They give you Versed and Propofol. In the earlier days of the treatment, they used to give sodium petothal, but it took patients 3-4 hours to get over the drug, so they switched to the versed and propofol.



This is exactly how the aversion therapy works. They call it Chemical Counter Conditioning.

After completing the 10-day treatment program, even smelling hand sanitizer (the kind with alcohol) gives me a slight feeling of nausea.




Thanks! I finished the program friday afternoon and am now back home. Now, I just need to complete the 2 "Recaps." The recaps are given at 30 and 90 days after the 10-day program. A recap lasts a 1 1/2 days and includes a Sleepy and a Duffy. The statistics I've seen of long term success rates show nearly 90% if you complete the recaps.

I can say that my cravings for alcohol are gone.

Q

Glad to hear that you're home. Be good to yourself, that was really tough! How courageous of you (and everyone there) to go through another 4 Duffies after the 1st one!! My hat's off to you, mate!

I think I had one of those drugs for a gastroscopy a few years ago. I remember having flash backs to when the Dr. put the tube in my mouth etc... I didn't realise that a person would be awake enough to have a conversation. Do they video these interviews? How do you feel about having such intimate conversations that you can't remember?

I'm curious too about the courses you did in the mornings. Was it some sort of cognitive/behavioural class?

Curi

The classes were actually really good at SSH. In the 6:30am class, we worked through the book "The Four Agreements" : http://www.amazon.com/Four-Agreements-P ... 1878424319

This book is just plain good for everyday life, especially those that lead stressful lives -- don't we all.

The 8:00am class typically was more of a real classroom setting where we worked through various aspects of addiction, what leads us to drink, etc. We covered alot of real practical stuff in this class.

There was a 2:30pm class that was typically some type of video. I would highly recommend the video "Pleasure Unwoven." This video dives into what is going on chemically in our brains that drives us to drink excessively: http://www.youtube.com/watch?v=wxiKVQR9 ... 37FD4C3FD1

Finally, there was a 7pm-8pm group session where graduates could come join the group and you talked about various topics. It looks like your typical addiction group, but is nothing like a 12-step group. These groups tended to be nothing but positive experiences for me.

Q

Q - I had a question. What is your opinion now about the difference between alcohol and drug addictions? It seems as though the aversion therapy would work so much better for alcohol than drugs. Do you think drug addiction is much harder to break than alcohol addiction? Why or why not? Thanks

P.S. Enjoyed the youtube video. Very interesting.

This is something people were asking while I was up at SSH. Probably 1/3 of the 40 or so patients in there were in there for drug addictions: cocaine, crack, oxy, meth, and heroin.

What I was told is that aversion works nearly as well on drugs like oxy, crack, cocaine, marijuana, meth, etc as it does for alcohol. The aversion isn't tied just to the taste of alcohol, but the entire experience of drinking alcohol. This is the reason the duffy room is setup like a mini-bar with bottles of all of the types of alcohol you like (and more) and you have you lay in your room for 3 hours smelling the alcohol soaked rag, looking at a bottle of your favorite alcohol, and thinking about drinking (oh and you feel like puking, and often do puke, the entire time.)

During one of the "technical" lectures, we were told that addiction is centered in the mid-brain (Limbic System), which is why it is sooo incredibly difficult to think your way into stopping using your willpower (prefrontal cortex). The mid-brain is our pleasure center, so it doesn't have much trouble over-riding our conscious thoughts/desires to stop drinking with just willpower. Aversion takes place in the reptilian complex of the brain, which is the part of the brain where our flight or flight reactions come from and other behaviors that keep us from hurting/killing ourselves. Essentially, when this part of the brain kicks in, it overrides everything else. With aversion, you have had such a negative experience with alcohol (or drugs) that the reptilian complex overrides the cravings in your mid-brain and says "Hey, the last several times we had this alcohol stuff around we got sicker than hell for 3 hours and felt like sh**. We aren't going near that stuff, so deal with it." I'm sure that medically, aversion is more complex than this, but that's how I understood the lecture on the topic.

A patient who roomed right next to me was treating for cocaine and I can tell you that guy was puking his guts out for nearly the entire 3 hours after he came out of the Duffy room. He reported his aversion to cocaine as quite high after 3 duffys.

Hope this helps.

