Healing 'holes' in brain provides Hope Posted by:Rocco--Sunday, November 28, 2010

Sally's sister, Sandy, saved an article from the Palm Beach Post for us to share concerning the cause and treatment of addiction at the Hanley Center, a noted nonprofit addiction treatment facility in West Palm Beach, Florida.

Healing 'holes' in brain may help addicts, says West Palm doctor - New Research and Treatment

By Barbara Marshall
Palm Beach Post Staff Writer


"Doctor, you have no idea how hard this is." Addicts say it all the time.

Looking at this motherly woman with the empathetic blue eyes, they ask, "What could you know about addiction, anyway?"

Dr. Barbara Krantz, the CEO and director of medicine at the Hanley Center in West Palm Beach, says gently, "Let me tell you my story."

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Dr. Krantz pulls up an image of a patient's brain on a computer screen. The man has been in and out of treatment for years, unable to stay off the drugs that are killing him.

Dr. Krantz, a 60-year-old former family doctor and one of the country's leading researchers in addiction medicine, zeroes in on what she thinks is the cause.

"There, see that?"

The SPECT image shows a brain that looks like Swiss cheese, as if something has been nibbling at the tissue.

The "holes," Krantz explains, are areas of reduced brain activity due to low blood flow. The largest "holes" are in the part that governs impulse control, called the prefrontal cortex.

To Dr. Krantz, the brain scan shows the patient can't stop using drugs because he can't control his impulsivity.

In other words, it wasn't lack of willpower or some character defect that made it impossible for the man to get clean. The part of his brain that might enable him to "just say no" was damaged.

"Begin to heal those "holes," which Dr. Krantz says is possible in a matter of months, and you may begin to heal the patient. Knowing what parts of the brain are affected by addiction also helps Hanley target therapeutic drugs, such as antidepressants, to enhance recovery.

"It's very, very cutting edge stuff," said Paul Kenny, a neurobiologist at Scripps Research Center in Jupiter, who is collaborating with Dr. Krantz on this research, which recently got Krantz and the Hanley center national attention in Time magazine.

In the world of addiction medicine, Dr. Krantz is the link between discoveries in the lab and their application to patients, Kenny said.

Former state senator Tom Rossin, the chairman of Hanley's board of directors, calls Dr. Krantz "One of those caring doctors we all would like to have but she's also one of the country's premier experts in the field of addiction."

She is passionate about demonstrating that addiction is a disease with a biological basis, like high blood pressure.

For more information on SPECT(single photo emission computer tomography) click on:

http://www.medicexchange.com/PET/hanley-center-acquires-east-coasts-spect-scanner.html

http://www.psychiatrictimes.com/addiction/content/article/113619/1592214

Thirty years ago, Dr. Krantz learned it the hardest way possible.

It began in the late 1970s with severe headaches - stress headaches, she thinks now, but then labeled migraines. She was 29, one of the first female family doctors in Palm Beach County. She and her then-husband had a 6-month-old baby when she went to a neurologist, desperate for relief from the pounding in her head.

He gave her a shot of Demerol and her wobbly world slid miraculously back into place. The throbbing headache was replaced by an seductive euphoria that let her float through hours of work and still be up scrubbing floors at 5 a.m. Within months, she was injecting Demerol daily, confident she wasn't addicted.

"My perception of an addict was a skid row bum, shooting heroin. I knew I wasn't an addict because I was a mom and it was prescription medicine," she said.

The drug gripped tightly, quickly. She says she was addicted within six to eight months. When making house calls to terminally ill patients who needed pain control, she'd give the patient a shot from a vial of Demerol and save the rest for herself.

In 1981, her mother pushed her into treatment. Eventually, she spent six months at a program for addicted physicians. She was perplexed, even angry, that no one there, at a facility that specialized in treating doctors, "could answer my questions about what was happening in my brain."

She resumed her practice, but still felt fragile and off-kilter. "The first two years (in recovery,) you just don't feel right. My brain wasn't back," Krantz said. "I still didn't have a clue about neurochemistry."

All the while, she was dealing with the public perception, even among fellow physicians, that her addiction stemmed from weakness and moral deficiency.

"The guilt and shame that I experienced for the first two years of my recovery were close to lethal" Dr. Krantz said.

In 1999, following several personal tragedies, she founded "His Great Commission", a non-profit medical outreach program, in his memory. For 10 years (before she had to close the program last year) Krantz and other volunteers ventured into the county's roughest neighborhoods, offering free basic medical care. Addicts all over the county grew to trust the tall blond woman who didn't preach and refused to judge.

"Not everybody can do what Barbara did," said Sandra White, of United Deliverance Church in West Palm Beach, who volunteered alongside Dr. Krantz. "It was admirable and risky."

Today, Dr. Krantz has built a national reputation as a lecturer and was quoted in September in a Time magazine article on prescription drug addiction, which she calls "Pharmageddon."

In 1990 there were barely 6,000 deaths from accidental drug poisoning in the U.S.

By 2007 that number had nearly quintupled, to 27,658.

In 15 states and the District of Columbia, unintentional overdoses have, for the first time in modern memory, replaced motor-vehicle incidents as the leading cause of accidental death; and in three more states it's close to a tie.

To read more about “Pharmageddon” click on:

http://www.cbsnews.com/stories/2010/09/04/earlyshow/saturday/main6835509.shtml

http://www.time.com/time/magazine/article/0,9171,2015763,00.html#ixzz16hdjyZ82

These days, three immutable certainties guide her life: addiction is a medical disease, God exists and as she knows intimately, the human spirit can soar above heartbreak with purpose and hope.

A carved wooden sign on her desk reads: "Care Deeply."

Tellingly, it faces visitors. Dr. Krantz doesn't need reminding.

Copyright © 2010 The Palm Beach Post. All rights reserved.

Copyright © 2010 Time Inc. All rights reserved

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