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Sobriety in a Bottle

Jody Briggs in the recovery room at Canterbury, where patients say they feel their brain chemistry change
C. STILES

This is the old Mike Briggs. Curled up on the bathroom floor — convulsing, sweating, heart racing. Retching into the toilet. The whites of his eyes shot with red. Every part of his body aching. He wants nothing more than the one thing he knows will put an end to the pain: a shot of vodka.

Soon comes delirium tremens: hallucinations and tremors so bad that some alcoholics suffer fatal seizures and heart attacks.

Every morning, Briggs, a former Marine with a round, Irish face and tints of red on his nose and cheeks, needs a swig to steady his hands enough to shave. He tops off his coffee with vodka from a bottle he keeps hidden beneath the kitchen sink.

He'll take another pull before he leaves for his job as production manager at a book publisher. Midmorning, he'll go to his car and sneak a few gulps from a bottle of cheap whiskey. At lunch, he'll down enough to make it to the end of the workday, but by 3:30 p.m., he'll be watching the clock. After work, he drives straight to the bar. When he wakes up the next morning, he starts the whole thing over.

Sometimes he holds the bottle to his lips and says, If there's a God, give me the strength to stop this. Then he takes another drink.

Now this is the new Mike Briggs, four months later. He's strolling around a doctor's office looking healthier than he has in years. His eyes are clear and tranquil. He feels happy, peaceful — unfamiliar emotions. This office, the Prometa Center at the Canterbury Institute in Boca Raton, is where Briggs, 60, says his life drastically and instantaneously changed one day.

It wasn't Jesus, rehab, or AA that did it. In January, he came here for an injection. The price was $13,000, and the drug is not approved by the Food and Drug Administration for treating addiction. But Briggs was told that the shot would forever end his cravings for alcohol.

"It wasn't overnight for me," Briggs says. "It was the same day. It was immediate. After I got the injection, I went to the next room and immediately felt different."

Briggs was given a new treatment for alcohol, cocaine, and methamphetamine addiction called Prometa. Greek for "positive change," Prometa involves three intravenous injections administered over three days in an outpatient setting and 40 days of prescription pills. Cocaine and meth addicts receive two additional injections after a month.

The treatment is marketed by California-based Hythiam Inc., which made headlines two years ago with a series of billboards in Los Angeles depicting the late actor Chris Farley, who died of a drug overdose in 1997. Next to Farley 's picture were the words: "It wasn't all his fault."

"The country is ready," says Chris Hassan, vice president of marketing and development for Hythiam. "People recognize that this is not a choice. This is a disease. It's not a character flaw. It's not a lack of willpower. There is a massive epidemic in this country."

Prometa's detractors say the treatment is 21st-century snake oil — albeit very expensive snake oil. Local addiction experts say that they've seen dozens of chemical treatments over the years promising amazing results but that they've all failed to meet expectations. Dr. Frank Vocci, director of the division of pharmacotherapies and medical consequences for the National Institute on Drug Abuse, says he's skeptical about the effectiveness of Prometa because there has been little clinical research on the treatment. Bruce Alexander, a Canadian psychology professor who has spent most of his life researching addiction, points out that addiction is multifaceted, and he doubts this is the solution.

Across the country, though, patients sing the praises of Prometa to anyone who'll listen. They log into recovery chatrooms and describe the treatment protocol with words like miracle, Godsend, life-saving, and even the most taboo word in the world of addiction: cure.


The drug in the IV is flumazenil, which was originally approved by the FDA to treat overdoses of drugs like Valium. The other Prometa drugs are gabapentin, which goes by the brand name Neurontin and was approved to treat epilepsy and to control seizures, and hydroxyzine, an antihistamine used as an anti-anxiety drug that the Canterbury people liken to "a strong Benadryl." All three medicines are being prescribed "off label" — for something other than what they were approved to do.

Twenty-six minutes after the injection began, Mike Briggs was done with his treatment for the day. He walked across the hall to the recovery room, hungry and tired. As he rested, munching on granola bars and candy, watching Law and Order on the expensive TV in the recovery room, he noticed something. He was happy. It was the first time he could remember feeling completely happy without the aid of alcohol.

 

Briggs says that for the first time in 48 years, his thoughts are not dominated by alcohol. "It's just another object," he says, like a tree or a chair. "I know alcohol is out there. I can remember drinking. I just don't have the urge to go out and have one."

Doctors prescribing Prometa report seeing the same success stories all the time. At Canterbury, which started treating patients with Prometa in December, they say more than 90 percent of their patients have stayed clean and sober since the first day of treatment. A Palm Beach man in his 20s said he used to snort Adderall, a stimulant prescribed to treat attention deficit disorder. He started abusing the drug in college and wasn't able to stop — until Prometa.

