Source:   Reuters
Pubdate:  Wed, 19 Nov 1997
Author:   Maggie Fox, Health and Science Correspondent

TREAT HEROIN ADDICTION LIKE DISEASE, EXPERTS SAY

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outdated laws and a false sense that addicts were somehow morally lacking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 brainrelated
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 drugseeking 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.