MGH Expert Optimistic about Addiction Recovery

In the face of a growing heroin epidemic, MGH psychologist John Kelly, PhD, strives to provide easy access to science-based information about recovery.

John F. Kelly, PhD, is determined to stop the flow of misinformation about addiction and recovery. As founding director of the new Recovery Research Institute, Kelly is working to provide easy access to the science of addiction treatment and recovery. To do so, Dr. Kelly and colleagues at the Recovery Research Institute are scouring the scientific literature and creating theirown syntheses and summaries of scientific research to build a reliable, easy-to-use resource at www.RecoveryAnswers.org.

 “There is a lot of bad information out there about addiction. We want to create a reliable and trustworthy source of information that is science based.”

Dr. Kelly—whose other roles include associate director of the MGH Center for Addiction Medicine, program director of the MGH Addiction Recovery Management Service and Elizabeth R. Spallin Associate Professor of Psychiatry at Harvard Medical School—sat down recently to talk about the project.

What is the Recovery Research Institute?

Dr. Kelly: At the Recovery Research Institute we are creating an evidence archive, a place where anyone can come to find evidence-based information on addiction treatment and recovery. There is a lot of bad information out there about addiction. We want to create a reliable and trustworthy source of information that is science based. For each topic there will be a one page, easy-to-understand summary of the evidence and its implications for clinical practice and recovery, a 20-page expert review published in a peer-reviewed journal and links to the original research articles.

What kinds of misperceptions do people have about addictions?

Dr. Kelly: There is a great deal of misinformation. For example, I’ve heard it said many times that only two percent of people recover from addition. That simply is untrue. The actual statistic is 65 percent. It’s important for people to know this because it’s a much more hopeful statistic. It may take several years, it may several treatments to get there, but about 65 percent of people are able to recover from addiction. It’s actually the best prognosis for any psychiatric disorder.

The growing use of heroin across socioeconomic lines is in the news. What is fueling this epidemic?

John Kelly, Ph.D., points out the pleasure center in the brain
The “pleasure center,” where addictions take hold, resides in structures deep inside the brain including the amygdala and nucleus accumbens.

Dr Kelly: Heroin use is spreading because of the over-prescription of painkillers (opiates) combined with the cheap availability of heroin. Seventy percent of young people start with painkillers from a medicine cabinet. They think of them as safe because they are prescribed by doctors. Young people who wouldn’t ordinarily try illegal drugs will try these. These drugs are very seductive, and when used at a higher level than prescribed, they are very addictive. People get addicted quickly to opiates, and soon can’t afford the $80 cost per pill for prescription medicine. So they turn to heroin which is relatively inexpensive. Quite rapidly, heroin becomes the top priority in their lives.

How can we start to solve the addiction problem?

Dr. Kelly: First, we ask, “How do we keep people well? How do we get them to cut down or eradicate alcohol or drug use and prevent relapse. How do we keep people healthy so they don’t end up in the emergency room?” One way is to catch the problem early. We know that the onset of addiction takes place in adolescence and young adulthood. That’s when young people are starting to drink heavily and use drugs and are likely to get into trouble. Just like with cancer or any other illness, the earlier we diagnose and treat addiction, the better the prognosis for early full remission. We need to do a better job of screening, assessment and intervention at the primary care level. There are some very effective, simple screening tools and the Affordable Care Act is going to mandate screening for substance use.

What research is underway at the Recovery Research Institute?

Dr. Kelly: In addition to building the research archive, we’re starting a national survey of SMART Recovery, a self-directed community-based program based on mutual help and scientifically supported psychological treatments. SMART Recovery offers an alternative to Alcoholics Anonymous for people looking for a non-spiritual, scientifically-based path to recovery. There are many studies assessing Alcoholics Anonymous, but SMART Recovery has not been studied.

“It may take several years. It may take several treatments to get there, but about 65% of people are able to recover from addiction.”

This survey will track people in SMART Recovery at 1 month, 3 months, and 6 months and compare them to a control group of people not going to SMART Recovery, but otherwise similar in age, gender, ethnicity and severity of addiction for all types of substance use. We’ll then track the study participants to see how engaged they are in the program, how often they are going and how their mental health and quality of life is. We are also about to start another new NIH-funded study to investigate how new emerging Recovery Community Centers help people get and stay in recovery from addiction. These are the first studies to examine these recovery resources.

What role can philanthropic support play at the Recovery Research Institute?

Dr. Kelly: Philanthropy enabled us to launch the Recovery Research Institute in October, 2013. Now we need funding to build the archive of evidence that will be accessible to everyone. It takes a lot of time to do this, which is probably why an archive like this doesn’t exist yet. This information is needed badly – not only by those affected by addiction but by medical professionals as well. I’ve sat with medical professionals on discussion panels who have said, for example, “There are no studies on AA.” Well, there are hundreds of published studies demonstrating the effectiveness of AA. It is our hope that anyone, a policy maker or a family member, can find the information he or she needs on our website, RecoveryAnswers.org.

To learn more about how you can support the Recovery Research Institute, contact us.