The Doctors Opinion on Alcoholism – Revisited (November 2011)
This program describes a physician's view of alcoholism, as presented in the literature of Alcoholics Anonymous and updated with the modern neurobiology of addictive illness. It includes a discussion of Dr. Silkworth’s explanation of alcoholism as a twofold disease, affecting mind and body, how Dr. Silkworth's opinion relates to the modern neurobiolgy of addictive illness, and identification of therapy for alcoholism as promoted by Alcoholics Anonymous and its relationship to Dr. Silkworth’s opinion. The program is presented by Dr. Herbert L. Malinoff, MD; addictionologist. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
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The Doctors Opinion on Alcoholism – Revisited (November 2011)
- 1. THE DOCTOR’S OPINION An explanation of addictive illness found in the “Big Book” of Alcoholics Anonymous Dawn Farm Lecture Series November 15, 2011
- 2. Herbert Malinoff, MD, FACP, FASAM Specialist in Chronic Pain and Addictive Illness Medical Director, Pain Recovery Solutions, PC Attending Physician, Saint Joseph Mercy Hospital, Ypsilanti, MI Clinical Faculty, University of Michigan Medical Center, Dept. of Anesthesiology Consultant to Michigan Pain Specialists, Ann Arbor, MI Secretary, American Society of Addiction Medicine 4870 Clark Road W. Suite 201 Ypsilanti, MI 48197 734/434-6600
- 5. BORING
- 10. >Regard Addiction as a moral problem >1% of medical school curriculum >Fail to adequately screen >Believe interventions are ineffective JAMA, 2003:290, 1299
- 15. The Problem Determines the Solution
- 16. The Solution makes no sense without an understanding of the problem
- 18. The Problem: Lack of Willpower (weak)
- 25. The Problem: Lack of Knowledge (dumb)
- 30. The Problem: Deep Psychological Problems (crazy)
- 34. 10,000 Pounds of Insight Isn’t Worth 1 Ounce of Behavior Change
- 35. The Problem: Lack of Character (bad)
- 41. Alcohol Problem vs. Alcoholism
- 51. “ The only relief we have to suggest is entire abstinence” “ The Doctor’s Opinion”, Alcoholics Anonymous p. xxx
- 52. Can’t start drinking Rx: “entire abstinence”
- 57. Obsession “ Compulsive preoccupation with a fixed idea”
- 58. “ They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort…..” The Doctor’s Opinion, Alcoholics Anonymous pp. xxviii-xxix
- 62. Can’t stop starting Rx: “Personality change sufficient to recover…”
Notes de l'éditeur
- I, however, am eager to test Wilde's description of absinthe's effects: "After the first glass, you see things as you wish they were. After the second glass, you see things as they are not. Finally you see things as they really are, and that is the most horrible thing in the world."
- Summary; addictive drugs activate the reward system via increasing dopamine neurotransmission In this last slide, the reward pathway is shown along with several drugs that have addictive potential. Just as heroin (morphine) and cocaine activate the reward pathway in the VTA and nucleus accumbens, other drugs such as nicotine and alcohol activate this pathway as well, although sometimes indirectly (point to the globus pallidus, an area activated by alcohol that connects to the reward pathway). While each drug has a different mechanism of action, each drug increases the activity of the reward pathway by increasing dopamine transmission. Because of the way our brains are designed, and because these drugs activate this particular brain pathway for reward, they have the ability to be abused. Thus, addiction is truly a disease of the brain. As scientists learn more about this disease, they may help to find an effective treatment strategy for the recovering addict. LIPOPROTEIN RECEPTOR AND OPIATE RECEPTOR FAT AND OPIATES IN DIET.