NIDA for Teens: The Science Behind Drug Abuse
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Medication-Assisted Treatment

Treating Addiction With Medication

Most people are familiar with taking prescription medications like antibiotics when they get sick. Some people also are prescribed medication to help with a problem like depression or ADHD. Did you know that some (not all) drug addictions actually can be treated with prescription medications, too? It may seem odd that someone addicted to a drug like heroin would start taking another drug so they can stop using heroin. But, research shows that some people respond very well to what is called “medication-assisted treatment.” Why Does Medication Help? If a person is addicted to an opioid (like heroin or prescription pain relievers), medication can help him or her get back to a better state of mind—beyond just thinking about seeking and using the drug. It also can help ease withdrawal and cravings, which can give a person who is addicted the chance to focus on changes needed to recover. Taking medication for opioid addiction is like taking medication to control heart disease or diabetes. It is not the same as substituting one addictive drug for another. Used properly, the medication does not create a new addiction. How Does Medication Work? Medications to treat opioid addiction (like methadone and buprenorphine) affect the same brain areas as the drugs of abuse they are opposing (like heroin and OxyContin)—but in different ways. Anti-addiction medications “trick” the brain into thinking it is still getting the drug, which stops withdrawal. They help the person feel normal, not high, and reduce drug cravings. Alcohol dependence also may be treated with medication. Three oral medications and one that is injected have been shown to help patients reduce drinking, avoid relapse to heavy drinking, or stop drinking altogether. Of course, these medications aren’t available over the counter at your local pharmacy. They are dispensed at treatment centers or by primary care doctors approved to prescribe them. Medication isn’t the only treatment for opioid or alcohol dependence—adding counseling or therapy can help, and the support of family and friends is often crucial to a person’s success. See NIDA’s new treatment resource, Seeking Drug Abuse Treatment: Know What To Ask. To learn more about medication-assisted treatment for opioid addiction, read the brochure, Medication-Assisted Treatment for Opioid Addiction: Facts for Families and Friends. Hand holding prescription drug

“Blending” Research and Real Life

In April NIDA is having its “Blending” conference. No, this is not a conference about smoothies…So what does “Blending” mean to NIDA?

Let’s start back a little ways.  First of all, doctors and treatment providers (the people who provide treatment to help addicted patients recover) don’t learn everything they need to know in medical school or college about taking care of patients.  Scientists are constantly testing new ideas for improving treatments—but once they find treatments that work, how do they get them to the doctors and others who are actually treating patients?

Maybe in an ideal world, every doctor, social worker, or psychologist could read every good research finding in a medical or scientific journal and automatically know how to make it work for their patients. But real life isn’t that easy. A decade ago, it took more than 17 years to turn scientific research results into actual treatments used for real people!  At the National Institutes of Health, scientists are working to change that, including NIDA scientists.

The NIDA “Blending” thing is part of this. We bring scientists together with the people who are actually treating patients with drug problems and “blend” their knowledge and expertise, testing treatments with actual patients and adjusting them to work better. The treatments that work the best are shared with others around the country, who are trained to use them.  This “Blending” helps speed up the process of getting treatments that work to the patients who need them.

Here are a couple examples of new treatment ideas that providers will learn about at this year’s Blending conference in Albuquerque:

  • New Treatments for teens and young adults who are addicted to opioids (drugs like Vicodin, Oxycontin or even heroin). There is a medication called Buprenorphine that has been successful with adults and now research is showing it may work for teens.
  • Treatment Vaccines. We usually think of vaccines as something we take to avoid disease, but vaccines are being developed that can help people quit smoking and quit doing illegal drugs like cocaine (stay tuned for more on vaccines.)

So if you are reading this, you now know as much about “Blending” as many of the people who will attend the conference. Congratulations!  And keep reading this blog to learn what we are learning about better ways to help people who struggle with addiction.

The "blending initiative" logo.

Smokin’ Hot Science

Did you ever wonder how scientists develop medications to help people stop smoking? High School Junior Ameya Deshmukh has been wondering about that since he was 7 years old. Because his parents work in science labs, he began learning about basic science from an early age. Now at age 16, he just won the first place NIDA Addiction Science Award at this year’s Intel International Science and Engineering Fair.

For his project, Ameya decided to search a database of 10,000 molecules to find one that will bind to nicotine receptors in the brain.  Those are the cells that nicotine molecules attach to and then cause their addictive effects in the brain. If we can learn how to link up the right molecules with the right receptors—say, by developing a special medication with that would go right to nicotine’s “sweet spot” in the brain—then we could block the pleasure that people get from cigarettes.  A lot of lives might be saved, since 440,000 people in this country die every year from tobacco-related diseases. This includes 35,000 who die from exposure to second-hand smoke. UGH!

Because identifying the right molecule can be like finding a needle in a haystack, Ameya used what is known as “rational drug design.” He first selected molecules based on previous research. Then he used computerized models to narrow the list of potential compounds even more. Finally, he tested the short list of molecules on human cells to identify which ones would bind to the receptors. With more research, Ameya’s work could point to new directions in developing medications to help people quit smoking.

When talking to the judges, Ameya stressed how important it was to develop these medications.  In 2009, 20.1 percent of 12th-graders, 13.1 percent of 10th-graders, and 6.5 percent of 8th-graders said they smoked in the month before the survey.  Unfortunately, many will get addicted.  The hard part is quitting, as seen in the nearly 35 million people who make a serious attempt to quit smoking each year, with most starting up again within a week.  So promising new medications are sorely needed.

NIDA’s Addiction Science award is given at the annual Intel International Science and Engineering Fair (ISEF), which was in San Jose this year. For more information on NIDA’s 3 winners, see NIDA’s news release at http://www.nida.nih.gov/newsroom/10/NR5-14.html

Are there serious public health problems that you could address in a science project?

Ameya Deshmukh with NIDA judges Dr. Ruben Baler, Dr. Pam Ling, and Dr. Cindy Miner

SBB Attends International AIDS Conference

SBB attended the International AIDS Conference in Vienna, Austria, and wow, what an experience! More than 20,000 people from all over the world came together in one place to discuss the progress being made in preventing and treating HIV and AIDS. Scientists, doctors, community activists, and many other groups all met to push for more support of AIDS programs. SBB was there because NIDA Director Dr. Nora Volkow was speaking at the conference about the link between drug abuse and HIV/AIDS. She said that many people who use drugs contract HIV through (1) sharing needles used to inject drugs (like heroin) and (2) doing risky things when they’re on drugs, like having unprotected sex.

Methadone Man and Buprenorphine Babe at the 2010 International AIDS Conference in Vienna

Many creative people were there. They even made art from pill packets used to hold HIV/AIDS medicines, making the point that catching people early in the disease and starting them on antiretroviral medications can greatly lower HIV spread and help prevent the progression to AIDS. Also, “Methadone Man” and “Bupenorphrine Babe” made an appearance—a compelling way to remind people that effective medicines are also available for drug abuse, and that drug abuse treatment can help prevent HIV. It is an urgent problem. In some parts of the world people who are addicted to drugs and have AIDS are just locked up in prison—with no treatment for either their AIDS or for their drug addiction.

To learn about the connection between drug abuse and HIV/AIDS, take a look at NIDA’s Learn the Link campaign at http://hiv.drugabuse.gov/index.html

Image from HIV/AIDS Conference