Dear Friends and Colleagues:
Attached a very interesting article regarding the promising results of a study using Topiramate for the treatment of alcohol dependence. For more information see http://jama.ama-assn.org/cgi/content/full/298/14/1641.
The authors conclude that:
"Our finding in this study that topiramate is a safe and consistently efficacious medication for treating alcohol dependence is scientifically and clinically important. Alcoholism ranks third and fifth on the US and global burdens of disease, respectively. Discovering pharmacological agents such as topiramate that improve drinking outcomes can make a major contribution to global health. Because topiramate pharmacotherapy can be paired with a brief intervention deliverable by nonspecialist health practitioners, a next step would be to examine its efficacy in community practice settings."
Looking forward to your comments.
Yours
Bernd
============================================================================
Topiramate for Treating Alcohol Dependence
A Randomized Controlled Trial
Bankole A. Johnson, DSc, MD, PhD; Norman Rosenthal, MD; Julie A. Capece, BA; Frank Wiegand, MD; Lian Mao, PhD; Karen Beyers, MS; Amy McKay, PharmD; Nassima Ait-Daoud, MD; Raymond F. Anton, MD; Domenic A. Ciraulo, MD; Henry R. Kranzler, MD; Karl Mann, MD; Stephanie S. O’Malley, PhD; Robert M. Swift, MD, PhD; for the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group
JAMA. 2007;298:1641-1651.
ABSTRACT
Context Hypothetically, topiramate can improve drinking outcomes among alcohol-dependent individuals by reducing alcohol's reinforcing effects through facilitation of -aminobutyric acid function and inhibition of glutaminergic pathways in the corticomesolimbic system.
Objective To determine if topiramate is a safe and efficacious treatment for alcohol dependence.
Design, Setting, and Participants Double-blind, randomized, placebo-controlled, 14-week trial of 371 men and women aged 18 to 65 years diagnosed with alcohol dependence, conducted between January 27, 2004, and August 4, 2006, at 17 US sites.
Interventions Up to 300 mg/d of topiramate (n = 183) or placebo (n = 188), along with a weekly compliance enhancement intervention.
Main Outcome Measures Primary efficacy variable was self-reported percentage of heavy drinking days. Secondary outcomes included other self-reported drinking measures (percentage of days abstinent and drinks per drinking day) along with the laboratory measure of alcohol consumption (plasma -glutamyltransferase).
Results Treating all dropouts as relapse to baseline, topiramate was more efficacious than placebo at reducing the percentage of heavy drinking days from baseline to week 14 (mean difference, 8.44%; 95% confidence interval, 3.07%-13.80%; P = .002). Prespecified mixed-model analysis also showed that topiramate compared with placebo decreased the percentage of heavy drinking days (mean difference, 16.19%; 95% confidence interval, 10.79%-21.60%; P < .001) and all other drinking outcomes (P < .001 for all comparisons). Adverse events that were more common with topiramate vs placebo, respectively, included paresthesia (50.8% vs 10.6%), taste perversion (23.0% vs 4.8%), anorexia (19.7% vs 6.9%), and difficulty with concentration (14.8% vs 3.2%).
Conclusion Topiramate is a promising treatment for alcohol dependence.
Wednesday, October 10, 2007
Wednesday, September 26, 2007
Membership Issues
Dear Friends and Colleagues:
I have participated in todays ASAM Membership Committee conference call.
Membership recruitment and retention is essential for the viability of our organization and we need to extend every effort to speak to those doctors who have yet to renew their dues.
I will therefore assist John to identify those members to be called ASAP to renew their membership.
I also consider it as a priority to form a membership committee to develop a membership recruitment and retention plan.
It is of interest to note that residents (physicians in postgraduate training programs) only comprise 5% of the total ASAM membership.
We need to attract those physicians early in their career and convey to them the message that addiction medicine may be a career choice in the future.
With the formation of ABAM (American Board of Addiction Medicine) and the subsequent creation of addiction medicine fellowships I see a unique opportunity to attract those physicians towards our profession.
All of these issues should be dealt with by an active and strong membership committee co-chaired by the Chapter President.
What are your thoughts regarding this issue?
Yours
Bernd
I have participated in todays ASAM Membership Committee conference call.
Membership recruitment and retention is essential for the viability of our organization and we need to extend every effort to speak to those doctors who have yet to renew their dues.
I will therefore assist John to identify those members to be called ASAP to renew their membership.
