Addiction

Episode 73: Oh No! Not Naltrexone! with Nancy Curran

Naltrexone, also known by its brand name, Vivitrol, is an opioid antagonist that kicks opioids off of opioid receptor in the brain, not unlike naloxone. But thanks to a combination of overprescription, unscrupulous marketing practices and ubiquitous use over more effective alternatives, naltrexone is a very controversial drug. In fact, a common reaction is Oh no! Not naltrexone!

Of course, naltrexone has some benefits and many people say their life has been saved by it. And at Narcotica, we don’t believe any drug is “bad” or “evil.” So where does this substance fit into the broader scheme of things? We’ve spoken about naltrexone many times on this show, but never this indepth before.

Narcotica co-hosts Zachary Siegel and Troy Farah speak with Nancy Curran, a nurse practitioner who has been practicing for 5 years in an OBOT clinic in the Lowell Massachusetts area, treating both opioid and alcohol use disorders. She prescribes buprenorphine (both Suboxone and Sublocade), as well as naltrexone (Vivitrol). She also treats patients who need Hep C treatment. Nancy is passionate about advocating for and educating her patients on their medication options, as well as their rights.

They discuss the history of hallucinogenic opioids, the shrewd and quasilegal marketing practices of Alkermes, Inc., how naltrexone stacks up against buprenorphine and methadone, why stigma persists against people who take certain opioid use disorder drugs but not others, the difference between addiction and dependency, some basic opioid receptor science, and much, much more.

Follow Nancy on Twitter at: @cashboygo

More background on naltrexone and the XBOT Studay can be found here and here. We also recommend reading Walter Sneader’s book: Drug Discovery, A History and also Nancy Campbell’s book OD: The Politics of Overdose.

You can read Zach’s article on Four Good Days and more here: https://www.nytimes.com/2021/05/11/magazine/addiction-movies.html

If you liked this episode, here are others you might enjoy:
Episode 19: Debunking Bupe Diversion Myths with Molly Doernberg
Episode 30: Getting Wrecked with Dr. Kim Sue
Episode 36: Moral Hazards and Naloxone, A Toxicologist’s Perspective with Ryan Marino

Follow Narcotica on Instagram, FacebookTwitter, YouTube and support us on Patreon. We just opened a shop where you can order Narcotica merch: narcocast.myshopify.com Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Aaron Ferguson
Music: Glass Boy / Nomad1
Intro voice: Jenny Schaye
Image: edit: Troy Farah

Episode 66: Overlooking Alcohol and The Nature of Addiction with Dr. Stanton Peele

Booze is one of the most ancient and most prolific drugs in society, yet for some reason, it’s always placed in some separate category. Drugs and alcohol. Even at Narcotica, we’ve done over 65 episodes about drugs and not one of them has focused solely on ethanol. We just haven’t gotten to it yet, we’ve had so many other topics we’ve wanted to explore.

The relationship people have with alcohol is so illustrative of Western society’s perspective on addiction and substance use, which is linked to the idea that addiction is a disease. But this framework, while a step above the idea that addiction is a moral failing, is still very destructive.

Narcotica co-host Troy Farah gets into why this is the case in an interview with Dr. Stanton Peele, a brilliant psychologist and the author of Love and Addiction, co-authored by Archie Brodsky, a 1975 book that has really turned the idea of addiction as a disease on its head. Many giants in drug policy analysis, including Maia Szalavitz and Dr. Carl Hart, have cited Love and Addiction as influential on their way of thinking.

Follow Stanton Peele on Twitter @speele5 and check out his new book, A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction.

If you liked this episode, here are others you might enjoy:
Episode 33: Party and Play—An Intro to Chemsex with David Stuart
Episode 61: Undoing Drugs—Harm Reduction’s Early History with Maia Szalavitz
Episode 51: The Joy of Drug Use with Dr. Carl Hart

Follow Narcotica on Instagram, FacebookTwitter, YouTube and support us on Patreon. Help keep this podcast ad-free! Your support is appreciated! We’re on Spotify, iTunes, Stitcher and more. Tell your friends about us! Rate us! And thanks for your support!

Producers: Christopher Moraff, Troy Farah, Zachary Siegel
Co-producer: Aaron Ferguson / Troy Farah
Music: Glass Boy / Crowander
Intro voice: Jenny Schaye
Image: Noun Project // edit: Troy Farah