NEW RESEARCH REVEALS HOW DRUGS, ALCOHOL AFFECT PARTS OF BRAIN

Explains Why Withdrawal Is So Difficult

FEBRUARY 12 ISSUE Scientists are discovering more about what regions of
the brain are affected by drug and alcohol addiction and new drugs and
therapy techniques are giving health-care professionals improved tools for
treatment, Newsweek reports in an extensive cover package on fighting
addiction. The February 12 special report (on newsstands Monday, February
5) contains stories by Newsweek experts about new medicines and treatment,
public policy initiatives and Hollywood's relationship with addicts.

New research on how cocaine, heroin, alcohol and amphetamines target
circuits in the brain is revealing the biological basis of addiction,
tolerance, withdrawal and relapse, reports Senior Editor Sharon Begley.
Through MRI as well as PET scans, neuroscientists are pinpointing what
happens in the brain during highs and lows, why withdrawal can be
unbearable and how changes caused by addictive drugs persist long after the
addict stops using.

"Imaging and other techniques are driving home what we learned from decades
of animal experiments," says Dr. Alan Leshner, director of the National
Institute on Drug Abuse. "Drugs of abuse change the brain, hijack its
motivational systems and even change how its genes function," he tells
Newsweek. And the agony of withdrawal is also a direct result of the
drugs' resetting the brain's pleasure circuits, which communicate in the
chemical language of dopamine. Withdrawal and abstinence deprive the brain
of the only source of dopamine that produces any sense of joy.

"This is why addiction is a brain disease," says Leshner. "It may start
with the voluntary act of taking drugs, but once you've got it, you can't
just tell the addict, 'Stop,' any more than you can tell the smoker 'Don't
have emphysema.' Starting may be volitional. Stopping isn't."

With alcohol abuse costing the country a staggering $185 billion a year --
more than every other illegal drug combined -- medications that act on the
brain to help control the urge to drink are forging a new direction in
alcohol treatment, reports General Editor Claudia Kalb. Acamprosate, a
non-addictive pill used for years in Europe, will soon be under review by
the FDA and could be available by prescription by the end of this
year. The new types of drugs "herald a whole new era in the treatment of
alcoholism," says Dr. Enoch Gordis of the National Institute on Alcohol
Abuse and Alcoholism. "The medications five to 10 years from now will be
even better."

But even proponents caution that the new pills are not a cure: their
effects are moderate and they're only intended for use in combination with
counseling or support. What the drugs do provide, scientists say, is a new
approach to help at least some of the addicts whom traditional therapies
fail. And researchers have also recently identified "hot-spots," or regions
of chromosomes, linked to alcoholism and are now zeroing in on the actual
genes, hoping they'll be new targets for designer drugs that will one day
strike at addiction with precision.

While overcoming addiction is never simple -- roughly half of all patients
fall off the wagon within a year of detoxification -- medication and
intensive long-term support may help even the most inveterate abuser to
succeed. Senior Editor Geoffrey Cowley reports on the types of treatment
available to addicts, including a new approach to fighting cocaine
addiction. Instead of trying to block cocaine's target in the brain,
researches are now exploring ways to neutralize the cocaine molecule
itself, whenever it enters the blood stream. At Yale, researchers have
started tests on a vaccine that generates cocaine antibodies for six months
which could reach the market by 2004 and there are about 60 other drugs
under study to combat the addiction, writes Cowley.

And in political circles, change is coming to the world of drug policy
writes Senior Editor and Columnist Jonathan Alter. In several states,
voters are taking matters into their own hands with referenda supporting
more treatment options. And yet another option is emerging, especially at
state and local levels of government, which combines flexible enforcement
with mandatory treatment. Many liberals and conservatives are finding
consensus around the idea of "coercive abstinence" -- using the threat of
jail to motivate substance abusers to get help.

And in a guest essay, screenwriter Stephen Gaghan, who recently won the
Golden Globe for his work on "Traffic," writes about his battle with
addiction. "I wasn't much different from my peers," he writes. "Except
where they could stop drinking after three or six or ten drinks, I couldn't
stop and wouldn't stop until I had progressed through marijuana, cocaine,
heroin and, finally, crack and freebase -- which seems for so many people
to be the last stop on the elevator ... When you wage a war on human
nature, the enemy is every one of us."