I also consider it as a priority to form a membership committee to develop a membership recruitment and retention plan.
It is of interest to note that residents (physicians in postgraduate training programs) only comprise 5% of the total ASAM membership.
We need to attract those physicians early in their career and convey to them the message that addiction medicine may be a career choice in the future.
With the formation of ABAM (American Board of Addiction Medicine) and the subsequent creation of addiction medicine fellowships I see a unique opportunity to attract those physicians towards our profession.
All of these issues should be dealt with by an active and strong membership committee co-chaired by the Chapter President.
What are your thoughts regarding this issue?
Yours
Bernd
Tuesday, August 14, 2007
Science Of Addiction: A JAMA Book Review
The Science of Addiction: From Neurobiology to Treatment
By Carlton K. Erickson, 288 pp, $32.
New York, NY, WW Norton Professional Books, 2007.
ISBN-13 978-0-3937-0463-1.
JAMA. 2007;298:809-810.
The term "addiction" commonly triggers stereotypic misperceptions about the compulsive, out-of-control use of illicit drugs resulting from a perceived amendable behavioral flaw. In 1988, the United States Supreme Court in a disputed decision declared alcoholism to be "willful misconduct." However, several decades of comprehensive genetic and neurobiological research have provided indisputable evidence that addiction is brain disease resulting from mesolimbic brain dysregulation that, if diagnosed in a timely fashion, can be properly treated. Addiction meets all characteristics of the disease concept, ie, (1) a clear biological basis; (2) unique, identifiable signs and symptoms; (3) a predictable course and outcome; and (4) the inability to control the cause of the disease.
In this context, Erickson's book provides a compelling overview of the "science of addiction" and superbly summarizes the state of the art of addiction medicine. In 10 easy-to-read chapters, the author guides the reader through basic neuroanatomy, neurobiology, and neurochemistry; the pharmacology of different drugs of abuse, including alcohol, depressants, and stimulants; current treatment algorithms; the strategies of addiction research; and the future outlook of the evidence-based research principles.
The text begins with a challenge of the terminology and characterization of "addiction," calling it unscientific, broad, too vague, and stigmatized. According to the author, the term provokes "pejorative misperceptions," and he uses the term "chemical dependence" instead to properly identify the impaired control over the drug use, the defining hallmark of this brain disease. He also suggests separating the colloquial term "addiction" from the scientific terminology of "chemical dependence," thereby not precluding its use but understanding its limitation. Erickson emphasizes that "the reluctance to define addiction as a disease stems partly from a desire to hold drug users accountable for their actions," and that "any approach that tries to understand addiction from a purist or unitary view misses other key components." Chemical dependence is a "compulsive, pathological, impaired control over drug use, leading to an inability to stop using drugs in spite of adverse consequences."
Drugs with a dependence liability not only produce a positive mood but trigger the mesolimbic dopamine system, resulting in an activation of the so-called "reward pathway." Neuroscientists believe that in some individuals the function of these neurotransmitter systems is disrupted due to genetic "miswiring," long-term exposure to a drug, or—more likely—a combination of genetic heritability, drug exposure, and environmental influences. This may explain why any drugs of abuse can induce dependence in susceptible individuals but not for every person who may use them occasionally or who has abused them during their lifetime.
The detailed review of the basic science of chemical dependence provides ample evidence that the dysregulation in the mesolimbic dopamine system constitutes the disease, just as poor dopamine function in the basal ganglia is the etiologic cause of Parkinson disease. Therefore, drug-seeking and drug-taking are only the symptoms of the disease, just as muscle rigidity and tremors are only the symptoms of Parkinson disease.
The author also provides a brief but comprehensive overview of the genetics of chemical dependence. Family, twin, and adoption studies demonstrate that genetic factors contribute to the risk of alcoholism. Scientists have identified some possible causative genes and certain risk genes which, in susceptible individuals exposed to drugs of abuse, may activate a cascade of neurochemical events leading to chemical dependence. The argument that chemical dependence is a brain disease, comparable to other brain diseases, begs the question about similar treatment approaches.
Erickson correctly emphasizes that any treatment approach cannot rely on pharmacological solutions alone. The treatment must be individualized and should take so-called harm reduction strategies, also known as harm minimization, into consideration. Such an approach includes methadone maintenance and needle-exchange programs that often ruffle the feathers of the proponents of abstinence-based programs.
