“Abstinence is followed by rebound hyperphagia and weight gain, and an important way to avoid relapse is not to get too hungry.”
Today, the center represents “an influential minority” in addiction psychiatry, Dr. DuPont said. He noted “a kind of split” in the field about treatment goals, with harm reduction favored in academic and publicly funded settings, and institutions such as the Betty Ford Center taking a contrary view.
“We are very skeptical that harm reduction is helpful in cases of true addiction,” Dr. Waite-O'Brien said.
In addition, while drugs like buprenorphine and benzodiazepines are used to support detoxification at the center, “we're leery about medications to help people stay sober,” Dr. Waite-O'Brien said. “Treatment is an emotional and spiritual process, and we haven't found a medicine that works for that.”
Arguably, the center could help bridge differences within the field. In September, for example, it initiated the Betty Ford Institute “to conduct and support collaborative programs of research, prevention, education, and policy development.” Their first undertaking, a consensus conference on the concept of recovery, introduced “an academic psychiatry perspective into an important area in which it has been less involved,” said Dr. Galanter, who chaired the conference. “To operationally define [recovery] will be useful for outcome research.”
In general, “rehabilitation programs have not been integrated much into academically grounded addiction psychiatry,” Dr. Galanter observed. He is chairing an AAAP committee aimed at fostering more communication between camps, “and Betty Ford is illustrative of the concept.”