AT THE CAPITOL: DRUG HELPS BLOCK CRAVINGS

A researcher at the U may have a cure for some compulsions - and the
state's expensive treatment options.

One by one, four men marched to the table, sat down, adjusted the
microphone and told lawmakers how a University of Minnesota researcher
helped them overcome their powerful and life-wrecking addictions.

Two stopped stealing. One stopped drinking. And the fourth stopped gambling.

They were all seeing the same doctor, S.W. Kim.

Kim is a University of Minnesota researcher and an associate professor of
psychiatry who has discovered that high doses of an opium-based drug,
naltrexone, effectively block cravings in patients with a wide range of
addictions, including gambling, alcoholism and kleptomania.

Kim said his studies also show the drug works to suppress cravings in
people with sexual addictions.

Members of the House Health and Human Services Policy Committee invited Kim
to Capitol Hill on Wednesday because the state spends millions of dollars a
year on treatment programs and they want to know if there are more
effective methods than those now being used.

"We spend a lot of money on standard therapies," Rep. Fran Bradley,
R-Rochester, told Kim. "I fear that we are throwing our money at pretty
ineffective programs."

Kim, who has published nearly 60 scientific papers on the therapy, told
lawmakers that, if given the chance, he and his colleagues "could save the
state a lot of money."

Naltrexone received FDA approval in 1994, but only in doses of 50
milligrams or less because higher dosages caused liver enzyme levels to
rise, Kim said. However, the drug is not effective at low dosages.

Kim discovered that the earlier studies were flawed because the researchers
failed to realize that many of the patients who experienced increased liver
enzyme levels also were taking over-the-counter pain medications. The
higher enzyme levels were caused by the other medications, not naltrexone,
he said.

When Kim boosted the dosage to about 150 milligrams a day, patients lost
their cravings after a week or two.

"Very few centers outside the University of Minnesota use this method," he
said.

Four of Kim's patients agreed to come to the State Office Building to tell
their poignant stories. All remained anonymous.

The first, a kleptomaniac, said he began stealing about six or seven years ago.

"I don't know why," he said. "You just have to do it. Once I started
stealing, I did it every day for two years."

The man said he got caught eight or nine times and that going to court
didn't slow him down. "On the way home from court, I stopped at a Sears
store and stole a TV set," he told lawmakers.

One day, he saw an ad describing a study Kim was conducting. He called, was
enrolled and began taking the drug.

"Within two or three weeks, the urges were gone," he said. "The cravings
never came back. It saved my life."

The second man was a 45-year-old sales representative for a bicycle company
who became so hooked on gambling that he contemplated committing suicide.

"I spent 90 percent of my time thinking about how I was going to approach
gambling the next day - what machines I was going to use and how much I was
going to spend," he said. "I didn't feel there was any hope."

He said the most he lost in one day was about $3,000, all in high-stakes
slot machines, where he could lose $50 on a single pull of the lever.

The man said he saw an ad for Kim's study in 1996, called, enrolled and
began taking the drug. Since then, he hasn't thought about gambling.

The third patient was a 58-year-old contractor from Plymouth who was an
active alcoholic for 30 years before he began taking the anti-craving pill.

"I was addicted; I craved booze," the man said. "Ninety percent of my life
was spent thinking about booze or going on a good binge for three days." He
went to detox at least a dozen times and went through six to eight
treatment centers without being helped.

A nurse at North Memorial Medical Center in Robbinsdale told him about
Kim's program at the university. "I waited two months to go," he said. "I
was pretty arrogant."

Once he began taking the pill, he stopped thinking about alcohol.

"I don't know what the pill does, but you could put a bottle of booze in
front of me and I would think of it as a bottle of ketchup," he said.

Rather than drink, he now spends his time building up his contractor
business, going on vacation and renovating his old farmhouse.

The last witness was a banker whose lifetime shopping addiction eventually
turned to kleptomania. It cost him his wife and his job.

"Bank presidents and kleptomania don't mix," he told lawmakers.

Over the years, the man saw at least 10 different doctors but found no one
who could help.

"I had excellent medical coverage so I have seen some of the top doctors.
One would think that you could get all the help you need," he said.

A year ago, the man received a call from his brother, who told him that Kim
was doing a study on impulse control.

"I had absolutely no faith that the pill would do anything, but I was
desperate so I would try anything," he said. Within two weeks, he noticed a
significant decline in his craving. Today, he can go shopping without
buying anything.

"I wish that I had met (Kim) five years earlier because it would have saved
my marriage, it would have saved my job," the man said, choking back tears.

Kim cautioned that the therapy wouldn't help all addicts because it only
works for those who have strong cravings.

Although the drug no longer is under patent, it remains fairly expensive -
from $3 to $5 a pill - because it is derived from opium, Kim said. But
that's a minor cost when compared to the other costs associated with
addictive behaviors, he added.