Chantelle works as a trouble-shooter at a Salt Lake City software
company. Attractive and stylishly dressed, the 32-year-old looks
every bit the successful career woman as she sips coffee in a downtown
Starbucks and tells her story. She’s a former prescription
painkiller and heroin addict whose nine-year free fall into drugs
cost Chantelle her children, ended her marriage, and left her living
in a junkyard sharing needles with other users.
Clean for three years, Chantelle believes the root of her addiction
lurks in her genes. “I was born addictive,” she says.
“It runs in my family.”
Medical research indicates she may be right: as scientists learn
more about chemical addiction, many believe the disease is genetically
based. For those who carry the genes, all it takes is the first
drink, or cigarette, or line of cocaine, and chances are, like Chantelle,
they’ll become addicted.
Research into genetics, pharmacology, neuroscience, and other areas
is providing new insight into how addiction affects the brain and
which genes may predispose people to the disease. Eventually, this
research may produce new drugs and therapies for addiction.
as medical researchers gain new understanding of addiction as a
disease, the social perception of those who are addicted remains
clouded in ignorance. Many people still hold the long-standing belief
that addicts are weak-willed, morally defective people who choose
to live the way they do.
That misapprehension is based on a lack of knowledge, says Barbara
Hardy MSW’83 PhD’01, associate director of the Utah
Addiction Center. Addiction has many contributing factors—biological,
environmental, psychological, and social—and if people knew
more about it, they’d view the disease differently, according
“More than anything it’s a lack of understanding that
addiction is a chronic, relapsing disease,” she says. “We
need people to make the shift from thinking, ‘These are bad
people,’ to thinking, ‘These are people who need help.’”
The Utah Addiction Center was established to facilitate that shift
in thinking. The center, located in Research Park, was founded three
years ago under the aegis of A. Lorris Betz, the U’s senior
vice president for health sciences. The center’s mission is
to promote the understanding of chemical addiction by addressing
the issue on three major fronts: fostering research to find better
ways to treat and, one day, perhaps, prevent addiction; providing
clinical training so doctors and other professionals can recognize
and help addicted patients; educating the health-care community
and public about addiction.
If the stigma of addiction stems from a lack of knowledge, the only
way to address that is through education. To that end, the center
sponsored a “Recovery Day” in September to bring the
issue into the open and to show that addicts are people “just
like you and me,” Hardy says. About 400 people attended the
event at the Gallivan Center in downtown Salt Lake City, and Hardy
is already planning another Recovery Day, along with other community
programs and initiatives, to begin reshaping perceptions of addiction.
Unfortunately, the lack of understanding surrounding addiction extends
beyond the general public to those in health care, according to
Hardy. It’s estimated that one person in 10 has a substance
abuse problem, yet the U.S. medical education system doesn'train
physicians to recognize the signs. If they could see the symptoms
early, doctors could refer addicts to the appropriate help and lessen,
perhaps substantially, the financial and social tolls of the disease.
For example, a patient may repeatedly see a doctor for stomach problems
that are diagnosed as an ulcer. But the underlying cause of the
ulcer may be alcoholism, and if the doctor recognizes that, he or
she can get the patient help. Many home and car accidents, assaults,
and incidents of child abuse have a chemical addiction component
that goes undiagnosed, too, according to Hardy.
As a first step to fill that educational void, the Utah Addiction
Center is joining with the U’s medical school to start a pilot
residency program to formally train new doctors to recognize the
signs of chemical addiction. The program, funded with the help of
a $50,000 grant from the Callister Foundation (See “And
Finally...”), begins in July for residents in the fields
of pediatrics, internal medicine, obstetrics and gynecology, and
family and preventive medicine.
While educating the public and training doctors can have an impact
in a relatively short time, research offers the most fundamental
level of impact.
center is committed to expanding research in genetics, pharmacology,
neuroscience, and the behavioral and social sciences, Hardy says.
The center’s role entails everything from writing research
grant proposals to initiating joint ventures among different groups
researching addiction. The center, in time, may hire its own researchers,
but Hardy doesn't anticipate ever having a large staff. She wants
to build on the considerable resources available at the U’s
Health Sciences Center. University scientists are already researching
addiction in numerous ways, including two of the most promising
areas—pharmacology and genetics.
