rapid detox- egad!

Preston Peet ptpeet at nyc.rr.com
Wed Jan 5 18:30:40 EST 2005


hi all,
    From my friend Alex Burns at Disinfo. I'm reminded once again how little 
fun this technique sounds.


> From Wired Magazine, available online at:
> http://www.wired.com/wired/archive/13.01/detox.html?tw=wn_tophead_4
>
> Instant Detox Kick heroin in 24 hours - no willpower, withdrawal, or
> preaching required. Call it a cure. Call it junk science. Call it the
> one-step program.By Joshua DavisPage 1 of 4 next
>
> Bryan Peterson sat on the toilet in the master bathroom of his Palm
> Springs, California, home and tried to find a vein between his
> knuckles. It was virgin territory - he had never injected himself in a
> spot he couldn't cover up. But now that he'd been fired from his job
> in the estimating department of a construction company, he didn't care
> about covering up anymore. Plus, he couldn't find a vein in his arms,
> which were swollen with pools of pus and heroin. The thin, translucent
> blue veins snaking across the back of his hand filled him with joy. He
> slid the needle in beside his knucklebone. It hurt.   Story Tools
> [an error occurred while processing this directive]
>
> Two weeks later, he'd blown out all the tiny veins in his hands and
> feet. Unable to absorb all that fluid, they burst, adding more blood
> to the already toxic mix festering under his skin. He started plunging
> the needle deep into his bicep, shooting heroin directly into the
> muscle. The drug seemed to sizzle as he injected it.
>
> Peterson was 36 and had been addicted for three years. Before that, he
> was just a normal working guy who liked to play guitar in a local rock
> band. Over the past two and a half years, he'd tried to kick his habit
> cold turkey three times and attended a few Narcotics Anonymous
> meetings. He'd make it through the first step - acknowledging that he
> was powerless over his addiction - and that was it. Even with the
> group therapy sessions and encouragement from fellow addicts, he
> couldn't stay clean for more than 10 days. The withdrawal pains were
> so unbearable, he fantasized about cutting off his legs to stop the
> aching. And when the pain subsided for a moment, he was racked with
> nausea and diarrhea. His body was holding him hostage: Either take the
> drug, it said, or you'll feel so much pain you'll want to die.
>
> Then one day Peterson was talking to a friend who mentioned a miracle
> treatment gaining popularity in the Los Angeles area. Doctors were
> anesthetizing addicts and using an intravenous drug cocktail to induce
> an almost instantaneous withdrawal from the heroin. Within 24 hours,
> an addict would be pronounced clean and sober. Peterson borrowed the
> $15,000 for the procedure from his family, shot up one last time, and
> headed for Orange County.
>
> "The 12-step program is an outdated 20th-century concept," says
> Clifford Bernstein, an assistant clinical professor of anesthesiology
> at UC Irvine and medical director of the Waismann Institute, the
> nation's leading rapid detox center. "For 70 years, thanks to
> Alcoholics Anonymous, addicts have been told they're suffering from a
> spiritual problem. AA assumes that you can talk someone out of their
> addiction - which is ridiculous. Addiction is a medical problem. If
> somebody has cancer, you don't try to talk them out of their disease."
>
>
> Bernstein's steeply angled eyebrows make him look surprised and angry.
> When he speaks, he's quiet and measured, but his expression suggests
> amazement at the foolish things people believe. His eyebrows arch even
> higher when he examines Peterson's ravaged arms.
>
> The procedure is scheduled to take place in the Garden Grove Hospital
> and Medical Center's intensive care unit, which Peterson now shares
> with a burn victim, a barely breathing obese woman, and a screaming
> elderly lady with multiple bone fractures. If he weren't about to
> undergo rapid detox, Peterson would be considered too healthy to be
> here. It's been 30 hours since he last shot up, and though he's well
> into the early stages of withdrawal, he's only suffering from a cold
> sweat, a dull ache in his leg, and a mounting panic.
