Week of July 6, 1998
We now know more than ever before about addiction and its neurobiological effects on the brain. Drug and alcohol dependence can stunt personality development so that people in recovery have to cope with maturing, as well as staying sober. The price, availability and supply of a particular drug can contribute to an epidemic of addiction. New medications make it easier to kick addictions, but unlike diabetes or schizophrenia, recovery still depends on free will: the daily personal decision to stay clean. However, there's still much to learn about how to support that process.
Two heroin users explain what it's like to live with an addiction. Dr. Alan Leshner of the National Institute on Drug Abuse tells us that while physical dependence can be alleviated, it's psychological compulsion, often uncontrollable, at the core of addiction. All drugs have an unique effect on the brain, but all produce a spike in dopamine, a neurotransmitter linked with pleasurable sensations. Prolonged drug use changes brain chemistry. Eventually, an addict's mere exposure to the learned cues of drug use will trigger chemical changes and cravings. Residential drug rehabilitation succeeds both through the absence of such cues, and through teaching addicts how to deal with cues.
Neither marijuana nor alcohol are benign substances, says Dr. Leshner. Between 8-10% of those who try marijuana will become addicted. There are effective drugs like methadone to deal with heroin addiction, but drugs to counter cocaine are just now entering clinical trials. Cognitive behavioral therapies have been shown to work synergistically with medications. One may initially make a choice to use drugs, but Dr. Leshner counsels us that weighing the moral liability of the addict is less relevant than pragmatically dealing with their addiction as a health problem. The National Institute on Drug Abuse offers many free brochures and papers about fighting drug addiction. You can contact the Institute toll-free at 800-729-6686. Information is available in both English and Spanish.
Dr. Beny Primm is a New York doctor whose life was changed by drugs, and who, in turn, changed thousands of lives as a result. After seeing many patients returning to Harlem Hospital with serious injuries stemming from drug abuse, he decided to treat the problem at the source by counseling recovering patients to get off drugs, and founding the Addiction Research and Treatment Corporation. 29 years later, he oversees ten neighborhood drug treatment centers. For more information, call the ARTC at (212) 932-2777 or (212) 961-0317 or write to them at 132 West 125th St., New York, New York.
In the 70s, Anne Beatts was a charter member of the Saturday Night Live writing staff. Today, she makes her home in California, where she writes a weekly humor column for the Los Angeles Times. Beatts has tried eliminating her bad habits with mixed results.
Why is it that some people are already thinking about their next cigarette almost before they're done with the one in their hand? Dr. Alexander Glassman is chief of clinical psychopharmacology at New York Psychiatric Institute and professor of psychiatry at Columbia University. He is a internationally recognized authority on depression and anti-depressive drugs, and has recently published research about depression and nicotine. The earlier in the day a smoker must have their first cigarette, the more addicted they are. Nicotine gum and patches help, about doubling long term success rates, but 75% of those who quit are smoking a year later. Relapse from smoking, like any other addictive drug, can be rapid and easy. Those who are subject to depression are more likely to smoke, and are more likely to become depressed when trying to quit. You can reach Dr. Glassman at the New York Psychiatric Institute, 772 West 168th Street, New York 10032.
John Hockenberry is heard weekly on The Infinite Mind. He turns his attention to the screaming headlines and the serious illness behind the tragedy of Michael Laudor.
