by Elena Vidrascu, MSc

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JPHMP presents Preventing America’s Next Drug Epidemic: A Multidisciplinary Approach, a new series designed to introduce the many facets of substance abuse, and how integrating the work of multiple partners may be the best approach towards prevention and treatment. This series will feature posts that integrate information from interviews in written, audio, and video format, as well as evidence-based research articles that may altogether inform best practices for tackling this current epidemic, as well as preventing future ones.

Despite scientific advances in our understanding of drug addiction, many are still dubious that addiction is a brain disease and anyone can succumb to it. For those who have difficulty believing that someone can become so attached to something that can steal so much from their life, I urge them to watch the TED talk by Helen Fisher, an anthropologist who studies brain scans of people madly in love, as well as those who have been dumped. Her work has revealed that love shares many aspects of general addiction. In fact, three main brain regions largely implicated in drug addiction are active among individuals who are in love. That love shares similar characteristics of addiction makes sense. We can become obsessively focused on an individual and crave that person, even after the relationship ends. We long for that someone who is now only an incessant memory, and that emptiness is inundated with feelings and thoughts that surface once we hear a song, watch a television show, go to bed, and so on. Dr. Fischer argues that “Romantic love is much more than a cocaine high…you lose your sense of self. You can’t stop thinking about another human being.”

A cocaine high is indeed relatively transient; however, time spent without the drug, once dependent on it, feels eternal. Lying, manipulation, sacrifice, and crimes are committed in order to have that substance fill some void. For most people in recovery from drugs, they must completely abstain from using, or they’re sent into a downward spiral once again. Drugs are ominously pervasive in our society; they’re featured in songs and the media, and alcohol, is socially accepted. At least with romantic love, it’s possible for someone to move on to a different, healthy relationship and break the cycle of dependence.

Drug addiction has several facets to it, which makes it so difficult to treat. Users may indulge in drugs when they’re anxious or stressed and receive instant gratification, but during recovery they must learn to cope in their absence. Despite limited availability, medications like Suboxone and methadone do provide clinically effective relief from various negative symptoms once an individual is no longer abusing drugs. These meds can reduce the cravings (ie, desire) for drugs, but for long-term maintenance of sobriety this means a constant substitution of one drug for another. Some argue that these medications bypass the real, underlying issues of addiction and fail to adequately address what may be causing cravings during recovery, which often lead to relapse, or resumed use of the drug. When soldiers in Vietnam became addicted to heroin, 95% of them broke this dependence once they returned home to the United States. In other words, they weren’t surrounded by those same triggers that might have fueled the abuse in the first place.

Addiction for most people isn’t always that simple, though. It depends on the age someone starts using, the frequency of use, the environment they grew up in, and the drug(s) they use. In recovery, individuals may feel apathetic to a world where they once lived in the shadows and fear learning how to reintegrate into their communities to find that lost pleasure. Medications may be the immediate fix for someone who is beginning recovery, but we don’t have great answers for how to maintain sobriety. Success rates of rehab programs aren’t entirely reliable, with a majority failing to follow up with former patients. It’s rare to find a recovering addict who has only been to one rehab program. With addiction classified as a relapsing, chronic disease, it’s essential that we focus more of our efforts on personalized treatment.

Many efforts are focused on the current epidemic, but we aren’t doing enough to curb overall drug addiction, regardless of the drug of choice. For some drugs, like cocaine, there isn’t any current FDA-approved treatment, and many individuals believe that another epidemic is imminent. I sat down with Mike Connors, Director of the Insight Program in Greensboro, NC, to learn about one approach to treating youth and young adults addicted to drugs.

One unique component of the Insight Program’s treatment is involvement of the parents. “If it’s a family disease, and if they’ve been affected by it, they need to be a part of the solution,” Connors says. Based on analysis of the various factors affecting the high success rate of the program, for parents that were involved in the recovery, attended meetings, and interacted with the staff, their children had a 50% greater success rate to remaining sober, than those parents who couldn’t or wouldn’t be a part of the program. After completion of the program, follow up support is available up to a couple years. As Connors puts it, “Any program can be successful in the short term. People need to get a lifestyle, and they’re not going to get that in 30 days.”

According to the Centers for Disease Control and Prevention, in 2015 it was reported that about 10.1% of individuals ages 12 and over used an illicit drug in the past month. We know that because of the brain’s ability to easily change during adolescent development, for better or for worse, the earlier one starts to use drugs, like alcohol, the more susceptible he or she is to developing an addiction as an adult. From speaking to individuals’ siblings, Connors believes that the problem centers around self-worth, and “those who have a high self-worth don’t tend to try drugs or fall in love with them.” And he knows from personal experience what it’s like to love drugs at a young age. With the help of the Insight Program, he was able to transfer that passion onto his desire to help others, a fervor that is evident when speaking to him. If we want to avoid youth having to chase drugs in the first place, prevention is clearly warranted, but how do we involve those not inflicted with the disease who think they will never get it?

Other aspects of the program that caught my attention are social integration, social support, and peer-led activities that give the child a sense of empowerment. Students help organize and lead social functions held on the weekends. The Insight Program has a steering committee where the staff facilitates and oversees everything, but the children help facilitate meetings and pick topics. From what Connors has observed, “The peer component has to be positive. There’s got to be an attractive alternative. If they’re (the kids) taking something that makes them feel better than anything has ever made them feel in their life, they have to look forward to the treatment…to laugh and be engaged, every day.”

In this series I will describe the efforts taken by those involved in the current epidemic and share insight from individuals whose work may provide some vision into what more we can do, collectively, to prevent another drug epidemic. This is a public health issue and therefore needs to be approached as one. This series will cover topics including physical activity, mindfulness meditation, civic engagement, and community-focused programs, as they relate to both prevention and treatment of substance abuse.

Hear the full interview with Mike Connors, below. Mr. Connors is Director of the Insight Program in Greensboro, North Carolina, which provides substance use treatment for youth and young adults.

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Elena Vidrascu, MSc, recently graduated from Wake Forest University with her MSc in Physiology and Pharmacology. Her primary field of interest is substance abuse, with goals to disseminate information to the public, including addicts and those in recovery, and to influence policy change to push for more integrative approaches towards prevention and treatment. In her spare time, she enjoys playing tennis, hiking, doing puzzles, and cuddling with her kitten Maple.