Herald.ie
WRITTEN ON: OCT 03 2008
Dr. Andre Waismann has found a method for treating opiate addiction that has proven incredible successful, yet his work is often overlooked by the medical community.
“My goal is that any drug addict in the world will one day be able to turn up at their local general hospital and say, ‘Good evening. I am hooked on opiates.’ Then they will lie down on a treatment table and be cured quickly before going home healthy. It will be as simple as taking a trip to the dentist, said Dr. Waismann from a medical center as he looked over the Gaza Strip from the Israeli town of Ashkelon, just a few miles north of the heavily fortified border that is constantly under attack from Kassam rockets.
Dr. Waismann runs a clinic that is based in Barzilai Medical Centre in southern Israel, and his method of treating opiate addiction is controversial, yet the results speak volumes. The treatment helps those who are addicted to heroin, morphine, and opiate-based pain medications, such as codeine and Vicodin. The technique works by helping a person through the difficult and painful withdrawal symptoms, such as nausea, fever, and stomach cramps that often prevent people from completing the detox stage in order to proceed with treatment to address their cycle of addiction. The patient is sedated during the procedure and wakes from anesthesia free of cravings and withdrawal symptoms. Over the next 10 to 12 months, the individual takes medications that counteract any effects of heroin or opiates as they become fully-functioning members of society. Dr. Waismann has successfully treated more than 11,000 patients in the last 14 years, and the treatment is known as accelerated neuro-regulation (ANR). When describing ANR to the medical community and laypersons, he explains that it works by reversing both the physical and psychological dependency on opiates.
Dr. Waismann’s goal is to have his techniques for treating opiate addiction used around the world, yet, despite his proven success, his approach is unpopular with drug treatment programs that use more traditional techniques. The foundation of Dr. Waismann’s solution for opiate addiction is recognizing the problem as a medical issue, and this contrasts with the more conventional thought that it is solely psychological in nature. Additionally, Dr. Waismann emphasizes that human beings, on the whole, desire to to healthy and functioning within society, including those that struggle with the abuse of heroin and other opiates.
Unconventional
In describing opiate addiction, Dr. Waismann explains that the underlying psychological issues stem from the addition; therefore, the addiction must be addressed first. After this, the person is able to receive treatment for any mental health issues. More traditional substance use programs attempt to remedy addiction by treating the psychological issues first, as it is believed to be the root of addiction and catalyst for opiate abuse. This conventional approach translates into using other substances, such as methadone, to help those with opiate addiction as they receive treatment for psychological problems, yet this only lends to trading one substance for another and has limiting effects for the overall issue of opiate addiction.
Based on his practical experience and success in helping those who struggle with opiate addiction, Dr. Waismann has come to recognize that his techniques are the most humane treatment, and policymakers who place psychological treatment with methadone above overcoming the medical issue of addiction have a type of backwards thinking that ultimately delays and undermines substance use treatment for opiates.
As Dr. Waismann explains, the same medical issues of dependency are experienced by heroin addicts, people who use opiate medications for pain, or any other situation that involves opiate drugs. Regardless of the initial reason for using, once the addiction sets in, the person experiences painful symptoms of withdrawal if opiates are not used on a regular basis. Thereafter, the person also experiences the psychological effects of drug addiction.
Conventional approaches for opiate addiction dictate that psychological problems are the motivating factor, but this is not the case. Opiate dependency occurs in the central nervous system, and can, therefore, be reversed. The first step is to remove the physical cravings that occur due to the changes in the central nervous system that are rooted in opiate use, abuse, and addiction. Using his technique, clinicians can treat opiate addiction without the use of methadone, extensive psychological counseling, and admission to rehabilitation centers.
Dr. Waismann was born in Brazil where he received training as an anesthesiologist. In 1985 he was serving in the Israeli army when he saw how soldiers became addicted to the painkillers that were administered. This opened his eyes to the truly pervasive character of addiction.
