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“We Haven’t Yet Begun to Fight!”

“We Haven’t Yet Begun to Fight!”. Carlton Erickson, Ph.D. Director, Addiction Science Research and Education Center University of Texas at Austin 2003. There once was a disease…. • people who had it were disgraced • sufferers felt isolated and alone

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“We Haven’t Yet Begun to Fight!”

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  1. “We Haven’t Yet Begun to Fight!” Carlton Erickson, Ph.D. Director, Addiction Science Research and Education Center University of Texas at Austin 2003

  2. There once was a disease….. • • people who had it were disgraced • • sufferers felt isolated and alone • • sufferers had permanent psychological damage • • the disease had insufficient funding for treatment • • there was poor understanding about the cause

  3. That disease was… • POLIO • (50 years ago) • If we had continued to onlytreat polio, today we would have computerized iron lungs! • But now polio is only a memory

  4. Today we face a challenge….. • • we’re trying hard to help people with drug problems, but we can’t help them all • • why? • - we hang on to outmoded beliefs • - we don’t have all the answers • - to policy makers, we appear to not know • what we’re doing - but there is a solution

  5. S.P.A.M. • • Stigma • • Prejudice • • Anger • • Misunderstanding • This has led to discrimination against addicts and inadequate $$ for treatment, education, research…

  6. Strange “addictions” • • cell phone • internet • • Thomas Kincaid • A.A. meetings • • television • shoes • • Ben & Jerry’s • cars • • exercise • Disneyland • • “other people” • chocolate

  7. We must clarify the words “addiction” and “alcoholism”Leshner (1997)

  8. According to DSM-IV*: • • substance (drug, chemical) abuse - overuse of drugs in cases where people are making poor choices about drug use: “a problem to solve” • • not a minor problem, since drug abusers produce a majoreconomic impact on society • * Diagnostic and Statistical Manual-IV-TR (DSM-IV-TR)

  9. But this is the disease • • substance (drug, chemical) dependence - impaired control over drug use, probably caused by a dysfunction in the brain’s “pleasure pathway” • (“a disease to conquer”) • • this requires twelve-step or other programs (“treatments”) • • dependence = addiction; alcohol abuse • is not “alcoholism”

  10. We must let people know clearly what we do • • we don’t treat “substance abusers” • • we treat chemical dependence • • we don’t treat gambling addictions • • we treat compulsive gambling behaviors • • what other disease……..?

  11. We need more research! • • There is lots of disagreement and misinformation in this field. • • This is a result of not having all of the facts. • • Facts come from good scientific research. • • Facts reduce stigma!

  12. Risk of Dependence • • data from National Comorbidity Survey • (n= 8,100), ages 15-54 y-o (both genders) • • dep occurrence in 10 years: cocaine, • 15-16%, alcohol, 12-13%; marijuana, 8% • • cocaine: 5-6% dep in 1st year of use, 80% within 3 years • Wagner & Anthony, 2002

  13. Important Point! • Dependence is not a loss of“will power”, for two reasons: • • The main problem with dependence • lies in the subconsciousMFB. • • Problems with the frontal cortex • produce a pathological impairment of • decision-making. • Thus, dependence is not primarily under conscious control!

  14. Today’s Options (It’s all about options….) • • traditional: 12 step programs (abstinence) • • talk: inpatient/outpatient/aftercare • • misunderstood: harm reduction, MM • • new: brief motivational counseling, CBT, MET, SO-involved therapy, vouchers • • medical tx: new medications to enhance abstinence - anticraving meds, methadone, buprenorphine, vaccines • (MM= Moderation Management, CBT= cognitive behavioral therapy, • MET= motivational enhancement therapy, SO = significant other)

  15. What are we doing? • • are we trying to help people with the disease? (yes) • • are we trying to help all people with drug problems? (sometimes) • • are we pushing one agenda at theexpense of other agendas? (often) • • are we really trying to work together? • (today, yes - after today……….)

  16. It’s About Time…. • ..that we put away our differences and focus on helping those who are suffering • …it’s not about one way (of helping) versus another way • …it’s about helping sufferers in whatever way we can…..

  17. It’s Our Responsibility to…. • • be research pushers • • be treatment/recovery pushers • • be prevention pushers • • be education pushers • • not argue about which one of the above is most important • • consistently push our importance • • while we disagree, people are dying…

  18. Can we focus more on broad-based research? • • like the organizations that promote research on “good diseases” (cancer, heart, AIDS)? • • to reduce stigma (with facts)? • • to find more treatments to help more people?

  19. There are websites that you can access for more information.www.niaaa.nih.govwww.nida.nih.govwww.utexas.edu/research/asrec

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