Addiction was once considered a moral failing, and overcoming it simply a matter of willpower. The advent of brain imaging and the dedication of research attention to the problem has led to the understanding that substance addiction is a brain disease with complex genetic, biological and environmental components. Ongoing research is continuing to clarify the mechanism by which individual substances cause dependence, to deepen understanding of risk factors and to develop new medications and treatment protocols.
Genetics and Epigenetics
Researchers agree that there is a genetic component to addiction to drugs like Valium and are beginning to identify specific genes involved. Epigenetics is the study of how genes are expressed, or turned off and on, by external factors. The way in which drugs of abuse produce epigenetic changes is an emerging field of study with broad implications. Recent research includes the following:
- A 2014 publication by the Canadian Centre on Substance Abuse reports that about 400 genes have been identified as increasing the risk for drug addiction. The report also notes the overlap between substance use disorders and disruptive behavioral disorders and states that a specific gene that affects the reception of the neurotransmitter GABA is associated with early onset alcoholism, substance use disorders in adults and conduct disorder in childhood and adolescence.
- A 2014 article in the journal Neuropsychopharmacology reports on an animal study which found a relationship between exposure to THC, a component of cannabis, and vulnerability to drug problems in the next generation. The animals exposed to THC demonstrated changes in the expression of certain receptor genes associated with reward sensitivity and compulsive behaviors. Their subsequently conceived offspring, who were not directly exposed to THC, sought heroin more aggressively than did the animals who were the offspring of unexposed animals.
Opiates and Opioids
Abuse of opiates, such as heroin and morphine, and their chemically similar cousins, opioid pain relievers like oxycodone and hydrocodone, has skyrocketed in recent decades. Policymakers, clinicians and researchers are all devoting attention to the issue. Recent research includes the following:
- A 2015 article by the National Institute on Drug Abuse (NIDA) discusses a study of opiate/opioid addiction treatment. Unsurprisingly, opioid abusers who did not inject drugs were found to have better treatment outcomes and stay in treatment longer than patients who injected pharmaceutical opioids or abused heroin. The researchers examined the use of the addiction treatment medications buprenorphine/naloxone and methadone. They had hypothesized that users of prescription painkillers would benefit more from buprenorphine/naloxone. This did not prove to be the case, however, leading to the conclusion that physicians should feel confident recommending either medication depending on personal factors.
- Another recent study of opioid addiction treatment was reported in a 2014 article in The Journal of the American Medical Association. The study examined detox methods and compared patients who were stabilized with the drug buprenorphine and then tapered off the medication over a period of one, two, or four weeks. Patients treated with the longer tapering period demonstrated better treatment outcomes.
Cannabis
Because marijuana laws are changing and states are loosening restrictions, there has been renewed focus on research into the health and social effects of cannabis use. Recent studies include the following:
- A 2015 article in the journal Addiction examined and consolidated the past 20 years of research on cannabis use. The researchers determined that approximately 10 percent of regular users develop dependence. Studies also found that regular use in adolescence approximately doubles the risks of cognitive impairment and psychoses in adulthood.
- A 2015 article in the journal Psychological Medicine examined cannabis use disorders in individuals between the ages of 16 and 30. The study determined that about 30 percent of people suffering from a cannabis use disorder continue in a pattern of persistent and problematic use for a period of seven years or longer. The study also found that women recovered significantly more quickly from cannabis use disorders than did men.
Benzodiazepines
A 2015 article in the journal Substance Use and Abuse notes that benzodiazepine and “Z-drugs,” often used to treat anxiety or insomnia, are among the most widely prescribed medications in the world. The article reported on a study of chronic users of the medications and determined that almost half of them had developed dependence. The risk of dependence was related to both the quantity of drugs taken and to psychiatric history.
New Medications
Medications are available to help with addiction to alcohol and to opiate/opioid drugs. There is much ongoing research into the development of drugs to treat other types of addictions. In a 2015 article, NIDA reports on the efforts to develop a drug to treat methamphetamine addiction. The article notes that a dozen promising compounds have been developed and the hope is that one will be ready for human testing and clinical trials in the near future.
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