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Naltrexone is already FDA approved, but not as an implant. Options are being studied and if all goes well, one could be greenlighted in 2024.
You might know Jeremy Miller from the '80s family sitcom "Growing Pains." But it's the pains of addiction that he wants to share now.
"Even on the show, I never had it together," he said.
Miller has a family medical history of alcohol use disorder on both sides. He began drinking at a very young age.
"My grandparents were very traditional '70s functional alcoholics," he continued. "Four-and-a-half years old, I would go around my grandmother and grandfather's parties afterwards and finish off all the beers."
He didn't touch alcohol again until age 12, binge drinking during the later seasons of the show.
As Miller grew up on camera, the alcohol habit worsened off camera.
"My brain chemistry hadn't changed to that point yet," he said. "It wasn't until after I got back from the second reunion, which was filmed in New Orleans, during Mardi Gras — it wasn't until I got back from that, I woke up one day and realized that I absolutely, unequivocally needed a drink."
He was missing important family events. Drinking and blacking out. At one point he nearly drowned while drunk.
"Had I ever owned a gun, I do not believe I'd be sitting here — those moments of self-loathing and despair," Miller continued. "There was no future. It didn't exist. I saw nothing beyond my next drink."
The future, now his present, is 11 years sober with a one-day relapse. That relapse propelled him to try a treatment he says saved his life: an experimental naltrexone implant.
"It's the size of a couple of aspirin," said Dr. Joseph DeSanto, who specializes in addiction treatment.
Patients must go through a minimal surgery where a doctor makes a small incision, inserts a pellet in each side of the abdomen and closes it with a couple of stitches.
The implants slowly release naltrexone and dissolve away.
"Nausea and headache are typically the two most common side effects that our patients come across," DeSanto continued. "And typically those side effects dissipate over time."
This is how naltrexone works: Inside our brains, we have nerves. Their endings have different receptors that receive chemical messages from neurotransmitters. Neurotransmitters are linked to feelings like happiness, focus, reward and motivation.
In an addicted patient's brain, substances overload the receptors. It's too much of those reward feelings. On repeat, the brain starts to crave it. Naltrexone fills the slot of the receptor for both opiates and alcohol but it does not activate it: No big reward feelings. The craving isn't there.
Another way to think of it: Take baseball, specifically, a baseball glove. You catch the baseball and now it just sits there. No other baseballs can come into the glove. With that ball in the glove, you can't do much with it. The naltrexone reaction in the brain is essentially the same.
"I kept waiting for that craving to return, for that want and need. And it never did," Miller said.
Mental health experts say overcoming cravings are crucial for the more than 20 million Americans with substance use disorder. They can last for months.
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The latest data from 2019 shows 9% of those in recovery say they used medication as part of their treatment.
Naltrexone itself is already FDA approved, but not as an implant. Patients currently have two options: a shot that works for 30 days or a daily oral pill.
Research has found naltrexone implants — like the one Miller got — last months longer and are more effective at preventing a relapse. So, the race is on to make a long-lasting implant and get it FDA approved.
Three-, six- and 12-month implants are being studied. If all goes well, one could be greenlighted in 2024.
"Since it's a new delivery route, we have to show the FDA the safety of that local site since it is a minor procedure," said Brady Granier, CEO of BioCorRx Pharmaceuticals Inc.
Right now, if someone in the U.S. wants to get an implant, they need a doctor to have a compounding pharmacy to make a pellet specific to them.
The FDA doesn't approve that custom med, meaning its effectiveness, quality and safety aren't a sure thing. It's also not covered by insurance. It's very expensive. Patients pay thousands of dollars out of pocket.
Miller says connections and generosity helped him get his implant.
"There were a lot of roadblocks, you know? Price was a very big thing," he said.
Mental health experts say these medical implants are not a magic fix. A patient should also undergo treatments like meetings, therapy and peer support.
Miller says for him, it meant working through his unresolved hurt.
"I had an abusive stepfather ... a lot of trauma that I did not deal with, was not equipped to deal with and was running from. And it created a lot of anxiety as well. And I found that alcohol soothed that anxiety at a very young age," Miller continued.
His healing includes his family and paying it forward. He's worked peer support and volunteers, and he shares his story with others.
"It's just a message that, yes, there is help. And if you want it bad enough, it can happen."
The Jeremy Miller story includes pain and hope and chapters that haven't wrapped yet.
Newsy’s mental health initiative “America’s Breakdown: Confronting Our Mental Health Crisis” brings you deeply personal and thoughtfully told stories on the state of mental health care in the U.S. Click here to learn more.
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