Opiates are particularly addictive because of the way the drugs work to modify the brain, specifically cells that work as opiate receptors. When a person ingests opiates, the effects take place within the pleasure center of the brain to reduce pain and give the person an overall sense of euphoria. As Dr. Waismann explains, “Our bodies produce natural opiates — endorphins. But when you start using heroin, your endorphin levels go down because your brain doesn’t need to produce it any more. The system collapses. Your dependency on heroin increases until the day you no longer produce endorphins and you become totally dependent on heroin. The more you put in your brain, the more receptors your brain produces and the more receptors you have, the more heroin you need. Eventually you reach the point where the amount of heroin that you need to feel high is the amount that kills you.”
Dr. Waismann and his team at ANR clinic use a technique that relies on drugs that are used by anesthesiologists. The process removes opiates from the receptors in the brain and then blocks the cells to prevent opiates from interacting. Before the procedure, the patient is assessed to determine a level of opiate dependency that is used to guide the treatment protocol. Next, the patient is sedated, and the drugs are administered. The team constantly monitors the patient who experiences no discomfort or withdrawal symptoms. At the conclusion of the procedure, Naltrexone is given to the patient for the opiate-blocking effect, and the patient takes the medication for up to 12 months. Naltrexone is used because it will prevent opiates from affecting the receptor cells should the individual use after the treatment. The procedure takes less than 36 hours, after which the person is no longer physically dependent on opiates and will not experience withdrawal symptoms nor cravings.
The practical evidence and amazing reports of Dr. Waismann’s techniques are ever-growing, yet the question remains: “Why is Dr. Waismann’s techniques being overlooked by those who provide opiate addiction treatment around the world?”
Crusade
Rapid detox has been at the forefront of opiate treatment in Israel, and Dr. Waismann has traveled around the world sharing his knowledge, insights, and technique since he first developed the approach. His work to raise awareness began with a collaboration with The Australian Women’s Weekly magazine 12 years ago. The publication flew Joanne Frare, a 25-year-old heroin addiction, and her brother, Peter, to Tel Aviv to receive treatment at Dr. Waismann’s ANR clinic. The project and outcomes generated so much attention and interest that Dr. Waismann traveled to Australia and shared his expertise with public health officials. In reviewing his trip, The Australian Women’s Weekly Magazine reported, “[Dr. Waismann] had just discharged four more Australians from his clinic and since Joanne Frare’s treatment, more than 25 other Australians have followed suit. All are healthy, most are home, and to a man — and woman — they are no longer addicted to the curse that is heroin.” In Frare’s home town of Lismore, more than 300 people joined together to celebrate the successful treatment of their friend and family member by gathering at a local club to listen to Dr. Waismann speak about his technique for opiate addiction.
Dr. Waismann’s methods for treating opiate addiction has been implemented in Cyprus, India, Italy, Brussels, Kazakhstan, Indonesia, Croatia, and many other places around the world. For him, the crusade is moral and not financial, and his mission is best described when he states, “Don’t send me your patients, they are already coming. Send me your doctors and I will teach them.”
And, amazingly, he refuses to cash in on his impressive results. “I will never open a private clinic anywhere,” he says, “I work in a government hospital, I will teach my technique anywhere in the world for free. People from developed Western countries fly to me in the Middle East, (where they are) under threat of rocket attack, to have proper medical care. It sounds strange, but that is the situation. Elsewhere, millions have been spent on research into drug addiction over the years but nothing has changed in the level of care for patients. Medicine however, has changed. So how come, with the biotechnology we have now that allows us to know what is happening in the brain and how dependency works, we cannot help those patients to have better more humane treatment?”
Yet, despite repeated efforts to expound his philosophy, his main claim to fame so far is as the man who nearly treated Amy Winehouse. Dr. Waismann made headlines in May when it was reported he had been approached by the singer’s family (though Winehouse’s management denied this).
