Progressive treatment helps solve addiction

Americans have long enjoyed a fickle relationship with drugs. Addictive medications and "recreational" drugs are touted by some and despised by others.

People who abuse drugs face complications, whether legal, economic, social or medical. Addicts are stigmatized as antisocial, immoral and weak, with little regard for the law.

In Agoura Hills, Akikur Reza Mohammad, MD, an assistant clinical professor of psychiatry and behavioral sciences at USC, is working to change stereotypes about addiction.

"There is no cure for addiction, just treatment," according to Mohammad, a certified addiction medicine specialist.

Mohammad centers his outpatient treatment regimen on the belief that addiction is a brain disease, a chronic medical illness.

"Someone who is genetically predisposed to develop diabetes and eats an unhealthy diet will become a diabetic," he said.

"The same is true for drug addicts. If they have the genes that make them prone to addiction and start drinking, they will become an alcoholic. Addiction is determined by both genetic and environmental components," and knowledge of the family's medical history can be a powerful tool in preventing substance abuse.

People from families with a pattern of addiction should avoid alcohol and narcotics, but for most patients, Mohammad said, the seeds of addiction grow from mental illnesses such as depression and bipolar or attention-deficit hyperactivity disorders.

While he prefers that people avoid addiction through awareness, he is working on an effective treatment for those already in the grip of drug abuse.

Differing from most 12-step programs, his approach encourages addicts to change their habits but also addresses underlying causes, or co-occurring disorders.

"Patients need a psychiatric assessment to check for problems other than addiction," Mohammad said. "Both complications need to be treated at the same time to prevent an exacerbation of problems.

"Many people use substances in an attempt to self-medicate but end up harming themselves and invariably affecting friends, family members and loved ones," he said.

Treating drug disorders with drugs may appear paradoxical, but Mohammad is convinced that treatments focused on behavioral modification only address symptoms. He believes that failure to treat underlying mental disorders leads to the high degree of recidivism reported by most rehabilitation centers.

"Unfortunately," Mohammad said, "marketing is involved with addiction treatment and this often comes at the expense of the patients."

He said he does not hoodwink patients into believing that his method is a cure-all, but reinforces the concept that recovery from addiction is a lifelong process.

"If a diabetic stops taking insulin, they will develop complications," Mohammad said. "If an addict stops his treatment, which includes medication and behavioral changes, he will return to using drugs."

Addiction is not merely the byproduct of a weak will, Mohammad said, and more people should seek medical treatment for drug dependency.

Using drugs such as suboxone, which is effective against opiate dependency, he weans patients off other substances before addressing underlying psychological problems and attempting behavior modification.

Specifically designed to treat opiate addiction, suboxone, unlike methadone, affects only a small number of opiate receptors in the brain, preventing the patient from developing a tolerance to the medication. Methadone treatment can result in a patient's needing progressively higher dosages to maintain the desired effect.

"Outpatient detox requires the patient to be medically stable with proper social support," Mohammad said. He usually refers people who don't qualify for outpatient treatment to Malibu Horizon, the rehabilitation center he founded and directs in Malibu.