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Utah center seeks answers on how to treat addictions

Utah center seeks answers on how to treat addictions

So far it mostly occupies a tiny office and the minds of its founders, but the fact that the Addiction Research and Education Center exists at all signifies a big shift in how we view people hooked on drugs.

"Addiction is a brain disease," said Glen Hanson, University of Utah neuroscientist and founder of the center. "Starting for everybody is voluntary. But stopping, for many people, is not."

Edward Callister couldn't stop. Despite repeated efforts to give up alcohol, including four stints at inpatient treatment centers, Callister ultimately died from his addiction in a single-car accident April 22, 1996.

"He was a bright, engaging, athletic young man," Louis Callister said of his son. "He knew and understood what it was doing to him, and he still couldn't quit," Callister recently told a legislative committee before announcing his financial and enthusiastic support for the new research center.

His son's life and struggle is the organizing element of the Edward G. Callister Foundation begun by his father and mother, Ellen. Its Web site is www.hopetoday.com.

The key element of addiction understood clearly by the Callisters and more every day by science is that dependence is not a failure of will but a foible of brain chemistry, Hanson said.

Alcohol, cocaine, methamphetamine and other drugs "can not only make you feel good, they can drastically alter the system that makes things feel good," said Hanson, who is also the director of the Division of Neuroscience and Behavioral Research at the National Institute on Drug Abuse. That agency has been the principal investigator of drug abuse research under the federally funded National lnstitutes of Health.

Once some people get started, it's impossible for some to stop, even though they understand the potential negative outcomes of the behavior, Hanson said. "But our response has been a little like telling someone with Parkinson's disease, 'Don't tremor.' "

The more science understands the brain, the clearer it becomes that addiction is a complicated disease process, he said. "It's like a dance between the environment and biochemistry of the individual. Using a drug for the first few times could be about feeling good. Addiction makes feeling what was normal feel bad, and the addict needs a drug just to feel right."

Science up to now has made some inroads to understanding brain chemistry and some aspects of addiction, he said. "But we really don't have a reason to be that comfortable with our success because the general community hasn't really benefitted from it."

That's where the center comes in. Unique in the country and funded in part by $1 million in seed money from Utah tobacco settlement money, the center is designed not only try to ferret out precursors to addiction but to interact with other researchers and share that information with the public.

Its office is housed in the U. Health Sciences Center and is a coordinated effort by several faculty members from various fields to promote understanding, development and application of more effective means of treatment and prevention of the diseases of chemical addiction, said center director and U. College of Pharmacy professor James Gibb. A curious fact about addiction is there has been no private, nonprofit support for research and education until now, despite the pervasive and tremendous impact it has on public health, Gibb said.

It's difficult to project the number of people who will ultimately be involved, Gibb said. "But there is definitely widespread support around the country for this."

No matter how well-known the center might become, "we won't ever find a panacea," Gibb said. "But we are starting to get a handle on addiction, and the more we find out, the more people we can help, and fewer will become addicts."

But there are people who have so-called addictive personalities, and research also shows that humans like to alter their state of consciousness. And despite all the negative effects and publicity around substance use and abuse, drugs do that and do it quickly.

"Absolutely true," Gibb said. "We're not expecting more research will make all that disappear. But while we all know the widespread effects of these addictions, we know very little about what makes one person a non-user or moderate user and what sends another into oblivion."

Hanson said alcohol and other drugs can literally make some people lose all perspective. Drugs change the neurological makeup of the brain, essentially scrambling its patterns. In addition, drugs are very persistent and can not only alter tolerance levels but also affect the possibility of relapse after someone quits.

Why certain individuals are more likely to become addicted is the focus of a lot of current research, and there is more understanding of what is going on chemically in the brain.

"Brain chemistry dictates who we are," Hanson said. Dopamine, for example, is an important neurotransmitter that is very sensitive to the effects of drug abuse. It is the principal transmitter or messenger on the pleasure pathways in the brain that get boosted by drugs.

A huge issue in drug treatment is relapse. Some people can stop for a while but will find themselves using again because environment has changed or a craving has been reignited in some way.

If specific reasons behind those cravings could be identified through work at the center, then a strategy for therapy might allow treatment providers to either minimize or compensate for the craving so that the person doesn't have that drive to come back to the drug.

A number of things can trigger someone's return to a drug, and long-term consequences of using do make people more prone to going back to a drug, Hanson said. "If a brain hasn't ever completely returned to its normal pattern of functioning, then that person is always close to the cliff."


E-MAIL: jthalman@desnews.com