Frequently Asked Questions
In discussions with our patients, many of the following questions have come up regarding The Freedom From Alcohol® Method and its related treatment.
To help you learn more about the program, we've posted the questions and answers here. Simply click on any of the following questions and you'll be taken to the answer.
- How does one get into Dr. Pearlman's program?
- How does The Freedom From Alcohol® Method treatment work?
- How do the Introductory Treatment and Internet Introductory Program options differ?
- What are the elements of The Freedom From Alcohol® Method?
- How much does the treatment cost?
- Who benefits from The Freedom From Alcohol® Method?
- How successful is the treatment?
- What is the key to the program's success?
- What is naltrexone?
- How does naltrexone work?
- Is naltrexone like Antabuse® (disulfiram)?
- Does naltrexone have side effects?
- How does Campral® (acamprosate) work in the maintenance of abstinence from alcohol?
- Why is ongoing supportive therapy and coaching important?
- Why is it important to complete the program in its entirety?
- What about Alcoholics Anonymous, sobriety and abstinence?
- Is the treatment covered under insurance?
How does one get into Dr. Pearlman's program?
To speak with Dr. Pearlman, call 1 (866) 285-3400 toll-free or (617) 620-2230, or click here to set up an appointment.
How does The Freedom From Alcohol® Method treatment work?
The treatment offers two basic options: the Introductory Treatment Program and Internet Introductory Program, both of which offer a combination of supportive therapies and medication aimed at controlling excessive alcohol drinking. In most cases, counseling follows a cognitive-behavioral and solution-focused framework. The basic The Freedom From Alcoho®l Method treatment program begins with an initial evaluation and consultation, followed by 5 to 10 follow-up visits, whose intervals lengthen as treatment progresses. In between sessions, telephone and/or e-mail contact is encouraged and is included in the fee. Generally, the basic treatment lasts from 3 to 6 months. After the basic treatment, follow-up sessions are recommended.
How do the Introductory Treatment and Internet Introductory Program options differ?
The basic elements of the two programs are the same. Patients in the Boston area able to work with Dr. Pearlman directly are eligible for the Introductory Treatment Program.
For patients unable to attend sessions in our Boston offices, the Internet Introductory Program is delivered and supported via the internet, e-mail and telephone. We work with your physician, who is supported in treating you with our technology.
What are the elements of The Freedom From Alcohol® Method?
The Freedom From Alcohol® Method is composed of three integrated components: Evaluation and Treatment, Pattern Identification and Life Design. While the three basic phases are the same for every patient, each program is customized to support your unique situation, whether implemented through Dr. Pearlman directly or through your own physician. The pace of the program is dictated by your commitment to your own goals. To learn more about the components of the program, click on The Freedom From Alcohol® Method.
How much does the treatment cost?
Both the In-House Freedom Program and Internet-Based Treatment Programs' initial evaluation and consultations cost $1995 and include an initial evaluation, 5 coaching sessions, and unlimited online support. To learn more about the costs and components included in the treatment, click here.
Who benefits from The Freedom From Alcohol® Method?
The treatment works for most excessive drinkers who seek to control, moderate or stop drinking entirely, regardless of the severity of their problem. It may not be appropriate, however, for someone who is currently attending AA or is otherwise abstinent. We do not seek, encourage or treat those who are meaningfully involved in AA recovery or are abstinent. We do, however, get referrals from AA "sponsors" and physicians who seek our treatment and support for those AA members or patients whose frequent relapses put their lives in danger. Our aim in these cases is to support, in a safe manner, a return to abstinence. This is a controversial area and we leave it to each patient to make his or her own decision in this matter. It is important to note that the vast majority of excessive drinkers do not see themselves as "alcoholics," let alone as candidates for AA (please see question 16 below).
