Pubdate: Mon, 21 Aug 2006 Source: Wisconsin State Journal (WI) Copyright: 2006 Madison Newspapers, Inc. Contact: http://www.madison.com/wsj/ Details: http://www.mapinc.org/media/506 Author: William Celis Public Access Journalism Bookmark: http://www.mapinc.org/pot.htm (Cannabis) Bookmark: http://www.mapinc.org/coke.htm (Cocaine) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/rehab.htm (Treatment) NEW DRUGS, NEW APPROACH FUEL MAJOR EFFORTS FOR MANY TO HAVE PRODUCTIVE LIVES Understanding Addiction: Part One Of Five Brain Research Is Key To Hope Seven. That's how many attempts it took Joseph Bryant to kick lifetime addictions that began with alcohol when he was just 10, followed by heavy marijuana use in his teens, and topped by a $700-a-day heroin habit in his 20s. After he served prison sentences for car theft and drug peddling, and as he took up residence in abandoned houses at the age of 27, he realized he had to change his life, or he would find himself, as he put it, "in jail for the rest of my life or dying on the streets of Baltimore." Bryant's seventh - and last - try to overcome his addictions, in 2004, couldn't have been better timed. Even as he bounced in and out of a string of ineffective treatment centers, innovative research and changing attitudes about drug addiction, treatment and recovery were starting to take hold. New and effective medications now suppress drug cravings. Hospitals and treatment centers are making stronger efforts to prevent people with addictions from falling through the cracks as they are passed between institutions. And physicians, hospitals and private clinics have learned that treatment means not only medical attention but also setting the stage for a successful reentry into a challenging life without drugs and alcohol, with social services, housing and job training. Not Weak Character The strongest treatment programs have always offered a smorgasbord of services under one roof or connected critical lifelines for their clients, but the push now across the country is fueled by groundbreaking brain research in the late 1990s that indicates that addiction isn't driven by weak character, loose morals or lax discipline. While downing those first few drinks or pills may be a choice, studies show genetics may take over for up to half of addicted Americans. Researchers have documented alterations in the brain linked to drug abuse, alcoholism or other impulse behaviors that suggested a genetic predisposition to addiction. In Madison, important research is looking at the impact of nicotine on adolescent rats, which may show why some young human smokers become addicted quickly. Also funded by the National Institute on Drug Abuse, studies by Charles Landry, an assistant professor in psychiatry at the UW School of Medicine and Public Health, have shown that brains of young rats show a dramatic response to an injection of nicotine equivalent to two or three cigarettes. Adult rats do not show the same response. "We're looking for biochemical markers that may help us distinguish whether the adolescent brain responds differently to drugs like nicotine, compared to the adult brain," Landry said. Because adolescent rat brains are similar to young human brains in many ways, the research may answer questions about why teenagers report tobacco withdrawal symptoms after less smoking than adults. And because nearly all addicted smokers started as adolescents, such research may mark the way toward reducing tobacco addiction. "It makes sense to look at the biochemistry to try to get a hint at what might be going on in the human brain," said Landry, a molecular neurobiologist. Saving Money, Lives The discovery of genetic predisposition has led to a growing sense that a connect-the-dots approach is needed at every turn to help people like Bryant, who has clearly benefited from his first comprehensive treatment plan - he's been clean since that summer two years ago. "It's a good time to be addicted," said Thomas McLellan, the founder and executive director of the Treatment Research Institute in Philadelphia, a research think tank that attempts to influence clinical practice and public policy through scientific and real-world studies. "The treatment is beginning to catch up with research. This will save a ton of money and, more importantly, lives." If addicts today stand a much stronger chance of getting and staying sober and clean, science is largely the reason. While environment and stress play a role, the studies indicate strong genetic and biological links passed through addicted parents make offspring more susceptible to addiction. If your parents or siblings are hooked on alcohol or drugs, these studies concluded, you have a 50 percent chance of addiction; some studies put the likelihood of addiction as high as 70 percent. What's more, once addicted, the part of the brain linked to the pleasure-reward system heightens cravings for the drug, so trying to stop addiction without treatment is near impossible. Armed with the science, pharmaceutical companies have responded with three different drugs to combat the cerebral cravings: buprenorphine, acamprosate and naltrexone. The drugs, available only this decade under a variety of commercial brands, are designed to curb or even eliminate cravings and minimize the side effects of withdrawal for both alcohol and specific drugs, like opiates, marijuana and cocaine. The drugs alone don't ensure successful recovery; they need to be part of a larger strategy, doctors say. For Bryant, one new medication provided the antidote to a string of failed recovery efforts. On his last try, Bryant turned to an uncle in New York who enrolled him in a Phoenix House treatment facility in Brooklyn, N.Y. What Bryant found there is everything researchers and social scientists recommend in a drug rehabilitation and recovery program - beginning with buprenorphine. The small orange pill, quickly dissolved under his tongue, eliminated Bryant's cravings. Costly Interruption Within his first week of treatment, Bryant was off buprenorphine and transferred from his detoxification room to a bed under the same roof, a logistical godsend at a critical time in treatment. Following his previous detox experiences, he had been sent to recovery centers often miles away; sometimes they had available beds, but more often Bryant had to wait two or three days. The interruption proved costly. That's when Bryant invariably found himself back on drugs. On the one occasion that he could immediately move from detox to a bed, he was told after 28 days that he was being discharged because another client needed the bed - and because his funds had run out. "Whether you are ready or not, you have to go. That's one of the messed-up things about recovery. People look at it as a business." Now drug-free for 18 months and in the last stages of his recovery program, Bryant still lives at Phoenix House, leasing a room for $15 a week until he saves enough money from his job as a carpenter to find his own place. - -State Journal reporter Anita Clark contributed to this story. If you need help To find help for addiction problems: Adolescent Alcohol/Drug Abuse Intervention Program, 122 E. Olin Ave., Suite 275; 262-1111. Alcoholics Anonymous, 6400 Monona Drive, Suite H; 222-8989. Alternative Recovery Options, at Capitol Associates, 440 Science Drive, Suite 200; 238-5176, ext. 365. ARO Counseling Center, 1050 Regent St., 255-1116. Center for Prevention and Intervention (formerly PICADA), 128 E. Olin Ave.; 246-7606; http://www.fsmad.org Gateway Recovery, UW Health, 25 Kessel Court, Suite 200; 278-8200; http://www.uwhealth.org Narcotics Anonymous, 258-1747; http://www.wisconsinna.org Newstart, Meriter Hospital, 202 S. Park St.; 267-6291; http://www.meriter.com/mhs/hospital/newstart.htm REBOS-Chris Farley House, 810 W. Olin Ave.; 255-5922. Tellurian UCAN, 300 Femrite Drive; 222-7311; http://www.tellurian.org - --- MAP posted-by: Beth Wehrman