>
> The reaction is normal. Opiate molecules have a chemical structure
> similar to endorphins - a natural hormone that regulates pain and
> pleasure. When a heroin user shoots up, the opiates in the drug plug
> into the nerve receptors normally occupied by endorphins. If opiates
> are administered repeatedly, endorphin production drops. The body has
> essentially been tricked into short-circuiting the natural
> pain-pleasure regulation system.
>
> The addiction turns ugly when the opiate is withheld. Without the
> presence of either the opiates or the natural endorphins, an addict's
> pain receptors cease to regulate brain signals. The unimpeded flow of
> stimulation causes acute pain while triggering a cascade of reactions
> throughout the body: sweating, uncontrollable diarrhea, vomiting, and
> severe depression. It's not fatal - though it may feel like it - and
> the addict often relapses just to stop the torment. It usually takes
> two to three weeks of suffering before natural endorphin production
> resumes and the pleasure-pain equilibrium is restored.
>
> Considering the ordeal, it's not surprising that quitting cold turkey
> works only about 5 percent of the time. To improve on that success
> rate, drug treatment experts have traditionally relied on three
> approaches: methadone, symptomatic treatment, and Narcotics Anonymous.
> Methadone, and its modern substitute buprenorphine, are opiates that
> don't produce a high. An addict taking these drugs has essentially
> moved from a risky, illegal dependency to a safer, legal one. But if
> they don't take the methadone, withdrawal begins within hours. For
> users who don't want to be addicted to any substance, treating the
> symptoms with a combination of anti-nausea, antidiarrheal, and
> sedation drugs can help ease the pain of withdrawal. Finally, the
> support of an NA group is usually recommended in conjunction with all
> other treatments. These methods have a success rate of 30 percent to
> 40 percent after a year.
>
> Bernstein says he has a better way to kick opiate addiction - one that
> painlessly strips the drug from the brain's nerve receptors in 20
> minutes. The procedure, which relies on a combination of medicines, is
> carried out while the patient is anesthetized - a conscious patient
> would be in so much agony there would be risk of a heart attack.
> According to Bernstein, the roughly 2,500 patients the institute has
> treated wake up after an hour and are no longer addicted. Even if an
> addict were to shoot up after the procedure, there would be no effect.
> The opiate would be blocked from binding with the receptors already
> occupied by naltrexone, a drug which must be taken orally for a year.
> Bernstein says 65 percent of Waismann patients are still clean after a
> year.
>
> Critics dismiss those numbers and denounce the Waismann method as a
> scam that takes advantage of desperate addicts. But the American
> Society of Addiction Medicine has come out in support of the
> treatment, and the society's former president claims that it's one of
> the most innovative developments in the field since the advent of the
> 12-step program in the 1930s.
>
> With a recent surge in the abuse of opiate-based painkillers such as
> OxyContin, the institute's business is booming. He has put up
> billboards across the country and has explained the procedure on MTV,
> CBS, and NBC. So far, he's drowning out his critics. And, like Lasik
> eye surgery in the 1990s, rapid detox is making the transition from
> experimental technique to standard procedure offered nationwide.
> Competitors have emerged: A rival rapid detox center opened last year
> in Los Angeles, and there are centers in Colorado, Florida, Illinois,
> Michigan, New Jersey, and New York. Hundreds of addicts are going
> through rapid detox each year, and proponents like Bernstein are
> positioning the approach as a modern, humane alternative to Narcotics
> Anonymous.
>
> Which makes Peterson an early adopter. Now anesthetized, he lies
> almost motionless in the intensive care unit. Blue fluid is being
> pumped through his veins. Withdrawal has never been so easy. But it's
> also never been so deadly.
>
> In 1988, Austrian physician Norbert Loimer was studying opiate
> withdrawal when he discovered that injecting addicts with naloxone -
> the intravenous form of the opiate blocker naltrexone - achieved what
> he referred to as "acute detoxification." It was accompanied by
> intense suffering, which he tried to alleviate by sedating the
> patients. It worked. His experimental process condensed the typical
> weeks-long withdrawal into a matter of days. Though he believed that
> the procedure was too dangerous to be offered to the public, he
> published his findings in a medical journal, where they were read with
> interest by addiction medicine specialists.
