Old Attitudes on Addiction Are Changing. So Are Treatments.

ARCHIVAL (CBS, EVENING NEWS, 3-6-18):
JEFF GLOR: America’s opioid crisis.

ARCHIVAL (CBS, WEEKEND NEWS):
ANCHOR: The opioid epidemic is getting worse.

NARRATION: At at time when 6 Americans are dying every hour from opioid overdoses…

ARCHIVAL (WPXI TV, STOPPING NARCAN DEATH, 6-29-19):
ANCHOR: They were dealing with a heroin overdose.

NARRATION: Do we need a new approach? Researchers, like Gary Matyas at the Walter Reed Army Institute of Research, think we do.

GARY MATYAS, Ph.D. (WALTER REED ARMY INSTITUTE OF RESEARCH): We’re working on a heroin/ HIV vaccine.

NARRATION: In animal studies, the vaccine blocks heroin’s effects by keeping it – and many other opioids – from reaching the brain.

GARY MATYAS: This mouse, the heroin went into the brain, it made it run around like crazy. Whereas the vaccinated mouse, behaved basically normally. This tells me that the vaccine worked.

NARRATION: The idea of a vaccine also represents an emerging shift in the way addiction is understood.

THOMAS MCLELLAN, Ph.D. (FORMER DEPUTY DIRECTOR, OFFICE OF NATIONAL DRUG CONTROL POLICY): Addicted people have been considered poor character, bad personalities, liars, cheats, bad moral upbringing.

NARRATION: Former deputy White House drug czar Thomas McLellan says that for years, punishment…

ARCHIVAL (ABC NEWS, 11-19-91):
REPORTER: Mandatory minimum laws, sometimes up to life in prison.

NARRATION: …and abstinence…

ARCHIVAL (ANTI DRUG COMMERCIAL):
FORMER FIRST LADY NANCY REAGAN: When it comes to drugs and alcohol, just say no.

NARRATION:…were considered the best ways to prevent drug abuse. And reforming an addict’s personality, the best form of therapy.

THOMAS MCLELLAN: They developed residential programs where that really was the nature of the treatment: character reformation. Bring that character down, and rebuild it.

NARRATION: But it turns out, for many people, these programs don’t work.

THOMAS MCLELLAN: 50 percent will relapse within six months, and most of those will relapse within 90 days.

NARRATION: Brain research published over the past decade or so has begun to explain why.

THOMAS MCLELLAN: Addiction is best considered a chronic illness of the brain.

ARCHIVAL (ANTI DRUG COMMERCIAL):
This is drugs…

THOMAS MCLELLAN: And it’s not just like the old commercials.

ARCHIVAL (ANTI DRUG COMMERCIAL):
This is your brain on drugs.

THOMAS MC LELLAN: The use of drugs gradually erode motivation, inhibition, reward sensitivity, and stress tolerance in your brain. If you take someone whose brain has been changed by drugs,“Just say no,” is perfectly ridiculous.

ARCHIVAL (ABC, NIGHTLINE 8-23-17):
REPORTER: There is a true epidemic sweeping America…striking without warning.

THOMAS MCLELLAN: People ask me all the time, “Why don’t we have medications to treat addiction?” Well, the truth is we do have medications, and many have been around for quite a long while.

ARCHIVAL (ABC, 6-3-71):
BILL GILL: Methadone, a bitter, inexpensive, synthetic drug.

NARRATION: Like methadone, a daily dose opioid that doesn’t produce the high.

NURSE: Vivitrol is the new drug that we’re using.

NARRATION: Or Vivitrol, a monthly shot that blocks heroin’s effects.

NURSE (GIVING AN INJECTION OF VIVITROL): This is going to sting.

NARRATION: Without these medications, the vast majority of opioid addicts will relapse.

Thomas McLellen says that combined with long term support and monitoring, medication doubles an addict’s chances of staying clean. But only about a third of treatment programs use this approach.

THOMAS MC LELLAN: It’s been thought that medications are simply a crutch. You’ll hear over and over, “They’re just a substitution for another drug.” They don’t believe in them. They don’t see the need.

NARRATION: And he compares the stigma around addiction treatment today to an epidemic from the early 20th century – Tuberculosis.

THOMAS MCLELLAN: Tuberculosis was not thought to be a medical illness. It was thought to be a lifestyle.

ARCHIVAL (STREAMLINE):
NEWS REEL: Poverty, and ignorance contribute to the spread of tuberculosis.

THOMAS MCLELLAN: Policy makers realized they had to do something. We’ll make a system of sanitaria and put them someplace way the hell out of town, away from us.

NARRATION: But tuberculosis is caused by a bacteria.

THOMAS MC LELLAN: The research was clear. TB was actually a pathogen.

NARRATION: By the late 1940’s scientists had discovered both drugs and a vaccine that worked.

ARCHIVAL (PATHE NEWSREEL):
After penicillin, streptomycin, science’s latest weapon against some forms of tuberculosis.

NARRATION: But they were not widely adopted for years.

THOMAS MC LELLAN: Because of political and financing and stigma issues, we didn’t implement evidence-based treatment for tuberculosis even though we could have.

NARRATION: When it comes to drug use, despite mounting evidence that it’s a chronic disease, some officials still believe in “just say no.”

ARCHIVAL (NBC NEWS, 3-15-17):
JEFF SESSIONS (U.S. ATTORNEY GENERAL): Just say no. Don’t do it.

NARRATION: But the latest opioid crisis …is starting to change some minds.

ARCHIVAL (NATIONAL GOVERNORS ASSOCIATION, 2-24-18):
ALEX AZAR (HEALTH AND HUMAN SERVICES SECRETARY): They need medicine to regain the dignity that comes with being in control of their lives. Having just one-third of treatment programs offer the most effective intervention for opioid addiction is simply unacceptable.

THOMAS MCLELLAN: Brain disease lasts for a long time. But it can be managed in the same way other chronic illnesses are managed. This is not a lost cause.

NARRATION: Gary Matyas is hoping his vaccine, which has been licensed to a drug company, will be a new tool for managing addiction.

GARY MATYAS: We want to test it in humans to see what happens.

NARRATION: If it works, addicts would be vaccinated after they detox – when they are at highest risk of death from an overdose.

GARY MATYAS: It would be part of their therapy for recovering. So, if they mess up and take a dose of heroin, the heroin won’t work.

(END)