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Addiction Doctors: New Medicines Can Help Treatment Take Root

April 30, 2012

CHARLESTON, W.Va. - As bad as the state's prescription drug abuse problems are, there are medicines that may be able to blunt the addiction so treatment can take root. West Virginia has the highest rate of prescription drug overdose deaths of any state. But doctors here are increasingly treating addicts with chemicals called antagonists, which reduce the euphoria, the cravings and the chance of overdose.

Doctor Ed Eskew, an addiction specialist who advises the Kanawha County drug court, says addiction hijacks the chemistry of the brain, and the antagonists can interrupt that hijacking. But he stresses that an addict has to be in treatment - such as an inpatient programs, talk therapy, or a 12-step group - for any kind of change to stick.

"You can take the drugs and alcohol away from the person, but unless you are treating the underlying disorder, the disease of chemical dependency, they will ultimately go back to drugs and alcohol."

He says addiction is so powerful because it bypasses the rational part of the brain. The drugs flood a more primitive area of the brain, first with euphoria, then with cravings. He says the primitive brain then overwhelms the decision-making process.

"This primitive brain takes over, which is telling them, 'If you stop using you are going to die.' The withdrawal symptoms, the psychological cravings, anxiety, the panic, the fear."

Dr. Eskew says the antagonists can interrupt that, temporarily, which gives treatment time to take hold. He says some doctors are suspicious of treating drug dependency with another drug, and many in the public favor jailing the addicts. But Eskew says jail doesn't work because addicts aren't fully in control of their decisions. On the other hand, he says, enforced treatment, such as what's given at drug court, is often effective.

"I think we could make a big difference, yes. You know, I can think off hand, off the top of my head, of a lot of people now that have come though drug court, successfully completed it, that are out there, productive members of society, that would be sitting in jail right now."

Dr. Eskew ran a workshop on the topic last week during the spring conference of the National Association of Social Workers, West Virginia Chapter. That's the largest event of its kind in the country.

Dan Heyman, Public News Service - WV