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Article written with little familiarity with the history and politics of drug and alcohol treatment!

Here is an example of an article written with little or no knowledge of the history and politics of drug and alcohol treatment.

The death rates for alcohol and drugs have climbed at an alarming rate and we have no strategy in place to address the problem. It is a tragedy that we have zero consumer advocacy, unlike what we have in for AIDS/HIV, NAMI, Epilepsy Foundation, etc.

The writer focused on the lobbying effort by Alkermes, the maker of Vivitrol, the monthly injection of naltrexone, and called it controversial! How many people have heard of naltrexone, the first and only non-addicting drug developed by the federal government over 50 years ago to protect detoxed heroin patients from relapsing when they returned home from incarceration or residential treatment? Why this visceral opposition to a relapse prevention medication that can make a significant difference in reducing opioid use and alcoholism? It is a well-known fact that opioid substitution treatment (OST) is less effective when the access or supply of legal and illegal opioids is not curbed or curtailed. Indeed, OST can inadvertently become fuel for the opioid epidemic bonfire!

The writer should have focused on why there are only three medications to treat opioid use disorder, and if methadone and buprenorphine are the gold standards, why the restrictions on the use of those two medications, and who benefits from the restrictions? Certainly not patients.

Naltrexone was approved by the FDA in 1984 for the prevention of relapse to opioid use and received approval for the treatment of alcoholism in 1994. Naltrexone was rejected on the grounds of poor compliance as compared to methadone and buprenorphine. To improve compliance, Alkermes introduced Vivitrol for the treatment of alcoholism in 2006 and received the indication to prevent relapse to opioid use in 2010. The writer should have taken the time to look at Vivitrol sales figures from 2006 or 2010 to date. It is both unfair and irresponsible for several reporters to write highly derogatory articles on Vivitrol without taking the time to obtain the relevant background information. Not one of them ever took the time to call me or come by the ARCA clinic in St Louis.

If we are going to make a dent in the opioid and alcoholism epidemic, it is critical we learn to utilize the five FDA-approved medications we have appropriately and not indulge in polemics. Indeed, we desperately need more medications in different classes to treat and prevent the spread of this epidemic, especially in minority communities. The big scandal is less than 20% of patients with substance use disorder receive any one of these medications.

Percy Menzies, M. Pharm.

Assisted Recovery Centers of America (ARCA)

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