In the last few years, new pharmacological treatments have broadened the opportunities for the outpatient management of patients with chemical dependencies. For example, anticraving, antirelapse, and abstinence-enhancing medications are now part of the treatment armamentarium for alcohol dependence and include naltrexone, acamprosate, and topiramate. The US Food and Drug Administration approval of buprenorphine for the treatment of opioid dependence extends the treatment outreach from federally approved methadone clinics to almost all physicians who have completed an 8-hour certification course.
In the remainder of the book, Erickson reviews the scientific methodology of addiction research and the exciting results of brain imaging studies in chemical dependence. These include positron emission tomography, functional magnetic resonance imaging, and single-photon emission computerized tomography. The imaging modalities illustrate that drug treatment as well as the anticipation of the active drug itself can trigger neurochemical changes and are valuable tools for studying the effectiveness and compatibility of interactional behavioral interventions and pharmacotherapy.
Unfortunately, the author has missed the opportunity to discuss the screening and brief intervention methods that can be incorporated into the clinical practice identifying patients at risk for chemical dependence. For example, the National Institute on Alcohol Abuse and Alcoholism has published valuable screening and brief intervention tools on its Web site1 that can assist health care professionals in risk stratification strategies for patients with chemical dependence. However, the book provides the knowledge that chemical dependence is a brain disease, and an understanding of this disease concept of addiction ensures that millions of individuals with chemical dependence can now receive appropriate and suitable treatments.
In summary, I recommend this excellent book as a "must-read" for any medical student, physician, or other allied health professional dedicated to the care of their patients with the treatable disease of addiction.
Financial Disclosures: None reported.
Bernd Wollschlaeger, MD, Reviewer
University of Miami
Miami, Florida
info@miamihealth.com
REFERENCES
1. National Institute on Alcohol Abuse and Alcoholism. A Pocket Guide for Alcohol Screening and Brief Intervention. http://pubs.niaaa.nih.gov/publications/Practitioner/PocketGuide/pocket_guide.htm. Accessibility verified July 18, 2007.
Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.
By Carlton K. Erickson, 288 pp, $32.
New York, NY, WW Norton Professional Books, 2007.
ISBN-13 978-0-3937-0463-1.
JAMA. 2007;298:809-810.
The term "addiction" commonly triggers stereotypic misperceptions about the compulsive, out-of-control use of illicit drugs resulting from a perceived amendable behavioral flaw. In 1988, the United States Supreme Court in a disputed decision declared alcoholism to be "willful misconduct." However, several decades of comprehensive genetic and neurobiological research have provided indisputable evidence that addiction is brain disease resulting from mesolimbic brain dysregulation that, if diagnosed in a timely fashion, can be properly treated. Addiction meets all characteristics of the disease concept, ie, (1) a clear biological basis; (2) unique, identifiable signs and symptoms; (3) a predictable course and outcome; and (4) the inability to control the cause of the disease.
In this context, Erickson's book provides a compelling overview of the "science of addiction" and superbly summarizes the state of the art of addiction medicine. In 10 easy-to-read chapters, the author guides the reader through basic neuroanatomy, neurobiology, and neurochemistry; the pharmacology of different drugs of abuse, including alcohol, depressants, and stimulants; current treatment algorithms; the strategies of addiction research; and the future outlook of the evidence-based research principles.
The text begins with a challenge of the terminology and characterization of "addiction," calling it unscientific, broad, too vague, and stigmatized. According to the author, the term provokes "pejorative misperceptions," and he uses the term "chemical dependence" instead to properly identify the impaired control over the drug use, the defining hallmark of this brain disease. He also suggests separating the colloquial term "addiction" from the scientific terminology of "chemical dependence," thereby not precluding its use but understanding its limitation. Erickson emphasizes that "the reluctance to define addiction as a disease stems partly from a desire to hold drug users accountable for their actions," and that "any approach that tries to understand addiction from a purist or unitary view misses other key components." Chemical dependence is a "compulsive, pathological, impaired control over drug use, leading to an inability to stop using drugs in spite of adverse consequences."
Drugs with a dependence liability not only produce a positive mood but trigger the mesolimbic dopamine system, resulting in an activation of the so-called "reward pathway." Neuroscientists believe that in some individuals the function of these neurotransmitter systems is disrupted due to genetic "miswiring," long-term exposure to a drug, or—more likely—a combination of genetic heritability, drug exposure, and environmental influences. This may explain why any drugs of abuse can induce dependence in susceptible individuals but not for every person who may use them occasionally or who has abused them during their lifetime.