>
> One of them was Lance Gooberman, an American MD who concluded that the
> danger of Loimer's rapid detox method was outweighed by the fact that
> addicts were dying on the streets every day. Gooberman knew the risks
> of drug dependence first hand - he was an alcoholic and had been
> hooked on methamphetamines before he began treating other addicts. He
> understood that many junkies wouldn't even consider kicking -
> conventional detox scared them too much. A faster, less painful
> withdrawal could mean the difference between going into treatment and
> death for many. So in 1994 Gooberman took Loimer's experimental work
> and turned it into a business.
>
> Over the next five years, Gooberman performed more than 2,300 rapid
> detoxifications in his offices in Philadelphia and southern New
> Jersey. According to county coroners, seven of those addicts died of
> complications relating to the procedure. That was enough for David
> Samson, New Jersey's attorney general, to file civil charges against
> Gooberman in October 1999, accusing him of "repeated gross
> malpractice, professional negligence, professional incompetence, and
> professional misconduct." Samson contended that rapid detox was an
> unproven treatment that put too much strain on patients' bodies. It
> just wasn't reasonable, the complaint explained, to assume that a
> two-week ordeal could be safely condensed into an hour. He argued that
> Gooberman was promising more than he could deliver and creating "a
> clear and imminent danger to the public's health, safety, and
> welfare."
>
> While Gooberman was building his practice on the East Coast, Bernstein
> was recruited to head up the Waismann Institute in Beverly Hills,
> California. The institute was founded by Clare Waismann, a Brazilian
> businesswoman who realized that rapid detox addressed an unmet need.
> The market was crowded with 12-step programs and methadone clinics,
> but all of them required addicts to stick with a program. Rapid detox
> largely removed willpower from the experience - it was a concept
> Waismann thought would make her institute the dominant detox facility
> on the West Coast and, eventually, in the nation.
>
> Bernstein was an ideal partner. He had attended a respected medical
> school (Rutgers), understood opiate addiction, and was a med school
> faculty member. He was energetic, believed in the treatment, and was
> ready to devote his credentials and time to winning mainstream
> acceptance for it.
>
> But the headlines generated by the case against Gooberman weren't
> making it easy. Gooberman was on trial, but the defendant in the
> three-year case was really the procedure itself. Most of the testimony
> concerned the alleged dangers and benefits of rapid detox. And since
> the FDA does not regulate medical procedures, the case became a battle
> over the legitimacy of the treatment.
>
> Samson laid out his argument clearly, beginning with the obvious:
> Opiate withdrawal is a nonlethal condition, but seven of Gooberman's
> patients had died. Anesthesia alone carries a small risk of death.
> When coupled with an infusion of novel drugs, there's no telling how
> dangerous it can be, particularly since there have been no large-scale
> scientific studies on the procedure's effectiveness. In essence, he
> was saying that the cure was worse than the disease.
>
> David Smith, a leading addiction doctor and former president of the
> American Society of Addiction Medicine, disagreed. Smith testified
> that rapid detox was the procedure of last resort for addicts who had
> tried everything else and failed. Many of them just couldn't withstand
> the pain of withdrawal. Gooberman offered them another option. His
> patients came from a population whose health was already compromised -
> just treating them was a risk. But the fact that he tried to help them
> didn't mean he was responsible for their deaths. "How many would have
> died if they'd stayed on drugs?" Smith asks. "Treatment is not a
> threat to public health, and the attorney general did a disservice by
> trying to criminalize it."
>
> The judge in the case agreed that Samson was overreaching. In a
> 353-page opinion handed down at the end of 2002, he concluded there
> was no evidence that rapid detox "caused or contributed" to the seven
> deaths. He called the treatment "potentially promising" - but rebuked
> Gooberman for a variety of medical oversights, fined him $11,500, and
> revoked his license for six months. The attorney general appealed, and
> Gooberman soon settled the case out of court. He agreed to pay
> $375,500 to the state and $30,000 to the families of the deceased. He
> also agreed to have his medical license revoked for two years. His
> reputation was damaged beyond repair. No hospital would hire him, and
> he disappeared from public view.
