When longtime alcoholic David Borenin fell off the wagon again a few months after marrying his wife for the third time, she insisted he get help, but none of the treatment centers he could find would help him, he said.
They'd seen Borenin many times before and didn't know what to do with him anymore.
"I'd basically burned out all the treatment centers all the way down to Washington state," said Borenin, 51, who lives in Haines.
That's when he turned to naltrexone, a drug studies have shown helps alcoholics kick their addictions. Yale University and the SouthEast Alaska Regional Health Consortium began a Southeast naltrexone study focusing on Alaska Natives in 2001. Last month, that study opened up to include non-Natives in the five Southeast communities being studied: Juneau, Haines, Klukwan, Sitka and Kake.
Participants undergo outpatient treatment for four months, receiving nine therapy sessions during that time and three in the year following the treatment. Two-thirds of participants receive active medication, said study investigator Robert Robin.
One-third receive naltrexone and sertroline, an anti-depressant; one-third receive naltrexone and a placebo; the rest receive two placebos. The study is double-blind, meaning neither the participants nor the researchers know who is receiving the placebos.
Forty people have enrolled in the study so far, Robin said. He said 37 or 38 of the participants have been successful in reducing their drinking or stopping altogether. The rest didn't finish the treatment, he said.
"The greater majority of people ... had considerable success in either greatly reducing their drinking or abstaining from alcohol completely," Robin said.
But because of the placebos and the double-blind nature of the study, researchers aren't sure what accounts for the success, Robin said.
"Everybody gets counseling and support. A lot of people even in (the placebo) group attain a certain level of success. We're encouraged by the overall response, but we don't know whether to attribute that to meds or to the counselors and support," Robin said.
Borenin is convinced he did not receive placebos during the four-month treatment program.
"I'm a lifelong taker of drugs and I know when I'm getting drugs," he said.
Since the study ended, he has been taking naltrexone voluntarily.
A binge drinker for 35 years, Borenin was homeless in Anchorage for a while, and drank several fifths of vodka a day in addition to any beer or drugs he could get his hands on, he said. Now he is training to become an alcohol and drug counselor.
"It's given me a whole new outlook. I am an advocate for naltrexone and sertroline as a tool, not as a miracle cure that anybody can just take and not drink anymore. It worked for me because I know all the stuff I'm supposed to know through treatment centers and Alcoholics Anonymous," Borenin said.
Naltrexone, which received U.S. Food and Drug Administration approval in 1995, has been the subject of many studies, and most show it is effective in treating alcoholism, said Ann Bradley with the National Institute on Alcohol Abuse and Alcoholism in Maryland. But a couple of studies indicate otherwise.
A study by Dr. Henry Kranzler of the University of Connecticut School of Medicine found naltrexone's utility was limited by adverse effects including neuropsychiatric and gastrointestinal problems and a high treatment attrition rate.
Robin said naltrexone side effects include nausea, fatigue and sleep disruption.
"It's pretty rare that symptoms get to the point that they can't be controlled or eliminated," he said.
The study will continue two to three more years, Robin said. It was opened to non-Natives partly to help researchers meet their goal of enrolling 198 participants and also because of demand from non-Natives.
Robin said the study originally targeted Natives because, while studies in the Lower 48 had measured the effects of naltrexone on white, black and Hispanic people, no studies had been done on Alaska Natives or American Indians.
Anyone interested in participating in the study can call SEARHC for more information, said spokeswoman Barbra Holian.
"They can give their name or they can call anonymously, but either way they can call and talk with someone who can tell them whether this program would be right for them," Holian said.
The program is no-cost, and participants receive $185 to compensate them for their time. The number to call is 463-3193.
Masha Herbst can be reached at firstname.lastname@example.org.