The detailed review of the basic science of chemical dependence provides ample evidence that the dysregulation in the mesolimbic dopamine system constitutes the disease, just as poor dopamine function in the basal ganglia is the etiologic cause of Parkinson disease. Therefore, drug-seeking and drug-taking are only the symptoms of the disease, just as muscle rigidity and tremors are only the symptoms of Parkinson disease.
The author also provides a brief but comprehensive overview of the genetics of chemical dependence. Family, twin, and adoption studies demonstrate that genetic factors contribute to the risk of alcoholism. Scientists have identified some possible causative genes and certain risk genes which, in susceptible individuals exposed to drugs of abuse, may activate a cascade of neurochemical events leading to chemical dependence. The argument that chemical dependence is a brain disease, comparable to other brain diseases, begs the question about similar treatment approaches.
Erickson correctly emphasizes that any treatment approach cannot rely on pharmacological solutions alone. The treatment must be individualized and should take so-called harm reduction strategies, also known as harm minimization, into consideration. Such an approach includes methadone maintenance and needle-exchange programs that often ruffle the feathers of the proponents of abstinence-based programs.
In the last few years, new pharmacological treatments have broadened the opportunities for the outpatient management of patients with chemical dependencies. For example, anticraving, antirelapse, and abstinence-enhancing medications are now part of the treatment armamentarium for alcohol dependence and include naltrexone, acamprosate, and topiramate. The US Food and Drug Administration approval of buprenorphine for the treatment of opioid dependence extends the treatment outreach from federally approved methadone clinics to almost all physicians who have completed an 8-hour certification course.
In the remainder of the book, Erickson reviews the scientific methodology of addiction research and the exciting results of brain imaging studies in chemical dependence. These include positron emission tomography, functional magnetic resonance imaging, and single-photon emission computerized tomography. The imaging modalities illustrate that drug treatment as well as the anticipation of the active drug itself can trigger neurochemical changes and are valuable tools for studying the effectiveness and compatibility of interactional behavioral interventions and pharmacotherapy.
Unfortunately, the author has missed the opportunity to discuss the screening and brief intervention methods that can be incorporated into the clinical practice identifying patients at risk for chemical dependence. For example, the National Institute on Alcohol Abuse and Alcoholism has published valuable screening and brief intervention tools on its Web site1 that can assist health care professionals in risk stratification strategies for patients with chemical dependence. However, the book provides the knowledge that chemical dependence is a brain disease, and an understanding of this disease concept of addiction ensures that millions of individuals with chemical dependence can now receive appropriate and suitable treatments.
In summary, I recommend this excellent book as a "must-read" for any medical student, physician, or other allied health professional dedicated to the care of their patients with the treatable disease of addiction.
Financial Disclosures: None reported.
Bernd Wollschlaeger, MD, Reviewer
University of Miami
Miami, Florida
info@miamihealth.com
REFERENCES
1. National Institute on Alcohol Abuse and Alcoholism. A Pocket Guide for Alcohol Screening and Brief Intervention. http://pubs.niaaa.nih.gov/publications/Practitioner/PocketGuide/pocket_guide.htm. Accessibility verified July 18, 2007.
Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.
Thursday, August 9, 2007
Upcoming Events
Dear Friends and Colleagues;
I want to inform you about two upcoming events:
1. August 22-24th, 2007, Florida Alcohol And Drug Abuse Association, Orlando Florida
* Stacy Seikel, August 22nd,6:30PM - 10:00 PM Presentation about
"Prometa, A Treatment Program for Methamphetamine,Cocaine and Alcohol
Addiction"
1. August 24th-27th, 2007, FMA Annual Meeting, Hollywood, Florida
* Reference Committees will discuss three FSAM resolutions
Please call me for any questions or further information.
Yours
Bernd
I want to inform you about two upcoming events:
1. August 22-24th, 2007, Florida Alcohol And Drug Abuse Association, Orlando Florida
* Stacy Seikel, August 22nd,6:30PM - 10:00 PM Presentation about
"Prometa, A Treatment Program for Methamphetamine,Cocaine and Alcohol
Addiction"
1. August 24th-27th, 2007, FMA Annual Meeting, Hollywood, Florida
* Reference Committees will discuss three FSAM resolutions
Please call me for any questions or further information.
