Addiction Treatment: Science and Policy for the Twenty-First Century

FROM THE JOHNS HOPKINS UNIVERSITY PRESS

Addiction Treatment
Science and Policy for the Twenty-first Century
edited by Jack E. Henningfield, Patricia B. Santora, and Warren K. Bickel

Addiction to alcohol, tobacco, and other drugs is one of the major public health issues of our time. In the United States, one in five deaths is the result of addictive drug use. This innovative book critically examines drug addiction treatment in the United States. It explores specific challenges (scientific, medical, social, and legal) to reaching the goal that treatment for drug addiction should be as accessible as treatments of diseases of the heart, liver, and lungs that often result from the use of addictive drugs. These essays, written by leaders in addiction science, medicine, and health policy, present diverse and often opposing points of view to foster thought and discussion.

The book consists of three parts. Part I examines the emerging science and theories that underlie the development of specific models for treating addiction to illicit opioids and stimulants, alcohol, tobacco, and prescription drugs. Part II explores the complications raised by the diversity of those with addictions, ranging from pregnant women who use intravenous drugs, young men who abuse methamphetamines, youths who smoke cigarettes, to adults who abuse alcohol to those who smoke marijuana or abuse prescription drugs. Part III provides a detailed analysis of health care, social, and policy issues that challenge our views about addiction and its treatment. It addresses controversial topics such as whether addiction should be considred a disease or a behavior, whether addiction should be handled as a criminal offense or treated as a public health problem, and whether stigmatizing addiction is helpful or not. Throughout the book, compelling examples of addiction art explore the human side of addiction through the lens of visual artists' stunning insights into addiction and recovery.

Addiction Treatment provides a solid foundation for understanding addiction as a treatable illness and for establishing a framework for effective treatment in the twenty-first century.

Jack E. Henningfield is an adjunct professor of behavioral biology at the Johns Hopkins School of Medicine and vice president for research and health policy at Pinney Associates, a consulting firm in Bethesda, Maryland, that specializes in science policy and regulatory issues concerning public health, medication development, and treatment of tobacco addiction. Patricia B. Santora is an assistant professor of psychiatry at the Johns Hopkins School of Medicine. Warren K. Bickel is Wilbur D. Mills Chair of Alcoholism and Drug Abuse Prevention and is the director of the Center for Substance Abuse Treatment at the University of Arkansas Medical Sciences.

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Comments

[Robert West]

Advancing the effectiveness of treatment for addiction is a very worthwhile goal but we must also remember that implementing effective treatment programmes and disinvesting in ineffective ones, and ensuring that when treatment programmes are implemented this is done well rather than badly, will save at least as many lives and probably more. I am struck by the lack of connection between what happens in practice and what the research indicates is a good idea with regards to treatment - and to the extent to which people become emotionally attached to particular treatment approaches with inadequate evidence of effectiveness.

[Jack Henningfield]

As one of the editors of this book, I look forward to comments on what others think about it. Our goal was to attract short essays on challenging and controversial issues from leading thinkers in addiction related science, policy, treatment, and other areas. We achieved that and most of the essays are just a few pages long and sharply pointed. We expect and hope they will provoke further thinking and action to do something to help people who are addicted.

I have been involved in addiction research since the early 1970s, and witnessed dramatic advances in the scientific understanding and treatment options. Our application of this knowledge, as discussed by former Surgeon General C. Everett Koop in the opening essay, has lagged far behind, and we have a long way to go to achieve his goal of making it as easy to get treatment as it is to get addicted. We hope that the addiction related art in the book might also help people to better understand the human side of addiction and recovery and foster compassionate support.

By way of disclosure and experience, I have worked and/or have been supported by the National Institute on Drug Abuse, World Health Organization, Robert Wood Johnson Foundation, and private companies on addiction treatment issues. I also consult to GlaxoSmithKline on treatments for tobacco addiction and share patents on new potential treatments for tobacco addiction (none of which have been developed into marketed products).

While we are a long way from treating addiction as easily as we treat most bacterial infections, I can tell you that we do have treatments for several addictions that rival our ability to treat diabetes, asthma, depression, and other disorders. I look forward to the day that it will be as easy and respectable to get addiction treatment as it is for these other disorders.