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Understanding Drug Abuse and Addiction:
Myths vs. Reality

A Town Meeting


Abstracts & Speaker Biographies


Understanding Drug Abuse & Addiction: Myths vs Reality

Alan I. Leshner, Ph.D.
Director
National Institute on Drug Abuse
National Institutes of Health
Room 5226
6001 Executive Boulevard
Bethesda, MD 20892-9591
(301) 443-6480

Research advances made over the past several decades have led to a better understanding of the full complexity of drug abuse and addiction and have built a sound scientific foundation on which to design prevention and treatment strategies that work. Metaphors that once were used to describe the harmful effects of drugs can now be replaced by scientific evidence showing real drug-induced physiological changes in the brains of drug abusers. Intuition- or ideology-driven interventions can be discarded for ones that are science-based. In addition to advancing the science base about drug abuse and addiction, it is equally critical that the knowledge gained from research be moved from the laboratory to the community. To make any real progress, all of the factions that play a role in this effort - researchers, practitioners, community leaders, and parents - must work together to identify the most feasible and effective means of using the science that is being generated to serve the needs of individuals and our communities.

Dr. Alan I. Leshner was appointed Director of the National Institute on Drug Abuse (NIDA) in February 1994. NIDA, one of the Institutes within the National Institutes of Health (NIH), supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. Before joining NIDA, Dr. Leshner had been with the National Institute of Mental Health (NIMH) from 1988, holding the position of Deputy Director and then Acting Director. He came to NIMH from the National Science Foundation (NSF), where he held a variety of senior positions focusing on basic research in the biological, behavioral, and social sciences, as well as on science education. Dr. Leshner went to the NSF after 10 years at Bucknell University, where he was a professor of psychology. Dr. Leshner's research has focused on the biological bases of behavior. He is the author of a major textbook on the relationship between hormones and behavior and numerous book chapters and papers in professional journals. Dr. Leshner received his undergraduate degree in psychology from Franklin and Marshall College and his master's and doctorate degrees in physiological psychology from Rutgers University.


Workshop A:(Repeated as Workshop D)
Understanding Drugs and the Brain: The Biobehavioral Impact of Drug Abuse

Treating the Addicted Brain

Michael Kuhar, Ph.D.
Chief, Division of Neuroscience
Yerkes Research Center/Emory University
954 Gatewood Road, NE
Atlanta, GA 30329
(404) 727-1737
(404) 727-3278 Fax
mkuhar@rmy.emory.edu

This presentation will look at how addicting drugs overwhelm the normal functioning of the brain and create changes in the brain. Thus, addiction is a brain disorder, and the key to treating the addicted individual is to understand the nature of that disorder. Therefore, a goal of research is to identify and understand these brain changes so that we can attempt to block or reverse them, possibly with medications. Animal studies show that medications for cocaine abuse, for example, are possible and effective in principle.

Dr. Kuhar is the Georgia Research Alliance Eminent Scholar and Candler Professor of Neuropharmacology at the Yerkes Primate Center of Emory University. His work on the chemistry of addiction is widely recognized, and he has received awards for his work from many professional societies. Dr. Kuhar has studied the mechanism of action of cocaine and has worked to produce medications for cocaine abusers. He is currently studying the changes produced in the brain by chronic drug use.


Brain Targets of Drugs of Abuse

T. Celeste Napier, Ph.D.
Professor
Department of Pharmacology
Director
Neuroscience and Aging Institute
Division for Research on Drugs of Abuse
Loyola University, Chicago
2160 South First Avenue
Maywood, IL 60153
(708) 216-3261
(708) 216-6596 Fax
cnapier@luc.edu

Recent NIDA-funded research has led to the important conclusion that drug addiction is a disease of the brain and that this disease will respond to treatment. To develop new treatment for addiction, we must understand the physiology of the “feel good” sensations that accompany the use of these drugs, as well as the intense desire for more drugs after these effects have worn off. This presentation will focus on NIDA-supported research under way to identify and characterize brain regions that are involved in these aspects of addiction. This work is providing new insights that will aid in the development of effective therapies for cocaine and heroin addicts.

Dr. T. Celeste Napier received her Ph.D. in pharmacology and experimental therapeutics in 1982 from the Texas Tech University Health Sciences Center. After her postdoctoral training at the University of North Carolina Medical School, she accepted a faculty position at Loyola University, Chicago, School of Medicine, where she is a Professor of Pharmacology and Neuroscience and the Director of the Neuroscience and Aging Institute Division for Research on Drugs of Abuse. Dr. Napier is the author of numerous publications in scientific journals and an editor of a book on the anatomy and function of the forebrain. Her neuroscience endeavors also include membership on several National Institutes of Health Grant Review Committees and service as Secretary (1994-1995) and President (1996) of the Chicago Chapter of the Society for Neuroscience.


Workshop B:

Pathways to Drug Abuse and Addiction: The Role of Risk and Protective Factors in Prevention Planning

Claire Sterk, Ph.D.
Associate Professor
Emory University
Rollins School of Public Health
1518 Clifton Road, NE
Atlanta, GA 30322
(404) 727-9124
(404) 727-1369 Fax
csterk@sph.emory.edu

This presentation will focus on the pathways to drug abuse using a risk- and protective-factor approach. Individual, familial or household, and community risk and protective factors will be addressed with a specific focus on the unique issues related to women and the use of crack cocaine, a drug that has dominated the Atlanta drug market since the 1980s. These research findings will be translated into suggestions for prevention and intervention programs targeting individuals at risk for use as well as actual users. Examples from ongoing projects in Atlanta will be included.