There isn't much in the way of clinical data on Prometa. Early research is promising, but the only published study involves a sample size of 50 patients and didn't have a placebo control. Dr. Harold Urschel of Research America in Dallas and Dr. Walter Ling at UCLA plan to publish studies later this year, but these are preliminary and also based on small sample sizes.

If it works, Prometa will change the way addiction is treated and the way society views addicts, Hythiam executives say. If they have their way, we'd think of a bad cocaine habit or a drinking problem the way we might think of hypertension or diabetes: as a disease that requires a lifestyle change and medical treatment.

The new approach is turning heads in South Florida, home of the largest recovery community in the country. At least five clinics from Miami to Palm Beach now offer the treatment, though the institute in Boca is the first Prometa Center outside of California and New Jersey.

Hythiam's mission is to make Prometa available to everyone who needs it. It foresees centers in every city and insurance companies ponying up for the treatment. It wants courts offering it as an option for drug offenders and would even like to see it integrated into traditional 12-step programs.

But company officials started marketing the protocol, which costs up to $15,000 per patient, based solely on the anecdotal testimony of doctors, patients, and company executives. They say they just skipped the "bureaucracy" — meaning FDA approval, among other hurdles — to get the medicine to sick patients as quickly as possible.

Dr. Matthew Torrington, medical director of the flagship Prometa Center in Santa Monica, says it would be unethical not to treat patients while waiting for clinical study results. "People are dying!" he shouts during an interview.

But by avoiding the traditional regulatory methods of approval, Hythiam also avoided the only thing researchers and health-care providers consider empirical proof: a series of double-blind, placebo-controlled studies published in reputable, peer-reviewed journals.

In theory, these tests are the only reliable way to determine a treatment's effectiveness. A good study has a simple, testable hypothesis. It explains the reasoning behind the theory being tested and describes the method of testing. Then it reports the analyzed data, accounting for any variables, followed by an appropriate conclusion.

Historically, these "evidence-based" studies were the only thing that mattered in the conference rooms where the white coats of medicine meet the white collars of business.

Prometa could change that. By going straight to the free market, Hythiam essentially told the business world, the treatment community, and addicts everywhere to put down the graphs and believe their own eyes.


Donna Butz, the receptionist at the Canterbury Institute, sees patients walk in sick and angry and walk out looking like different people. "By the time they come out, they're so happy," she says.

Why? Because of an immediate change in brain chemistry, says Dr. Mark Schwartz, medical director of Canterbury Institutes in both Boca Raton and New Jersey. He's prescribed Prometa for alcohol and stimulant addiction for more than a year.

"Your brain, my brain, anybody's brain is made of billions of nerve cells called neurons," he explains to patients. "They're like little wires that carry chemical-electric signals. And these nerve cells are hooked up into different patterns, different circuits."

Each circuit performs a different function in the brain. "The way these cells are connected is through a little space where one nerve cell secretes a chemical called a neurotransmitter," he says. "These neurochemicals interact with the next cell in something called a receptor, sort of like pieces that interlock. And they either turn on or turn off the next cell in the circuit."

If your brain were a car, the neurochemical GABA would be your brake system. GABA — gamma-aminobutyric acid — is the brain's primary inhibitory neurotransmitter, which means it helps calm and focus you. Glutamate would then be the brain's gas pedal. GABA keeps glutamate from overexciting you. Too much glutamate can cause a seizure, and too much GABA can put you in a coma.

 

Every drug of abuse mimics a biological reaction in the brain. Among other things, alcohol mimics the braking system. And when alcoholics use these artificial brakes often enough, the brain stops utilizing GABA — your natural brakes. In an addict's brain, the GABAa-1 receptors fold up into a different configuration. These altered GABA receptors are associated with anxiety, compulsivity, insomnia, irritability, and cravings.

"That's the period of time where you've stopped using alcohol or stimulants — you're abstinent — but your brain hasn't reset," Schwartz says.

Prometa researchers hypothesize that flumazenil, administered intravenously in large doses, changes the GABA receptors back to their pre-abuse state — as if the addict had never met and fallen in love with that drug.

The drug treatment is what doctors call "an acute treatment," as opposed to drug-for-drug replacement treatments like methadone or maintenance therapies that require repeated doses, like Vivitrol. And the drugs are only a portion of the Prometa treatment. "Prometa isn't just the medicines," Schwartz says. "Prometa is the medications coupled with a psychosocial program and nutritional recommendations. What patients tell me clinically is that they are better able to engage in the behavioral component of therapy."

