From left to right: Dr. Ron Stall, Jim Pickett and Gregorio Millett. Pickett attended the PROMETA presentation. Photo by Andrew Davis_________________
Dr. Andrea Barthwell—an addictions specialist and a board member of Hythiam, the company behind the controversial PROMETA treatment regimen—gave a presentation promoting the program (used to combat alcohol, cocaine and meth dependence) Oct. 16 at DePaul University, 1150 W. Fullerton.
However, before Barthwell talked, attendees saw a short film that featured testimonials from people who went through the PROMETA program as well as from company-affiliated doctors who have treated patients. Clients said that they now have 'wonderful lives' and one husband even said about his wife that he now has 'his best friend back.' However, the phrases 'results are not typical' and 'paid Hythiam consultant' (the latter in reference to at least one physician in the video) repeatedly faded in and out. It was also stated that 'clinical studies are underway to evaluate' PROMETA.
Barthwell, who stressed on more than one occasion that PROMETA (which is not yet approved by the Food and Drug Administration) is 'not a magic bullet,' discussed several topics, including the neurological basis of addiction, the program itself and clinical studies. For example, from a neurophysiological standpoint, she said that normalizing part of a structure called the GABA receptor (which is involved in seizures and cravings) is becoming a promising approach.
Barthwell said that PROMETA is an integrated outpatient treatment approach that incorporates physiological, nutritional and psychosocial aspects. The medical component involves, among other things, the 'physician-supervised administration of three oral and IV medications in a unique dosing method,' according to a PROMETA brochure. Among the nutrition-related facets are having clients take daily supplements and high-quality proteins, while psychosocial aspects involve the development of life skills and the prevention of relapse. She also presented a list of inclusion and exclusion criteria; aspects such as being medically stable fit in the former category while severe alcohol withdrawal and pregnancy were in the latter. Regarding clinical studies, Barthwell cited one study of 36 individuals that showed, among other things, that none of the subjects reported increased cravings; however, a more important experiment is taking place at UCLA, and will reportedly provide data in 2008.
After Barthwell's talk, patient advocate Steve Farrell provided a personal testimonial about his PROMETA experience. Farrell, 46—who was treated Oct. 5, 2006—painted himself as a go-getter regarding everything from work to fitness for two decades. However, 'the brakes failed in 2003,' he said. 'I was introduced to meth a party. After the first time I did it, I instantly knew it was going to be trouble.' He eventually enrolled in PROMETA—paying $15,000 in the process (a rate Farrell said is 'much lower than conventional rehab'). 'It felt right. It was convenient and minimally invasive in my schedule.' When they first put the protocol in him, he said that a 'fog had lifted.'
A question-and-answer session generated quite a bit of discussion. Dr. Kevin Osten, who is with Lakeshore Hospital's VALEO recovery program and is a member of the Chicago Crystal Meth Task Force (CCMTF), wondered that, if the clients in the video have not experienced typical results, then what is typical. One person who replied was a representative who said that 'until there are specific studies showing specific patterns, [showing that results are not typical] is a requirement and a responsibility.'
Another attendee said that the whole presentation seemed like 'a major sales job.' He also told Barthwell that he felt that her 'explanation of addiction was very naive. ... Most of the really important things in addiction are going on inside the neuron [nerve cell], not outside in the GABA receptor.' Barthwell replied that the talk was for a mixed audience (of medical and lay people) however, the attendee responded that she gave a talk, but it 'wasn't an accurate one.'
The day after the talk, Windy City Times asked CCMTF's Jim Pickett what he thought of the presentation—and he was not impressed. 'I want science—and most of us in the community want science before we start advocating for a treatment,' he said. 'I think it's irresponsible that they're pushing forward with such little science, with just open-label studies.'
A PROMETA ad recently appeared in some gay publications that moved the CCMTF to issue a letter to warn readers that '[d]espite how wonderful something may appear, there is no 'magic formula,'' as Pickett told Windy City Times in an article that appeared in its Sept. 1 issue.
