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(photo credit: Judy Siegel)
Addiction to heroin, cocaine and other opioids should be regarded like the medical disease it is, and not the result of weak wills or criminal minds, says Dr. Miriam Adelson, an Israeli-born researcher of methadone treatment for narcotics addicts who has established methadone clinics in Tel Aviv and New York.
"The stigma is so high, but addiction is not isolated to specific groups, and no group is immune."
Adelson, who was born in Israel, happens to be the wife of the 14th richest person in the world, the third richest American and the world's richest Jew - 73-year-old Sheldon Adelson of Las Vegas.
They reputedly have a fortune of $16 billion, the result of her self-made husband's decades of uncanny success in building hotels, casinos and convention centers in Las Vegas, the Far East and other parts of the world.
Instead of lounging near swimming pools and concentrating on her wealth, Adelson - married to the billionaire for about 13 years - frequently travels to Tel Aviv, where she set up a methadone clinic for addicts at Tel Aviv Sourasky Medical Center, similar to the two she and her husband established in the US. Dr. Adelson was honored on Sunday with an honorary doctorate from her alma mater, Tel Aviv University, along with her mentor and current colleague at New York's Rockefeller University, Prof. Mary Jeanne Kreek.
It was Kreek who made the discovery that methadone - an oral synthetic narcotic and endorphin-replacement pharmaceutical developed by Bayer in Nazi Germany when it feared running out of pain-killing morphine from Turkey - is effective and safe in replacing the craving of addicts for narcotics without giving them a "high."
In a press conference at TAU on Sunday before the two women received their honorary degrees, Dr. Adelson and Prof. Kreek said that narcotic addiction, which is growing in Israel as in the US, affects every ethnic, religious, socio-economic and educational group.
About 60 percent of the risk of becoming an addict is due to genetics, including "risk-taking" genes, but peer pressure and other environmental factors also play an important role, added Kreek. "We have formulated the relative weight of all these factors.
"When an addict takes drugs chronically, his brain is changed for long after the drug has disappeared from his system," said Kreek, who is head of Rockefeller's lab researching the biology of addictive diseases, with 50 scientists working under her.
"The brain is not normal after chronic narcotic use. We studied animals that liked drugs and those that didn't, but after they were exposed to narcotics, their brains became identical to each other."
After completing her specialty in internal medicine, Adelson was recommended for work in Kreek's lab as a promising researcher. She was sent in 1986 by the late Prof. Dan Michaeli - then head of Tel Aviv Sourasky Medical Center - as a "brilliant, early-career specialist in internal medicine" to Manhattan's prestigious Rockefeller University due to increasing worries about narcotic addiction and AIDS in Israel. Dr. Adelson had intended to return to open a methadone clinic in Israel.
But she "met the love of my life" and married Adelson. "I always say I got stuck in America," she said. (Her husband was present at the honorary doctorate degree ceremony and the press conference.) She and Kreek worked together on a variety of aspects of methadone for 21 years. The Adelson clinic in Tel Aviv now serves 320 patients from all walks of life, and there are currently negotiations with the mayor of Rishon Lezion to do the same there, Dr. Adelson said.
"Israel needs more methadone treatment centers, and the staff must be knowledgeable," said the two women. "Clinics must be humane and attractive like other health clinics and not terrible places like some in the US."
They both endorsed programs in which addicts' used hypodermics are switched for sterile needles so they are not infected with Hepatitis B or C or HIV and are exposed to doctors who can point them towards rehabilitation and give counselling.
"There is a biological need in addicts for drugs, so it is foolish to refuse to exchange needles in the belief that this will encourage addiction."
At the Tel Aviv clinic, the retention rate of methadone patients is very high - 70% - with only a minority of program dropouts, said Dr. Adelson.
They expressed their concern that during the last three to five years, there has been a "surge of prescription-drug [amphetamine] opiate addiction. Over 10% of 12th graders here have used off-label opiates at least once." The two women said that addiction in Israel and the US follow very similar patterns. "I wish we could educate kids to know that if they don't feel well, instead of getting addictive drugs on the street, they should go to a doctor for help."
While tobacco smoking can easily lead to narcotic addiction, they said, marijuana is the first time that people step over the line from licit drugs like tobacco and alcohol to illicit drugs. They both strongly opposed the use of marijuana for medical use (it is legal in Israel, by special Health Ministry license, to some patients suffering from excruciating pain due to disease).
They said that methadone, a strong painkiller with few side effects, can effectively be substituted for medical marijuana.
"Low doses of methadone are a godsend for chronic pain management," added Kreek. "It is a 'boringâ€š' drug in that you can't get high from it even if you inject it. So it is ideal for pain when you don't want to be in a euphoria but want to work and have a normal life."
Many clinics around the world give either too-low or too-high doses of methadone to addicts, said Kreek. In the future, dosages will be determined by genetic profiles of patients, she said.
While no new drug is needed as a heroin replacement, said Kreek, "we desperately need a new drug to combat marijuana and cocaine addiction."
Sheldon Adelson, who was born to a poor Jewish family in Boston, sold newspapers on street corners as a child and set up his first business at 12, has had his share of pain. He said at the press conference that when he suffered from severe pain "equal to giving birth and having kidney stones," his wife gave him methadone, which was a lifesaver.