The explanation goes like this: The medicine allows patients to deal with any psychosocial issues that may have led to addiction in the first place — say, the trauma of child abuse — without the interference caused by irrational cravings. The psychosocial programs can be meetings with the staff therapist or group counseling.

"This isn't a magic bullet," says Hythiam executive Hassan. It's important for patients to know that addiction is multifaceted and that the biological aspect treated by the Prometa drugs is only part of the treatment, he says. "You've got to do the nutritional; you've got to do the psychosocial. You've got to do the aftercare."

A 53-year-old lawyer who had the treatment more than a month ago describes the effect as being like the initial booster rocket on a space shuttle. Prometa helped get him through the first few layers of atmosphere in the recovery process.

"AA just wasn't working for me," says the lawyer, who asked that his name not be used. "I would sit through meetings where people talked about how they lost their jobs and their kids and their houses; then I'd go outside and hop into my Mercedes and drive home. It works for some people; it just wasn't the right environment for me."

In March, he got his first Prometa shot. Now when it comes time to unload at the end of a busy day, he doesn't need several glasses of wine like he used to. With the boost from Prometa, he says, he can propel himself through recovery.

Nearly 3,000 patients have been treated with Prometa nationwide since 2003. Hassan says Prometa patients are more focused when they enter group therapy. "People who run the meetings and aftercare providers will tell you that people who have had Prometa are totally different in groups than people who haven't."

Hythiam purchased the protocol from Dr. Juan Jose LeGarda, the Spanish researcher who developed it. He wasn't the first doctor to try using flumazenil to treat addiction, but he experimented with different ways of delivering the drug. "What he found over time was that this had a significant, robust effect on patients," Hassan says. "He saw the outward effect on human beings. We now have clinical results that document why those results were the way they were."

In 2005, Hythiam CEO Terren Peizer took his company public, raising $150 million by reminding investors that this was a way to make money and help people. In the '80s, Peizer worked for (and later testified against) Michael Milken, who went to prison for securities fraud.

Hassan says Hythiam's mission is to make Prometa available to anyone who wants to get sober. Earlier this month, Hythiam announced its first managed-care reimbursement program with CIGNA HealthCare in Dallas. CIGNA will reimburse qualified patients who receive the Prometa treatment at a few clinics in Dallas and will study the clinical and financial results.

Schwartz already participated in a small pilot study in New Jersey with Blue Cross and Blue Shield. The study examined expenditures in the 12 months before treatment and the 12 months after treatment to see which would potentially be less expensive for insurance companies. The results?

"It's difficult to give any kind of meaningful statistics," Schwartz says. "In general, it seems that 70 percent are able to stay sober right out of the gate. Some people have slips and come back to sobriety. And some people don't stay sober, which is the nature of addiction."

 


Prometa's lack of "meaningful statistics" doesn't sit well with Dr. Frank Vocci of the National Institute on Drug Abuse in Washington, D.C. In addition to his work at NIDA, Vocci has been an FDA reviewer and a researcher in the clinical neurosciences branch of the National Institute on Mental Health.

"There have been companies like Hythiam before making claims that they have the medical solution to addiction," he says. "And in the absence of any significant data, they can claim anything they want." The addiction community, however, won't be satisfied with anything short of double-blind studies. A placebo-controlled, double-blind study has half the patients receiving the medication and half receiving something with no physical effect, like a sugar pill. Neither the doctors nor the patients know who got what.

"They've got studies that show this working in animals, but they make some big leaps by saying it's the same in humans," Vocci says. "It's those leaps I have a problem with."

By marketing the treatment before testing it, he says, the desperate addict is left to decide how much he trusts the doctors who will profit from this unproven, expensive treatment. Patients are told over and over before the treatment, You'll feel good. You'll feel so good. So it comes as no surprise that when asked how they feel after the treatment, they say, I feel good.

In a newsletter published by the California Society of Addiction Medicine, Dr. Richard A. Rawson, a UCLA psychiatry professor, wrote of Prometa: "Claims of effectiveness not substantiated with FDA-style testing results are inconclusive at best, misleading at worst. As decisions are made by policy makers to pay for new treatments with taxpayer dollars... it may be considered inadvisable to allow public reimbursement for experimental procedures."

At Research Across America, a clinic in Dallas that runs tests for drug companies and government agencies, Dr. Urschel has been testing Prometa longer than anyone in the country. Last year, he published the first study of Prometa in the Mayo Clinic Proceedings medical journal. He gave the Prometa drugs — but not the psychosocial therapy — to 50 adult meth addicts for one month, then kept track of them for two more months. He says the results were "phenomenal."

