Sobriety in a Bottle

Is Prometa the greatest innovation in addiction treatment history or 21st-century snake oil?

A year into the study, which followed 40 meth addicts who were given Prometa, a county auditor wrote a report criticizing the initial results. The report says 50 percent of the Prometa patients failed a drug test within 14 months after treatment, about what they'd found in previous drug court settings.

The county halted the trial after spending $250,000. The rest of the money was allocated to the University of Washington to study the data collected during the trial.

"What happened in Washington was 100 percent political," Hassan says. "The individuals who wrote the audit report had no knowledge of addiction or recovery." In Hassan's view, the results were great.

Jody Briggs in the recovery room at Canterbury, where patients say they feel their brain chemistry change
Jody Briggs in the recovery room at Canterbury, where patients say they feel their brain chemistry change
Mike Briggs sits in the chair where he received his injections of flumazenil.
Mike Briggs sits in the chair where he received his injections of flumazenil.

Still, plenty of people with knowledge of addiction have problems with Prometa. There is one method of recovery that has a better track record than the others, says a man who leads an Alcoholics Anonymous group in Broward County. He says following the 12 steps outlined in The Big Book used by AA is the most effective, proven answer. The 57-year-old asked that his name not be used, in accordance with the traditions of the program.

He says that he doesn't want to disparage any treatment program but that "I've seen more chemical solutions for sobriety come around like wildfire only for people to learn it's just another thing that doesn't really get at what needs to heal."

Bruce Alexander, a Canadian researcher, says he's "dubious of all the chemical solutions." For decades, Alexander, a psychology professor, did research at Simon Fraser University in British Columbia. He recently retired to write a book about his findings. He is widely considered one of the most innovative minds in addiction.

Alexander believes that focusing on a chemical solution ignores the more important issue of why people become addicted. His theory is that addiction is a result of people living disconnected, stressful, unhappy lives.

He and his team looked at the role environment plays in addiction. Traditionally, scientists studied addiction by putting rats in cramped individual cages and either injecting them with drugs or watching them down drug-laced solutions. Like human addicts, the rats ignored food and water and often died.

The researchers at Simon Fraser wondered if maybe the rats drugged themselves to death not because the drugs were so irresistible but because the rat's lives were so stressful. Like humans, they responded to isolation and boredom by self-medicating.

So Alexander's team built a giant playground for the lab rats. The 200 square feet of bright, painted tubes, tunnels, and toys was dubbed "Rat Park." They painted scenic views on the walls for the rats and left plenty of open space for socializing.

Then Alexander studied two groups of rats: one lucky group of rodents in Rat Park and one control group in the isolated cages. They gave both groups water and a sweet morphine solution. He found that the isolated rats drank more than 12 times the amount of morphine as the Rat Park group. Researchers continued to sweeten the morphine solution, but the residents of Rat Park barely touched it — they were too busy playing and mating. Alexander's book, which will be published in August by Oxford University Press, is titled The Globalisation of Addiction: A Study in Poverty of the Spirit.

"I gave up any serious interest in brain chemistry as a way of understanding addiction sometime in the early 1990s after exploring a string of heavily hyped earlier chemical theories," Alexander says. "I decided that this approach is doomed to failure."

Seeing Mike Briggs discuss his life after taking Prometa, it's hard to imagine the calm man in front of you as a raging drunk. But his wife, a slim, fit woman named Jody, says she lost more than 20 pounds during Mike's worst bouts with booze.

Briggs is typical of the patients in Boca. He first realized he had a drinking problem 30 years ago, when he woke up one Sunday with "the shakes." The only thing that could calm his hands was a beer.

He tried everything. He went to inpatient centers and outpatient centers. He tried stopping on his own, and he tried AA. He put together a few stretches of sobriety, but he'd inevitably end up drinking again.

For Briggs, life was a constant arithmetic problem. Based on the intensity of his shaking and urges, he had to calculate how much alcohol would be enough to function but not so much that people noticed he was drunk. He often miscalculated.

Jody knew never to speak of her husband's drinking. At parties, he could keep it to a drink or two, but only because he'd gone to the bar beforehand and pounded four or five. He'd even go to different liquor stores on different days so the employees behind the counter didn't realize how much he drank.

Briggs is what the recovery industry calls a "high-bottom drunk." He hasn't amassed a pile of DUIs or assault charges. He hasn't lost a job or a house because of his drinking. He says he just couldn't deal with feeling sick all the time.

At one point three years ago, Jody took their teenaged son and separated from Mike. They got back together after he put together a year of sobriety. Jody, who now works as director of sales at Canterbury, says that when they started treating patients, she never expected her husband would be one of them. But when he relapsed again in December, it was time for Prometa.

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