Utah has a big problem with that. I'd say it's close to our No. 1 concern. Utah was in the top five; I'd say it's in the top 10 now. Our culture is more sympathetic if we get in trouble with prescription drugs than we are for heroin and cocaine. Nobody will hug you when you do those things. If you're a prescription addict, usually there is a story. —Glen Hanson
SALT LAKE CITY — If John Lennon was right and life is what happens while you are busy making other plans, then Glen Hanson is his proof. While he was making other plans for a career in dentistry and waiting 30 years for the University of Utah to build a dental school, he became one of the foremost experts on drug addiction.
He literally wrote the (text)book on it, and taught a popular pharmacology class at the U. From 2001 to 2003 he served as the director of the National Institute of Drug Abuse in Baltimore, responsible for 85 percent of all research on drug abuse in the world. He is director of the Utah Addiction Center. He has spent more than 20 years researching the response of the brain to drugs. He once testified for a U.S. Senate hearing on drug abuse.
So, imagine the eye-rolling pain he must endure when he encounters so much ignorance on the subject. Testifying before the state Legislature a few years ago, he argued that the tax on tobacco should be raised as a means to attack teen smoking. “I said 90 percent of those who smoke start as teens, and if you increase the cost of tobacco you will decrease use. It’s as simple as that. If you do this, the research says fewer will start smoking. If you start at 13 and get past age of 21, then the odds of you getting off tobacco are about 5 percent. If you start smoking as an adult, the chance of quitting is 90 percent. That drug has changed the brain during a critical development period.”
Then Hanson winced at the argument made against it. “They said if you raise the tax,” he recalls, “people will go to Wyoming to buy tobacco and Utah will lose revenue!” Hanson lets that sentence hang there for a moment, allowing the daftness of such an argument to settle. “They passed the law, raised the tax and, guess what’s happened? Smoking has declined almost 30 percent just as research indicated. And lawmakers complain because of lost revenue!”
Hanson was once invited to participate in an anti-methamphetamine campaign, along with officials from law enforcement, the Legislature and then-Gov. Jon Huntsman Jr. As he recounts it, “One of the proposals was, let’s demonize it; make meth guys look like criminals. I told them, yes, there is the criminal element here, but these people are really hurting and there are terrible things that happened to them. It’s a disease. Treat it as a disease. Addicts ended up in jail and there was this constant cycle. We told the Legislature it doesn’t work because it’s a disease. We explained that the brain changed under the influence of addiction and decision-making parts are damaged.”
He showed slides that revealed brain damage as meth addiction progressed, eventually leading to Parkinson’s disease. It was a medical outcome and he urged treatment. “I saw Huntsman and I could see the wheels turning,” says Hanson. “He goes to a treatment center with his wife and sees these mothers who are meth addicts with their children and they’re crying because this drug has destroyed lives. Huntsman stayed there hours. It changes your mind. You’re not to going to make it a vigilante effort. It turned the campaign around and turned it into helping these people.”
For two years Hanson spoke to thousands of people about the medical side of addiction in town meetings around the state, many of them approaching him after to relate their stories. “They were so grateful we were looking at them as real people rather than as members of a criminal enterprise,” he says.
Hanson now watches with incredulity as marijuana legalization gains traction. “It’s not about the science,” he says. “It’s about the economics. It’s ridiculous in terms of why people vote for this. 'Oh, this is a freedom thing,' they say. I have a hard time not laughing when they say, ‘It’s no worse than alcohol and tobacco!’ My response: Did you know tobacco kills 400,000 people every year in a way that is so agonizing and horrific, and that it costs $200 billion a year to treat? Did you know alcohol kills 100,000 a year and costs $200 billion? That’s a half-million deaths and half a trillion to treat it per year!”
As the National Institute of Drug Abuse director, Hanson witnessed politicians wrestle with the drug issue. He reported to Gen. Barry McCaffrey, director of the Office of National Drug Control Policy (aka, drug czar), a Cabinet-level position. President George W. Bush decided to oppose a program in which drug users could come to a clean house to obtain clean needles to prevent them from using used needles that could kill them and spread disease. Hanson received an email from McCaffrey asking him to provide the president with research that supported his position against the needle exchange program.
“I find 12 papers and every one of them says the opposite,” Hanson says. “(The needle exchange program) encourages them to get in treatment and they’re more likely to stop using drugs with the needle exchange. I send that back to the drug czar and explain. He writes back and says, ‘You’re not a team player.’ But they decided not to oppose the program.”
This is Hanson’s calling: Educating the world about drug use and abuse. He is a long way from where he set out decades ago as a young student. Born in Idaho and raised in California, he graduated from BYU with an undergrad degree and then from UCLA School of Dentistry. After practicing dentistry for two years in Orange County, he came home one night and told his wife, “I think I’m destined for academics.” Already weary of the repetitiveness of his job, he decided he was more cut out for research and academia. His work as a dentist, in which he dealt with pain medication and addiction issues, led him to a different direction.
