Tuesday, March 13, 2007

HBO Addiction Project Launched

In a recent post, I mentioned the fact that HBO, in partnership with the Robert Wood Johnson Foundation, the National Institute of Drug Abuse, and the National Institute on Alcohol and Alcohol Abuse, is beginning a comprehensive effort---The Addiction Project---to bring addiction to the fore of the American mind. The main thesis of the project is that addiction is a preventable, treatable, chronic brain disease with identifiable patterns of remission and relapse. That project launches in earnest this Thursday, March 15th at 9pm, with the initial airing of the 90-minute centerpiece film, followed by subsequent airings as well as 14 additional short films targeting specific aspects of addiction.

This project is a "multi-platform" undertaking involving cable television, the HBO website, podcasts, a DVD, a companion book, four independent documentaries on HBO2, and a 30-city community outreach program reaching across the country. You can access Robert Wood Johnson's site dedicated to the project here. The HBO Addiction Project website is designed to respond to the visitor using "dialogue navigation" which utilizes information entered by the user to guide the visitor to specifically targeted information regarding treatment, family support, or other aspects of addiction and its multifactorial effects on life, health, healthcare, and community. HBO will also be making all 15 films available for free on their website once the initial airing has occurred on March 15th. Additionally, the entire series will be offered for free to all cable TV subscribers from March 15th to 18th---regardless of HBO subscription---if your local cable provider is supporting that offer. Community-based events will be organized, including house-parties with local film screenings, utilizing the AddictionAction website as a clearinghouse for tools to assist in organizing, networking and community outreach.

I am privileged to have been sent an advance copy of the four-DVD set and accompanying press kit, and recently sat down to watch the 90-minute centerpiece film. Presented as a number of separate segments, the film uses interviews with national addiction experts, personal stories, and scientific data which all serve to underscore the new science of addiction, its psychosocial and economic impact, and the overall ramifications of addiction for our country as a whole. The film touches upon many subjects, whetting the appetite for more information rather than saturating the viewer with only one point of view.

The segments include "Saturday Night in a Dallas ER" which treats more than 15,000 alcohol- or drug-related injuries per year; "A Mother's Desperation" portraying a mother's attempts to assist her addicted young adult daughter; and, "The Science of Relapse", which provides new scientific evidence for the physiological reasons for relapse based on the latest brain imaging technologies. Other segments illuminate, among other things, treatment with buprenorphine and methadone, adolescent addicts, and insight into a clinical trial of Topiramate for the treatment of alcoholism.

No discussion of addiction and its treatment would be complete without a discussion of the ravages which managed care and the health insurance industry have wreaked upon the treatment of addiction. The filmmakers are keen to point out that 44% of Americans who cannot access substance abuse treatment claim that prohibitive costs or inadequate insurance coverage are the prime factors for that lack of access. A very moving story---"Steamfitters Local Union 638"--portrays how a local New York union has chosen to become self-insured in order to make its own decisions regarding accessibility of healthcare for its members. The union has created a 24-hour hotline for members seeking assistance locating substance abuse treatment, and then provides intensive peer-run aftercare in order to increase the chance of successful recovery. Rather than solely paint a bleak picture of addiction treatment vis-a-vis the insurance industry, the filmmakers chose instead to highlight a small group who has taken responsibility for access to quality healthcare. However, the filmmakers also make it exceedingly clear that families and addicts themselves are taking the fight for addiction treatment to state legislatures and Congress, fueling activism on all sides of the treatment equation.

As a layperson with no real knowledge of filmmaking, I can safely opine that the 90-minute centerpiece film being presented on HBO is of the highest quality, offering insight, hope, scientific fact, heart-wrenching stories, political and economic perspectives, and a place from where a larger national conversation can begin. The scope of the first film is daunting enough, and one could walk away feeling that each individual segment deserved 90 minutes of its own, and that conclusion would not be a misguided one. However, I am sure that the folks at HBO know that in the Information Age, the American attention span is short, and presenting a film made up of easily digestible segments introducing much broader topics is a good way to engender interest and spark desire for further conversation and learning. To that end, it appears that the very richly endowed web-site will provide just the tool for allowing interested parties to further explore the issues at hand.

First, I must pause to praise HBO for even attempting to comprehensively tackle so unpopular a subject as addiction in an era when "American Idol" and other less intellectually stimulating fare dominates the airwaves. Being a premium cable channel, one reality that hits home is that a great number of people most in need of seeing these films may very well be left out of the picture altogether, although it appears that many local cable providers will make HBO available at no cost for the three days of the project's launch. Still, outside of those three days, a woeful number of Americans will not have ready access to such stellar information, and these gaps are where HBO's planned community outreach programs could make a difference. Hopefully, organizations, individuals, schools, businesses, and government agencies will take advantage of this project's scope, bringing this conversation into classrooms, workplaces, and statehouses across the country. This is obviously the aim of the project's organizers and developers, and much credit to them for the valiant effort.

