JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006)
JAMA NEWS RELEASES
PARTICULAR TREATMENTS EFFECTIVE FOR ALCOHOL DEPENDENCE
AMERICANS LESS HEALTHY THAN ENGLISH
SOME NONHORMONAL THERAPIES MAY OFFER RELIEF FROM HOT FLASHES, BUT WITH POSSIBLE ADVERSE EFFECTS
EARLY USE OF STATINS AFTER ACUTE CORONARY SYNDROMES DOES NOT REDUCE SHORT-TERM RISK OF HEART ATTACK, STROKE OR DEATH
LACK OF HEALTH INSURANCE ASSOCIATED WITH SIGNIFICANTLY DECREASED USE OF RECOMMENDED HEALTH CARE SERVICES, WITH INCOME LEVEL NOT MAJOR FACTOR
JAMA REPORT (VIDEO NEWS RELEASE SCRIPT)
VIDEO: Windows Media | Quicktime
RADIO REPORT: MP3
NALTREXONE OR SPECIALIZED COUNSELING EQUALLY EFFECTIVE IN TREATING
ALCOHOL DEPENDENCE
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
Save the Date: JAMA will present new research on HIV/AIDS at a media briefing on Sunday, August 13, from 10 a.m. – 12:30 p.m., at the International AIDS Conference in Toronto. Program and registration information will be included in a future email.
Please Note: The FOR THE MEDIA Web site now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org
TV Note: This week's JAMA video news release is on treatments for alcohol dependence. The release will be fed Tuesday, May 2, from 9:00 - 9:30 a.m. ET on Intelsat America 6 (formerly Telstar 6), Transponder 11 (C-Band) and from 2:00 - 2:30 p.m. ET on Intelsat America 6, Transponder 11 (C-Band). For more information, call 312/464-JAMA (5262).
JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ONLINE
Go to www.jamamedia.org for more information and to apply for access.
Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006
Media Advisory: To contact Raymond F. Anton, M.D., call Tim Gehret at 843-792-2626. To contact editorial author Henry R. Kranzler, M.D., call Kristina Goodnough at 860-679-3700.
PARTICULAR TREATMENTS EFFECTIVE FOR ALCOHOL DEPENDENCE
CHICAGO—Medical management combined with the drug naltrexone or with a specialized behavioral therapy can be effective treatments for alcohol dependence, according to a study in the May 3 issue of JAMA.
About 8 million individuals in the U.S. currently meet diagnostic criteria for alcohol dependence (also called alcoholism), a leading preventable cause of illness and death and a major contributor to health care costs, according to background information in the article. In primary care settings, the prevalence of alcohol use disorders ranges from 20 percent to 36 percent; most of those patients are never treated and, if they are, do not receive specialty care. Several behavioral treatments and at least two medications approved by the U.S. FDA, naltrexone and acamprosate, have shown efficacy in the treatment of alcohol dependence. However, no large-scale randomized controlled study has evaluated whether combined drug treatment with or without behavioral therapy could improve outcome.
Raymond F. Anton, M.D., of the Medical University of South Carolina, Charleston, and colleagues evaluated the effectiveness in treating alcohol dependence with medical management and naltrexone, acamprosate, or both, with or without combined behavioral intervention (CBI) provided by behavioral health specialists. The trial (the COMBINE Study), conducted from January 2001 – January 2004, included 1,383 recently alcohol-abstinent volunteers with a diagnosis of primary alcohol dependence. The participants were divided into 9 groups. Eight groups of patients received medical management with 16 weeks of naltrexone or acamprosate, both, and/or both placebos, with or without CBI. Medical management included sessions with a medical professional focused on enhancing medication adherence and alcohol abstinence. A ninth group received CBI only (no pills). Patients were evaluated for up to one year after treatment.
The researchers found that all groups showed substantial reduction in drinking. During treatment, patients receiving naltrexone plus medical management, CBI plus medical management and placebos, or both naltrexone and CBI plus medical management had higher percentages of days abstinent (80.6, 79.2, and 77.1, respectively) than the 75.1 in those receiving placebos and medical management only. Naltrexone also reduced the risk of a heavy drinking day over time, most evident in those receiving medical management but not CBI.
