Pubdate: Sun, 02 Jul 2017
Source: Boston Globe (MA)
Copyright: 2017 Globe Newspaper Company

Author: Herbert Rakatansky


Strong motivation to seek and continue treatment makes a difference

In "Stop calling addiction a brain disease" (Ideas, June 25), Sally
Satel and Scott O. Lilienfeld write of how Michael Botticelli, the
drug czar under President Obama, "drew an analogy between having
cancer and being addicted. 'We don't expect people with cancer to stop
having cancer,' he said." Comparing addiction to progressive brain
cancer is misleading. Better to compare it to diabetes. Diabetics
cannot choose to lower their blood sugar. Diabetics do have a choice,
however - to enter treatment and take their medications and modify
their diets. Addicts have a similar choice. They can enter and remain
in treatment programs. But a strong motivation is necessary. Such
motivation results from the realization that an essential component of
their life is at risk.

Addicted doctors, motivated by their desire to continue to practice
and their need for absolute and continuous sobriety, may have their
treatment under the auspices of a physician health program (in 47
states). Multiyear contracts include attendance at prescribed
therapeutic sessions, medication if needed, and continuous urine,
blood, and hair monitoring for drug use. Immediate consequences result
from breaching the contract or failing the treatment. Does this
approach work? Indeed it does. The five-year continuous sobriety rate
is 75 to 90 percent.

Cultural and financial supports are critical to support addicts in
making this choice to treat their chronic brain disease (addiction)
and to ensure that high-quality treatment programs are available for
all addicts who choose to enter them.

Dr. Herbert Rakatansky


The writer is a clinical professor of medicine, emeritus, at Warren
Alpert Medical School at Brown University, and is chairman of the Rhode
Island Medical Society's Physician Health Committee
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