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