Dr. Andre Waismann, Rethinking Addiction
“I am not a genius – just a doctor who is tired of seeing heroin addicts being tossed onto the sideline or fed methadone to keep them under control,” says Dr. Waismann, a doctor pushing for the treatment of drug addiction to be brought into mainstream medicine.
During a visit to Cyprus last week, Waismann, who is the chairman of Megama, Institute for Research of Opiate Dependency in Israel, spoke to the Weekly Review about his radical new method of making heroin addicts “clean” – work that has established his reputation in countries as far afield as Indonesia and Costa-Rica.
Born in Brazil, Waismann trained in surgery and ISU medicine – expertise he has taken into his work treating addiction. His method focuses on treating opiate dependency at the receptor level by blocking opiate receptors in the brain to precipitate withdrawal symptoms, while at the same time controlling those symptoms. The technique, which is carried out while patients are unconscious, takes addicts through the withdrawal process in a short time-span, surrounded by medical staff to manage the symptoms.
Waismann explains that heroin addiction is a medical condition, “a central nervous system disorder that is reversible. These people are not mad nor are there people with addictive personalities. They are trapped by body and mind that constantly craves opiates, and can be healed without methadone, without psychological counseling and without being locked away in rehabilitation centers.” He adds that the treatment has a good future if it is introduced at a level where addicts get the same level of care as any other patient.
But Waismann emphasizes that he is not looking for more patients to treat – he simply wants to ensure that a technique that he believes to be far more widely employed. “I do not want you to send me your addicts. Send me your doctors instead, so that I can teach them the treatment. Then they can return to Cyprus and help the addicts here responsibly”
Waismann says it also imperative that politicians put the treatment of addiction where it belong – in the hands of medical doctors – and takes steps to regulate procedure of treating drug addiction here.
It was during his military service in the Israeli army in the 1985 that Waismann got an early taste of just how pervasive drug addiction is, when he saw that drugs administered to wounded soldiers, even war heroes, gave rise to narcotic addiction. Later, working in neo-natal clinics, he bore witness to the newborn babies of heroin users suffering severe addiction problems. At the time, the only treatment, a long and painful process that weans the patient off heroin and onto methadone. Although bearable and sometimes successful in adults, in babies the treatment can cause brain damage. And, as Waismann points out, methadone is equally difficult and painful.
Waismann became increasingly determined to find the common denominator between babies born addicted to a substance, the addict on the street and war heroes. He concluded that the link was that they all suffered from a physical illness that needed a medical approach, rather than being psychiatric cases.
Psychiatrists and psychologists have had limited success in treating addictions, he says, as the psychological aspects of the secondary side effects of the untreated primary condition.
Waismann’s method, which has been successfully implemented since the mid-1995, relies on the skills of anaesthetists and ICU doctors to reverse the illness of addiction. Under the revolutionary treatment, an antinarcotic drug or narcotic antagonist called Naltrexone is administrated to the patient in a four-hour process, during which the patient is under anaesthetic, suppressing the unbearable pain that would otherwise accompany the treatment. Naltrexon tablets are then taken for the following 10 months, by the end of which the body’s receptors will have changed and shrunk, thus reversing permanently the effects of narcotic craving.
Waismann describes addiction or opiate dependency as neuron adaptation.The continuous intake of external narcotics, he explains, damages the very basic and delicate natural balance of narcotic-like substances produced by the human brain – substances that regulate our sense of pain, fluid levels, sleeping patterns, blood pressure and other important functions. External narcotics lead to a new regulation. Their abrupt interruption causes sever distress to the body, including vomiting, diarrhoea, stomach and bone pain, sweating and sleeplessness which can last for 10 days. This sustained pain and discomfort is why most addicts fail to make it to the end of the detox process, which requires that the heroin stored in the bone and fat tissue is used up. When the stored up heroin is exhausted, the body starts the process of neuro-regulation. Waismann’s treatment blocks the opioid receptors in the brain to which the active components to heroin – as well as naturally-produced endorphins – bind, so that regardless of how much heroin there is in the body, it can no longer reach the brain. The patient therefore becomes immediately “clean”, sleeping through an extremely powerful process of withdrawal. Waismann refers to his technique as ANR, or accelerated neuro-regulation, which reverses both physical and psychological dependency. To him, addiction, or opiate dependency, is neuro-adaptation. Whenever a new element is introduced into the body’s biological cycle the brain adapts to it. If the element is taken away, the body will suffer. “Methadone replaces one dependency with another. It is a medication for society not for the patient,” he underlines.
Initially, Waismann treated all patients seeking the treatment himself. But today he says he is more interested in teaching and training at academic and governmental institutions and foundations worldwide, giving freely of his knowledge and experience.
“In the last 50 years, nothing has changed with regard to treating opiate dependency, because it was taken out of mainstream medicine,” he says. Waismann concludes that today, his name is mentioned in any discussion of ANR treatment. But his greatest wish, he says, is for the treatment to become so widely available that he will be just another doctor. At that stage, he says, he will feel he has finally succeeded.