Reduction
of Drug Residues: Applications in Drug Rehabilitation
Megan
Shields, M.D., Shelley
Beckmann, Ph.D. and R. Michael Wisner
Presented at the 123rd Annual Meeting of
the American Public Health Association
Abstract
It
is increasingly evident that the accumulation
of drug residues and their lipophilic metabolites
in the body plays a role in drug addiction.
Such residues are associated with persistent
symptoms and their mobilization from body
stores into blood correlates with drug craving.
A detoxification method developed by L.
Ron Hubbard was specifically targeted at
reducing levels of fat-stored chemical resides
in the body and thereby alleviating the
long-term effects of such compounds. We
were interested in determining whether drugs
were eliminated during this program and,
if so, what types of symptomatic changes
occurred as a consequence.
Concentrations
of drug metabolites in both sweat and urine
were measured in eight clients who had been
actively using drugs prior to treatment
with the Hubbard program. Treatment occurred
at the Narconon drug rehabilitation center
in Los Angeles. Cocaine, amphetamine, and
benzodiazepine metabolites were detected
by fluorescent immunoassay in both sweat
and urine of these clients. Following start
of treatment, metabolite concentration increased
in either sweat or urine in five cases.
In two cases the level of drug was below
detection prior to treatment, but became
detectable while doing the detoxification
program. Drugs continued to be eliminated
for up to five weeks.
A
separate series of 249 clients with a history
of drug abuse rated the severity of their
symptoms before and after treatment with
the Hubbard program. Prior to treatment
their chief symptomatic complaints included
fatigue, irritability, depression, intolerance
of stress, reduced attention span and decreased
mental acuity. These same symptoms were
dominant in those who had ceased active
drug abuse over a year prior to treatment.
Following treatment, both past and current
users reported marked improvement in symptoms
with most returning to normal range. This
detoxification program represents a vital
innovation in drug rehabilitation: an approach
aimed at a long-term reduction of the predisposition
for drug abuse.
Introduction
Residues
of many drugs - including LSD, phencyclidine,
cocaine, marijuana and diazepam - are known
to accumulate in the body. These compounds
may be retained for extended periods of
time, and are especially abundant in long-term,
hard core drug users.
Persistent
symptoms associated with drug abuse often
linger long after abuse has ceased. The
consideration that accumulated residues
may play a role in the persistence of symptoms
led to the development of a program aimed
at reducing levels of foreign compounds
in the body and thereby assisting in the
recovery of the individual.
This
detoxification program is one component
of the Narconon drug rehabilitation program.
It has been empirically observed that clients
are more alert and do better on the balance
of the Narconon program after completing
the detoxification component.
We
were interested in evaluating the effects
of the detoxification program on both the
elimination of drug metabolites and the
alleviation of symptomatic complaints. Therefore,
we measured the levels of various drug metabolites
in both sweat and urine over the course
of the detoxification program in eight clients
with long-term drug abuse problems.
We
also monitored the change in severity of
self-reported symptoms in a series of 249
clients with a history of drug abuse who
were treated with this detoxification program.
Methodology
Detoxification
Program:
The
detoxification program developed by Hubbard
is aimed at mobilizing and eliminating foreign
compounds, especially those stored in the
fat. Components include:
(a)
Exercise, preferably running, to stimulate
circulation and enhance the turnover of
fats.
(b)
Prescribed periods in a low temperature
sauna to promote sweating.
(c)
An exact regimen of vitamin, mineral, and
oil intake. Niacin in gradually increasing
doses is used to transiently increase fat
mobilization. Oil supplementation both reduces
enterohepatic recirculation and promotes
the exchange of fat. Vitamin and mineral
supplements are included to replace vitamins,
minerals and electrolytes lost during increased
sweating and to correct any nutritional
deficiencies.
(d)
Sufficient liquids to offset the loss of
body fluids through sweating.
(e)
A regular diet including plenty of fresh
vegetables.
(f)
A properly ordered personal schedule which
provides the person with the normally required
amount of sleep.
Clients
are on this program up to 5 hours per day,
every day, until program completion. Daily
aerobic exercise is followed by frequent
periods in a low-heat (60-80 C) sauna. Niacin
is administered immediately prior to the
exercise and sauna to assist with the mobilization
and elimination process. The program is
pursued individually until a stable clinical
improvement is achieved, generally from
4 to 28 days.
Treatment
Population:
249
clients with a history of drug abuse rated
the severity of their symptoms before and
after treatment with the detoxification
program. 87 symptoms were rated on a scale
of 0 (none) to 5 (severe).
These
clients could be divided into three subgroups:
(a)
59 clients who were doing the detoxification
program as part of a drug rehabilitation
program;
(b)
52 clients who had used drugs recently but
were occasional drug users without marked
addiction; and
(c)
49 clients whose last reported use of drugs
was from one to ten years prior to the detoxification
program.