Dr. Claire Sterk is an Associate Professor in the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health at Emory University. She serves as the Atlanta representative of NIDA's Community Epidemiology Working Group and is a member of the executive committee of the Atlanta/Emory Center for AIDS Research. Currently, she coordinates two NIDA-funded studies; one on multigenerational drug use among women and another project to implement and evaluate a gender-specific HIV risk reduction intervention for African-American women. Dr. Sterk's books are Fast Lives: Women Who Use Crack Cocaine, as published by Temple University Press (Philadelphia), and Tripping and Tricking: Street Prostitution During the AIDS Era, in press at the Social Change Press (New York).


Resiliency: Research-Based Preventive Skill Reinforcement

James P. Griffin, Jr., Ph.D.
Room 524, BSHE, RSPH
Emory University
1518 Clifton Road, NE
Atlanta, GA 30322

Among the important prevention programming difficulties affecting African-American male youths is the dearth of real-world examples in which prevention theory is culturally specific and well integrated into practice. This presentation operationalizes the resiliency concept as it relates to research-based, front-line prevention programming services.

The Building Resiliency and Vocational Excellence (BRAVE) African-American Men's Program, serving adolescent males, builds on prevention research-based methods already shown to be effective with minority populations. The program combines a number of components including life skills training, mentoring, goal setting, mutual peer reinforcement, recreation, case management, and manhood development. The BRAVE Program operates on the following premise: Youths who attach themselves to positive, successful community role models, cultivate adaptive skills appropriate for community settings, internalize social norms that equate manhood with personal responsibility, and develop potentially rewarding vocational careers will be less likely to become involved with alcohol, tobacco, and other drugs and engage in violence.

Dr. James P. Griffin, Jr., is a senior faculty associate in the Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA. He teaches public health-related subjects including interdisciplinary and multicultural team building. Dr. Griffin has 23 years of human services experience in direct service, consultative, evaluative, and management capacities with special and general populations. This service included statewide consultation for the Ohio Department of Mental Health and Mental Retardation in Columbus. In the past 10 years, Dr. Griffin has designed, implemented, and evaluated prevention initiatives and conducted mental health and chemical dependency assessments and referrals in a crisis setting. As Special Assistant to the Director for the Urban Initiative at the University of Louisville, Dr. Griffin provided onsite coordination of research-based technology transfer for alcohol, tobacco, and other drug use prevention. In this position, he consulted in five cities: Atlanta, Louisville, Memphis, Miami, and Washington, DC. He has also been the director for a State-level health information services section in Georgia's Division of Public Health. He is now co-principal investigator and project director for a multicultural health education and health promotion project funded by the Health Resources and Services Administration. Dr. Griffin is also the principal investigator for a substance abuse and violence prevention program, the BRAVE African-American Men's Program funded by the National Institute on Drug Abuse.


NIDA Treatment Initiatives and Innovations

Alan I. Leshner, Ph.D., will discuss the findings of nearly three decades of scientific research on effective treatment approaches to drug additiction. Future research initiatives will be addressed including the establishment of the National Drug Abuse Treatment Clinical Trails Network designed to conduct treatment research in real-life settings with diverse populations.

Kathleen Carroll, Ph.D., will address key components of behavioral therapies used in drug addiction treatment with a particular focus on cognitive-behavioral therapy, an effective treatment approach for cocaine addicted persons.

Andrea G. Barthwell, M.D., will discuss the health consequences of drug abuse, including HIV/AIDS and hepatitis, and the need to link drug treatment with other health care services to adequately meet the complex needs of drug addicted patients.

Moderator: Sue Rusche, Cofounder and Executive Director, National Families in Action, Atlanta


Kathleen Carroll, Ph.D. Associate Professor of Psychiatry
Yale University School of Medicine
34 Park Street, Room 5-208
New Haven, CT 06519
(203) 789-7080, ext. 336
(203) 789-7088 Fax

Dr. Kathleen Carroll is an Associate Professor of Psychiatry at the Yale University School of Medicine, Director of Psychotherapy Research at the Substance Abuse Treatment Unit, and Scientific Director of the Center for Psychotherapy Development for Opioids and Cocaine. The author of more than 100 peer-reviewed journal articles, book chapters, and manuals, Dr. Carroll has research and treatment interests that lie in the area of specifying and evaluating psychosocial treatments for substance users, linking treatment interventions to outcomes, and evaluation combinations of psychotherapy and medications to enhance treatment outcome.

Andrea G. Barthwell, M.D. President
Encounter Medical Group
1010 Lake Street, Suite 210
Oak Park, IL 60301
(708) 383-2700
(708) 383-2959 Fax
agbmd@aol.com

Dr. Andrea G. Barthwell is President of Encounter Medical Group, a multispecialty group providing medical services to behavioral health systems and psychiatric services to primary care settings. Dr. Barthwell is the immediate Past President of the Illinois Society of Addiction Medicine and Past Board Member of the Chicago AIDS Advisory Task Force and AIDS Pastoral Care Network. She is a member of the Center for Substance Abuse Treatment (CSAT) Treatment Advisory Board and NIDA Initial Review Group.


Workshop C:

Cognitive Behavioral Therapy in the Treatment of Cocaine Abusers

Kathleen Carroll, Ph.D.

Cognitive-behavioral therapies (CBT) are among the most frequently evaluated approaches to the treatment of substance use disorders and have been found to be effective in several clinical trails of cocaine-dependent individuals and other types of substance users. This presentation will focus on the theoretical background of this approach, goals, the fundamentals of implementing CBT with substance users, and a brief review of the evidence supporting its effectiveness with drug abusers.


Workshop D: (Repeat of Workshop A)

[Atlanta Town Meeting Index]



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