Treatment Failure or Inappropriate Treatment Paradigm?

Report: David Hasselhoff Hospitalized for Alcohol Poisoning

Monday, May 04, 2009

AP

David Hasselhoff

Actor David Hasselhoff was rushed to a Los Angeles hospital Saturday after his teenage daughter reportedly found him unconscious on the floor of his Encino California home as a result of alcohol poisoning.


The former “Baywatch” star reportedly registered a staggering .39 blood alcohol level. The legal limit in California is .08 percent.

A rep for Hasselhoff later said the actor regretted drinking too much Saturday, but is otherwise doing fine.

I wasn't surprised to read this story. And the comment by the Baywatch star is a perfect example of the pathological denial that is a part of this disease. "He
regrets drinking too much, but is otherwise doing fine." Excuse me? Fine?

Mr. Hasselhoff has been to treatment in the past and had a famous video filmed by his daughter when he was so drunk he couldn't get off the floor. This latest story is a good indication of how far his disease has progressed. Without intensive long term, residential treatment, Mr. Hassellhoff will undoubtedly be found dead in the next 5 to 10 years.

Many will point to this incident as proof that drug treatment doesn't work. On the surface that appears to be a logical conclusion. That would be an incorrect conclusion.

Condemning ALL addiction treatment modalities as failures because Mr. Hasselhoff relapsed is the same as saying when a person with cancer dies it proves ALL cancer treatments don't work, or that antibiotics don't work because someone died of overwhelming sepsis.

The scientific and medical approach to "legitimate" diseases such as cancer, cardiovascular disease, diabetes, etc. is based on one simple principle...recognize the signs and symptoms of the disease as early as possible and then begin the evidence based treatment protocols as soon as possible. The longer we wait to seek medical assessment and treatment, the more difficult treatment becomes, and the chance of a full recovery decreases.

Yet this is exactly what happens in almost all cases of addiction, regardless of the chemical abused. Most individuals don't recognize the early signs of substance abuse and addiction, especially if it's a family member or a colleague. When the disease progresses and signs become more pronounced, the family and colleagues may refuse to believe that the person is developing the disease of addiction. When the signs of addiction can no longer be ignored, they might tell the person to seek help. The addict isn't capable of recognizing the disease in themselves (pathological denial) and generally reacts in anger, telling everyone they don't have a problem and they can handle it themselves. Finally, someone will spout one of myths associated with this disease: "He hasn't hit bottom yet. Treatment won't work until the addict hits bottom.

Bottom for the disease of addiction (this includes alcohol) is death. The last time I checked, death can't be treated successfully.

In order to get the addict into treatment, an artificial bottom is created through a planned and rehearsed intervention. Once the addict accepts the gift of treatment, the protocols must be evidence based (that means they can show evidence of successful treatment outcomes) and of sufficient time and intensity to achieve the desired results...abstinence from mood altering drugs and a change in the way they approach life's situations. Recovery breaks through the wall of denial of the addict, the family and colleagues while providing safe detoxification from the drugs of abuse. It provides a safe environment and the addict is taught to recognize stressors and cues that lead to drug use, and then develop skills to deal with those triggers in order to remain clean and sober.

Returning to old places and the people we used drugs with is one of the major risk factors involved in returning to drug use. Moving back home with a family who received no counseling about their issues and inappropriate behaviors developed while trying to deal with the addict is like throwing an endangered species right back into the polluted lake that was killing them in the first place.

This is a family disease, both genetically and environmentally. If the addict is treated and the family is not, relapse is likely. It's time to change the paradigm of this disease and the treatment methods from an acute model (wait until there is a crisis and send them to short term treatment) to a chronic disease model (recognize it early, intervene, and treat it aggressively for longer periods of time, and then have appropriate followup care and support). Until that happens, there will be more tragedies like Mr. Hasselhoff.