Yours
Bernd
Tuesday, August 7, 2007
California To end Physicians Monitoring Program
Dear Friends and Colleagues:
Attached some info regarding a very troublesome development in California.
Yours truly,
Bernd
============================================================================
Calif. To End Program for Addicted Doctors
August 7, 2007
News Summary
The Medical Board of California has decided to end its diversion program for doctors who are grappling with addiction problems, the San Diego Union-Tribune reported Aug. 5.
The decision came in the wake of a report that concluded that the 27-year-old diversion program didn't do enough for addicted doctors and failed to protect patients. The program is scheduled to end next June unless the board decides to somehow overhaul it.
If the program ends, California would be the only state in the U.S. without a diversion mechanism for addicted doctors.
Under the program rules, doctors who confidentially sought help with addiction problems could keep their licenses if they attended treatment and self-help groups, and submitted urine tests. The Medical Board appoints a monitor to keep track of their progress, but the report said oversight was lacking.
Research showed that about 18 percent of doctors who entered the program completed treatment, far short of the 90 percent completion rate in North Carolina, for example.
Jeoffry Gordon, a past president of the Medical Board, said the state should offer some type of treatment to doctors. Others suggested that physicians be barred from practicing for six months while they get treatment.
============================================================================
Attached some info regarding a very troublesome development in California.
Yours truly,
Bernd
============================================================================
Calif. To End Program for Addicted Doctors
August 7, 2007
News Summary
The Medical Board of California has decided to end its diversion program for doctors who are grappling with addiction problems, the San Diego Union-Tribune reported Aug. 5.
The decision came in the wake of a report that concluded that the 27-year-old diversion program didn't do enough for addicted doctors and failed to protect patients. The program is scheduled to end next June unless the board decides to somehow overhaul it.
If the program ends, California would be the only state in the U.S. without a diversion mechanism for addicted doctors.
Under the program rules, doctors who confidentially sought help with addiction problems could keep their licenses if they attended treatment and self-help groups, and submitted urine tests. The Medical Board appoints a monitor to keep track of their progress, but the report said oversight was lacking.
Research showed that about 18 percent of doctors who entered the program completed treatment, far short of the 90 percent completion rate in North Carolina, for example.
Jeoffry Gordon, a past president of the Medical Board, said the state should offer some type of treatment to doctors. Others suggested that physicians be barred from practicing for six months while they get treatment.
============================================================================
Tuesday, July 10, 2007
Chantix For The Treatment Of Alcohol Addiction?
Anti-smoking drug Chantix works for alcohol too
Medical Studies/Trials
Published: Tuesday, 10-Jul-2007
According to researchers a popular anti-smoking pill may also curb the urge to drink alcohol.
The drug varenicline is already on the market under the brand name Chantix to help smokers kick the habit but new preliminary research now suggests it could also be useful in helping heavy drinkers quit.
The research which was carried out on rats provided the rodents with intermittent access to 40 proof alcohol for four months and by varying the access to the liquor supply the rats were made to crave it.
The researchers say every time the rodents had access to booze, they upped their intake and drank all day and withdrawing the alcohol made them want to drink even more.
After months of this behaviour and a total of 37 binge-drinking sessions, all the rats cut their drinking in half when given varenicline.
When taken off the drug, the rats did not immediately imbibe more, a rebound effect that has affected other treatments.
Varenicline has been available as a smoking cessation aid for nearly a year in the U.S. and the European Union, and as well as being safe it does not suppress the appetite and is not metabolized in the liver.
Bartlett says this is a major plus because long term drinkers often have liver damage.
According to the researchers the drug targets a pleasure center in the brain and has the potential to be considered as a treatment for addictions such as gambling and painkillers.
Varenicline works by latching onto the same receptors in the brain that nicotine binds to when inhaled in cigarette smoke, an action that leads to the release of dopamine in the brain's pleasure centers; the drug blocks any inhaled nicotine from reinforcing that effect.
The new study suggests alcohol also acts on the same locations in the brain and varenicline, might be equally as effective for curbing drinking.
Selena Bartlett, a University of California neuroscientist who led the study says the drug has already proven itself safe for people trying to stop smoking and is now a potential drug to fight alcohol dependence.
Experts say smoking and drinking often go together and a single drug able to tackle both addictions is not surprising.
The researchers at the University of California along with the National Institute on Alcohol Abuse and Alcoholism, plan to conduct clinical trials in humans of the drug's effectiveness in curbing alcohol cravings and dependence.
