HBO Addiction: An Interview with Nora Volkow

"Science has shown that the brain has a remarkable ability to recover from addiction. With continuing advances in medical and behavioral treatments, addiction will soon be commonly accepted as a manageable chronic disease."

This summary statement is displayed at the end of the 30 minute interview with Dr. Nora Volkow, Director of the National Institute on Drug Abuse, done by HBO in its series on addiction. I agree whole heartedly that the brain has the remarkable ability to find ways around the damage caused by prolonged drug and alcohol abuse. However, the premise that addiction will soon be commonly accepted as a manageable chronic disease seems a little far-fetched to me.

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You can see the whole interview on the HBO: Addiction website by clicking here. Next to the video, you will see three chapters that are clickable links and these will give you access to the whole interview in roughly 10 minutes segments. This portion of the series was done by Liz Garbus whose bio you can find here.

In an informal therapy group, Dr. Nora Volkow, Director of NIDA, discusses addiction as a brain disease with addicts and family members. She notes the environmental, behavioral and genetic factors that can make an individual vulnerable to addiction and how the disease leads to abnormal behavior. Additionally, Volkow uses brain imaging to illustrate how drugs and alcohol physically alter the brain, which is important in understanding addiction. Addicts are incorporated into this program as they share their difficult struggles with the disease.

Other than my previous comment about the near future acceptance of addiction as a treatable disease, I thought most of what Dr. Volkow had to say was right on the money. Early treatment works best, relapse is common but not failure, and the need for longer treatment periods all ring true. However, I think one needs to be careful when treating depression or other less than absolutely severe mental conditions during the first stages of treatment, especially with other drugs. It is the humble opinion of this writer, and I know I will raise some hackles with this statement, that all addicts and alcoholics are depressed… mostly because they have an addiction and their life is in the crapper! Treat the addiction first; detox and then recovery for a while before a diagnosis is made for chronic depression.

One thing that is not just my opinion is that all alcoholics and addicts are looking for that certain something they can rely on to get them through life, anti-depressants fit this bill quite admirably at first but often lead to other and illicit self medication. If one is in recovery, yet still reliant upon drugs, it is very difficult to change the “mode” of one’s thinking. I call it thinking like an alcoholic. If this is just a short term solution, such as in methadone maintenance, it should always be referred to in this way by both doctor and patient.

Let me know what you think of the video segments and feel free to make any suggestions about how I am reviewing this great series.

PS: Dr. Volkow is the recipient of the first ever TDA Salute.