Of the 50 subjects, 31 completed the 90-day program, an unheard-of retention rate for a methamphetamine addiction study. Patients in similar studies often drop out and begin using again in a number of days. The problem with the Dallas research: This was an open-label study. The patients and the doctors knew everybody was getting the medication, and there was no way to measure the placebo effect.

Urschel will publish the first double-blind study on Prometa later this year. He won't reveal specific findings before publication but says: "The results are very positive. We had a significant decrease in cravings across the board in the Prometa group over the placebo group."

Other studies are scheduled for publication this year. The studies are funded by Hythiam through unrestricted research grants, meaning that Hythiam has no control over how the results are disseminated. None of the studies has a sample size larger than 120.

Urschel says he's had positive results in both his research and in his private practice, where he offers Prometa to patients, among other treatment options. He says he keeps the research completely separate, in buildings ten miles apart. Vocci says a doctor testing a treatment at a research facility and prescribing the same treatment in a separate private practice is "not uncommon."

What is uncommon, though, is the frankness with which Urschel discusses how quickly popular ideas in the industry can come and go. Without being able to see what's going on in the brain, he says, all we have are hypotheses.

"All these findings and understandings, they may change in a year or two," he says. "They used to put leeches on people to cure them."

Urschel says there is significant data from studies on rats addicted to methamphetamine that show the GABA receptors work better with these doses of flumazenil. "But," he adds, "who knows what's really happening or why things are working?

"As scientists, we really have such a very minimal understanding of truly how the brain works. We don't really know how Tylenol works or how aspirin works, much less the other medicines. We as humans tend to think of things in very simplistic terms so we can understand them."


Dr. Matthew Torrington says he doesn't need to understand how the chemistry works. He just knows it does. As medical director for the Prometa Center in Santa Monica, California, Torrington has treated more patients with Prometa than anyone in North America. The only person in the world who's treated more patients with Prometa is Dr. LeGarda, the Spanish man who devised the treatment.

 

"It's the most fascinating biologic intervention I've ever seen," says Torrington, whose passion for the subject leads to occasional bouts of shouting. Before working at the Prometa Center, where he receives a consulting fee from Hythiam, Torrington attended Jefferson Medical College in Philadelphia. He did his residency at Christiana Care in Wilmington, Delaware, with a focus in family medicine. He is also a research fellow at UCLA.

"Make no mistake, this is not a fucking cure," he says. He speaks in fast, rhythmic sentences occasionally seasoned with beach-dude profanity. "Prometa just helps with the physical dependence," he tells his patients. "It doesn't change your psychologic situation. It doesn't change your social situation. It doesn't change your spiritual situation. If you don't change those things, if you don't move out of the crack house, it doesn't matter how good Prometa is. It's not gonna work." His voice gets louder. "You gotta move out of the crack house! Or you're gonna die!"

He says the first problem people have with Prometa is that it sounds "too good to be true."

"It's just part of the solution," he says . "Fixing somebody's brakes doesn't do shit for their steering or their bald tire or their bent rim or the bad guidance system in their Nav computer. All that stuff has to be fixed, and addicts are suffering from all those things. It's just one piece of the puzzle."

He takes the GABA-brake system metaphor to entertaining, poetic lengths while explaining the type of patients for whom Prometa is most effective. "Sometimes you see people who've been busting their ass, they've got every other piece, but they still keep failing, because when they hit that steep left turn, they don't have enough braking tone to keep it on the road, and they end up crashing into the guardrail or going over the side," Torrington says. "When you get their brakes working again, they go around that turn and they're fine."

He says that he used to be a rising research star at UCLA but that his association with Hythiam and Prometa has made him an outcast in the research community. He admits he's been fired from places, passed over for grants, and, worst of all, called a sellout.

But he gets most worked up when people suggest that Hythiam should have waited to treat patients until after clinical studies were published.

Torrington talks about doing research on Suboxone to treat heroin addiction before the drug was FDA-approved. But when the study was over, Torrington had to take his patients off the medication. Today, Suboxone is widely prescribed for several opiate addictions, essentially replacing methadone as the treatment of choice for heroin addicts.

"I had it in my office, and I couldn't give it to them because it wasn't FDA-approved. And at least one of them died of an overdose waiting for Suboxone to be FDA-approved. You know what? That makes me crazy, bro! I don't like to lose, man. I'm a winner. And I don't like it when my patients die!"

The only problem with Prometa right now, he says, is that it's too expensive and too hard to get. "Yes, it's expensive right now, but so were airbags. Airbags started on the SL [Mercedes]. Then the S [Mercedes]. Then the Porsches. Then the BMWs and the Saabs and the Volvos. And then nine years later, they were standard equipment on every car sold in the United States. Essentially, we're in year two."

