DEAR DR. ROACH: I have a question regarding people who are addicted to cigarettes. How come there is no drug addiction treatment? I’ve heard that trying to quit smoking is much harder and harder than quitting heroin. Ideas? – CAM
ANSWER: It is incredibly difficult to quit smoking. Many tobacco users are physically addicted to tobacco, which means they will experience withdrawal symptoms. Many will also exhibit psychological signs of addiction, which is characterized by compulsive drug seeking and use, even in the face of negative health consequences.
Inpatient rehabilitation can be a very effective way to combat drug addiction. Among those who have spent six months in in-patient drug or alcohol addiction treatment, the success rate (measured by abstinence) is around 70%. Shorter rehabilitation times mean less efficiency.
I think you can probably see the reason why inpatient rehabilitation is not used for smoking: It is a very expensive and time consuming procedure that few can afford. It is used when the threat of physical harm from drugs and alcohol is extremely high.
Smoking has a high potential for harm. On average, a smoker lives eight to twelve years less than a non-smoker. Successfully quitting smoking is one of the most powerful things a person can do for their health, because most of this difference in life expectancy can return, and the sooner a person quits, the better. is. Stopping, even after many years, improves function and longevity.
Short of inpatient rehabilitation, there are proven techniques to help a person quit smoking. The combination of behavioral interventions (such as smoking cessation clinics or group classes) and pharmacological interventions (such as nicotine replacement, bupropion, or varenicline) is best. A person’s regular doctor is the first place to start, but there are experts who can help treat smoking disorders. In the United States, ongoing advice and support is available through a nationwide program at 1-800-QUIT-NOW
DEAR DR. ROACH: I recently heard about a study done by the Cleveland Clinic on the prevention of Alzheimer’s disease. The results are good: 69% prevention of people likely to have developed Alzheimer’s disease. The drug that gave these results was Viagra. I told some of my friends about it and they brushed it off or didn’t take it seriously. I would take it if it could prevent this horrible condition. Some of my relatives have developed dementia in their later years, but I don’t know if the medicine prevents other forms of dementia. Do you know if it will be offered to people who may be at risk? – GH
RESPONSE: A study published in December 2021 by The Cleveland Clinic looked at prescription records against insurance claim data and found that those who took sildenafil (Viagra) had a reduced risk of drug claims. insurance for Alzheimer’s disease. The group also identified a potential mechanism of action – improved growth of brain cells and decreased formation of an abnormal protein (tau) – whereby Viagra could presumably help prevent Alzheimer’s disease.
As interesting as it is, it is far, far from proving that Viagra reduces the risk of Alzheimer’s, which will require a clinical trial. I don’t recommend sildenafil or similar drugs just to reduce the risk of Alzheimer’s (or other forms of dementia).
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Dr Roach regrets not being able to respond to individual letters, but will fit them into the column where possible. Readers can email their questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2022 North America Syndicate Inc.
Is the reluctance to prescribe certain drugs justified?