Bel Air Center for Addictions

Alcohol Addiction
Tobacco Addiction
Opiate and Narcotic Addiction

ALCOHOL ADDICTION
Affecting the Brain's Reward Pathways

Nearly 14 million Americans abuse alcohol or are alcoholic. Alcohol abuse destroys families, undermines communities, and contributes to 100,000 deaths each year, including half of all traffic fatalities. In addition to its untold emotional costs, alcohol abuse takes a staggering financial toll. Every year, alcohol dependence and abuse costs Americans over $100 billion in lost earnings, medical care, alcohol-related crime, and accident damage.

Society pays a great price for alcohol abuse, but it also helps to promote it. Movies, music, and advertising imply that drinking makes people glamorous, sophisticated, and popular. Excessive drinking is often laughed at and seen as a harmless and natural rite of passage to adulthood. In fact, alcohol dependence can lead to broken families, financial problems, physical injuries and illnesses, legal crises, and psychological devastation.

Scientists view alcoholism not as a reflection of weak character but rather as a complex, chronic, life-threatening disease with powerful psychological and genetic components. Alcohol acts on the brain's reward pathways through intricate mechanisms that are not fully understood. The disease takes many forms and defies an easy solution. Some people are able to maintain fairly normal function, superficially masking their drinking problems, while others lose complete control of their lives. Whatever their personal situation, individuals suffering from alcohol dependence are at a significant risk for a multitude of medical, legal, financial, and social problems.

The Bel Air Center for Addictions recognizes the complexity of alcohol dependence, and treats each patient through a comprehensive program designed to respond to his or her individual circumstances. Not every person who abuses alcohol is an alcoholic. Some individuals can reduce the harmful effects of alcohol on their lives by decreasing their alcohol consumption. Others must attempt to stop drinking altogether. An addiction specialist offers a range of treatment programs, from helping a problem drinker recognize his situation and embrace the need for change, to intensive intervention with detoxification, medication, and counseling. No single treatment works in every case or in every person, but appropriate treatment with medications, counseling, and referrals can help manage alcohol withdrawal, reduce cravings, and provide essential support to the addicted patient. Alcohol abuse unravels individuals, families, and neighborhoods. However, with specialized care and patience such as that given other complex diseases like diabetes, hypertension, and asthma, people addicted to alcohol can find reason for hope and the possibility of a better life.

TOBACCO ADDICTION
A Disease of the Brain's Reward System

Tobacco use is the leading preventable cause of death in the United States, responsible for 440,000 deaths and more than $75 billion in medical costs each year. Countless studies have proven that smoking causes chronic lung and heart disease, contributes to numerous forms of cancer, and endangers the lives of nonsmokers exposed to second hand smoke. Every day, thousands of young people under the age of 18 try their first cigarette, and many of them will continue smoking into adulthood. Though aggressive non-smoking campaigns have reduced teenage smoking rates, researchers nevertheless project over six million children living today will die prematurely because of tobacco.

Most people know the dangers of tobacco use, but many find it very difficult to quit. That's because every aspect of smoking contributes to addiction. Cigarettes deliver highly addictive nicotine to the brain within seconds of taking a puff. A few minutes later, the smoker craves another dose and will suffer withdrawal symptoms without it. By varying the way they smoke, users maintain complete control over the speed and intensity of drug delivery. Additionally, opportunities for smoking abound, the drive to work, a coffee break, relaxing with friends. A person who wishes to quit faces a drug as dangerous as heroin, but legal, easily obtainable, and socially convenient. While tobacco addiction is challenging, new neurobiological research offers hope. Scientists now believe that addiction is a disease of the brain's reward system rather than simply a choice or a sign of personal weakness. Like other serious, chronic diseases such as asthma or diabetes, addiction has physical, behavioral, and genetic components, and requires persistence and specialized care to be treated effectively.