Hythiam, he admits, alienated the addiction community early on. "The original marketing people, who have all been fired, were idiots," he says. "They didn't understand addiction. They had a billboard in L.A. that said 'Addiction is biologic; treatment is medical.' I wanted to scream. I did scream! Addiction is biologic, psychologic, social, spiritual, and nutritional. The treatment has to be biologic, psychologic, social, spiritual, and nutritional. 'We didn't have room for that,' they said. 'You're idiots,' I said."

Torrington believes the doctors who haven't used this treatment might not approve because it takes away from their business model. "There's a lot of repeat business in addiction," he says. "Hythiam's trying to capitalize too, but people have ponied up $150 million in venture capital and publicly traded money to try and believe in this idea and perpetuate it.

"This is America, bro. The only thing in this country that works is commerce. I don't believe in the government. I don't think they can do anything right. The media? Sorry, bro, but it seems like it's controlled by special interests. The only thing that really works is companies. Starbucks works. Everybody's addicted to caffeine."

Many of Prometa's staunchest detractors are receiving millions of dollars in federal grant money to study treatments for meth addiction, and Hythiam's approach cuts into their business, Torrington says. Dr. Rawson of UCLA, the one who urged political officials in California not to spend precious taxpayer money on treatments like Prometa, has at least $20 million in grant money to study the treatments for meth, according to NIDA.

 

"How do you think [Rawson] feels about slimy Terren Peizer coming up with the answer to methamphetamine?" Torrington asks. "I understand the need for data, but that dude just submitted grants to study Wellbutrin for methamphetamine dependence. I mean, Fuck you, dude! Wellbutrin doesn't work!"

He says he believes LeGarda will get the Nobel Prize. "Every time I see him, I beg him to invite me to Stockholm when he goes."

If the current studies get published and show statistically significant differences between patients who took Prometa drugs and patients who received the placebo — which Torrington says will absolutely happen — it could become unethical to withhold the treatment from anyone.

"Addiction is our biggest problem," Torrington says. "Our jails are full of addicts. Our health-care system is clogged with people suffering from addiction. We're not treating them effectively.

"We can have a revolution in addiction medicine that will be the single greatest victory in the history of medicine. We can't beat cancer, but we can beat people dying from the self-administration of drugs against their will."


The people pushing Prometa are the source of the negative vibe surrounding it, says Ben Brafman, who owns Destination Hope, an inpatient program in Fort Lauderdale geared toward men. "They come across as the stereotypical salesmen... promising a miraculous cure in some pill or shot. It has a bad reputation around the recovery community down here."

Brafman's program focuses on the issues addicted men struggle with: low self-esteem, anger management, family problems. "Nothing takes the place of good old-fashioned hard work and therapy," he says. "Medication might clear up a cloudy day and give you the opportunity to do what you need to do to get well. Maybe Prometa can do that, but I don't think it can do more than that."

He says the fact that Hythiam has been marketing Prometa without clinical research is "laughable." "I tell people to do their research for a reason," he says.

Prometa came under heavy fire in Pierce County, Washington, near Seattle, when county commissioners agreed to fund a $400,000 trial program, treating methamphetamine addicts in family court or felony drug court.

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.

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.

Briggs had his first injection January 11. He purposely scheduled the first day of treatment on a Friday so he wouldn't miss more than a day of work.

And sure enough, after becoming the seventh Prometa patient at Canterbury, he was back at work Monday morning.

After his first injection, he sat on one of the plush couches in the recovery room and gazed out the tall windows, where he could see the ocean in the distance.

"It's hard to explain," he says. "My brain just felt different."

Briggs returned the next two days for the same treatment. Each day, he felt better than the day before. He hasn't had a drink since. But if he did relapse, Jody explains, Canterbury would re-treat him for free. "We don't want people walking around saying this doesn't work."

For Briggs, Prometa ended his insane arithmetic. "All those times I was thinking about how I could drink and how much I had to drink to feel better without going over, I knew it wouldn't work," he says. "But I kept doing the math. I kept trying. That's the insanity of addiction — knowing what will happen but not being able to think rationally about what you're doing.

"But with this," he says, "I can actually think clearly."

Whether it's folded GABA receptors changing shape in his brain or something else, Briggs says he doesn't care.

"I'm a different person than I was before I had the shot," he says. "I can see the difference. "

Jody points to her husband with both hands. She watches him, still amazed at how much he's changed in the months since he began treatment.

"Look at him," she says. "It works."


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