Q

Thanks. Another question since I find you and your answers very interesting. What is your opinion now of TSM vis-a-vis aversion therapy, since one seemed to work well for you and the other didn't? TSM touts that it "resets the brain to pre-addiction levels" in terms of the endorphin pathways and what not. Do you feel as though aversion therapy "resets" you to pre-addiction levels in some way, or will you always be one pleasant drink away from being right back where you were before Schick Shadel (i.e. once you lose your aversion, won't your brain just pick off where you left off?). Or, does the process of becoming averted to something actually change some sort of "pathway." Personally, I've had more of an experience of "indifference" to alcohol (for the first time in 30 years!) versus aversion. I look at it about like I look at a nice hot dog or something. Sure, every once in awhile I like a good hot dog, but I can do without.

I still think very highly of TSM. However, there is some difference between what I learned at SSH vs Dr. Eskapa's book. Dr. Eskapa and Sinclair state cravings are driven by endorphines whereas the SSH folks state that alcohol cravings are driven by dopamine. I really don't understand brain chemicals, so perhaps they are both right and the endorphines (which are like drugs such as heroin) cause the release of dopamine (a neurotransmitter). If this is the case, then perhaps the reason it didn't work the second time is that there was something else in my alcohol addiction that was also releasing dopamine beside endrophines. I simply don't know.

Aversion shuts down the receptors in your brain that want dopamine as it relates to drinking alcohol, so you just don't crave anymore. However, they are still there. If I could get past the nausea long enough to actually start drinking again (it currently makes me gag to smell it), then I would go right back to my old drinking levels very quickly. They tell you at SSH not to test your aversion.

Q

Interesting stuff.

I did consider aversion therapy, but I often woke up throwing up continuously, and have had the 'both ends' experience yet that didn't put me off drinking. Only thing that has is Naltrexone and TSM, which in a way is a similar theory but different. I think alcoholism is linked to and can be caused by dopamine and endorphins systems, in different amounts in different people - hence why TSM works excellently for some, baclofen for others(although I think baclofen is linked to gaba too), and some need both medications.

I am also convinced all ways of getting over addiction do require work on the self, because we aren't lab rats we have to under go the psychotherapy and counselling stuff, so we get over the 'addictive' or 'dry drunk' behaviour. Removing the cravings with medication makes this much more attainable and doable, than having to fight the physical drive all the time.

Keep us updated on your progress because like any other method, learning to live without booze is a great big long-term journey.

Hi Q,

I hope you are recuperating well.

I enjoyed that video very much and am almost at the end of The Four Agreements. I'd never heard of either of them before so thanks for sharing. I have to admit that while I like what Ruiz has to say, I just don't like how he says it, I'm having a hard time with all the god talk, but I find the Four Agreements to be sound advice, even if there seems to be little practical examples and techniques.

Are you still averse?

Curi

I am thanks. I talked to a few of the other guys I went through the Schick program with and I'm glad I had a few down days before going back to work. One of the guys went immediately back to work middle of last week and he was suffering.

I feel really good at the moment, both physically and mentally.




Glad you enjoyed them. I really liked that video as well. I shared it with my wife to give her some insight into what was driving my addiction. The interesting thing about this video is that alot of that information is really fairly new research. It really pokes some serious holes in these 12-step programs and shows just how difficult it is to overcome an addiction with willpower alone. Given what's going on with your brain chemicals in an addiction, it is a losing battle trying to get over it with just willpower.

I agree with you about the Four Agreements. Some of the "spiritual stuff" is kind of out there -- especially the first part before the four agreements are presented. He is tying his message to the Toltec people from what 800BC or some such. However, the agreements and how he presents putting them into practice in your life are so valuable for someone battling an addiction. The first 3 agreements are not easy to keep on a consistent basis, but help so much to heal wounds and also reduce stress in your life. However, the 4th agreement (Always do your best) is the most powerful.




Oh yes. My aversion to alcohol is quite strong. The Schick Shadel folks have really figured out how to shut down those receptors that cause craving, because I just don't have them. It's like someone flipped a switch. When I see other people drinking or I see alcohol now, I'm just indifferent to it. I might as well be looking at a bottle of some regular beverage that I just don't like. It's pretty amazing really.

I understand I'm only a week out from finishing the program, but this is the same feeling towards alcohol that graduates are telling me they feel years after the program. I'll continue to report my progress after the recaps and what not on my blog.

Thanks for the note Curi.

Q