I was recently invited to the screening of a new HBO documentary series called “Addiction”. I had the pleasure of meeting the filmmakers as well as some of the medical experts, like Nora D. Volkow M.D. and Mark Willenbring M.D., who helped shed light on this phenomenon. I was quite amazed at what I learned about the science of addiction, its new perception as a ‘chronic but treatable brain disease’ and the many misconceptions surrounding it.
If addiction is a brain disease, I wondered: how does one ‘get’ the disease and why are some people more prone to ‘get’ it than others?
According to Mark Willenbring, M.D., Director of the Treatment and Recovery Research Division of the National Institute on Alcohol Abuse and Alcoholism/National Institutes of Health and one of the main experts involved in the documentary series, the risk factors for addiction include genetics, environment, availability of drugs or alcohol and a person’s developmental age. The earlier a person starts to abuse drugs or alcohol, the greater their chance of becoming addicted.
One documentary that particularly moved me was entitled “A Mother’s Desperation”. Here a mother tries to rescue her 23-year old daughter from heroin addiction and a life on the streets by resorting to have her arrested.
Other documentaries in the series explained that many addicts also suffer from mental disorders such as depression or ADHD. This led me to pose another question: what comes first-the addiction or the depression/ADHD?
Apparently, there is no easy answer to this question. Robert Swift, M.D., Ph.D., Professor of Psychiatry and Human Behavior at Brown University Medical School Center for Alcohol and Addiction Studies explained that there are several possibilities:
1) Addictive disorders may be caused or worsened by substance use; 2) substance use may cause or worsen mental disorders; or 3) substance use disorders and mental disorders may have a common etiology.
The reason, he explains, is that the risk for both substance use disorders and mental disorders is affected by both genetics and environment. Some genetic factors can promote risk for one or both disorders and some may protect against one or both disorders. The same situation occurs with environmental factors. Some environmental factors may increase risk and others may decrease risk.
The good news is there are treatments for addiction.
While no single treatment is appropriate for all individuals, there are certain combinations of treatment that are scientifically proven to be most effective such as integrating treatments for coexisting mental and drug disorders. New FDA-approved medications are also available that may help reduce the risk of relapse. Finally, scientists are now using brain imaging to see how drugs and alcohol physically alter the brain and are using this information to develop targeted therapies.
If it does nothing else, this documentary series will hopefully open up conversation about addiction and get people talking about it as a brain disease and a treatable illness rather than a moral failure of sorts.
Image from Volkow ND et. al., 2001 Journal of Neuroscience 21(23):9414-9418
Technorati Tags: addiction