William Brangham:
My next guest is one of the researchers who helped establish that addiction is in fact a brain disorder, that taking certain drugs over time can change how our brains actually work.
Dr. Nora Volkow is the head of the National Institute on Drug Abuse, which is part of the NIH and is one of the world’s biggest funders of research into drug abuse and addiction.
Dr. Volkow, so good to have you on the program.
We have been reporting on a few of the medications that show effectiveness for treating opioids and alcohol abuse disorders, and I wonder that, from your long research on this topic, what role do you see medications playing in helping people address their addictions?
Dr. Nora Volkow, Director, National Institute on Drug Abuse: In the case of opioid use disorders, they are — they have been crucial and they have been lifesaving. And, again, it’s one of the drivers that is now reducing the number of people that are dying.
So, in the case of opioid addiction, we have very effective medications. The problems are, number one, that only a small percentage of people that would benefit from them, approximately 25 percent, will get prescribed this medication.
Second problem is, they start taking them and that protects them from overdosing. But at six months, 50 percent of them will stop taking their medications. So — and we only have three, buprenorphine, methadone, and naltrexone.
So we need a wider variety of medications and we need alternatives so that people that don’t respond to one medication can have options that go beyond two — those three medications and, importantly, combinations of medications that may make it easier for patients to stay in treatment, because that’s crucial for someone to have the long-lasting preventing effects of the medication treatments.