Acamprosate showed no significant effect on drinking compared with placebo, either by itself or with any combination of naltrexone, CBI, or both. During the 16 weeks of treatment, there was an overall difference in percent days abstinent between those receiving placebo pills and medical management alone (73.8), placebo pills and medical management plus CBI (79.8), and CBI alone (no pills or medical management) (66.6). One year after treatment, these between-group effects were similar but no longer significant.
“In conclusion, within the context of medical management, naltrexone yielded outcomes similar to those obtained from specialist behavioral treatment (i.e., CBI). We found no evidence of efficacy for acamprosate and also no evidence of incremental efficacy for combinations of naltrexone, acamprosate, and CBI. Somewhat unexpectedly, we observed a positive effect of receiving placebo medication and medical management over and above that seen with specialist-delivered behavioral therapy alone. Medical management of alcohol dependence with naltrexone appears to be feasible and, if implemented in primary, and other, health care settings, could greatly extend patient access to effective treatment. Future studies that evaluate the usefulness of continued or intermittent care of alcohol-dependent individuals over the longer term should be considered,” the authors write.
(JAMA. 2006;295:2003-2017. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by National Institute on Alcohol Abuse and Alcoholism Cooperative Agreements and career scientist awards. The acamprosate, naltrexone, and their matching placebos used in this study were donated by Lipha Pharmaceuticals. For financial disclosure information, please see the JAMA article.
EDITORIAL: EVIDENCE—BASED TREATMENTS FOR ALCOHOL DEPENDENCE – NEW RESULTS AND NEW QUESTIONS
In an accompanying editorial, Henry R. Kranzler, M.D., of the University of Connecticut School of Medicine, Farmington, comments on the findings of the COMBINE Study.
“While this important study provides evidence of the efficacy of some treatments for alcohol dependence, it also raises a number of questions. In view of studies from Europe providing consistent evidence that acamprosate helps to maintain abstinence, the lack of efficacy of this medication in the COMBINE Study is perplexing. Although population differences must be considered, differences in study design may have contributed to the lack of replication of the European acamprosate studies. The modest effects of the specific treatments and a lack of additive or synergistic benefits of combining treatments suggest that other compounds and therapeutic approaches should be explored to yield further improvements in the treatment of alcohol dependence.”
“The findings from the COMBINE Study should be of great interest to primary care physicians treating patients with alcohol dependence. Patients who decline an offer of pharmacological treatment to reduce their drinking can be referred for intensive behavioral treatment. Notably, however, the beneficial effects of naltrexone were seen in the context of medical management similar to what is routinely available in primary care practice. This offers the prospect that an efficacious treatment for alcohol dependence can be made as widely available as are current treatments for smoking cessation and major depression,” Dr. Kranzler writes.
(JAMA. 2006;295:2075-2076. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Dr. Kranzler receives support from the National Institute on Alcohol Abuse and Alcoholism. He reported receiving research support from and serving as a consultant or speaker for Alkermes, Bristol-Myers Squibb, Drug Abuse Sciences, Forest Laboratories, and Ortho-McNeil Pharmaceuticals.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006
Media Advisory: To contact corresponding author Michael Marmot, M.D., email: m.marmot{at}ucl.ac.uk.
AMERICANS LESS HEALTHY THAN ENGLISH
CHICAGO—Middle-aged to older U.S. residents have higher rates of diabetes, hypertension, heart disease, heart attack, stroke, lung disease and cancer than their English counterparts, according to an article in the May 3 issue of JAMA.
The United States spends considerably more money on medical care per capita ($5,274) than the United Kingdom ($2,164). However, whether greater financial expenditures translate into better health for a country’s citizens is uncertain. Strong links between socioeconomic position and health exist in both the U.S. and the U.K. Comparing social differences in illness across both countries can give insight into possible causal explanations for the relationship between socioeconomic status and health.
