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The Future of Addiction Science and Treatment


Dr. Petros Levounis, M.D., M.A., is one of the leading authorities on the science of addiction. He’s published 11 books (most on the subject of addiction), is the current president of the American Psychiatric Association, and serves as professor and chair of the Department of Psychiatry at Rutgers New Jersey Medical School.

We talked to him about what we’ve learned about addiction in recent years, and how those findings can help people get on the road to recovery.

Dr. Petros Levounis, M.D., M.A.

President, American Psychiatric Association

Treatment works and people get better. In 2023, we have more tools than ever before.

Why has the rate of addiction increased in the past few years?

The most recent data (April 2023) on deaths due to opioids has shown that, if anything, there is a bit of a decrease in mortality. So, this is good news, of course, but we remain cautiously optimistic about the opioid epidemic. Tremendous efforts have been made in terms of opioid treatment, and more specifically, medications for opioid use disorder, but there is still a lot of work to be done.

Also, during the pandemic, people with problematic drinking — but not quite the severe form of the illness — showed a decrease in their alcohol consumption. We understand that perhaps this was due to decreased socialization opportunities. At the same time, however, people who live with the severe form of alcohol use disorder saw a significant increase in their alcohol consumption. And of course, we’re very, very concerned about that.

What are some of the key indicators of addiction you can look for in yourself or a loved one?

Keep an eye open for noticeable changes in yourself or your loved one. Are you noticing a change in performance at school or work? Are you or your loved one falling behind in responsibilities across the board? Is there a lack of enjoyment in the hobbies or activities they loved in the past? Have you noticed a change in sleep patterns?

A person living with an addiction to a particular substance or behavior often starts thinking about and craving for it 24/7. They spend tremendous amounts of time trying to obtain the drug, using the drug, coming down from the drug, and starting the process all over again.

What are some good strategies for starting and having a conversation about addiction with a loved one?

For someone living with a substance or behavioral addiction, there is often a discrepancy between where they are in life and where they would like to be. Sometimes this discrepancy can become evident in a simple discussion about everyday life. What are they struggling with or missing out on?

One important point I should make: Even though families and loved ones can understandably get frustrated with someone who is living with addiction, it is almost never a good idea to use “tough love” interventions with someone unless you have the guidance of a professional. Such confrontational approaches typically cause much more harm than good.

Another thing we often hear is that if the person doesn’t want to help themselves, there’s not very much that can be done. In 2023, we have techniques and approaches to help these people, even if they don’t want to come to our office. It often starts with their families or loved ones. We can teach them motivational techniques to use at home and move the person toward a stage of thinking about making changes or taking that first step toward getting help.

What is something people may not know about the science of addiction?

Once a person gets addicted to a particular substance or behavior, there are changes that happen in the brain that remain for a long time, if not for the rest of the person’s life. That does not mean that people will not recover. In fact, most people who at some point in their lives meet the criteria for an addiction will end up beating the disorder. However, the vulnerability to go back to the “using stage” can last for a long time if not for their entire life.

Is there a common myth about addiction that isn’t actually true?

Yes — and it all starts with the phrase “it’s all about.” People often think addiction is all about one particular thing like genetics, environment, adverse childhood experiences, lack of self-control or willpower, lack of faith, lack of love, or even untreated psychiatric disorders. The reality is that the reason for a person’s addiction is very often a combination of things. This is the most widespread myth about addiction, and perhaps the most dangerous one in terms of getting people better.

Bottom line?

Treatment works and people get better. In 2023, we have more tools than ever before. We have safe and effective medications for tobacco, opioids, and alcohol use disorders; advanced psychotherapies for all addiction; and powerful 12-step programs that help people live healthy lives.

So, the bottom line is that if you are concerned about yourself or a loved one, have a talk with them and seek the help of a professional. It could be a psychiatrist, a primary care physician, or someone you trust. Have the conversation and open the door to recovery.

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