Present at the Future by Ira Flatow Read Free Book Online

trained well enough to see evidence that might be right in front of them.
    “In fact drug and alcohol addiction are among the largest, most prevalent problems that we have; they present a major public healthproblem in addition to an individual and family problem. And at almost every health care setting, whether it’s a physical health care setting or mental health care setting, patients present themselves for other types of disorders and they also have a co-occurring substance use disorder.” This presents an opportunity for physicians and nurses to actually engage and screen patients. Are they using alcohol or drugs in a harmful way? Have they already become addicted or dependent on these substances? “A doctor can actually catch a patient, where something is moving forward into becoming a major abuse or dependence problem, and can help by educating a patient and referring them to treatment, to intervening earlier on in the course of the disease process. Of course, in every area of medicine, what we try to do is intervene as early as possible. But often doctors and nurses haven’t had adequate clinical training to screen and diagnose and to understand what the treatment processes are.”
    In many cases, says Volkow, doctors in emergency departments are afraid to ask patients if they are addicted to drugs. “Why don’t they ask the question? Because drug addicts are stigmatized and doctors feel uncomfortable asking the patients do they drink, do they take cocaine. And they don’t even know how to ask that question sometimes—and certainly they don’t recognize it.” And even if they do know to ask the right questions, they may not know how to follow them up. “Unfortunately, there is no parity for the treatment of drug addiction. So as a result of that, many medical insurances will not cover the cost of doing an evaluation for drug addiction and proper referral. A patient that is addicted when they have a job or they are referred by their physician is very different from the situation of a person that is homeless, that doesn’t have a job, that doesn’t have a family, that ends up in the emergency room, and you are actually hand-tied in terms of what you can offer.”
    And many times, people with addiction problems may never show up in a physician’s office or emergency department. Though they appear in countless television and film plots, the people whocontinually show up in clinics for treatment represent just the tip of the iceberg, says Greenfield. “In fact, the vast majority of folks who have substance abuse disorder problems, many are working every day. They are taking care of various kinds of responsibilities out in the world, and they are actually having problems with addiction. Sometimes those things manifest themselves at home rather than at work. Sometimes they may not show up in an emergency room, but they may show up, maybe, in a mental health care clinic or a physical health care clinic.
    “So this is not just in the emergency room with someone who’s coming in acutely, multiple times, but it’s much more generalizable to all sorts of health care settings where we, as medical professionals, can do a much, much, much better job at diagnosing early and referring for treatment many, many individuals who could actually benefit from all the available treatments that do exist and are actually effective.”
    “THIS IS YOUR BRAIN ON DRUGS…”
    Remember that commercial? Really an anticommercial, about the dangers of drugs? The frying pan, the burned egg? It sent a clear message that addiction is not just a bad habit but is also a complex chemical interaction in your brain. And one of the breakthroughs in the addiction field was the realization, says Dr. Rob Malenka, professor in psychiatry and behavioral sciences at Stanford University, that whether it’s nicotine or alcohol or cocaine or heroin, they all work on the brain’s reward circuitry.
    “Through evolution, the brain has evolved to tell