June 23rd, 2008
01:39 PM ET

Rehab medication

By Caleb Hellerman
CNN Medical Senior Producer

When it comes to drug and alcohol addiction, we all know the way to get clean is through the 12 steps, and if you can afford to check yourself into rehab, all the better. If Amy Winehouse can just stick it out in the hospital, she’ll be fine.... right? We “know” these things until we hear from people like Dr. Mark Willenbring, who runs the division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism.

Dr. Willenbring is full of surprises. For one thing, he told me that for most people, “rehab” – a hospital stay - doesn’t work any better than outpatient treatment. A scary thought for those pricey centers to the stars, where a stay can top $40,000 a month.

He also likes to talk about medication, which gets touchy. Last year on Larry King Live, Willenbring argued with Susan Ford, chair of the Betty Ford Center in Arizona, after she said she’s still waiting for evidence that medication is helpful in fighting addiction. The Ford center isn’t alone; I’ve talked to several people who went through prominent treatment centers who say the option of medication was mentioned either very little, or not at all.

But Willenbring says a therapist who doesn’t believe in using medication to treat addiction is like a cardiologist who doesn’t believe in using drugs to lower blood pressure. Every case is different, but in clinical studies, two drugs - naltrexone and topiramate - have been shown to sharply improve the effectiveness of treatment. They seem to work best in conjunction with therapy, but Willenbring says in 20 years we’ll largely treat addiction the way we treat depression now – in an outpatient setting, often by a primary care doctor and often with a pill.

Have you ever struggled with addiction? How did you get clean?

Dr. Willenbring will be part of an upcoming Dr. Sanjay Gupta Special Investigations Unit hour on new treatments for drug and alcohol abuse.

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