James Banks, Ph.D., of University College London and Institute for Fiscal Studies, London, and colleagues compared data from the U.S. and England to assess the relative health of older individuals and how health varies by socioeconomic status in the two countries. The researchers used data from the U.S. Health and Retirement Survey (HRS; n = 4,386 residents) and the English Longitudinal Study of Aging (n = 3,681 residents) to compare self-reported health, income and education. To determine whether the tendency to report illness explained health differences, the researchers also used data from the National Health and Nutrition Examination Survey (NHANES; n = 2,097 residents) and Health Survey for England (n = 5,526 residents) to compare biological markers of disease. The study was limited to non-Hispanic whites in both countries.
The researchers found that U.S. citizens in late middle age are much less healthy than their English counterparts for diabetes, hypertension, heart disease, heart attack, stroke, lung disease and cancer. Diabetes prevalence was twice as high in the U.S. (12.5 percent) than in England (6.1 percent) and hypertension was approximately 10 percentage points more common in the U.S. Smoking behavior was similar in both countries, with about one in five people between the ages of 55 and 64 years currently smoking. Obesity rates were much higher in the U.S. and heavy drinking was more common in England. In both countries, disease prevalence was much higher among individuals of lower income and education, compared with those at higher income and education levels. Differences in socioeconomic groups between the two countries were so great that those in the top education and income level in the U.S. had similar rates of diabetes and heart disease as those in the bottom education and income level in England.
“Although access to health care is important, differential access can only offer a partial explanation for our findings,” the authors write. “… health insurance cannot be the central reason for the better health outcomes in England because the top socioeconomic status (SES) tier of the U.S. population have close to universal access but their health outcomes are often worse than those of their English counterparts.”
“Two simple but powerful conclusions follow from our comparisons using biological and self-reports of disease in England and the United States. First, Americans are much sicker than the English. … Second, the SES-health gradient is also not a reporting mirage… Instead, the SES-health gradient appears with equal force in either self-reports or biological measures of health.”
(JAMA. 2006;295:2037–2045. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the JAMA article for funding/support information.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006
Media Advisory: To contact Heidi D. Nelson, M.D., M.P.H., call Rachel MacKnight at 503-494-8231. To contact editorial co-author Jeffrey A. Tice, M.D., call Nancy Chan at 415-885-7277.
SOME NONHORMONAL THERAPIES MAY OFFER RELIEF FROM HOT FLASHES, BUT WITH POSSIBLE ADVERSE EFFECTS
CHICAGO—A meta-analysis of previously published studies examining the use of nonhormonal therapies for treating menopausal hot flashes finds that some therapies are effective, but less so than estrogen, and have possible adverse effects that may restrict their use, according to an article in the May 3 issue of JAMA.
Hot flashes are the most common symptom related to menopausal transition. They are experienced by more than 50 percent of menopausal women, can persist for several years after menopause, and for some women can interfere with activities or sleep to such a degree that treatment is requested, according to background information in the article. Estrogen has been used as a hormone supplement for nearly 60 years to treat menopausal symptoms. However, recent studies reporting adverse effects such as cardiovascular events and breast cancer have raised important concerns about its use and have led to increased interest in other therapies for improving menopausal symptoms. Evidence of the efficacy and adverse effects of nonhormonal therapies is generally lacking or unclear.
Heidi D. Nelson, M.D., M.P.H., of the Oregon Health and Science University and Providence Health System, Portland, Ore., and colleagues conducted a meta-analysis of randomized controlled trials to compare the efficacy and adverse effects of nonhormonal therapies for menopausal hot flashes. The researchers identified 43 relevant trials, including 10 trials of antidepressants, 10 trials of clonidine, 6 trials of other prescribed medications, and 17 trials of isoflavone extracts.
