Drug Abuse Research:
Science for Policy and Practice
Summary of PresentationsModerator: Mr. Daniel Schecter
Assistant Deputy Director/Acting Deputy Director for Demand Reduction
Office of National Drug Control Policy, USA
Dr. Donald R. Vereen
Medical Officer, Office of the Director,
National Institute on Drug Abuse,
Department of Health and Human Services, USA
Dr. Vereen began by stating that the conference attendees' joint mission is to bring the power of scientific research to bear on drug abuse and addiction. Science, he claimed, has brought us to an unprecedented understanding about drug abuse and addiction, which has revolutionized our view. As this research indicates:
- Drug abuse is a preventable disease, and
- Addiction is a treatable disease.
As Dr. Vereen noted, users report they take drugs to feel better, to self-medicate, to relieve depression, and in response to peer pressure. In reality, he explained, from the standpoint of neurophysiology, they are stimulating the striatum, two crescent-moon shaped areas in the middle of the brain, that are sometimes called the "pleasure center." Preventing experimentation with drugs that stimulate this pleasure center is our joint objective, Dr. Vereen told the audience. The long-range, joint objective, he claimed, is to emphasize protective factors and resiliency.
Drug abuse is a preventable disease, and addiction is treatable.
Dr. Vereen's second major point was illustrated by slides he showed of images of the brain under normal conditions and while under a drug's influence. The point was that addiction is a brain disease that affects complex behavior and thinking, particularly the functioning of the brain's frontal lobes. After a period of abstinence, he explained, visible recovery occurs. He stressed, however, that the brain can function abnormally even when there are no obvious structural changes. He also emphasized the possible molecular, subcellular brain activities affected by drugs. Although this is a simplified model, Dr. Vereen noted that treatment efforts make it clear that the brain can be changed by pharmacological and behavioral interventions.
Using research as a tool is an innovation, but research-based innovation need not be to the detriment of community-based efforts.
Addiction is not simply a brain disease, Dr. Vereen indicated. It is a brain disease expressed behaviorally within a social context. Thus, he stressed that the motivation for use, treatment, and long-term recovery must also occur within this context. The National Institute on Drug Abuse, he claimed, is committed to doing research on all these levels. It is also committed to having research data replace ideology as the basis for what we do about drug abuse and addiction. He proffered that, while there is no magic bullet, we must all sing the same song, and it must begin with research.
Although understanding the brain's reward system is important, Dr. Vereen stressed that we must be careful to recognize that this system is not the only thing playing a role in drug abuse and addiction. The reward system also operates within a context; understanding the system and the context in which it operates can help us to better understand addiction and the underlying motivation for taking drugs in the first place.
It is important to say that using research as a tool is an innovation, but research-based innovation need not be to the detriment of community-based efforts which are also being supported. The challenge is to evaluate what we are doing to make a difference and to determine its effectiveness. Research and community-based efforts need to work together as we look forward to working with all of you.