It also may be difficult to start treatment in the middle of a severe binge that incapacitates the patient and interferes with his or her ability to understand the technology due to intoxication. In addition, people drinking heavily may be in need of a detoxification program. The treatment may not be recommended for people with acute liver disease, pregnant women or individuals using or physically dependent upon opiates. A doctor's physical examination prior to treatment can help to clarify these issues and determine the suitability of the program for a given patient. A doctor can also help review the risks and benefits inherent in The Freedom From Alcohol® Method program.
How successful is the treatment?
In clinical trials, treatments similar to The Freedom From Alcohol® Method approach have been shown to significantly reduce craving and drinking. In a survey of 147 patients from the first ContrAl Clinic in Finland (see the link to ContrAl.com website), nearly four out of five patients (78%) successfully reduced their drinking below a level of increased risk for mortality and morbidity. Many halved their alcohol consumption from what it was prior to treatment. A quarter of the patients reported having been abstinent during the last month. The treatment was unsuccessful in 12% of the patients, most often because of a failure to follow instructions. As to the long-term efficacy, the method is still young and trials are ongoing. (Note: Michael Pearlman, M.D., was the Medical Director of ContrAl America. He developed the clinical protocols for testing in North America and had medical oversight of this program from 1998 through 2000.)
What is the key to the program's success?
We believe the key factor in successful treatment is the patient's ability to make a conscious choice to pay attention to what is going on relative to drinking, coupled with the clear intention to control, moderate or stop drinking entirely. The issue of the alcoholic versus the heavy drinker when working with an individual is often blurred and we allow the patient to make his or her own distinctions. The drug naltrexone, used in our approach, is only a part of the success rate, which ultimately is based on the patient's decision to take charge of his or her life and destiny. Therefore, a direct correlation with naltrexone, drinking rates, patient satisfaction and moderation or abstinence is hard to factor at this stage, as the program's results are based on the experiences of only several hundred patients. There are no double-blind studies pending at this time.
What is naltrexone?
Naltrexone is a medication that blocks the effects of drugs known as opioids (a class that includes morphine, heroin and codeine). It was originally used to treat the negative effects of opiates and now also treats dependence on opioid drugs. Naltrexone medication is approved by the FDA as part of a comprehensive treatment for alcoholism. In clinical trials evaluating the effectiveness of naltrexone, patients who received the drug were twice as successful in remaining abstinent and in avoiding relapse as patients who received a placebo. In some cases, additional or alternative medications, such as topiramate, an anti-convulsant and commonly used as a treatment for mood-disorders, may be indicated.
How does naltrexone work?
Naltrexone appears to work by preventing the neurophysical reinforcement of alcohol craving that ordinarily occurs from alcohol consumption by blocking the opiate receptors. As a result of these blocked receptors, the urge to drink is gradually weakened, and alcohol becomes less of a charged or concerning issue. Naltrexone does not, however, reduce intoxication, but may instead slightly increase the detrimental effects of alcohol on driving and similar activities. Naltrexone is a passive substance with no stimulating or tranquilizing effects. Unlike Antabuse® (disulfiram), which has commonly been used to treat alcohol abuse, naltrexone does not produce an adverse effect in combination with alcohol. Naltrexone is a safe, effective, FDA-approved medication for the treatment of alcoholism as part of a comprehensive treatment program.
Is naltrexone like Antabuse® (disulfiram)?
Unlike Antabuse® (disulfiram), naltrexone does not produce an adverse effect in combination with alcohol. Naltrexone in and of itself is a passive substance with no stimulating or tranquilizing effects. Most patients do not notice any effect of naltrexone, other than observing that their thoughts and behaviors move them to drink less or abstain.
Does naltrexone have side effects?
In general, naltrexone is well tolerated with no severe side effects. In the largest study, the most common side effects of naltrexone affected only a minority of people and included the following generally short-lived symptoms: nausea (10%), headache (7%), dizziness (4%), fatigue (4%), insomnia (3%), anxiety (2%) and sleepiness (2%).
