Distinguished panel discusses advancements in understanding alcoholism

What has changed since Bill W and Dr. Bob met each other, and began their program in 1935?

Some of the most distinguished leaders in the field of addiction were on stage sharing their expertise at the Illusion Theater on February 10 following a performance of Bill W. and Dr. Bob. Carol Falkowski, Minnesota’s longstanding drug abuse expert and Drug Abuse Strategy Officer of the Minnesota Department of Human Services, moderated the panel.

When it comes to addiction, much has changed since 1935.  Alcoholism is now recognized as a chronic disease with behavioral components. Through research, we have learned about the nature and strength of the genetic and environmental contributors to addiction. There are new medications that work effectively to stem the craving for alcohol, and there are many more options for the effective treatment for alcoholics and addicts.

John Curtiss, Director of The Retreat, a supervised living facility for recovery in Wayzata, reminded us this is where the Minnesota Model began. A model that instead of putting alcoholics in a sanatorium, or treating them as schizophrenics, treats alcoholics with respect and dignity in a therapeutic community. Hazelden began in 1949, stemming, in part, from a similar approach at Wilmar State Hospital that introduced patients to the principles of AA.  In 1935, there was not the hope for recovery from alcoholism that there is now. He referred to the moment in the play when Bill W and Dr. Bob met, how that moment is replayed by hundreds of thousands of members of AA who have experienced that connection (“fellowship”) which has been the significant factor in keeping them sober.

Dr. Mark Willenbring, former Director of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Washington, D.C., reported even though we have made huge advances in our understanding of alcoholism and addiction less than 5 percent of the people who ask for treatment receive treatment. Here and nationally only one in eight seeks treatment at all. He urged people to speak up in support of the basic science and research conducted by the National Institutes of Health, the umbrella agency of both NIAAA and the National Institute on Drug Abuse (NIDA).

These agencies in the United States support research that advances our understanding about the disease. Yet this research needs support and it needs people to speak up -- he compared it to the funding for research for diabetes, if there is the danger of diabetes funding getting cut, thousands of  people will call and urge to keep this research funded, with alcoholism, because of the anonymity, this simply does not happen.

He also emphasized that AA is “not treatment,” and also not for everyone. He said only about of a third of his patients are interested in AA at all.

Mark Mishek CEO and President of Hazelden Foundation underscored the importance of recognizing addiction as a disease, a major difference between now and 1935.

Carol Ackley, President and CEO of the River Ridge Treatment Center, spoke about how much we are learning about the chemistry of the brain.  We are now able to see the molecular changes in the brain that increase an individual's risk when exposed to chemicals. We now have new medications that can help some people. She also described how we now have treatment strategies that speak to women, after reminding us that most of the research about alcoholism until the 1970s had been done with men. She noted, "Women are different from men. Women's brains are different from men’s brains.” Accordingly, the pathways to recovery for women and men vary as well.

Ackley also encouraged the community to talk -- to deliberately move past the tradition of anonymity. “Now it's time to talk louder, sharing our experience, strength, and hope. Those of us who can talk loudly must speak out for those who can't."

Peter Hayden, Co-Founder and President of Turning Point, a community health agency dedicated to culturally competent care for those with chemical health issues, echoed Ackley’s call to find different treatment strategies not just for the differences between men and women but also for different cultural groups “everyone cannot be treated the same."

Looking ahead to what will assist a patient in 10 years, Dr. Gavin Bart, who is in the Division of Addiction Medicine at Hennepin County Medical Center, sees a promising future where “we will be able to prescribe anti-craving drugs, we will be able to see when a patient is genetically predisposed to becoming an alcoholic and then be able to offer a broader variety of treatment choices for individuals including medication-assisted treatment, peer support, and behavioral interventions.”

Falkowski ended the evening by noting that addiction is a complex illness and challenging to treat. She noted how fortunate we are in Minnesota to have the depth of expertise represented by the panelists, each of whom bring to the dialogue a unique and valued perspective.