Session to Examine International Addiction Treatment Trends

The latest trends in addiction treatment outside the United States will be examined in presentations today during Symposium 11, “International Perspectives on Addiction Medicine.”

The session, presented from 10:15 a.m. to 12:15 p.m. in Continental A on the Lobby Level of the Chicago Hilton, is sponsored by the International Society of Addiction Medicine (ISAM). It will feature presentations from two addiction specialists from Iceland, as well as reports on work in the United Kingdom and Russia.

“In addition to providing a perspective on new research that emerged internationally, the session also will give attendees an idea of what practice is like overseas, and that puts a lot of what we do into perspective,” said presenter Marc Galanter, MD, FASAM, Professor of Psychiatry and Director of the Division of Alcoholism and Drug Abuse, New York University Medical Center.

ISAM was developed to help establish projects to integrate the most recent research findings for presentations to clinicians worldwide and to promote further research. Iceland is of particular interest because it is an island of about 325,000 people that is relatively homogenous, said Jag Khalsa, PhD, MS, Chief of the Medical Consequences Branch, National Institute on Drug Abuse.

Thor Tyrfingsson, MD, Medical Director of Treatment at SAA, the National Center of Addiction Medicine, Iceland, and Ingunn Hansdottir, PhD, Assistant Professor at the University of Iceland, will discuss the importance of international connections on the island in a unique situation.

“We had a collapse of the financial system in Iceland in 2008. That has had a huge impact on our living and social conditions,” Dr. Tyrfingsson said. “There has been tremendous change in our society. I will talk about how that has affected stimulant abuse in Iceland.”

In the weak economy, the use of the three leading illegal drugs—amphetamines, cocaine, and ecstasy—declined, probably because people had less money to buy drugs, he said

“What we found was that people started to use methylphenidate instead of illegal drugs,” Dr. Tyrfingsson said. “What happened was that methylphenidate was used more often per day. This drug that we used to think was harmless [to treat ADHD] can be used compulsively and dangerously, as it has been used in Iceland.”

Iceland has a health care system where the government pays for most of the costs of medications, so citizens began taking advantage of the increase in ADHD diagnoses.

“They emphasize diagnosing ADHD better for children, adolescents, and grown-ups, and try to monitor the prescriptions,” Dr. Tyrfingsson said. “A lot of money has gone out to the community. They spend more on that drug in Iceland than for detoxification for all alcohol and drug addiction.”

Using a grant from the U.S. National Institute of Drug Abuse, Iceland has increased its data collection to share internationally.

“If you follow the news, you know about the financial crisis in Europe,” Dr. Tyrfingsson said. “The question is what happens in that social situation. Iceland is a small laboratory to research what happens to drug addicts in a country that goes into a financial crisis.”

Another speaker in the session will be George Woody, MD, Professor, Department of Psychiatry, University of Pennsylvania, who is involved in collaborative research worldwide. He will discuss addiction treatment in Russia.

Brian Hurley, MD, a resident in the adult psychiatry residency training program at Massachusetts General Hospital and McLean Hospital, will discuss the treatment of opioid addiction in the United Kingdom.