In terms of further challenges, I urge HBO, The Robert Wood Johnson Foundation, and all other parties involved in the project to remember that many languages are spoken in this multicultural society, and that dubbed versions of this film should be made urgently available in as many languages as possible, so that the reach of this project can go deep into the many subcultures and distinct racial and ethnic groups which comprise our country today. Subtitles can be quite useful, but we also do not want to overlook those illiterate segments of the population which also need to hear the addiction message loud and clear. Many first-generation grandparents living in culturally isolated pockets of numerous American cities also need to hear this story so that they too can be recruited into the effort to stem the tide of addiction among the younger, English-speaking, assimilated generations which they are helping to raise. The message is a hopeful one, and will only be more hopeful if these segments of society are appropriately reached.

I have no criticism to offer The Addiction Project at this time, prior even to its public debut. The scope of the undertaking is enormous, and if enough communities and key players within those communities can access this information and actually spur citizens to action, then the project will be an unmitigated success. If HBO and its partners are equal to the task of reaching out to communities of color, the disenfranchised, the uninsured, and the populace at large, while advocating for pressure to be put on managed care companies to increase coverage for addiction treatment, then a great deal of success and broad influence will be assured.

Unfortunately, I am fairly certain that the current Administration on Pennsylvania Avenue in Washington, D.C. will turn a blind eye to this rising movement, even as its embattled military veterans suffer disproportionately from Post-Traumatic Stress Disorder and the addiction which can often result from such trauma. As citizens, it will be up to us to push our legislators for the drafting of legislation to force insurance companies to increase coverage for the treatment of addiction, and only we can hold their feet to enough fires to ensure even a modest change.

Perhaps someday, when universal single-payer healthcare is an accepted fact and an inalienable right of all citizens, our grandchildren will wonder how we ever could deny treatment to those among us suffering from addiction. Perhaps some of these stories presented by HBO and The Addiction Project will be faint memories, with affordable treatments for addiction as ubiquitous as medications for hypertension are today. We can only hope that this will be the case in the future, with addiction relegated to the ranks of other chronic diseases. Until then, an undertaking like The Addiction Project is a crucial and timely one, and we can only hope that its influence will be felt far and wide.


Anonymous said...

The current administration's response to everything healthcare is abstinence. You'd do better by conversing with the proverbial brick wall. Bush has exchanged science for partisanship. However, this work about addiction is important, and the tide will eventually tearn again toward enlightenment, social justice, reason, compassion, tolerance, inclusiveness and sciecne. May the work and the people survive until those days return.

Thanks for writing this, Keith!

Anonymous said...

In terms of alcohol addiction - and speaking as a recovering (recovered?) alcoholic who has not had a drink in seven and a half years - I think that abstinence IS the only solution.

As someone who also works for a mental health charity in the UK I am also deeply sceptical of any pharmaceutical interventions.

Keith, looking at your profile and in the context of your post, I wonder whether you would like to add my novel "Hotel Veronica" to your "pile of books"? You can view a sample chapter at http://www.lulu.com/content/439199
and look it up on Amazon or on my website alfredthomasbooks.com

You can also email me: david@alfrefthomasbooks.com

Keep up the good work!

Anonymous said...

Sorry that's


Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

David, while I agree that abstinence is the best solution, if one accepts that addiction is a brain disease (and not just a failure of will), then one must also accept that there may be individuals who just cannot abstain by will power alone. You are a lucky and strong individual who has succeeded. Others are not so lucky/gifted.

Our President says that abstinence is the best prevention for STDs and unwanted pregnancies. While this may be true in essence, it does not assuage the burgeoning libidos of adolescents which are mostly controlled by powerful surges of hormones. While we would never offer medications to a teenager to decrease their natural sex drive, alcoholics and addicts do sometimes require biochemical assistance in turning off the brain mechanism that keeps them using. This craving mechanism has indeed been identified via brain scans, showing that the brains of addicted individuals do work differently than the non-addicted population.

So, to say that abstinence is the ONLY way suggests that those who cannot abstain are failures. I would beg to differ, offering that those who fail to abstain may have some issues with impulse control, and it is those individuals who we can target for medical treatment to subdue their cravings.

Your ability to be abstinent by will power alone is wonderful---and I have patients who have also done it successfully. Let's also allow that some may simply need that extra push to lay the substance aside.

Anonymous said...

the addiction can be cured by showing some rehab program , the ONLY way is , "Prevention is better than cure"

John Bosco

Addiction treatment and recovery resources for the addict and their families. http://www.addictiontreatment.net

Anonymous said...


Prevention is better than cure. And to do that, addicts have to be helped to develop an aim in life. They need a motive to leave addiction and move on.

Comprehensive resources for those looking for recovery from addiction.