The researchers found: “This systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials of nonhormonal therapies provides supportive evidence for the efficacy of selective serotonin reuptake inhibitors (SSRIs) or serotonin noradrenergic reuptake inhibitors (SNRIs) [such as paroxetine, venlafaxine, fluoxetine and citalopram], clonidine, and gabapentin in reducing the frequency and severity of menopausal hot flashes based on a small number of fair and good [quality] trials (SSRIs or SNRIs and gabapentin) or poor and fair [quality] trials (clonidine). The trials do not support the efficacy of red clover isoflavone extracts and present mixed results for soy isoflavone extracts. Evidence for other therapies is limited due to the small number of trials and their deficiencies. Few trials compare different therapies head-to-head and relative efficacy cannot be determined.”
“Despite increasing interest in therapies for menopausal hot flashes that avoid use of estrogen, the efficacy and safety of other options currently are not well supported. The SSRIs or SNRIs, clonidine, and gabapentin provide some evidence of efficacy. However, effects are less than those for estrogen therapy, few trials have been published and most have methodological deficiencies, and generalizability beyond the small clinical populations studied could be limited. Adverse effects and cost may prohibit use for many women. Although these therapies may be most useful for highly symptomatic women who cannot take estrogen, they are not optimal choices for most women,” the authors conclude.
(JAMA. 2006;295:2057-2071. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: For funding/support and financial disclosure information, please see the JAMA article.
EDITORIAL: ALTERNATIVES TO ESTROGEN FOR TREATMENT OF HOT FLASHES - ARE THEY EFFECTIVE AND SAFE?
In an accompanying editorial, Jeffrey A. Tice, M.D., and Deborah Grady, M.D., M.P.H., of the University of California, San Francisco, discuss the findings of Nelson et al.
“Women with hot flashes should understand that most symptoms resolve over several months to several years. Those women with mild symptoms may find adequate relief by wearing layered clothing and keeping the home and bedroom cool. For women with more bothersome symptoms, clinicians should understand the advantages and disadvantages of both hormone therapy and nonhormonal alternatives. Hormone therapy is more effective than nonhormonal alternatives but should probably be avoided by women at high risk for venous thromboembolic events, cardiovascular disease, and breast cancer. Nonhormonal alternatives are less effective than estrogen, generally have more symptomatic adverse effects, and long-term adverse effects are not as well documented. With all medicines or dietary supplements used for symptomatic treatment, the lowest effective dose should be used and stopped as soon as symptoms improve or resolve. A better understanding of the pathophysiology of hot flashes will likely be necessary for the development of nonhormonal therapies that equal or surpass the efficacy of hormones.”
(JAMA. 2006;295:2076-2078. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: For financial disclosure information, please see the JAMA article.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006
Media Advisory: To contact corresponding author Heiner C. Bucher, M.D., M.P.H., email: hbucher{at}uhbs.ch.
EARLY USE OF STATINS AFTER ACUTE CORONARY SYNDROMES DOES NOT REDUCE SHORT-TERM RISK OF HEART ATTACK, STROKE OR DEATH
CHICAGO—Beginning use of statins within 14 days of acute coronary syndromes (such as heart attack or unstable angina) does not decrease the risk of death, heart attack, or stroke, for up to 4 months, based on a meta-analysis of previously published studies, according to an article in the May 3 issue of JAMA.
Numerous clinical trials and meta-analyses show that long-term therapy with statins reduces the risk of myocardial infarction (MI – heart attack), stroke, and death in patients at varying risks for cardiovascular disease, according to background information in the article. The short-term effects of early treatment with statins in patients after the onset of acute coronary syndrome (ACS, including MI or unstable angina) for these outcomes is unclear.
Matthias Briel, M.D., of the University Hospital Basel, Switzerland and colleagues conducted a meta-analysis of previous randomized controlled trials to determine whether early use of statins within 14 days following the onset of ACS reduces cardiovascular illness and overall death at 1 and 4 months. The researchers identified 12 trials involving 13,024 patients with ACS.
The researchers found that there were no statistically significant risk reductions from early statin therapy for total death, total MI, total stroke, cardiovascular death, fatal or nonfatal MI, or revascularization procedures (percutaneous coronary intervention or coronary artery bypass graft) at 1 month and 4 months of follow-up.
