Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

___________________________________________

Thursday, March 15, 2007

San Francisco Chronicle
TV REVIEW - Addiction

HBO's latest will keep you glued to the TV

Wednesday, March 14, 2007




Addiction: Documentary. Nine segments by individual directors. 9 p.m. Thursday, HBO. Repeat broadcasts through March 27 on HBO and HBO2. For information and resources on addiction, visit www.hbo.com.


The first segment of HBO's anchor documentary, "Addiction," reminds you of those films they used to show you in high school. You are in an emergency room in Dallas and doctors are working on someone whose arm has been sliced open. The gore is supposed to scare you, and, for a second, it's just like "CSI," realistic but, still, not real.

On Thursday, HBO launches an extraordinary multimedia project on addiction with the 90-minute film. Yes, it targets addiction for what it does to the lives of those who can't help themselves and for what it does to the lives who can't help loving them. But part of what makes the project so important and compelling is that the nine films that make up "Addiction" collectively target the various mythologies of addiction that perpetuate and exacerbate the problem.

The facts of America's addiction problems are shocking, yet we've heard many of the numbers before, or ones like them: One-tenth of all Americans older than 12 have substance abuse problems; alcohol and drug abuse costs the American economy $366 billion annually; 1 out of 4 Americans has a family member struggling with addiction.

Those numbers are sprinkled among the nine films by directors such as Barbara Kopple ("Harlan County, USA"), Albert Maysles ("Grey Gardens") and D.A. Pennebaker and Chris Hegedus ("The War Room"). But the individual short films tell even more indelible stories beyond the numbers. We watch a guy die in the Dallas ER, the victim of a drunken-motorcycling accident, while a doctor tells us that about half of all trauma cases relate to substance abuse.

After the man dies, his body disappears beneath a mound of bloodied towels and he's wheeled away like a pile of laundry while the doctor offers another probability: that the guy left his house in the morning and set out on his activities, not even considering the remotest possibility that the day would be his last.

In "A Mother's Desperation," by Maysles and Susan Froemke, a woman makes the painful choice to have her 23-year-old daughter arrested. The daughter turns herself in, saying it was just too hard trying to get high every day. Her mom drives her home from the police station and talks about wanting to "make a contract" with her. Somehow, we're not sure it's going to take. And it's with that doubt that we're next led into "The Science of Relapse," by Froemke and Eugene Jarecki, which, in combination with "Brain Imaging," by Rory Kennedy and Liz Garbus, explains the physiological reasons for addiction and why even the best of intentions cannot always protect a recovering addict from relapse.

Relapse, as one doctor puts it, is "not a failure of the treatment but a part of the disorder." Simply put, the human brain has "stop" and "go" functions. For an addict, the go function kicks in before the stop mechanism can react. That's one of the reasons addiction should not be viewed as a moral issue. Every time we condemn as morally weak someone with substance problems, it's the same thing as ignoring someone who is drowning.

It's probably not a surprise that 95 percent of adults who abuse alcohol started drinking before they were 21. The layperson probably thinks that drugs and alcohol are just part of a youthful rite of passage. "The Adolescent Addict," by Kate Davis and David Heilbroner, confirms that teenagers have a higher risk of drug or alcohol dependency and that society does a bad job of identifying the problem early on. Often, we chalk the problem up to typical teenage behavior and dupe ourselves with the traditional dismissal that he or she will "grow out of it."

But while the kids themselves say they turned to booze and pills because they were bored, medical experts interviewed by Davis and Heilbroner point to something more insidious and pervasive: For many kids, drugs and alcohol are the only coping mechanism they have. They haven't yet learned the better mechanisms that come with adulthood and experience on the planet.

Many films about addiction and substance abuse seem to fall into one of two categories: They are either entirely cautionary, like those films we were subjected to in high school, or they show us how the sun can shine over a clean and sober life. By constructing a single film from nine works by individual directors, Froemke and her co-producer, John Hoffman, reflect the multiplicity of problems, viewpoints and, yes, mythologies surrounding addiction.

We get a warm feeling of hope watching a mom congratulate her teenage son as he graduates from a treatment program. A few minutes later, when a 42-year-old man, who's just seen brain-imaging evidence of what his meth addiction is doing to his body, tells Dr. Nora Volkow that he'll quit "in a year or so," we know he's doomed. A young couple try to get themselves off opiates. He's been using for four years and figures he'll have to give up the new drug Seboxone and switch to methadone for financial reasons.

For someone who's been using for a longer period of time, insurance and managed care programs can be a formidable obstacle. Justin can't afford the $150 he would have to shell out for Seboxone, but his story doesn't begin to compare with the tragedies related by a group of Pennsylvania parents who have lost their children because they couldn't get proper care for them.

Testifying before a Pennsylvania state legislative committee, one mom holds up a picture of her daughter, Ashley, who was released after seven days in a treatment center because her insurance wouldn't fund a longer stay -- despite the center's professional determination that a 28-day initial stay was warranted. A few days later, her mother found Ashley in her room, her fingernails blue, the TV remote still clutched in her hand.

As an adjunct to the film, HBO has created a supplementary series of 13 films meant to focus more specifically on individual aspects of a massive and massively complex problem. The supplementary series will be shown on HBO2 digital cable, beginning Friday. In addition, a four DVD-set, including the 14-film series, will be available in stores beginning Tuesday. A companion book, "Addiction: Why Can't They Just Stop," published by Rodale Press, is already available in stores. And HBO has set up a comprehensive adjunct to its Web site with resource information.

It's a lot, but after watching the opening documentary, you can't help wondering if it's anywhere near enough.

E-mail David Wiegand at dwiegand@sfchronicle.com.