Residency programs give boost to addiction medicine
NEW YORK - There is an age-old debate over alcoholism: Is the problem in the sufferer’s head or is it a physical disease, one that needs continuing medical treatment in much the same way as ailments such as diabetes or epilepsy?
Increasingly, the medical establishment is putting its weight behind the latter diagnosis. In the latest evidence, 10 medical schools, including Boston University Medical Center, have just introduced the first accredited residency programs in addiction medicine, in which doctors who have completed medical school and a primary residency will spend a year studying the relationship between addiction and brain chemistry.
“This is a first step toward bringing recognition, respectability, and rigor to addiction medicine,’’ said David Withers, who oversees the new residency program at the Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, Pa.
The goal of the residency programs, which started July 1 with 20 students at the various schools, is to establish addiction medicine as a standard specialty along the lines of pediatrics, oncology, or dermatology. The residents will treat patients with a range of addictions and study the brain chemistry involved as well as the role of heredity.
The rethinking of addiction began about 15 years ago, when researchers discovered through high-resonance imaging that drug addiction resulted in actual physical changes to the brain.
Armed with that understanding, “the management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension, or diabetes,’’ said Dr. Daniel Alford, who oversees the program at Boston University Medical Center. “It’s hard necessarily to cure people, but you can certainly manage the problem to the point where they are able to function’’ through a combination of pharmaceuticals and therapy.
Central to the understanding of addiction as a physical ailment is the belief that treatment must be continuing in order to avoid relapse. Just as no one expects a diabetes patient to be cured after six weeks of healthy diet and insulin management, Alford said, it is unrealistic to expect most drug addicts to be cured after 28 days in a detox facility.