatment of stimulant dependence, opiate dependence and pain.
Dr. Torrington’s most recent inpatient work includes safety and efficacy trials for new pharmacotherapies for stimulant dependence as well as investigations in GHB pathophysiology.
Dr. Torrington’s outpatient work includes medication trials for use in the treatment of both cocaine and methamphetamine dependence. Dr. Torrington is currently examining pain tolerances and thresholds in opiate dependent patients both before and after treatment.
Most recently Dr. Torrington has been collaborating with Dr. Walter Ling in the development of outpatient treatment models for opiate dependence focused on buprenorphine in combination with cognitive behavioral therapy. Dr. Torrington maintains a private practice specializing in patients with substance use disorders.
Call it a disease and bill the taxpayers.
Buyer beware. If this was the miracle some claimed it is, why would more marketing and hyperbole be necessary? Wouldn’t it sell itself?
Some treatments work for some of the people some of the time. No treatments work for all of the people all of the time. New treatments usually cost more and fill the “chic and hip” markets quite nicely.
The Prometa site which I couldn't access earlier, and which had more information about Dr. Michael Torrington
"Site temporarily unavailable, please try again Server too busy"
is now working again.
Prometa: The Prometa Treatment Program for Alcohol, Cocaine and Methamphetamine Dependence
Matthew Torrington, M.D.
The PROMETA Treatment Program represents a promising new treatment that has inspired me to dream of a world where craving is neutralized and individuals do not die from the self administration of poison against their own will. *
As a research doctor, I am always interested in learning about new treatments and therapies. In 2004 my research mentor, Dr. Walter Ling, was approached to do a randomized, double-blind clinical study on the Proemta Treatment Program for the treatment of methamphetamine dependence. At that time, I was working on government-funded outpatient trials of new medications for methamphetamine dependence. Despite the fact that I did not know which patients were getting active medicine and which were getting placebo, I knew that the medications being tested were not helping my suffering patients enough.
I accompanied Dr. Ling to observe a patient being treated with the PROMETA Treatment Program. The process seemed to be extremely well tolerated, and the patient I observed told me something I had never heard before, "I'm not thinking about methamphetamine anymore."
This patient's experience — that he had been dependent on methamphetamine for more than eight years, and was no longer even thinking about the drug — flew in the face of everything I knew about addiction treatment. I began speaking with other physicians, observing and talking to more patients, and learning as much as I could about the PROMETA Treatment Program. While Dr. Ling's study is not yet complete, the more I have learned about the scientific rationale of the treatment process and the more clinical experience I have garnered, the more optimistic I have become about the ability of this treatment to help those who are suffering so much.
The PROMETA Treatment Program is designed to target the disease of substance dependence where it resides: in the body and in the brain. I believe that the best addiction treatment combines biologic, nutritional, and psychosocial components. Failure to address any one of these areas minimizes an individual's chance for recovery. Simply put, the best biologic intervention will never substitute for psychological and social change. However, when psychological and social interventions are maximized and patients still cannot succeed, the serious need for biologic interventions is poignantly illustrated. The biologic component of PROMETA represents an exciting new approach that offers hope to those suffering from substance dependence.
I am often asked to give examples of patients I have treated using the PROMETA Treatment Program. Having treated many patients, it has become very easy to relate stories of positive change. While I know that every patient's results will vary, I am excited and optimistic by what I have seen, and I am fascinated by patients' reports of dramatically reduced or eliminated cravings for drugs and alcohol after PROMETA. I believe the PROMETA Treatment Program represents a new and exciting approach to the treatment of substance dependence that offers hope to those suffering from alcohol, cocaine, and methamphetamine dependence.
Recently, I told a female colleague about one patient in particular. This man was in his mid-30s, had been using meth for 10 years, and had been to five treatment centers, yet continued to relapse. After I treated the patient with PROMETA, he informed me that he was not thinking about drugs, he was eating better, sleeping better, and doing better all around. My colleague seemed to be listening to what I was telling her, but she remained guarded and skeptical.
Later that day, we saw the patient together. He told us that he had slept well the night before, was eating normally again, and was not thinking about methamphetamine anymore. This was the same news I had heard the previous day, and it did not really affect me. My colleague, however, having listened to him tell his story was on the verge of tears. What she told me later was that, even though I had told her other success stories — including this man's — hearing it from the patient in his own words made it real for her. She told me that she now understood how important this treatment could be for her as a treating physician and to her patients who struggle with substance dependence.
The experience she described was not dissimilar to my own initial experience. For both of us, it was hearing directly from individuals being treated as they described the difference they felt being free from their craving for drugs. Many of my patients proudly report to me that situations that may once have enticed them to the point of relapse no longer pull them back in. They tell me, "I don't have that conversation I used to have with myself, that I can do it just this one time."
This is quite significant, and also leads to another important aspect of the successful treatment of drug dependence. It has been my experience that even when a medical intervention is used successfully, the maintenance of abstinence is predicted more on the patient's ability to implement psychological and social changes that may lessen the chances of relapse. A patient healing from substance dependence is always recovering, and therefore needs to establish a life that includes ongoing psychosocial support. Whether it is group therapy, individual therapy, a 12-step program, or another source of support, to maintain sobriety there must be an ongoing and accessible environment of understanding and caring.
I feel that we are at an exciting and promising stage in the history of addiction treatment. Addiction is a biologic, psychological, and social problem that requires biologic, psychological, and social interventions. The PROMETA Treatment Program represents a promising new treatment that has inspired me to dream of a world where craving is neutralized and individuals do not die from the self administration of poison against their own will.