The Bel Air Center for Addictions helps smokers stop using tobacco through a comprehensive smoking cessation program specifically targeted to each patient. Studies suggest that properly selected treatment matched to a patient's individual characteristics can improve that individual's chance of quitting. Rather than merely advising a patient to stop smoking, an addiction specialist will apply a variety of methods and medications to treat the addiction. Nicotine replacement therapy can systematically taper a smoker off the nicotine in cigarettes by replacing it with a safer, more controlled source. Replacement therapy comes in several forms, including gum, inhalers, patches, and lozenges. While it may seem illogical to use nicotine as an addiction treatment, studies have shown that patients who use nicotine replacement therapy are twice as likely to stop smoking. As patients become more comfortable without cigarettes, they can learn to deal effectively with the everyday events that once triggered their desire to smoke. Some patients may need to continue nicotine replacement therapy indefinitely. Others may succeed in reducing or even eliminating it. In any case, since it is not nicotine, but the many other substances in tobacco that cause most of the problems associated with smoking, the patient on replacement therapy has made a giant step toward protecting their health.

Another Therapy Utilizes a Non-Nicotine medication that targets portions of the brain that control craving. This can be very effective in conjunction with nicotine replacement therapy. Research continues into new addiction drugs and treatments. While no magic pill exists yet that can eliminate nicotine addiction, with proper care many smokers can learn to live without cigarettes and their devastating health risks.

OPIATE AND NARCOTIC ADDICTION

Heroin and prescription painkillers control the lives of millions of Americans from every profession, age group and zip code. People who never imagined themselves as "junkies" wake up every morning with an all-consuming need to use opioid drugs. While their paths to addiction differ, their uncontrollable dependence on their drug does not. Without help, these otherwise ordinary people risk the loss of their jobs, their families, and their futures. Until recently, the most successful treatment has come at a humiliating price. Addicted individuals seeking relief from painful withdrawal symptoms commuted to government- licensed methadone clinics. There they waited in line for their daily dose of methadone, bathed in the clinic's stigma of misery and personal failure. Fortunately, a revolutionary new medication has begun to change this grim scene. Buprenorphine (pronounced byoo-pren-OR-feen) moves addiction treatment from the public clinic to the private doctor's office. Prescribed confidentially by a physician, buprenorphine can eventually be taken at home, through 30-day prescriptions filled at the local pharmacy. Buprenorphine, like methadone, can eliminate physical craving for opiate drugs and withdrawal sickness. What's more, it prevents heroin and other narcotic drugs from creating a "high". Buprenorphine has fewer side effects than methadone and it relieves the chills and nausea of withdrawal without clouding the mind. With a clear head and restored dignity, patients can work to reclaim their lives.

Unfortunately, many people still believe that drug dependency signifies personal weakness. But recent neurobiological research reveals a very different picture. Addiction specialists now view addiction as a disease of the brain's reward system. Like hypertension or depression, addiction is influenced by both genetics and lifestyle. It is complex, chronic, and remarkably stubborn. Nonetheless, addiction is a legitimate disease that can and should be treated like any other mainstream illness. A new generation of drugs led by buprenorphine begins to do just that.

Patients take buprenorphine every day in the form of a small orange tablet that dissolves under the tongue. Once in the body, buprenorphine pries heroin and other narcotic painkillers away from pleasure receptor sites in the brain. It then occupies those sites in an awkward but persistent fashion -- well enough to keep other opiates away and relieve withdrawal symptoms, but poorly enough to prevent its own abuse.

Buprenorphine treatment involves much more than a pill. Patients must commit to a long term, closely supervised program involving regular doctor visits, counseling, and urine screens. Only specially licensed and trained physicians can prescribe the drug. Like every other medication, buprenorphine has risks, costs, and complications, and it can't help everyone. It does not cure addiction. Buprenorphine temporarily removes the physical attraction of other opiate drugs by replacing them in the brain with a far less dangerous substitute. While receiving treatment, patients can live and work normally without withdrawal symptoms or worry over how they will get their next dose of drugs or medication. Buprenorphine offers a very good treatment option for a severe chronic medical problem. Scientists hope their growing knowledge of the brain will some day produce a permanent cure for this all too common but often misunderstood disease.