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Despite steady progress in understanding and treating drug addiction, research in the field is hindered by public stigma, according to a report from the National Academy of Sciences.
The report, "Dispelling the Myths About Addiction," was released by the academy’s Institute of Medicine (IOM) in November. It urges a concerted effort to raise public awareness that addiction is treatable and preventable, and outlines steps to stimulate interest in addiction research and motivate scientists to pursue careers in the field.
The report amplifies the conclusions of a report from a National Institutes of Health (NIH) consensus panel on heroin addiction recommending the elimination of barriers to methadone treatment. At present, a bewildering maze of federal and state regulations discourages many potential treatment providers from using methadone to treat heroin addicts (Psychiatric News, January 16).
The new report defines addiction as "a brain disease similar to other chronic, relapsing conditions. . .and manifested by a complex set of behaviors that are the result of genetic, biological, psychosocial, and environmental interactions." It notes that many Americans continue to apply the term only to illegal drugs, although nicotine and alcohol have a far greater economic and social impact than all other drugs of abuse combined. The report emphasizes four classes of drugs—alcohol, nicotine, opioids, and stimulants—because they have the greatest economic and public health impact.
U.S. medical schools now devote less than 1 percent of their curriculum to drug abuse and addiction, the report observes. It suggests greater emphasis on addiction training by accrediting organizations and increased direct mentoring to provide both role models and training.
The report recommends that the United States Department of Education provide greater incentives to elementary, middle, and high schools to increase addiction curricula. These could include direct funding or provision of education material.
Professional societies, such as APA, should give more emphasis to facilitating undergraduate curricula on addiction, the report suggests. In addition, certifying bodies such as the American Board of Psychiatry and Neurology, should enhance addiction training in graduate and medical school programs, according to the report.
The report recommends that all treatment professionals have at least a basic knowledge of neuroscience and how addictive drugs affect the brain and interact with environmental and physiological conditions. It urges continuing education for all involved in the field and suggests "competence-based documentation" for treatment professionals seeking licensing and recertification.
To encourage careers in addiction research, the report suggests an increase in the number of research career development awards provided through the National Institute of Mental Health and the National Institute on Drug Abuse (NIDA). It recommends adding programs for student-directed summer research at NIDA and the National Institute on Alcohol Abuse and Alcoholism. It also urges industry and private foundations to join with universities to fund career development in addiction research, and urges the federal government to establish debt forgiveness or deferral for scientists conducting clinical research on addiction in publicly funded settings.
The report further recommends that federal agencies such as NIH, NIDA, and the Substance Abuse and Mental Health Services Administration provide funds to train primary care physicians in addiction treatment.
To educate the public, the report urges governmental, consumer, and advocacy groups to support campaigns based on an interdisciplinary view of addiction that stresses treatment efficacy and the role of brain physiology and function. Treatment providers, state and local health departments, and advocacy groups should join hands to develop practical strategies to raise public awareness of the nature of addiction and the importance of treatment, it adds.
Copies of Dispelling the Myths About Addiction are available from the National Academy Press for $39.95 plus shipping by calling (800) 624-6242.