April is Alcohol Awareness Month and serves to remind us that about 23 million people struggle with alcohol and drug abuse in the United States.
The staggering economic costs, estimated at half a trillion dollars annually, are just a part of this human tragedy and public health challenge. And, of course, there are many social ills, such as traffic accidents and criminal behavior, which can be linked directly to drug abuse.
While the consumption of a substance might be voluntary at first, the transition from drug use to addiction is genetically and biologically influenced. We now know that the addicted brain is biologically distinct and that treatment solutions need to focus on rebalancing brain function and behavior. Comprehensive treatment to rebalance behavior in substance abusers can work, but we must continue to minimize the barriers for those in need of treatment. Research efforts support the use of therapeutic medications and vaccines to arrest or reverse the course of drug abuse in those affected.
The Food and Drug Administration has approved eight prescription medications to help fight addiction — three for alcohol, three for opioids and two for nicotine dependence. The FDA also has approved several forms of nicotine replacement therapy, such as patches and gum, which are available over the counter.
Clinical research has shown that the proper medication can complement other treatment efforts and result in effective reduction of withdrawal symptoms and suppression of relapse. The proper medication also can help patients break from patterns such as committing crimes to get money to buy drugs.The use of these medications to treat addictions, despite their effectiveness, is not widespread.
I believe the reason that medication therapy in addiction is not widely accepted is because of the belief that their use will “replace” the abused drug with a new drug. However, these medications have limited abuse liability, or they would not be approved by the FDA. Moreover, there still is a need for more options in medications. For instance, there are no available medications for the treatment of cocaine and methamphetamine addictions.
One of the primary efforts of the Center for Addiction Research at UTMB is to expand medication options, especially to suppress craving for drugs.We also want to understand how to identify the patients who will best respond to a given therapeutic strategy.To address this issue, we are identifying key biomarkers in patients to ultimately better diagnose their disorder and predict the best therapeutic combination of medication and behavioral therapy.
Our center, and others in Texas and the nation, is focused on identifying these biomarkers. We are using imaging and other advanced technologies to identify the specific brain and blood indicators that better describe a patient’s disorder.
This identification is critically important for the future and tailoring individual treatment programs for greater success.
These research efforts will provide a tremendous benefit to both individuals and society at large, improving lives and reducing the staggering toll of substance abuse.
Kathryn A. Cunningham is a professor of pharmacology and the director of the Center for Addiction Research at UTMB.