Why can't all addicts be treated like Navy pilots?

Great question. The same could be asked about doctors.

This overstates the impairment in the midbrain, but is roughly accurate.

Addicts are people with broken brains. That's the latest from experts on neuroscience and addiction studies at the University of Utah School on Alcoholism and Other Drug Dependencies this week. They're saying that genetics and early trauma can result in vulnerability to addiction.

But people with broken brains can get better. I'm hearing a lot of hope on that front. Kevin McCauley, the school's keynote speaker, was a Navy flight surgeon who helped administer the very successful "Keep 'em Flying!" approach for Navy pilots. McCauley says this approach resulted in a 95 to 97 percent rate of return to flying status for pilots suffering from alcoholism.

This high success rate occurs because of a comprehensive approach to treatment. Pilots are told that if they develop an alcohol problem, they can come to their superiors for the best available inpatient treatment; they will be returned to flying status as soon as possible; and they will receive long-term peer support. The pilots are treated like needed, valued members of the Navy community. Of course, they will also be tested regularly for drug use of any kind.

McCauley is convinced we could see an equally high recovery rate for other alcoholics and addicts if we offered them the same treatment. Today, only a handful of privileged addicts enjoy access to excellent inpatient treatment, a promise of return to high-status employment, and the mix of support and accountability provided to the Navy pilots.

Why don't we offer all addicted people this same winning combination?

For one thing, as a society, we're stuck on the idea that addiction is a moral failing and not a disease. The experts at the School on Alcoholism refute this convincingly. Defects in the midbrain - the part of the brain that regulates survival functions such as eating and self-defense - lead to an overpowering demand for a substance that will make the person feel better. Getting enough of the drug equates with the drive for survival in the addicted brain.

While the addicted person is busy getting and using drugs to placate the demanding midbrain, the person's prefrontal cortex - that part of the brain that deals with morality, spirituality, and other higher concerns - is shut down. No wonder addicts are known for immoral acts. Their instinctive brain is screaming for more drugs at any cost while their moral brain is on hold!