Matthew Torrington, M.D.
The PROMETA Center™
Santa Monica, CA
* Matthew Torrington, M.D. is a paid consultant of Hythiam, Inc., the company that licenses the PROMETA Treatment Program.
Prometa Info: Matthew Torrington, M.D.
Those are all good and valid points.
Since taxpayers already pay for the high cost to society for alcohol and drug addiction, which costs are justified, which costs more and which, if any should taxpayers have to pay for?
- costly unproven, unsanctioned by the FDA treatment; or
- costly treatment already approved by the FDA which according to some reports, doesn't always work; or
- taxpayers should not have to pay for any treatment for alcohol and drug addicts?
These pharmacological “silver bullets” appear on the treatment market all the time and I have never seen one that works.
LOL you think drugs don't exist in jail.
“The only effective treatment is to separate the methamphetimine addict from his source for at least six months and expose him to A.A., Narcotics Anonymous or some other 12-Step program.”
Some time back I recall seeing a tv special about meth in rural area of MO. The thing that struck me was the large amount of time & attention in the 1 hour given to the story of one guy who had been meth free for about a year, if I recall correctly. He was apparently an exceptional case. That shows how rare it is for someone to get off it. Here in Northern AZ I have read letters to the editor whining about the need for “rehab rather than jail”. And if the high rate of relapse is brought up you will be told that kicking meth takes multiple rehabs because “No one succeeds with just one”. And “we need more rehab centers” can be translated to “We want YOU to pay for it rather than us”. Rehab is a industry for those with degrees in social work and little more than that.
The ideal setting for this kind of treatment is an in-house, longterm treatment facility.
Of course no treatment will work if the client is not willing to participate in the treatment. If the client is ready to recover, and wants it bad enough, he can get sober in a corn field.
“Rehab is a industry for those with degrees in social work and little more than that.”
This I know:
A person can detox physically under medical supervision in a few days.
After that it is the mental aspect of addiction which must be dealt with.
Hospital 30 day programs can cost $40,000 and up. Yet good sober living home can get a person through the same 30 days for as little as $600.
The expensive program will tell the departing “patient” to continue attending Twelve Step meetings, read the book, do the steps with a sponsor, who has a sponsor. Same for the good sober living home.
About Twelve Step programs: The program works, if the alcoholic/addict works the program. Too few do.
Yeah, rehab is hit and miss and definitely not a science. It is a more humane course of action than jail. I think probably just as many people recover in jails and prisons as do in rehab. Most prisons have some type of drug/alcohol program and these vary in quality. Some jails now have rehab programs. The last statistics I saw give the recovery rate for alcoholics at 4 percent and narcotics addicts at about 3 percent. The rest of them spend their lives in and out of institutions and die prematurely from a variety of causes.
I worked in prison drug/alcohol addiction treatment for four years in two different jurisdictions. The program worked pretty well for participating inmates as long as they were locked up. Once they are released most go right back to what got them locked up to begin with. But a few have been sober for years and lead successful lives.
Last I looked, the success rate for recovering from addiction to drugs or alcohol - five years clean I believe it was - is under 15%. That’s for all treatments and no treatment (individual on their own).
Treatment/counseling/support groups can help provide tools, but there’s no magic bullet.
I'm not knee-jerk critical of anything else that works, but Suboxone, approved in 2003, is the real deal.
If you're looking for relief from those addictions, Google it. You can be off real narcotics in 24 hours without missing work.
The extensive Methadone lobby has kept this drug from becoming the treatment of choice, I've read. Methadone is a huge sub-economy funding a lot of third world jobs in America.
I'm not knee-jerk critical of anything else that works, but Suboxone, approved in 2003, is the real deal.
If you're looking for relief from those addictions, Google it. You can be off real narcotics in 24 hours without missing work.
As opposed to the money you spent on drugs.
As opposed to the money you spent on drugs.
If the push to have all Psych illness treated on par with physical illness, ie remove the payment caps for these diagnose es, health care costs will become completely unsustainable.
Sorry about the second post. Not sure how that happened, being an experienced Freeper. Yes, I've heard the same thing, except that the Methadone Industry is pure buggy-whip stuff when compared to Suboxone. The latter is 21 Century medicine, eeking it's way through the noise level. The authorized physicians (bumped up from 30 to 100 patients each by the late Republican Congress) are mostly former Methadone Clinicians.
I'm not as sure about how extensive the (what we used to call "Meth") vested lobby is, but the Insurance lobby is even more extensive, as are the managers of pharmacy requests, like Big Medco, managing tens of thousands of plans large and small. Inevitably, even a corrupted Market force will edge the Meth Clinics to the margin.
Add that to the one in ten physicians who have, from time to time, become addicted to opiate/opioids. Meth is maintenance and "Bupe" eliminates withdrawal, the rationalized bugaboo that stops most from seeking treatment.
A decade from now, Sub will lose it's patent status, as did Valium. You can bet the "left-handed free-radical" variants of Bupe will crush the Methadone business.
Show me the research studies.Double blind placebo controlled studies conducted at major research centers (Harvard,Yale,Columbia,Cornell,Mayo Clinic,Stanford,etc) are the only things that prove anything.
Since taxpayers already pay for the high cost to society for alcohol and drug addiction, which costs are justified, which costs more and which, if any should taxpayers have to pay for?
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Once drug use (alcoholism, etc.) are declared diseases (which I strongly disagree with), it basically requires insurance companies to pay for more and more types of treatment. Insurance companies in this context include the taxpayer funded medicare, medicaid, SCHIP, etc. gov’t insurance programs. Wait til Hillarycare is adopted.
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