“As a dentist, you might be the first health professional to see (drug issues),” says Hanson. “You need to understand how to manage these folks. A lot of (abusers) start as teens, and they’ll see a dentist before they see a doctor. I have a chance to identify a drug problem and do something about it. A lot of these abusive substances cause dental issues.”
His interest in drug abuse turned into a career and much more than a way merely to identify problems in his patients. He earned a doctorate in pharmacology from the University of Utah, thinking he would focus on pain medication and teach at the dental school that he hoped someday would come to the University of Utah. He did a fellowship in neuropharmacology at the National Institutes of Health in Bethesda, Maryland, studying drugs that are used to react with brain systems for the treatment of pain. Somewhere along the way his drug/brain research strayed from pain to addiction and drug dependence.
“The systems are the same,” he says. “They not only block pain, but also activate those reward systems that can lead to dependence. There’s a euphoric component. After a while it’s hard to sort the two out — for pain or pleasure. You have this compulsive need to get the drug. You reach a point you will steal money or neglect responsibilities to get the drug and it consumes you and controls your behavior.”
The study of narcotics seemed especially relevant in Utah. Hanson says Utah consistently ranks near the bottom among states in tobacco, alcohol and drug abuse, with two exceptions. From about 2000 to 2005, Utahns ranked among the worst for meth abuse. Young women with children were especially vulnerable. According to Hanson, law enforcement busted more than 300 meth labs in one year. Then there is prescription abuse.
“Utah has a big problem with that,” he says. “I’d say it’s close to our No. 1 concern. Utah was in the top five; I’d say it’s in the top 10 now. Our culture is more sympathetic if we get in trouble with prescription drugs than we are for heroin and cocaine. Nobody will hug you when you do those things. If you’re a prescription addict, usually there is a story. It didn’t start with the idea you’re going to be addicted. It’s just part of the sequence of dealing with chronic pain. Now you’re in this position of being dependent. Stress really seems to precipitate this.”
In 1980, Hanson, who had continued to practice dentistry to keep his skills up, joined the faculty at the University of Utah still hoping someday to teach dentistry. There was one big problem: The U. had no dentistry school, which seems remarkable considering the school boasted a famous medical school. Utah considered creating a dental school about the time Hanson returned, but decided against it.
“I decided I’ll start working here and if a dental school pops up I’ve got my D.D.S. and Ph.D.,” he says. So he taught pharmacology in the medical school, including a class called common medicines. The course took off. Hanson taught 800 students in the 500-seat auditorium. Then he taught a night class, attracting 2,400 students. The class was eventually broadcast on campus TV. He estimates 30,000 students went through the class during the 30 years he taught it.
He co-wrote a textbook with Peter Venturelli and Annette Fleckenstein: “Drugs and Society.” It has been used by hundreds of universities for two decades.
So there he was, teaching classes, writing textbooks and doing research, mostly on psycho stimulants. He made some eye-raising discoveries in his research. He discovered that meth, coke and ecstasy damage certain regions of the brain resulting in cognitive deficits. In animal research he discovered those drugs also damage the areas of the brain involved in Parkinson’s. Intrigued, he began a study of the medical records of 2 million Utahns looking for a link between Parkinson’s and meth dependence. He confirmed that there is a higher rate of Parkinson’s among those drug users, especially women. The discovery has significant implications.
“What it says is that amphetamines may be a model for predicting what goes wrong with Parkinson’s,” Hanson says. “Can we then figure out what things prevent Parkinson’s, since we know what causes it? It’s spun off in an intriguing direction. We’ve discovered other links with Parkinson’s we had never known, but we’re not ready to release the findings yet. People who have a particular mental health problem are more likely. That’s research — go down this trail and start to look here and there and things pop up.”
At the time, Hanson was practicing part-time dentistry, teaching at the university, serving as a major in the Army Reserve, conducting research at the NIH, working on his book and writing grants. Then in 1999, he was hired by the National Institutes of Health as director of the neurobiology and behavioral research, with a $250 million budget. Two years later he became director of NIDA with a $1 billion budget with responsibility for the vast majority of all drug abuse research in the world.
He returned to the University of Utah in 2003 and almost the first thing he did was begin planning for an addiction center at the school. “I thought it would be a good fit for the U.,” he says. Collaborating with the Callister Foundation, he created the Utah Addiction Center, a think tank that identifies projects and lobbies for bills that consider the medical aspect of addiction.
“There’s been some really great things done,” says Hanson.
Hanson, now 69, also realized another of his career ambitions, finally. The university created a dental school in 2013 — its first new college in six decades. Construction of the Ray and Tye Noorda Oral Health Sciences Building — home for the dental college — was completed last spring. Utah appointed Hanson interim dean of the University of Utah School of Dentistry, providing another milestone in a career filled with milestones.
“I had to wait 30 years, but we finally got the dental school,” says Hanson. “It’s been incredibly fulfilling.”
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