Last night I learned about a drug called Disulfiram. I won't go into the technical details about how it works, but what's important is that it causes individuals who take it to feel almost immediately nauseous when drinking alcohol. The most common use is to help alcoholics attain and maintain abstinence.

This method of treating addiction is called aversion therapy and the more literary of you will recognize the similarities to the "treatment" given the protagonist of Burgess' A Clockwork Orange. For those of you who haven't read the novel, the character in question is psychopath who spends much of the first portion of the novel beating, robbing and raping indiscriminately. Captured and imprisoned, he is treated with The Ludovico Technique. After this treatment he is set free only to discover that any violence makes him violently ill. It's important to not that he still wants to commit violence but that he is prevented biologically. Unable to commit suicide (He can't abide any violence, even to himself), abused by his previous victims and unable to defend himself, his life becomes a tortured prison.

After the protagonist receives the treatment, a priest criticizes it. He claims that people must be allowed to choose whether to commit good or evil.

Disulfiram treatment worries me. It can only be given with the patient's consent and I can't imagine prescribing it to anyone whose health wasn't seriously threatened by alcohol abuse, but I'm still disturbed by it. My anecdotal experience leads me to believe recovering alcoholics tend to shift their dependence onto cigarettes, and overeating. Though less concrete you could argue that many shift their addiction to religion or therapy as well which, though less harmful physically, may still spring from the same root cause.

This drug addresses the symptoms and not the cause of the addictive behavior. If I have a patient with a failing liver, am I really making him healthier by giving him an opportunity for that liver to heal in exchange for damaging his lungs with cigarettes and diabetes due to secondary obesity?

As doctors we're asked to look at problems and offer solutions, but this is the first treatment I have read about that has really made me ethically queasy.