Naltrexone medication is a passive substance with no stimulating or tranquilizing effects. Further, naltrexone does not interfere with other medical and psychiatric medications, such as anti-depressants (e.g., Celexa®, Lexapro®, Luvox®, Paxil®, Prozac®, Zoloft® and Effexor® or Welbutrin®), mood stabilizers and other tranquilizing medications. The only contraindication to the use of naltrexone is opiate or opioid (analgesic or pain-killing) medication.
Naltrexone is likely to have little impact on other medications patients commonly use, such as antibiotics, non-opioid analgesics, like aspirin, acetaminophen and ibuprofen, and allergy medications.
How does Campral® (acamprosate) work in the maintenance of abstinence from alcohol?
Campral®, which was recently approved by the FDA, is a drug developed in Germany and prescribed extensively throughout Europe for the past several years. It will soon be available to clinicians and patients in the U.S. and will be included in The Freedom From Alcohol® Method treatment. As an alternative or in concert with naltrexone treatment, Campral® will also be offered in conjunction with supportive counseling and coaching, just as with naltrexone. The key difference is that Campral® is taken by patients with alcohol dependence on the days they are abstinent during their treatment, along with coaching to maintain optimal performance. Campral® offers an additional tool to support the control and moderation of alcohol craving. Campral® and naltrexone can be prescribed on differing days as appropriate.
Why is ongoing supportive therapy and coaching important?
The medicine alone may not be sufficient because a lifestyle change is involved, most especially a shift in perspective. The therapy provides perspective on the issues and feelings related to drinking from various points of view, coupled with a plan, based on your choices and goals, on living a life free of dependence on alcohol.
The ongoing consultations support the patient in understanding how the diminution of craving works and how to accentuate benefits of decreased or ceased alcohol consumption. The program offers strong support and assistance to the patient as he or she observes patterns related to drinking and the resistances inherent in those patterns. Further, a key part ofThe Freedom From Alcohol® Method program is assisting and coaching the patient in making the breakthroughs that lead to success based on his or her goals and life design.
Why is it important to complete the program in its entirety?
It is critical that patients understand that alcohol craving and drinking may decrease slowly over many weeks and that they should not worry if they do not see immediate or dramatic improvement at the outset. The key is to stay with the program to experience all of its beneficial effects. The path of the program is designed to lead you to an understanding about your resistances, help you develop vision and intention about where you want to be and, ultimately, assist you in designing your life, allowing you to have things way you want them to be.
What about Alcoholics Anonymous, sobriety and abstinence?
This is an important and valid question. According to AA statistics, there are currently 1.6 million alcoholics in the U.S. attending its program. It is likely that there may be somewhat less who are consistently sober and are meaningfully involved in the AA program. In any event, AA is a wonderful, effective program with success in helping the willing alcoholic. It has proven to work for those who are able to take advantage of its resources and tools. However, there are also people who are abstinent by means other than AA and we do not seek, encourage or treat those who are abstinent.
AA lore, along with information from U.S. agencies tracking the demographics of alcoholism, suggests that there are an additional 40 million to 50 million Americans who suffer from "alcoholism" in one form or another. For a variety of reasons, most of these people cannot and will not consider AA as an acceptable treatment path. Many people are not ready for or comfortable with the idea of being termed alcoholic and many are not prepared to abstain completely. We are not looking to AA for its participants. Rather, The Freedom From Alcohol® Method is a resource that can compliment AA in supporting sobriety and abstinence and, most importantly, in reaching the millions of people who are in a problematic situation regarding their drinking and are seeking safe, effective treatment. A primary focus of the The FreedomFromAlcohol Method protocol is to encourage and support people not to drink.
Is the treatment covered under insurance?
We do not participate in any HMOs, managed care plans or other insurance plans. However, most patients may be able to obtain at least partial reimbursement for our services as an out-of-network provider. Please check with your insurance provider.
Everyone Needs Help Sometime In Their Life, Let Me Help You Now
