A DIFFERENT APPROACH
UNM researcher says ‘harm reduction’ a new path in addiction treatment
When it comes to addiction, the cornerstone, and often first step of most treatment programs, is abstinence.
Those struggling with addiction are told to completely stop using the substance or performing the activity to which they are addicted. University of New Mexico scientist and professor Katie Witkiewitz hopes her research will help modify that approach, especially for those who do not seek help and also help those who are sober avoid relapse.
Currently Witkiewitz and her colleague Eric Claus at UNM are researching how the brain changes when heavy users reduce their alcohol intake. She said while abstinence is preferable, it’s not the road everyone is willing or able to take.
“One of my main focuses is the idea that harm reduction might not require abstinence,” she said. “Of people who might need help, 90 percent never seek treatment.”
She said her research is looking at the how the brain changes — how harm is reduced — in those who cut back on drinking. She calls her approach pragmatic and would like to ultimately create a public message backed by research in hopes it would motivate people to reduce their drinking because they see it as beneficial. She said she would also like to make other types of recovery, such as reduction, a part of the general conversation about treating addiction.
“It’s (drinking) part of our culture,” she said. “It’s social and people want to enjoy the social aspect so what would happen if someone reduced by three drinks? Would it reduce harm on the brain? We want to bring data to this discussion.”
Witkiewitz grew up in upstate New York “miles from anything” in a small rural community. The nearest store was 45 minutes away but it was a lifestyle she loved, even as a young person. Upon moving to Albuquerque, she decided to make the East Mountains her home, which she said reminded her of home.
Witkiewitz was recruited in 2012 by UNM’s Center on Alcoholism, Substance Abuse and Addictions (CASAA) director Barbara McCrady. Witkiewitz was already conducting research with her colleagues in Seattle about using mindfulness and meditation to treat addiction. Witkiewitz said CASAA’s internationally renowned reputation for developing science-based behavioral treatments made it hard to resist.
“It was the best decision I ever made,” she said. “I keep joking I found my forever home.”
McCrady called Witkiewitz an outstanding researcher with excellent statistical analysis skills.
“She’s incredibly productive and efficient,” McCrady said. “She’s also a nice person and very generous with her expertise.”
Jane Ellen Smith, professor and chair of the UNM Psychology Department, said universities across the country have routinely tried to recruit Witkiewitz but she is committed to New Mexico and her work at UNM. She has dedicated herself, Smith said, to improving the lives of people suffering from substance abuse problems. Witkiewitz was recently awarded the distinguished title of regents professor. According to a university news release, this title is given to professors for “their accomplishments as teachers, scholars and leaders both in university affairs and in their national/international professional communities.”
“Dr. Katie Witkiewitz is a bit of a mystery; nobody can quite figure out how she accomplishes all that she does while remaining a wonderfully pleasant, fun and humble person in the process,” she said. “I’ve never seen such an impressive combination of energy and efficiency.”
Witkiewtiz said she knew she wanted to enter the field of psychology but addiction wasn’t necessarily her first choice. Her mentor while attending graduate school in Montana was doing research on addiction.
“It really clicked for me,” she said. “I started working with people with addiction and it became almost a passion overnight.”
She was speaking at a conference when Alan Marlatt, psychology professor and director of the Addictive Behaviors Research Center at the University of Washington, asked her to come work with him. Witkiewitz and her classmates, using Marlatt’s previous research, developed Mindfulness-Based Relapse Prevention treatment, which aims to keep those in recovery from relapsing. Marlatt has since passed away.
The first step of the treatment, she said, is for someone to notice either their discomfort or craving. The next step is to pause before taking action and finally learning to stay with the discomfort or pain until it subsides instead of using substances to alleviate the feelings.
“In other treatments, when people experience hardship — even after their treatment — when people experience depression or a breakup, they go back to using right away,” she said. “Because treatment didn’t teach them how to deal with that big, terrible thing that just happened. Whereas in our studies, we’ve found that when people experience those really hard things, they don’t have to go back to using. They’ve learned a totally different way of coping.”