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---------------------------------------------------------------------------- Science will alter the way we treat addicts, experts say ---------------------------------------------------------------------------- WASHINGTON (October 2, 1997 5:04 p.m. EDT http://www.nando.net) - Drug addiction is a complex brain disorder and should be treated as a medical condition, not a crime, scientists said Thursday. A series of reports in the journal Science described what experts know about drug addiction -- its biological basis, what treatments worked and which did not. Alan Leshner of the National Institute on Drug Abuse said that although science had revolutionized the understanding of drug abuse, policy-makers had done little to act on it. "It is time to replace ideology with science," Leshner wrote. "There is a wide gap between the scientific facts and public perceptions about drug abuse and addiction," he added. "The more common view is that drug addicts are weak or bad people, unwilling to lead moral lives and to control their behavior and gratifications." But he said research had shown this was untrue. "Scientific advances over the past 20 years have shown that drug addiction is a chronic, relapsing disease that results from the prolonged effects of drugs on the brain," he wrote. "A major goal of treatment must be to reverse or to compensate for those brain changes." George Koob and colleagues at the French national research institute INSERM in Bordeaux described addiction as "a cycle of spiraling dysregulation of brain reward systems." Normally, a person's own mental and physical resources are enough to keep a balance. But taking drugs, over time, breaks this down. "Various forms of behavioral therapies and psychotherapy have been shown to be effective in treating addiction, particularly in combination with pharmacotherapy," they wrote. Eric Nestler and colleagues at the Yale University School of Medicine said scientists were just beginning to understand the physical changes on a molecular basis. "The ability of drugs to alter the brain depends in part on genetic factors," they added. "Ultimately, a detailed understanding of the molecular and cellular mechanisms of addiction will transform the way society views and treats this illness," they wrote. Randolph Nesse and colleagues at the University of Michigan at Ann Arbor said there might be evolutionary reasons for vulnerability to drug addiction. "Drugs of abuse create a signal in the brain that indicates, falsely, the arrival of a huge fitness benefit," they wrote. Similar misunderstandings of brain signals led people to eat too much fat and sugar, they said. Treatments are possible, said Charles O'Brien of the University of Pennsylvania Veterans Administration medical center in Philadelphia. O'Brien said the narcotic buprenorphine was related to morphine but was less addictive, bupropion reduced the craving for nicotine and work was being done on vaccines against drugs like cocaine. He said 115,000 former addicts were using methadone in the United States, and it had been shown to stop their craving. Another drug, levo-alpha acetyl methadyl (LAMM), blocked withdrawal and craving and only needed to be taken two to three times a week. Naltroxene blocked craving and worked for some heroin addicts and disulfiram makes alcoholics sick when they drink, so they can quit. Yet such resources were not being used, he said. "Several studies have shown that for every $1.00 invested in the treatment of substance abuse, there are cost savings of $4 to $12," he wrote. "Unfortunately, the cost-savings are long-term effects and the profit-oriented world of managed care appears to focus on short-term goals." By MAGGIE FOX, Reuters Copyright 1997 Nando.net <http://www.nando.net/newsroom/ntn/health/100297/health23_19235_noframes.html> ---------------------------------------------------------------------------- [log in to unmask]