>
> That left one man in the media spotlight - just in time for a surge in
> demand. Bernstein made it through rapid detox's early years without a
> fatality, and now OxyContin abuse was skyrocketing. The treatment had
> been legally vindicated, and Bernstein's main competitor on the
> national stage couldn't practice medicine anymore.
>
> Bernstein smiles as the cameraman holds the shot. It's early in 2001,
> and the Gooberman case rages on. 48 Hours, the CBS newsmagazine show,
> is documenting the plight of Troy Swett, a 22-year-old OxyContin
> addict. Swett has just arrived at the hospital in Orange County to be
> detoxed, and Bernstein is ready for his close-up. "Congratulations for
> coming," Bernstein says, shaking Swett's hand. "It's the first step."
>
> In a traditional 12-step program, the first step is to admit
> powerlessness over the addiction. Now, according to Bernstein, the
> first step is arriving at the Waismann Institute. This kind of
> national exposure is important for Bernstein. It's an opportunity to
> continue redefining how the public thinks about addiction.
>
> During the segment, Bernstein notes that 90 to 95 percent of his
> patients are clean after a month. The on-air reporter asks about
> long-term effectiveness, to which Bernstein replies, "People walk out
> of here, their withdrawal is finished, and they're not craving." And
> the segment moves on.
>
> But the numbers deserve more scrutiny. They are compiled by the
> Waismann staff without independent confirmation. They are also based
> solely on follow-up phone calls, and there's no guarantee that
> everyone is called. (At least one Waismann client, OxyContin addict
> Tim Lincoln, says he was never contacted after he returned home to
> Texas. He relapsed after two months.) Bernstein doesn't defend the
> absolute accuracy of the success rate stats. "Maybe it's a little
> off," he says, "but it's still much, much higher than methadone or
> Narcotics Anonymous programs."
>
> Even substantiated statistics wouldn't necessarily prove that rapid
> detox is better than conventional treatments. The type of patients who
> come to the Waismann Institute tend to have more family and social
> support and can afford the $15,000 fee. They are more likely to get
> clean in any kind of treatment program. And there's another twist:
> Bernstein says that about 70 percent of his patients are addicted to
> prescription painkillers. He admits that the success rate for heroin
> addicts is probably lower, but he doesn't know the exact figure.
> Still, Waismann advertises a single success rate - 65 percent - and is
> therefore luring heroin abusers with a potentially exaggerated
> promise.
>
> Bernstein cites independent studies to buttress his claims. A study
> from the University of Miami School of Medicine in 2000 reports a 55
> percent abstinence rate six months after rapid detoxification. A
> German clinical investigation in 2000 found a 68 percent success rate
> at 12 months. But neither study compared the procedure with a control
> group, so it's impossible to state whether patients would have been
> more or less successful with another treatment.
>
> Herbert Kleber, director of the division on substance abuse at
> Columbia University, takes issue with Bernstein's claims. "I challenge
> him to take 100 addicts off the street and show a 65 percent success
> rate," Kleber says. "He won't be able to."
>
> Kleber has just completed the largest scientific study of rapid detox
> to date, and his numbers don't come close to matching Bernstein's.
> Using a $1 million grant from the National Institute on Drug Abuse,
> Kleber followed 105 abusers through rapid detox and two other
> treatments. He found that after three months, rapid detox fared no
> better than other methods.
>
> But even if it doesn't work as advertised, it's still a useful
> treatment that can seem like a miracle cure. Even Tim Lincoln, the
> relapsed OxyContin addict from Texas, grudgingly admits it served a
> purpose. Before he went to see Bernstein, he tried to quit twice, only
> to suffer a week of diarrhea, nausea, and severe depression each time.
> Though he didn't feel good after rapid detox, he didn't have any
> diarrhea or nausea. Essentially, Bernstein's treatment allowed him to
> skip that first and most painful week of the process.
