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Clinicians Took Their Morning Meds

November 1, 2006
by Gary A. Enos, Editor
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The breakfast line for a Sept. 30 session at the annual conference of NAADAC, The Association for Addiction Professionals snaked into the hallway and practically outside the doors of the Burbank, California, conference center. But what these eager attendees really hungered for was information about the medications that even for nonprescribing clinicians are changing perspectives about treatment.

The educational breakfast program, “Pharmacotherapy: Integrating New Tools Into Practice,” was underwritten by an unrestricted educational grant from the makers of Vivitrol, the new once-monthly injectable form of the antialcohol medication naltrexone. The sight of a number of addiction counselors being turned away at the door for a seminar on drugs to treat substance addiction (attendance was limited to 200 and preregistration was mandatory) had to have some attendees thinking, “Something in our field is changing.”

Interestingly, a distinct minority of seminar attendees raised their hands when asked if any clients of theirs were presently using either form of naltrexone or the drug acamprosate for their alcohol dependence. But clearly these counselors had a keen interest in determining what their role could be in facilitating medication use in concert with therapy. This year's NAADAC attendees could not ignore that both NAADAC's immediate pastpresident and new president were reporting significant success with client medication use in the New Hampshire and Indiana programs where they work full time.

And it is also clear that pharmaceutical companies increasingly see counselors as an important conduit to medication treatment, especially since many physicians remain uninformed on—or indifferent to—the options now available for people with addictions. Not only was information on the newest drugs on prominent display at the NAADAC exhibit hall, but representatives for older medications such as Antabuse for alcohol dependence and methadone for opiate addiction made themselves available as well.

“The part that's exciting is we have a lot of choices now,” said Gerry Schmidt, who chairs NAADAC's Public Policy Committee and copresented a pharmaceutical-sponsored training session about acamprosate at the conference. “All of a sudden we have some very attractive options.”

Certainly a number of challenges remain, including achieving a better understanding of the dynamics of physician-counselor relationships and a clearer picture of these newer drugs' effects for both the positive and negative. NAADAC, which has conducted several trainings around the country over the past year, has pledged to remain involved in helping members understand where medications fit into the treatment system. It is an era of multiple options, and more clinicians and programs appear to be adopting a phrase that new NAADAC President Sharon Morgillo Freeman, PhD, APRN-CS, referred to at one point as her mantra: “Whatever works.”

Gary A. Enos, Editor