Pharmacology researchers are learning that neurobiological factors
of addiction compromise the brain’s ability to function in
key areas, such as decision-making and compulsive behavior, says
Glen R. Hanson PhD’78, professor of pharmacology and toxicology
at the U. “We believe addiction is a brain disease,”
says Hanson, who is just finishing a two year stint as interim director
of the National Institute on Drug Abuse, National Institutes of
Health, in Washington, D.C., and plans to return to the U this spring.
Stress appears to play a role in addiction by releasing chemicals
in the brain. Smokers, for example, often increase their nicotine
intake when they’re under stress, so researchers are looking
for drugs that block stress and its consequences. Some antidepressants,
such as buproprion (Zyban), can be effective treatments, and Hanson
believes it’s possible that within 10 years more medications
may be available to help addicts. But Hanson doubts there will ever
be a pill that will eliminate addiction entirely, the way antibiotics
stop infection. Drugs will have to be accompanied with behavior
modification therapy, he says.
Hanson believes genetics plays a large role in addiction, with up
to 60 percent of the propensity to become addicted having a genetic
root. In alcoholism, that percentage may be even higher, while with
heroin it might be a little lower. This doesn't mean people are
predetermined to become addicted, says Hanson, but it increases
the odds when they’re exposed to certain environments.
The genetic component of addiction, particularly in nicotine, is
the focus of a five-year, $11 million grant U researchers just received
from the National Institutes of Health. The researchers, from the
School of Medicine and
Eccles Institute of Human Genetics, are pursuing the hypothesis
that nicotine addicts have a receptor gene in their brains that
predisposes them to addiction and the physical consequences of smoking.
These receptors, the researchers theorize, are critical in determining
susceptibility to Chronic Obstructive Pulmonary Disease(COPD), one
of the most devastating consequences of smoking cigarettes for long
Although smoking doesn'typically cause the same sort of behavior
as other chemical addictions, the consequences of it are staggering.
An estimated 50 million Americans smoke, with 450,000 deaths annually
attributed to cigarettes, according to John Hoidal, professor and
interim chair of the medical school’s internal medicine department
and principal investigator of the study. (Raymond Gesteland, the
U’s vice president for research, is co-principal investigator.)
Smoking is also a tremendous drain on the economy, costing nearly
$100 billion a year in medical expenses and lost productivity.
Data show a strong genetic component in COPD, emphysema, and even
atherosclerosis, a vascular disease that is the leading cause of
smoking-related deaths, according to Hoidal. The risk of developing
illnesses caused by smoking seems to cluster in some families, and
the study will examine genetic causes of addiction in both people
And, according to Hoidal, whose medical specialty is the lungs and
their related systems, the study may provide information on the
broader field of addiction. “The hope is it will have wider
implications,” he says.
For Chantelle and other addicts, research that zeroes in on the
roots of addiction cannot come fast enough. Chantelle started using
painkillers to escape an unhappy marriage and, in the depths of
her drug abuse, exhibited every form of bad judgment possible. She
stole painkillers meant for her husband’s 90- year-old grandmother
who was slowly dying. She convinced her dentist to perform root
canals on healthy teeth so she could get Percoset, a prescription
painkiller. She even made one-day trips to Tijuana and back to Salt
Lake City to obtain a pain reliever not legal in the United States.
Finally, her addiction led to heroin and a life on the street that
endangered her in many ways.
Her husband took their children and filed for divorce. After a number
of attempts to get clean through various programs, Chantelle, with
the help of drug counselors and therapists, finally found the way
three years ago, and today takes life day to day. She has re-established
contact with her children, who now live in Florida with their father
and his new wife, and speaks with them daily.
Despite all that happened, Chantelle was lucky in a couple of ways.
Her parents and siblings—a close Mormon family—never
deserted Chantelle, and today she has good relations with them,
although she no longer practices the LDS religion. And, in what
may be just pure luck, even after sharing needles with strangers,
Chantelle did not contract HIV or hepatitis C.
Not a day passes when Chantelle doesn'think of her bout with addiction
and how the disease ruled her life. That’s fine with her—some
things should not be forgotten.
“I don’t want to forget it,” she says. “I
have to remember what happened.”
—Phil Sahm BS’78 is a writer in the
Office of Public Affairs for the Health Sciences Center.
Utah Addiction Center 801-581-8216 www.uuhsc.utah.edu/uac