Focused Treatment Systems is a part time, labor of love enterprise of two people, described briefly below. We originally intended to write a second book, a reference manual on AWS, and may get around to it some day, but for now our only product is our Alcohol Withdrawal Treatment Manual. We wanted to write a very practical manual for clinicians first, and I think that was the right decision.
Paolo DePetrillo, a graduate of Brown University School of Medicine, worked for many years in the clinical treatment of alcohol withdrawal before accepting a post as a Senior Investigator at the NIH's National Institute on Alcohol Abuse and Alcoholism. He currently runs a consulting company which performs pharmacogenetic analysis. In addition to many scientific publications, he is one of the authors of the entry on "Withdrawal" in Macmillan Reference USA's Encyclopedia of Drugs, Alcohol and Addictive Behavior (oddly enough in conjunction with another McDonough who is no relation).
Mark McDonough, a graduate of Harvard Graduate School of Education, is a writer and educator currently working in the IT field. After doing perhaps a little bit too much "personal research" in the alcohol field as a young adult, he developed a strong interest in substance abuse treatment issues and the health and behavioral effects of alcohol. He's a very enthusiastic amateur chef with a special love of Indian food and still enjoys a good microbrew now and then.
I have something of a habit of talking Dr. DePetrillo into things -- some well-advised, some perhaps not. When I first heard that Paolo was leaving clinical practice for research, it seemed a shame to me that the insights he developed while treating thousands of AWS patients would be lost, except to those who had worked with him directly.
Dr. DePetrillo is modest almost to a fault, but I was originally a science major before wandering off into writing and teaching, and it sounded to me like he had made some real progress in understanding AWS treatment. As a writer, I also thought it would be an interesting challenge to take the knowledge of an expert in a field I knew almost nothing about and turn it into something that would be easy to understand and easy to put into practice.
I was also attracted to the approach. The idea of treating specific symptoms with specific agents rather than using benzodiazepine monotherapy sounded like a major improvement. It also sounded like monotherapy was a scientific "living fossil," a type of treatment standardized at a time when we knew very little about the neurochemistry of the brain. I figured it would take a year or two to finish the book -- ha ha.
In fact, it took about 5 years, depending on when you start counting, partly because we both had small children at the time. Along the way, I learned a ridiculous amount about alcohol withdrawal and various (to me) obscure aspects of pharmacology, pharmacokinetics, and neurochemistry. I occasionally startle my family doctor to this day by blurting out some random factoid.
When we finally finished, the book found its first audience among nurses -- we like to think that's because our system just works, and can be put into practice right away. In the first few years after publication, about 90% of our sales went to members of the nursing profession. We were invited to various nursing conventions, most notably that of the ISPN, and met a lot of great people. The book continues to sell steadily to nurses, and is used as a textbook in at least one school of nursing.
I think we underestimated the hold that benzodiazepine monotherapy had on physicians. One of the only reviews we got in a physician's journal was a complete pan. It ran in an Australian medical journal under the memorable headline "The Yankee Way of Kicking Grog." Apparently the authors were under the impression that our approach was the standard amongst those crazy Americans -- if only. Of course, they couldn't really find anything substantive wrong with the book. But it did not advocate benzodiazepine monotherapy and was therefore on the face of it ridiculous.
We did get a few orders from Australia out of it.
In the last year or so, we have started to get more orders from physicians, both in the U.S. and abroad. In fact, in the last year or so, the book has started to sell better than it did when it was first published. Why, we're almost breaking even!
A friend of ours recently told us that he ran across a very heated discussion of alcohol withdrawal treatment in a physicians discussion group and after reading a bit, realized that they were arguing about our book! If you are one of the arguers, pro or con, by all means contribute to our vast fortunes by buying a copy of the manual and checking it out for yourself. While we are not (unless you wave a lot of money at us) in the consulting business, we can certainly put you in touch with people who have put the system into practice in a variety of settings -- just contact us. And while he might not want me to mention it, Dr. DePetrillo has been known to give talks and do grand rounds presentations. Just don't tell him I told you.
If you've been taught that AWS treatment begins and ends with benzos, the approach may sound heretical, but it really does work, and it really does lead to better outcomes. And better outcomes for patients is really why we wrote the book, all joking aside.
Medical Disclaimer
All material on this website is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. The authors will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising therefrom.