With rich and storied histories, it’s no wonder that organizations like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), have been so successful in helping millions of people on the path to recovery from alcohol and drug addiction.
For Katie Witkiewitz, professor of Psychology at The University of New Mexico and a scientist with UNM’s Center on Alcoholism, Substance Abuse, and Addictions (CASAA), the nuances of addiction run deep.
“I would characterize my research as focused on addiction – how people develop addiction, as well as how to treat addiction,” Witkiewitz says, “and on mechanisms of change, both inside of treatment and outside of treatment. So, specifically, how do people with an addictive behavior change that behavior?”
Plumbing these depths earned Witkiewitz a two-year term appointment as chairperson of the Addiction Risks and Mechanisms Study Section [ARM] by the National Institutes of Health (NIH) Center for Scientific Review. Her areas of expertise – empirically supported treatments and mechanisms of behavior change – and five-year history with the Center for Scientific Review made Witkiewitz an ideal candidate to chair the study section.
In a letter regarding Witkiewitz’s appointment, the NIH states that individuals are selected to chair based on “…demonstrated competence and achievement in their scientific discipline as evidenced by the quality of research accomplishments, publications in scientific journals, and other significant scientific activities, achievements and honors.”
The qualifications are high because the chairperson is responsible for leading a group of peers in their review of up to 300 grants annually. Three times a year, the study section meets to review and discuss up to 100 individual grants from various national institutes.
“As chair of the study section I’m responsible for running the meeting and making sure that all grants get a fair and equitable review,” says Witkiewitz,” and for maintaining scientific rigor of the review process, to highlight discrepancies between reviewers when those arise, and then also to summarize all the grants that we are reviewing over the course of two days.”
All of this responsibility might sound like a promotion, but it’s actually more work at no extra pay. Witkiewitz does it happily, for the love of science.
“I really love being in a group of people who also love the science, who care about it and want to make sure the integrity and rigor of science is maintained. Everyone in the room is committed to that, to doing and promoting good science,” Witkiewitz says.
She goes on to acknowledge the critical aspects of the work – contributing to decisions being made about funding new projects and supporting public health efforts.
“Because my study section is focused on addiction, it’s a big public health crisis, obviously,” Witkiewitz says. “I care deeply for people who are suffering from addiction and other mental health disorders, and this is an opportunity to affect not just the work I do at UNM, but also the work being done across the country. It feels wonderful to give back in that way. Even without much compensation.”
According to the National Institute on Drug Abuse (NIDA), while underage alcohol use is declining, overall illicit drug use in America is on the rise. All over the news, there are headlines addressing the opioid crisis, and last fall the White House declared it a public health emergency. The government has yet to offer additional funding to address the problem, and many public health officials have taken it upon themselves to tackle addiction in new and innovative ways, and subsequently, they apply for grants in support of their work. It’s a charge Witkiewitz does not take lightly.
“My research on addiction has focused on the use of mindfulness-based interventions in the treatment of addiction. We have found that behavioral treatments for addiction tend to be the most widely-used and the most effective. So treating people not with a medication, but with a behavioral treatment.” Witkiewitz says. “One of the biggest reasons I think these treatments are so effective is that mindfulness meditation really isn’t about so much the addiction, per say, but about what’s going on for the person. Why were they addicted in the first place?”
There’s a stigma around drug and alcohol use that persists throughout society, and even into the medical community. It’s pervasive to such a degree that the American Medical Association (AMA) offers numerous resources “...that can help you (medical professionals) better understand, treat and remove stigma in your practice and community.” Witkiewitz is committed to fighting against these prevalent stereotypes.
For every person with an alcohol or drug use disorder I’ve ever met, no one ever set out saying, “Oh, I really want to develop an alcohol use disorder,” or “I really want to develop an opioid use disorder.” Nobody says that.” Witkiewitz asserts. “For everyone I’ve ever worked with, there’s a reason they’ve become addicted to a drug; almost everyone I’ve ever met is searching for something, they’re reaching for something, they’re trying to get something out of the drug or alcohol.”
What Witkiewitz has discovered is that mindfulness and meditation are useful tools not only to combat the cravings people feel toward drugs and/or alcohol, but for giving people the tools they need to take on upheaval in their day-to-day lives, instead of relapsing to the comforts of substance use.
“What people are finding is that when they’re trained in the mindfulness techniques of being present and being okay with being in the current moment, they can then bring that into their daily lives. It’s a very radically different way of treating addiction.” Witkiewitz says. “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. 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. With not just the addiction, but with life.”
Witkiewitz is keenly interested in the How and Why of addiction, and understanding the mechanisms by which people change. Her recent work trends toward precision medicine approaches, or how we can identify specific treatments for specific individuals that are going to be the most effective. She sees very promising results in her work with addiction, mindfulness and meditation.
“What mindfulness meditation is really about is allowing whatever is wrong, whatever is happening that’s making you want that drug… kind of facing it for the first time.” Witkiewitz explains. “Life is hard for all of us. Depression is hard, anxiety is hard… everything that people feel are reasons people use alcohol and drugs… what if you could be with that, and sit with it?”
As chairperson of the ARM study section, Witkiewitz sees firsthand how funding impacts the lives of individuals who are struggling with addiction. She recognizes the strength of the contribution she and her colleagues are making to the NIH, to science, and to the lives of people who need help.
“We have a real opportunity to shape science and to shape the scientific agenda by providing our own peer perspectives on the grants.” Witkiewitz allows. “We’re saying (to the NIH), “Yeah, this is something we value. This is a grant we would like to see funded in our community.” We don’t make funding decisions, obviously, but our feedback to NIH becomes instrumental in their funding decisions.”
In addition to all of this work at UNM, with CASAA and for the NIH, Witkiewitz has written 5 books and over 165 peer-reviewed journal articles and book chapters. One can’t help but wonder if she sleeps.
“I’ve been productive,” she laughs. “I definitely sleep. I actually really value sleep, and balance in my life. I don’t work nights or weekends, typically. I also have amazing collaborators and students who are committed to publishing addiction science.”
When pressed to share how she manages to juggle such a heavy workload and also prioritize her valuable personal time outside of work, Witkiewitz acknowledges that she, too, has discovered the power of mindfulness.
“I have to say, meditation really helps with productivity. I’m just much more focused when I am working, and much more efficient.” Witkiewitz declares. “For what it’s worth, I used to think I didn’t have time to meditate. It turns out that having a regular mindfulness meditation practice really opened up my life in a way that was unexpected.”