Dr. Waismann is typically discreet. “I do not comment on specifics, but was in touch with the family of a particular celebrity. I was told, ‘We are doing fine, we are controlling it, we don’t need your help.’ If they are trying to control this person’s dependency with methadone or any other heroin substitute, they are not helping, they are prolonging the illness. I have treated many famous people and many politicians and businessmen. For every one of them you have hundreds of other people who are not famous.
“The media concentrates on the celebrities, but there are many people dying because they are not being given proper treatment.”
Adam Catalove is a 31-year-old morphine addict. He was prescribed the painkiller at the age of 20 after radical surgery to repair his collapsed lungs resulted in nerve damage that left him in excruciating pain. If Catalove was in a car that drove over a stone, waves of pain would rip through his body. He became dependent on his medication, and after eight years did not know whether he needed the morphine to control the pain or whether he needed the morphine just because he needed the morphine.
He became a zombie, sitting in a chair in his parent’s home watching his life slip away through the glazed eyes of an addict. Unlike Winehouse, Catalove did not have the luxury of choice when he first took the narcotic, he became dependent on, but he became an addict just the same. His father, Simon Catalove, a 69-year-old businessman who emigrated to Israel before Adam was born, cared for his son.
Simon Catalove says, “Adam ended up on 165mg of morphine a day. He hadn’t slept in a bed for eight years; it was too painful for him. Instead, he spent his days in a reclining armchair. Eventually he was partly paralyzed and in a wheelchair. Three years ago, we started reducing his medication and got him moving again on walking sticks but he still needed 100mg of morphine a day and he was dependent. If he went a day without his dose, he would start withdrawal symptoms. After all these years you can’t suddenly give that up.”
Detoxification
If Adam Catalove hadn’t been living in Israel, the next step would have possibly been a detoxification program, maybe as an in-patient, or with methadone. Instead, earlier this month, his father took him to Dr. Waismann’s clinic.
“If someone told me two weeks ago that there was a treatment that would render him morphine-free in less than two days I wouldn’t have believed them,” says Simon Catalove now.
“Since the treatment his eyes have changed. He is a different guy. The main difference is his attitude. He is positive about life again. He’s even started driving.”
Such life-affirming plaudits are impressive, but they hold little credence with drug policymakers in Europe where accelerated opiate detoxification program like Dr. Waismann’s are often treated with disdain. Dr. Waismann argues this is because “the subject of drug-dependency treatment is not in the hands of proper doctor, it is decided by psychologists, psychiatrists and social workers”. Medical research counters that the process is at best highly selective in the people it works for and, at worst, dangerous.
Independent charity Drugscope acknowledges that there are some benefits to the method, but warns that a cautious, measured approach is needed. Spokesman Harry Shapiro says: “The principle of treatments like the Waismann technique is that they are a way of getting through the very unpleasant withdrawal symptoms without being conscious of what is going on. But to tout this as a cure for heroin addiction is extremely misleading because coming off heroin is a long process. Getting the drug out of your body is the easy bit; the difficult bit is staying off it.”
The charity advocates a wide range of treatment options, but warns that heroin addicts who undergo rapid detox need their Naltrexone use monitored closely as they are at high risk of overdose if they misuse subsequently because they lose their tolerance to heroin. Shapiro continues: “These treatments get people through the obstacle of withdrawal, but have not got much claim beyond that. After that, it is down to the user and the support network they have around them, so in that sense it is no different from any other method. Different methods work for different people, Narcotics Anonymous works for certain people, as does methadone. You can’t treat all people with drug problems as one group. Everyone is different.”
And therein lies the crux of Dr. Waismann’s struggle — there is no consensus to his belief that dependency is an illness and can be removed from a patient in the same way an infected appendix. He remains unperturbed but he knows he has a battle on his hands.
“I fought in Israel for over 10 years to be allowed to use my techniques in a government hospital,” he said. “People couldn’t believe someone could quit 20 years of heroin addiction in 36 hours without the withdrawal pains and cravings. It sounds too good to be true, but it is not. It is a huge historical change and it will take time; all I am asking is to get the debate started.”
