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Nora D. Volkow, MD, director of the National Institute on Drug Abuse at the National Institutes of Health, spoke to students and faculty at the University of Maryland School of Pharmacy's 2006 Ellis Grollman Lecture in Pharmaceutical Sciences May 10 and presented new images of the drug-addicted brain.
Volkow discussed how addiction is a disorder that involves complex interactions among a wide array of biological and environmental variables, and how new research has demonstrated the neurochemical and functional changes that occur in the brains of addicts.
Studies have shown that drugs to boost dopamine levels make people euphoric, but in the long run, repeated drug use reduces the ability of the dopamine pleasure center to produce euphoric or good feelings. Dysfunction in inhibitory control systems, by decreasing the addict's ability to refrain from seeking and consuming drugs, ultimately results in the compulsive drug intake that characterizes the disease of drug addiction. The discovery of such disruptions in the fine balance that normally exists between brain circuits may help researchers to develop more successful treatments for addiction.
Following the lecture, Volkow talked to news reporters about the recent statements by talk-show host Rush Limbaugh, U.S. Rep. Patrick Kennedy, and local sportscaster Keith Mills that they have become addicted to prescription pain killers. She said those cases are far from typical, but the problem of addiction to prescribed pain killing drugs is growing nationally.
Volkow also spoke to many faculty members and students at the School of Pharmacy to learn about research at the School. She was especially interested in the development of new opiate pain killers that do not possess the potential for addiction. Jia Bei Wang, MD, PhD, is studying how receptors respond after chronic treatment with opioids such as morphine or oxycodone, in order to model the dependent state, and how Andrew Coop, PhD, is designing new analogs of morphine in which dependence does not develop. Both projects have the long-term goal of creating new therapeutic drugs for the treatment of pain, but without the addiction liability of current treatments.
Speaking to The Baltimore Examiner newspaper, Volkow said people with dominant, outgoing, successful personalities actually have brains wired in such a way that makes them less likely to enjoy drugs and become addicted to them. "Some genes may protect you. Some may make you vulnerable. But genes can only take a person so far. Environment - that is, the how much people are exposed to drugs - is equally important."
In comments to The Daily Record, she said it is up to doctors, pharmacists, family members - and even employers - to be aware of the signs of drug abuse, prescription or otherwise, and to be open-minded about the problem. Volkow estimates as many as 10 percent of employees are abusing substances. "That's pretty high," she added. People exposed to prescription drugs as adolescents are "much more likely later to have problems with these drugs," she said.
Destigmatizing addiction inside the workplace is key, Volkow told The Daily Record, and making treatment available and affordable as part of an insurance plan, for example, is key to success. "If you have education and provide an infrastructure that would allow the person to seek help, it is clear it is considered a disease and not stigmatized," she explained. Otherwise, "the employee will not want to come up and say, 'I'm a drug addict,'" she added.
"If you have chronic pain, it is horrible. It can devastate someone's life. Opiate painkillers are incredibly beneficial for people who suffer from severe pain," said Volkow.
