Dear
Readers,
With the scattered mishmash of information and misinformation available to
professionals and to the general public concerning addiction, it is no wonder that there
is so much inconsistency in the approaches taken by either group as they try to solve the
riddle of how best to address the problem.
For example, in order to properly treat an addict, the treatment provider must be aware of
what matters in addiction. Too often, the uncredentialed, untrained provider will
focus on the wrong aspects of the illness. He or she may be overly concerned
about whether the patient has been using a physically or psychologically addictive
drug. This issue revolves around whether or not dramatic physical withdrawal symptoms
occur when the individual stops taking the drug...the premise being, that the more
dramatic the physical withdrawal symptoms, the more dangerous the drug...a
supposition which is simply not true.
Clinically it doesn't matter much what physical withdrawal symptoms occur except for
alcohol withdrawal which can result in death if improperly treated. Heroin withdrawal may
cause the addict to wish he could die, but it doesn't kill . Cocaine and methamphetamine,
like many of the most addictive and dangerous drugs, do not produce severe physical
withdrawal symptoms. What really matters is what we now know is the essence of
addiction: compulsive drug seeking and use, even in the face of serious health and
social consequences. These are the characteristics toward which treatment should be
directed, for they are the basic reasons for the huge health and social problems
caused by those who are addicted to alcohol and other drugs.
Virtually all drugs of abuse have common effects, either directly or indirectly, on a
single pathway: a reward system deep within the brain. Activation of this
system appears to be a common element that causes users to continue taking drugs. This is
not unique to any one addictive drug...all addictive substances effect this circuit...It
is simply there...It is not learned!
A "switch" in the brain seems to be thrown as a result of prolonged alcohol or
other drug use. Initially usage is a voluntary behavior, too often by the young
(averaging 11 to 12 years of age in the U.S.) seeking the excitement of a "high"
or "just to feel good". Once the "switch" is thrown, however, the
individual can quickly move into the state of addiction, characterized by compulsive drug
seeking and use. The younger the original use, the quicker the process.
Acute alcohol or other drug use modifies many brain functions; prolonged use results in
changes which persist long after the individual stops using. The addicted brain is
distinctly different from the non-addicted brain; it is manifested by, amongst others,
changes in brain metabolic activity and responsiveness to the environment. Strong
scientific evidence shows that prolonged and even short term exposure to alcohol and other
drugs can cause some fundamental changes in brain function and structure which will move
an individual into a state of addiction making it, essentially, a brain
disease.....the treatment of which should be the keystone of any strategy designed to help
"win" the so-called "war" on drugs.
Addiction
is an illness involving critical biological, behavioral, and social elements...It is a
disease which is rotting our country's inner core. Too few in our federal and state
governments seem willing to change course...to turn away from the present
unsuccessful "war" against drugs and turn toward the adoption and funding
of appropriate preventative and treatment strategies designed to address the root causes
of it all. |
