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Treat heroin addiction like disease, experts say

11/19/97

By Maggie Fox, Health and Science Correspondent

BETHESDA, Md. (Reuters) - Heroin addiction is a disease and should be treated as such, a panel of U.S. experts said on Wednesday.

The panel, called together by the National Institutes of Health (NIH), said outdated laws and a false sense that addicts were somehow morally lacking meant only a small percentage were being treated for what amounts to a medical condition.

``Opiate addiction is a medical disorder and basically is a brain-related disease,'' Dr. Lewis Judd, chair of the Department of Psychiatry at the University of California, San Diego and head of the panel, told a news conference.

``We are convinced that it is a medical disease. It is not a weakness of the will or a moral issue.''

The panel spent two days listening to scientists who study addiction, doctors, community workers and interested members of the public before issuing its report, which calls for increased funding for treating addiction.

The report, to be sent to 100,000 people and posted on the NIH's internet website at http://consensus.nih.gov, said heroin addiction was a widespread problem.

``We agree with the estimate that there are 600,000 addicts in the United States. However, most concerning to the panel is the fact that we are only aware that 115,000...are currently in treatment in the United States,'' Judd said.

The report said three federal agencies -- the NIH, the Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA), oversee methadone and other treatment programs. Methadone is less addictive than heroin and is used to wean addicts off the more dangerous drug.

Added to this are state agencies.

The panel recommended streamlining by removing responsibility for treatment programs from the NIH and FDA. Judd said cutting some of the red tape and oversight would draw more doctors into treating addicts.

``It will also free up considerable amounts of time of the staffs of these clinics, who are certainly beleaguered,'' he said.

``We know of no other area of medicine where the federal government intrudes so deeply and coercively into the practice of medicine,'' Judd added. ``If extra levels of regulation were eliminated, many more physicians and pharmacies could prescribe and dispense methadone, making treatment available in many more locations than is now the case.''

All addicts should be in treatment, Judd said.

This would benefit more than the addicts. ``It would significantly reduce the crime associated with drug-seeking behavior. And, importantly, it would reduce transmission of AIDS/HIV, since 75 percent of news AIDS cases in the United States today are coming from intravenous use.''

Society should be educated more, with state and federal government taking the lead in telling people heroin addiction was not an ethical failing, the panelists said. All doctors, nurses and other health care experts should be taught how to diagnose and treat heroin addiction.

Insurance, both public and private, should pay for treatment, the panel added.

The panelists heard evidence that there is a genetic component to addiction, and that drug use literally changes the brains of people, making them even more susceptible.

Last month several reports in the journal Science highlighted the most recent research.

George Koob and colleagues at the French national research institute INSERM in Bordeaux described addiction as ``a cycle of spiraling dysregulation of brain reward systems'' while other experts explained the possible role of genes and how the drug worked on a molecular level in the brain.