The researchers add that serious adverse events associated with early initiation of statins are rare.
(JAMA. 2006;295:2046-2056. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: For funding/support and financial disclosure information, please see the JAMA article.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, May 2, 2006
Media Advisory: To contact Joseph S. Ross, M.D., call Karen Peart at 203-432-1326.
LACK OF HEALTH INSURANCE ASSOCIATED WITH SIGNIFICANTLY DECREASED USE OF RECOMMENDED HEALTH CARE SERVICES, WITH INCOME LEVEL NOT MAJOR FACTOR
CHICAGO—Higher-income adults without health insurance are nearly as likely as lower-income adults without insurance to not use recommended health care services such as cancer screening, cardiovascular risk reduction and diabetes management, according to a study in the May 3 issue of JAMA.
More than 45 million Americans - nearly one-fifth of the non-Medicare population – lack health insurance. Lacking health insurance has serious negative health consequences, according to background information in the article. Research has demonstrated that uninsured adults are less likely than insured adults to receive preventive services, such as screening for breast, cervical or colorectal cancer and not receiving recommended treatment for chronic illnesses, such as diabetes, arthritis or hypertension. Although the uninsured comprise a range of income levels, little attention has been directed at higher-income uninsured adults and their patterns of care.
Joseph S. Ross, M.D., of Yale University, New Haven, Conn., and colleagues examined whether an increased income weakens the association between being uninsured and using fewer recommended health care services. The researchers analyzed data from the 2002 Behavioral Risk Factor Surveillance System, a nationally representative telephone survey of households regarding medical history, health behaviors and health care use. Participants were community-dwelling adults (n = 194,943; 50 percent women) aged 18 to 64 years in 2002.
The researchers found that use varied widely across different types of recommended services. Among cancer prevention services, 51 percent of eligible adults used colorectal cancer screening while 88 percent of eligible women used cervical cancer screening. Among cardiovascular risk reduction services, 38 percent of obese adults received weight loss counseling while 81 percent of eligible adults with cardiovascular disease used aspirin regularly. Among services for diabetes management, 33 percent of adults with diabetes received a pneumococcal vaccination while 88 percent had glycosylated (linked to glucose) hemoglobin measurement.
Health insurance and annual household income were both strongly associated with use of recommended health care services. Among higher-income adults, lacking insurance was associated with significantly decreased use of recommended health care services; increased income level did not weaken the association between being uninsured and using fewer recommended health care services for cancer prevention, cardiovascular risk reduction, or diabetes management.
“Our research may indicate that a greater proportion of uninsured than insured adults believe that the recommended health care services are not sufficiently beneficial either to purchase using out-of-pocket funds or to receive by enrolling in health insurance,” the authors write.
The researchers add that the findings present two important policy implications to consider. “First, policy makers attempting to improve health and health care for the uninsured should recognize that targeting only the lower-income uninsured may miss some individuals experiencing the consequences of lacking health insurance. … Second, if adults do not understand that these recommended health care services are of sufficient value, policy makers and physicians may need to improve educational strategies.”
“The results of our study suggest that [proposed health care] reforms may increase the number of adults not receiving recommended health care; adults using out-of-pocket funds to purchase health care services, whether they are enrolled in health savings accounts, employer-sponsored high-deductible insurance plans, or plans with substantial cost sharing, may not purchase recommended chronic and preventive care at levels comparable with adults enrolled in traditional health insurance plans.”
(JAMA. 2006;295:2027-2036. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: No external funding was used for this research project. Dr. Ross is a scholar in the Robert Wood Johnson Clinical Scholars Program at Yale University, sponsored by the Robert Wood Johnson Foundation.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
JAMA REPORTS
VIDEO: Windows Media | Quicktime
RADIO REPORT: MP3
NALTREXONE OR SPECIALIZED COUNSELING EQUALLY EFFECTIVE IN TREATING
ALCOHOL DEPENDENCE
VIDEO:
B-ROLL
Walking down hall into Dr. Anton's office
Alcohol being poured
AUDIO:
THREE YEARS AGO, WALKING INTO THIS DOCTOR'S OFFICE WAS THE HARDEST THING
SYLVIA HAD EVER DONE, BUT AFTER YEARS OF DAILY, HEAVY DRINKING, FELT SHE
HAD TO.