Sample Collection
for Drug Measurement:
Eight
clients with a current drug addiction program
agreed to contribute urine and sweat samples
as they went through both withdrawal (if
needed) and the detoxification program.
Four
smoked cocaine almost daily and had been
using cocaine from eight months to 18 years
prior to treatment. Three were frequent
users of amphetamines and valium (diazepam).
One used cocaine and heroin.
Urine
and sweat samples were collected on program
entry and every two to three days during
the detoxification program.
The concentration
of drug residues in urine and sweat samples
was determined by the polarized fluorescent
immunoassay (PIF) technique at a 95% sensitivity
of approximately ng/ml.
Results
Symptom Severity:
Clients
reported the severity of symptoms both before
and after detoxification treatment. Irritability,
fatigue, depression, intolerance of stress,
reduced attention span, decreased mental
acuity, nervousness and impaired memory
were the main complaints of these clients.
(Table I)
Table
1
Symptoms Prevalent In Drug Users
Self-Reported Symptom Severity
| Symptom
|
All Users
|
Current Users
|
Past Users
|
|
|
|
|
|
| Fatigue
|
2.5
|
2.7
|
2.3
|
| Stress
Intolerance |
2.3
|
2.7
|
2.2
|
| Decreased
Mental Acuity |
2.3
|
2.5
|
2.1
|
| Irritability
|
2.2
|
2.8
|
1.8
|
| Reduced
Attention Span |
2.1
|
2.6
|
2.0
|
| Impaired
Memory |
2.1
|
2.3
|
1.9
|
| Depression
|
2.0
|
2.7
|
1.5
|
| Nervousness
|
1.8
|
2.4
|
1.4
|
| Lethargy
|
1.7
|
1.9
|
1.2
|
| Recreational
Drug Use |
1.7
|
3.5
|
0.6
|
| Sleepiness
|
1.6
|
1.8
|
1.3
|
| Emotional
Instability |
1.6
|
2.1
|
0.9
|
| Alcohol
Use |
1.6
|
2.7
|
0.9
|
| Coffee
Use |
1.6
|
1.5
|
1.5
|
| Headaches
|
1.5
|
1.7
|
1.4
|
| Confusion
|
1.5
|
1.8
|
1.0
|
| Lumbalgia
|
1.5
|
1.4
|
1.4
|
| Tobacco
Use |
1.4
|
1.8
|
1.3
|
| Muscle
Aches and Pains |
1.3
|
1.4
|
1.0
|
| Sleeplessness
|
1.2
|
2.0
|
0.8
|
The
symptom profile for current users is compared
to the profile for past users in Figure
1. Though the severity is higher for symptoms
in current users, the complaints overlap
remarkably in the two groups. This strongly
supports the concept that persistent symptoms
in the general population are related to
past drug use.
Following treatment, the self-reported symptom
severity improved markedly (Figure 2). The
reduction in symptom severity was statistically
significant for 80 of the 87 symptoms, and
highly significant for 74 of them, including
each of the chief complaints of this population.
Drug Metabolites
in Sweat and Urine:
Drug
metabolites were found in both sweat and
urine for seven of the eight clients participating
in this study. Five of the eight clients
showed an increase in the concentration
of drug metabolite in sweat or urine when
the detoxification program was initiated.
Drug
metabolites were not detected in the urine
of two clients before the start of detoxification
treatment but were detected after the program
began. This supports the argument that drug
metabolites were metabolized from stores.
Drug
metabolites were detectable in both sweat
and urine for up to five weeks following
the start of detoxification treatment. (Figure
3)
Discussion
The
detoxification method developed by L. Ron
Hubbard has previously been shown safe and
effective in reducing levels of various
chemicals in humans, including polychlorinated
biphenyls and pesticides and in decreasing
the adverse signs and symptoms associated
with exposure to these chemicals.
Use
of this detoxification program at Narconon
is based on the premise that drug residues
remain in body tissues long after active
use has ceased and that these residues contribute
to both persistent symptoms and the craving
for drugs.
This
study demonstrates that the detoxification
program developed by Hubbard is effective
in alleviating many of the symptomatic complaints
reported by drug users.
Cocaine,
amphetamine and benzodiazepine metabolites
are found in both the urine and the sweat
of individuals who have used these drugs
as they undergo detoxification treatment.
Individuals
report marked reductions in drug craving
following this program.
Considering
the high level of recidivism in drug users,
the potential effects of drug residues on
recidivism and the alleviation of these
effects through detoxification, it becomes
evident that detoxification treatment has
broad application in the drug rehabilitation
field.