>
> It was an illusory victory - Lincoln relapsed within two months. He
> eventually found the willpower to suffer through the withdrawal on his
> own and, with the help of Narcotics Anonymous, is clean now. But for
> addicts who cannot make it through that first week of withdrawal any
> other way, the $15,000 procedure may be their only hope. And for white
> collar addicts - business executives, doctors, celebrities, sports
> stars - the quick fix promised by rapid detox is a powerful draw.
>
> Amanda, a busy Northern California medical-supply sales rep who asked
> that her real name not be used, was popping 20 Vicodins a day but
> didn't want to take a lot of time to deal with her addiction. Before
> she found out about Waismann, she was preparing for a 30-day detox in
> Malibu. Bernstein, she says, cured her in a weekend: "They put me
> under Friday. I was a little groggy Saturday. By Sunday, I was ready
> to get back to work. And I had no desire for the pills."
>
> While criticism from within the medical community hasn't influenced
> Bernstein, competition may. In November, Chicago-based Midwest Rapid
> Opiate Detoxification Specialists opened a center in LA. Jake Epperly,
> the clinical director, distinguishes his method from the Waismann
> practice by emphasizing "the absolute necessity of a continuing care
> recovery program" based on Narcotics Anonymous. Epperly runs his own
> halfway house in Chicago and markets his group as the only rapid detox
> service in the US with a 28-day inpatient aftercare program.
>
> Of course, closely monitoring a former user's sobriety is a pillar of
> NA. Addicts are expected to attend 90 meetings in 90 days and speak
> regularly with a sponsor who has been off drugs for an extended
> period.
>
> Bernstein has never offered a robust aftercare program. He trusts in
> the science, not the therapy. At the Waismann Institute, the $15,000
> fee includes 6 to 12 follow-up phone calls from a psychologist.
> Bernstein is particularly adamant that the Narcotics Anonymous
> approach is counterproductive. "The last thing I want is for my
> patients to sit in a room with a bunch of other addicts and spend all
> their time talking about drugs," he says. "It's like a cult. Plus,
> that's where all the drug dealers hang out."
>
> But Bernstein is adapting. He says that he is in the process of
> creating his own Waismann-branded luxury recovery center near a beach
> in Orange County, where addicts can stay after detox. According to
> Bernstein, it'll be nicer and more effective than Epperly's program.
> Rather than attend group meetings, patients will be encouraged to play
> golf and take walks on the beach.
>
> Epperly scoffs at the approach. "Golfing won't keep them off drugs,"
> he says. "Just because their bodies don't crave it doesn't mean they
> psychologically don't want it."
>
> Bryan Peterson is sitting in the backyard of his parents' suburban
> home in the hills outside Las Vegas. It has been two weeks since he
> underwent rapid detox. The swelling in his extremities has gone down,
> and the scabs on his arms have fallen off. There are dark bags under
> his eyes, and his skin looks like yellowed parchment. But he manages a
> meager smile. For the first time in two years, he's been sober for
> more than a few days. "Everything just looks a little greener," he
> says, staring out at the mostly gray desert.
>
> Then he taps his fingers on the glass table in front of him. He lights
> a cigarette. He's got nothing to do. His next scheduled phone
> conversation with the Waismann psychologist isn't for three days.
> Peterson admits that he opened the yellow pages a couple of days ago
> and found the address of a local methadone clinic. "It's the easiest
> place to score," he says. But he didn't go, and he says that he feels
> better every day. By mid-November, he was still clean and he moved
> with his fiancée to Glasgow, Kentucky. It's a dry town - no alcohol is
> sold within city limits - and it's supposed to be very green.
> Contributing editor Joshua Davis (jd at wiredmag.com) wrote about
> supercoca in issue 12.11.
>
>
> Copyright (C) 1993-99 The Conde Nast Publications Inc. All rights 
> reserved.
>


Peace and love,
Preston Peet

"Madness is not enlightenment, but the search for enlightenment is often 
mistaken for madness"
Richard Davenport-Hines

ptpeet at nyc.rr.com
Editor http://www.drugwar.com
Editor "Under the Influence- the Disinformation Guide to Drugs"
Cont. High Times mag/.com
Cont. Editor http://www.disinfo.com
Columnist New York Waste
Etc. 




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