The drug is already approved by Food and Drug Administration and this should speed the process up.
But skeptics warn that varenicline does not work for all smokers and it's highly unlikely it will work for all drinkers and some experts insist there is a common biological basis for addictions to both alcohol and tobacco.
Although drug company Pfizer provided the drug for the study it was not involved in the research and is apparently undecided whether to seek broader FDA approval for the drug.
The study is published in the journal Proceedings of the National Academy of Sciences.
Medical Studies/Trials
Published: Tuesday, 10-Jul-2007
According to researchers a popular anti-smoking pill may also curb the urge to drink alcohol.
The drug varenicline is already on the market under the brand name Chantix to help smokers kick the habit but new preliminary research now suggests it could also be useful in helping heavy drinkers quit.
The research which was carried out on rats provided the rodents with intermittent access to 40 proof alcohol for four months and by varying the access to the liquor supply the rats were made to crave it.
The researchers say every time the rodents had access to booze, they upped their intake and drank all day and withdrawing the alcohol made them want to drink even more.
After months of this behaviour and a total of 37 binge-drinking sessions, all the rats cut their drinking in half when given varenicline.
When taken off the drug, the rats did not immediately imbibe more, a rebound effect that has affected other treatments.
Varenicline has been available as a smoking cessation aid for nearly a year in the U.S. and the European Union, and as well as being safe it does not suppress the appetite and is not metabolized in the liver.
Bartlett says this is a major plus because long term drinkers often have liver damage.
According to the researchers the drug targets a pleasure center in the brain and has the potential to be considered as a treatment for addictions such as gambling and painkillers.
Varenicline works by latching onto the same receptors in the brain that nicotine binds to when inhaled in cigarette smoke, an action that leads to the release of dopamine in the brain's pleasure centers; the drug blocks any inhaled nicotine from reinforcing that effect.
The new study suggests alcohol also acts on the same locations in the brain and varenicline, might be equally as effective for curbing drinking.
Selena Bartlett, a University of California neuroscientist who led the study says the drug has already proven itself safe for people trying to stop smoking and is now a potential drug to fight alcohol dependence.
Experts say smoking and drinking often go together and a single drug able to tackle both addictions is not surprising.
The researchers at the University of California along with the National Institute on Alcohol Abuse and Alcoholism, plan to conduct clinical trials in humans of the drug's effectiveness in curbing alcohol cravings and dependence.
The drug is already approved by Food and Drug Administration and this should speed the process up.
But skeptics warn that varenicline does not work for all smokers and it's highly unlikely it will work for all drinkers and some experts insist there is a common biological basis for addictions to both alcohol and tobacco.
Although drug company Pfizer provided the drug for the study it was not involved in the research and is apparently undecided whether to seek broader FDA approval for the drug.
The study is published in the journal Proceedings of the National Academy of Sciences.
Addiction Research In The News
I hope you didn't miss todays (07/10/07) great interview with Dr. Volkow on NPR (Fresh Air) entitled "No,really, this is your brain on drugs."
Nora Volkow, director of the National Institute on Drug Abuse, ranks as one of the U.S.'s leading addiction researchers. She's helped demonstrate that addiction is in fact a disease — a disease of the brain — and that all addictions, whether it's to drugs, alcohol, tobacco, sex, gambling or even food, are more alike than was previously thought.Volkow, who's the great-granddaughter of Russian revolutionary Leon Trotsky, grew up in Mexico City — in the house where her famous ancestor was assassinated.
Very informative and fascinating.
A MUST for anybody who is interested in addiction and want to draw others towards other profession.
LINK: http://www.npr.org/templates/story/story.php?storyId=11847222
Yours
Bernd
Nora Volkow, director of the National Institute on Drug Abuse, ranks as one of the U.S.'s leading addiction researchers. She's helped demonstrate that addiction is in fact a disease — a disease of the brain — and that all addictions, whether it's to drugs, alcohol, tobacco, sex, gambling or even food, are more alike than was previously thought.Volkow, who's the great-granddaughter of Russian revolutionary Leon Trotsky, grew up in Mexico City — in the house where her famous ancestor was assassinated.
Very informative and fascinating.
A MUST for anybody who is interested in addiction and want to draw others towards other profession.
LINK: http://www.npr.org/templates/story/story.php?storyId=11847222
Yours
Bernd
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