VIDEO:
SOT/FULL
@ :09
Super: Sylvia
Alcohol dependent
Runs :12
AUDIO:
"It was a problem that was never going to go away and I finally knew it
was either going to be die... or get help, or do something about it."
VIDEO:
B-ROLL
Exterior of Medical University of South Carolina
Lab technician performing tests
GFX/JAMA Cover
AUDIO:
SYLVIA ENROLLED IN A STUDY HERE AT THE MEDICAL UNIVERSITY OF SOUTH
CAROLINA IN CHARLESTON, WHERE RESEARCHERS COMPARED VARIOUS KINDS OF
TREATMENT FOR ALCOHOL DEPENDENCE. THEIR FINDINGS APPEAR IN JAMA, THE
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL
@ :34
Super: Raymond Anton, M.D.
Medical University of South Carolina
Runs :08
AUDIO:
"This study and others have shown that people should be optimistic about
treatment for their alcohol problems, that treatment does work."
VIDEO:
B-ROLL
Dr. Anton in hall with colleague
Naltrexone pills
Acamprosate pills
Sylvia with counselor
Sylvia with Dr. Anton
AUDIO:
DR. RAYMOND ANTON (ANN-tahn) AND HIS COLLEAGUES STUDIED THE EFFECTS OF A
NUMBER OF DIFFERENT TREATMENTS IN 14-HUNDRED ALCOHOL-DEPENDENT PEOPLE.
THE TREATMENTS INCLUDED TWO FDA-APPROVED DRUGS, NALTREXONE
(nal-TREX-own) AND ACAMPROSATE (ah-CAM-pro-zate). SOME PEOPLE GOT THE
MEDICATIONS ALONE, SOME ALSO RECEIVED SPECIALIZED BEHAVIORIAL
COUNSELING, OTHERS GOT THE COUNSELING BUT NO MEDICATION. EVERYONE IN
THE STUDY HAD REGULAR VISITS WITH A HEALTH CARE PROVIDER FOR THE 4-MONTH
STUDY PERIOD.
VIDEO:
SOT/FULL
Raymond Anton, M.D.
Medical University of South Carolina
Runs :20
AUDIO:
"We were surprised by two findings from our study. One was that
acamprosate was no more effective than placebo alone and two, that while
naltrexone was effective in its own right, combining it with the
specialized counseling added no more effectiveness than naltrexone by
itself."
VIDEO:
B-ROLL
Naltrexone pills
Sylvia with counselor
AUDIO:
THE MOST EFFECTIVE TREATMENTS IN THE STUDY WERE THE NALTREXONE ALONG
WITH REGULAR MEDICAL VISITS, OR THE SPECIALIZED COUNSELING ALONG WITH
REGULAR MEDICAL VISITS. THESE OUTPATIENT TREATMENTS MAY APPEAL TO
PEOPLE WHO WOULDN'T SEEK INPATIENT CARE, BUT WANT HELP.
VIDEO:
SOT/FULL
Sylvia
Alcohol dependent
Runs :10
AUDIO:
"Taking the medication kept you on track, on focus, you felt like you
were doing something for yourself, rather than against yourself."
VIDEO:
B-ROLL
Both kinds of pills
AUDIO:
SYLVIA HASN'T BEEN TOLD WHICH MEDICATION SHE GOT IN THE STUDY, BUT SHE
SAID THE PILLS, AND NOW COUNSELING, WORK FOR HER.
VIDEO:
SOT/FULL
Sylvia
Alcohol dependent
Runs :03
AUDIO:
"I never could have done it by myself."
VIDEO:
B-ROLL
Alcohol shots being poured
AUDIO:
SHE URGES OTHER PEOPLE TO SEEK THE HELP THEY NEED. THIS IS MAVIS PRALL
WITH THE JAMA REPORT.
