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The Controversy Around Pharmacology as an Adjunct in Addiction Programs

In performing a literature review regarding the history of addiction treatment and recent medical advances, Adam McLean of New Roads stated a fascinating conundrum: that the undeniable accomplishments of abstinence through 12 Steps and other group-support recovery programs, in the face of disastrous natural consequences, has conditioned the larger population to view the use of “pharmacological-assisted therapy” for addiction treatment, negatively.  In other words, the proven effect of a chemical that blocks the drug effects, in lab animals and in adjudicated adults, is challenged as tainting the client’s agency in regards to drug-seeking drive.  Again, this controversy is within the addiction treatment world, but medical intervention isn’t hotly debated in treating depression or anxiety or ADHD.

Naltrexone is the first opioid antagonist approved to treat alcohol dependence since Antabuse (disulfiram) and works at the cellular level by preventing excitation of opioid neurons despite the intake of intoxicant, thereby preventing the euphoric experience.  NXT has been prescribed for other addictions (ie., stimulants) and  process addictions, including gambling. Because of its efficacy, compliance taking oral dosage (Revia) has proven to be very poor, in self-administration.  Vivotrol is a 30 day dissolving pellet of naltrexone inserted in muscle tissue.  In 5 major naltrexone efficacy studies, “medication adherence was the most critical factor: “for those that were 90% compliant, relapse rates were only 14% compared to a relapse rate of 52% of those that were non-compliant.”


Adam McLean is a seasoned admissions and marketing professional focused on his work in mental health and chemical dependency.  He is currently completing his Ph.D in clinical psychology from Saybrook University in San Francisco, CA.  Adam is working at New Roads Behavioral Health located in Fort Lauderdale, Florida and Salt Lake City, Utah.  He also works with the National Association of Drug Court Professionals (NADCP) working on alternative sentencing for chronic drug offenders.