- Pennsylvania Model of Recovery
The Pennsylvania Model of Recovery offers an effective option for individuals suffering from alcohol and substance dependence issues utilizing Evidence Based Treatment, rather than spiritual or faith based treatment.
”The Pennsylvania Model is a medical model, in which a full range of empirically tested treatment options is offered to individuals who are dependent upon alcohol.” (Lloyd Vacovsky, Director, American Council on Alcoholism). The Pennsylvania Model views alcohol and substance dependence as an acute disorder of the pleasure center of the brain. This is treated as a Biological, Psychological and Social condition, and not as a lack of character or willpower. The Model does not require a spiritual epiphany or the acceptance of a Higher Power nor admitting being powerless over their addiction(s) as a necessary condition for recovery.
The Model fully embraces the utilization of pharmacotherapy with safe, effective fully FDA approved medications, which address the biological component of the disorder. The Pennsylvania Model, in addition to the use of effective, approved medications, also relies heavily upon counseling tools, for example Cognitive Behavioral Therapy, Rational Emotive Behavioral Therapy and Motivational Interviewing to address the Psychological and Social components of recovery. This type of integrated program is distinguished from other protocols which generally reject the use of pharmacological agents as an aid in the recovery process.
The Pennsylvania Model of Recovery is so named in recognition of the work and research of the University of Pennsylvania, School of Medicine, Center for Studies of Addiction (http://www.med.upenn.edu/csa/), and in particular the research of Dr. Joseph Volpicelli, MD, PhD of the University of Pennsylvania. The foundation for the Pennsylvania Model is fully researched and documented. One source of documentation can be found in the report of the Project MATCH Research Group. (1993). Project MATCH: Rationale and methods for a multisite clinical trial matching patients to alcoholism treatment. Alcoholism: Clinical and Experimental Research, 17, 1130-1145.
Dr. Volpicelli recognized that alcohol dependence is indeed a disease, albeit a very complicated disease with these distinct Biological, Psychological and Social components. He came to believe that treatment should be more broad-based and include such new developments as pharmacotherapy, for example the utilization of naltrexone as an important component of the treatment processes.
The University of Pennsylvania has a 30-year history of clinical studies, which has led to the development of these protocols. The medical and scientific community has recognized the research of the University of Pennsylvania for developing important advances in the treatment of alcohol and drug dependence. For example, the University pioneered the use of the pharmacological agent naltrexone HCI, which suppresses the craving to consume alcohol or opiates, and dramatically reduces relapse. (Archives of General Psychiatry, 49:876-880, 1992 Volpicelli etc.)
The vast majority of treatment providers incorporate the protocols of the Minnesota Model, which has as one of its cornerstone the acceptance of a higher power before recovery can be fully achieved. This is the model that has been used to train treatment professionals for decades. As a result, the Minnesota Model has been accepted almost without question as the only effective treatment option. It can be a very rigid method that does not allow individuals to stray far from established guidelines.
While the use of medications is not specifically discouraged by AA or the Minnesota Model, neither is it encouraged. For many years, even the use of physician prescribed anti-depressants was actively discouraged by some well meaning AA groups. The bias against the use of any medication that alters mood or the need to consume alcohol is a common attitude among AA members in some groups. This is largely due to the fact that many medications (especially psychotropic medications) are not understood by the general public, and in turn, by members of the AA community. As a result, this continuing bias against the use of appropriate medications has resulted in disastrous consequences for many individuals, dramatically reducing their utilization. It became apparent to Dr. Volpicelli and to many treatment providers that new options for the treatment of dependence needed to be developed.
In April 1997, Assisted Recovery Centers of America, working with Dr. Volpicelli, became the first non-academic, non-institutional treatment provider to fully embrace the protocols of the Pennsylvania Model. While acceptance of the model has been slow, its use is now becoming an option that many treatment providers are now offering their clients.
In July 2005, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) endorsed one of the cornerstones of the Pennsylvania Model. In Helping Patients Who Drink Too Much: A CLINICIAN'S GUIDE 2005 Edition, National Institutes of Health (NIH) Publication No 05-3769 ( [http://www.niaaa.nih.gov] ) states that "All approved drugs have been shown to be effective adjuncts to the treatment of alcohol dependence." Further, "They have been shown to be helpful to patients in reducing drinking, reducing relapse to heavy drinking, achieving and maintaining abstinence, or a combination of these effects."
A primary cause for the slow process of acceptance of pharmacotherapy appears to be the lack of understanding among treatment professionals and physicians, as to the proper use of approved medications. The vast majority of whom, have very little experience with pharmacotherapy for the treatment of alcohol dependence. While many medical and treatment professionals are generally receptive to the concept of pharmacotherapy, most have never heard of the most promising medication for the treatment of alcohol dependence, Naltrexone, years after its approval by the United States Food & Drug Administration on December 30, 1994. In addition to Naltrexone (ReVia®), other medications currently utilized in the United States for the treatment of alcohol dependence include Vivitrol® (injectable long lasting naltrexone), Campral® (acamprosate), Ondansetron (Zofran®) and to a lesser extent Topamax® (Topiramate).
* [http://www.ACA-USA.org American Council on Alcoholism]
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