The Behavior and Biology of Addiction
A panel discussion of addiction as chronic illness with genetic, environmental, and social aspects. The discussion explores how an improved understanding of both the behavior and biology of addiction can help to guide efforts toward prevention and treatment. Recorded live at The Jackson Laboratory in Bar Harbor, Maine.
The Jackson Laboratory hosts community discussion about opioid addiction.
Last month, more than 150 people gathered at The Jackson Laboratory (JAX) in Bar Harbor, Maine for a community discussion about addiction, specifically the opioid epidemic. “The Behavior and Biology of Addiction” program focused on treating addiction as a chronic illness with genetic, environmental and social aspects, and sharing the latest efforts toward prevention, treatment, and law enforcement initiatives.
Panelists included Daniel Johnson, Ph.D., LCPS, CCS, Executive Director of the Acadia Family Center; Elissa Chesler, Ph.D., Associate Professor at JAX; Sheriff Scott Kane of the Hancock County Sheriff’s Office; and Jonathan Fellers, M.D., of Maine Medical Center. Chuck Hewett, executive vice president and COO of JAX moderated the discussion.
Opioid addiction is a nationwide concern, and the intensity of this epidemic is increasing both in Maine and around the country. Kane reported that this year, Maine has lost 286 people to opioid overdoses — a number that already exceeds last year’s total.
“Those are just the cases law enforcement is involved in," Kane said. "We have a lot of work to do.”
Speaking to the complicated nature of this epidemic, Fellers asserted that addiction is a chronic disease, and one that, despite having effective treatments, has a high mortality rate.
“Longitudinal studies where the first contact with patients was at age 22 found that, by age 30, half of the participants had died," said Fellers. "It’s a very hard illness with genetic, psychosocial aspects that play a major role. I want clinicians to treat this as a chronic disease just like they do diabetes or hypertension. We can’t stigmatize this as a moral failure.”
Chesler, who studies addiction using mice models, echoed the importance of not blaming people struggling with addiction, and encouraged attendees to focus on helping them get treatment and services.
“When I look at my research, I know that there are no ‘bad ones’ in there, and I think that’s really important," Chesler said. "We have to look at the factors that make individuals go down that path, like their underlying biology and differences including stress and social networks. Understanding that can help toward de-stigmatizing addiction and change the focus to getting the assistance needed to recover.”
Chesler continued: “Take cancer as an example — you wouldn’t give someone a certificate and send them on their way after one cancer-free screening — you examine them regularly. But that’s not what we do with addiction today.”
Kane echoed her concern.
“Unfortunately, our jail is the largest detox center in Hancock county — stop to think about that," he said. "Law enforcement has become the catcher’s mitt. We don’t have counseling or services to identify the root of what’s causing people pain and why they’re using. I’m a police officer and that’s above what I’m trained to do, but I’m doing everything I can to help people get the services they need, and really treat them like people.”
“From my perspective,” Kane said, “I know they don’t belong in jail, and we’re scurrying to find resources, because I really believe if someone comes to us and we can’t help them, we may never get the chance again and they can become a statistic.”
The need to develop robust treatment and counseling programs, especially in conjunction with law enforcement, was a theme throughout the night. A program in Gloucester, Massachusetts, for example, was heralded as a great example. The Angel Program encourages people with addiction issues to come to the police station to ask for help. Rather than be arrested for drug-related charges or jailed, officers help guide participants to “Angels” at a local hospital, and they are immediately connected to the care and treatment they need.
Kane and his team are working on a similar initiative called Project Hope but, as he noted, “the difference is that healthcare covers this in Massachusetts — not here.”
“If we could develop a model to offer treatment in jail so people could start their recovery and come out without cravings, we’d be ahead of the game,” Fellers asserted. “But we don’t have the resources. Treatment works for people with opioid addiction, but we don’t have enough options. We spend $700 billion on addiction but only a small percentage of that on treatment… it’s penny-wise and pound-foolish. We simply can’t arrest our way out of this problem.”
Johnson, who has spent the last 30 years in addiction services, is as committed to his work as ever. “There are resources in Maine — like 211 which is a state-run directory of community services — and there are good, effective models for us to learn from like Vermont’s hub and spokes program. We need to help our primary care doctors get more involved in care and solutions.”
“It’s miraculous and amazing to see people who succeed and get everything back to lead wonderful lives, Fellers said. "There’s a lot of hope in that.”
Hewett closed the panel discussion on a positive note.
“This is a disease. It can be treated, but not easily or casually or without commitment," he said. "We need to combine treatment with love, compassion and acceptance, and create connections with each other.”