Addiction research has given rise to much new discovery in the decade since publication of the first edition of famed academician and researcher Carlton Erickson, PhD's The Science of Addiction. Now on the brink of the official release of the book's second edition (W.W. Norton & Co.) early next month, Erickson says genetic and neurobiological research has led to some important conclusions and will continue to.
“I think the big thing, and I hope I'm not being overly biased, is that the science is in that this is a brain disease,” Erickson tells Addiction Professional. Erickson, who directs the Addiction Science Research and Education Center at the University of Texas College of Pharmacy, wrote a regular column on addiction research findings for Addiction Professional in the 2000s.
This is not to say that all individuals who drink or use drugs at problematic levels have a brain disease, says Erickson, who repeats this consistently in the book's latest edition. He points out that one of the potentially huge benefits to advances in genetic research will involve being able to personalize interventions based on genetic factors, identifying potential problems early and intervening with less intensive treatments than what would be needed for someone with full-blown substance dependence.
Erickson mentions in the book's preface an abundance of “alternative facts”/false claims that he believes are plaguing the field, with authors who proclaim addiction to be a choice causing the most concern for him.
“These are pseudo-experts, some of whom have PhDs,” says Erickson, who is Emeritus Professor of Pharmacology and Toxicology at the University of Texas. “The people writing these books don't see people in the treatment centers. They haven't read about the neurobiology.”
The Science of Addiction: From Neurobiology to Treatment seeks to educate addiction professionals at all levels on the principles and applications of neuroscience. “Through such understanding, they will be better able to empathize with their patients and apply such science to principles of treatment,” he writes.
The book covers in great detail what addiction is and isn't, discussing where it occurs in the brain and how it is diagnosed. The pharmacology of drugs of misuse is addressed, and a diversity of treatment strategies are explored. Erickson says he has learned that The Science of Addiction is being used as a text in several universities' addiction counseling curricula.
Dangerous myths exposed
The book lists 10 prevalent myths related to addiction that Erickson says reflect misconceptions among both professionals and the general public. These are among the myths he considers most damaging:
A person cannot overdose on alcohol. A lack of understanding of alcohol's dangers among young people has a significant effect in settings such as college campuses, Erickson says.
Self-help is an appropriate way to overcome the disease of addiction. The idea of an individual overcoming addiction through sheer willpower or revelation is not supported by science, Erickson says. Self-help in this context does not refer to 12-Step meetings, which Erickson says have value but by themselves are unlikely to work for individuals with severe levels of illness.
'Crack babies' are a major clinical problem. A child born to a mother with a crack use problem is not born addicted, Erickson emphasizes. “Withdrawal is not addiction,” he says. A child exposed to drugs or alcohol in utero will have acute problems at birth, he writes, but labels such as “crack babies” serve only to stigmatize over the long term.
New frontiers in research
Erickson's book also lists several resesarch trends that are expected to yield strong conclusions over time, in areas such as opioid overdose prevention, the relationship of age of first use of alcohol to development of alcohol use disorders, and translational research to inform how to apply research findings to treatment settings. But Erickson reserves his greatest enthusiasm for research into genetic vulnerabilities to addiction and what such findings can ultimately produce.
“Even though this research is very, very difficult, and is moving slowly, it is like a rolling wall of water—you can't stop it,” he says.
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