The scientific knowledge we have accumulated will be used to transform the way we treat addiction and how we prevent drug abuse in the first place, or its escalation to addiction.
Genes account for about 50 percent of a person’s risk of becoming addicted, and environmental factors influence the effect of these genes—an area of research called epigenetics. Progress in genetics/ epigenetics research will lead to more refined prevention and treatment interventions targeted to individual risk or to modifiable environmental influences.
Emerging medication targets and treatment approaches will capitalize on our expanded knowledge of underlying neurobiology and brain circuitry involved in addiction. For example, research has revealed new candidate systems (e.g., cannabinoid) that may be promising targets for the development of medications to treat addiction and other disease (e.g., pain). Medications will also be developed to affect systems common to multiple addictions, such as stress-induced relapse, or cognitive remediation. Of critical importance to the development of future addiction therapies is the notion of brain plasticity as a two- edged sword: the same malleability that can bring about deleterious brain changes also holds promise for effective and enduring treatments.
Immunotherapy (e.g., “vaccines”), will be available to sustain abstinence, even prevent addiction. Studies are underway to develop or improve vaccines that use antibodies to bind the drug while it is still in the bloodstream, preventing it from entering the brain. A vaccine for nicotine addiction is already in advanced efficacy trials, having garnered significant improvement in smoking cessation rates and continuous long-term smoking abstinence.
Pharmacogenomics—or understanding how variations in an individual’s genome affect his or her response to a medication—will advance sufficiently to allow physicians to individualize patient treatment for maximum efficacy and minimal adverse effects.
The Mental Health Parity and Addiction Equity Act of 2008, along with increased accessibility to insurance coverage provided by the Affordable Care Act, will expand access to substance abuse treatment and improve delivery of integrated healthcare for addiction and its health consequences. This will require well-trained substance abuse treatment providers and seamless integration with the mainstream healthcare system.
Primary care physicians and other healthcare professionals will routinely screen their patients for substance abuse and help prevent its escalation to addiction. By Identifying substance abusers—already over represented in the patient population—physicians can provide better and more comprehensive patient care that will improve outcomes for many medical conditions where substance abuse is already present.
Early and appropriate substance use intervention will also alleviate the significant societal costs of drug abuse and addiction, currently estimated at about $600 billion a year.
Material Posted above is Courtesy of National Institute of Drug Abuse
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