Pringle, Janice L; Emptage, Nicholas P; Hubbard, Robert L
Many addiction treatment patients suffer from health and psychosocial problems in addition to substance misuse at the time of their treatment entry. Outpatient treatment programs have attempted to address these problems by providing or facilitating access to comprehensive health and social services. Nevertheless, previous research have suggested high levels of unmet needs for these services in the addiction treatment population. Using data from a large study on community-based outpatient addiction treatment, this article provides additional information on levels of unmet service needs and the relationship between need and receipt of services during treatment. Our results suggest extremely high levels of unmet needs for a wide variety of health and psychosocial services. Specifically, the data suggest that unmet service needs may be far more prevalent than previous estimates and that addiction treatment populations in rural areas may be particularly disadvantaged.
Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M
Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.
Knott, Anne Marie; Corredoira, Rafael; Kimberly, John
Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.
Cookson, Camilla; Strang, John; Ratschen, Elena; Sutherland, Gay; Finch, Emily; McNeill, Ann
High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings. Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment. Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p < 0.001), and only 29% of staff thought it should be addressed early in a client's primary addiction treatment, compared with 48% of clients. A large unmet clinical need is evident with a widespread failure to deliver smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.
Tran, Bach Xuan; Vu, Phuong Bich; Nguyen, Long Hoang; Latkin, Sophia Knowlton; Nguyen, Cuong Tat; Phan, Huong Thu Thi; Latkin, Carl A
The rapid expansion of methadone maintenance treatment (MMT) services has significantly improved health status and quality of life of patients. However, little is known about its impacts on addiction-related stigma and associated factors. A cross-sectional survey was conducted in 2013 in Vietnam's capital, Hanoi, and Nam Dinh province among 1016 methadone maintenance patients; 26.6 % at provincial AIDS centers (PAC) and 73.4 % at district health centers (DHC), respectively. Drug addiction history and related stigma, health status, MMT-related covariates, and sociodemographic characteristics were interviewed. More than one-sixth of the sample reported experiencing felt or enacted stigma, including Blame or Judgement (17.2 %), Shame (19.9 %), or Others' fear of HIV transmission (17.1 %). These proportions were higher in PACs than in DHCs, which are integrated with other HIV or general health care services. Very few patients reported being discriminated at the workplace (2.5 %) or at health care services (1.7 %); however, 15.6 % of patients at PACs and 10.6 % of patients at DHCs reported discrimination in their communities. Drug users taking MMT for longer periods were less likely to report felt stigma. Other factors associated with stigma against MMT patients included the lack of comprehensive services, higher education, presence of pain/discomfort, and anxiety/depression, self-reported HIV positive, and number of previous drug rehabilitation episodes. The study shows a high level of stigma against MMT patients and emphasizes the necessity to integrate MMT with comprehensive health and support services. Mass communication campaigns to reduce stigma against people with drug addiction and HIV/AIDS, as well as vocational trainings and jobs referrals for MMT patients, are needed to maximize the benefits of MMT programs in Vietnam.
Bach Xuan Tran
Full Text Available Abstract Background The rapid expansion of methadone maintenance treatment (MMT services has significantly improved health status and quality of life of patients. However, little is known about its impacts on addiction-related stigma and associated factors. Methods A cross-sectional survey was conducted in 2013 in Vietnam’s capital, Hanoi, and Nam Dinh province among 1016 methadone maintenance patients; 26.6 % at provincial AIDS centers (PAC and 73.4 % at district health centers (DHC, respectively. Drug addiction history and related stigma, health status, MMT-related covariates, and sociodemographic characteristics were interviewed. Results More than one-sixth of the sample reported experiencing felt or enacted stigma, including Blame or Judgement (17.2 %, Shame (19.9 %, or Others’ fear of HIV transmission (17.1 %. These proportions were higher in PACs than in DHCs, which are integrated with other HIV or general health care services. Very few patients reported being discriminated at the workplace (2.5 % or at health care services (1.7 %; however, 15.6 % of patients at PACs and 10.6 % of patients at DHCs reported discrimination in their communities. Drug users taking MMT for longer periods were less likely to report felt stigma. Other factors associated with stigma against MMT patients included the lack of comprehensive services, higher education, presence of pain/discomfort, and anxiety/depression, self-reported HIV positive, and number of previous drug rehabilitation episodes. Conclusion The study shows a high level of stigma against MMT patients and emphasizes the necessity to integrate MMT with comprehensive health and support services. Mass communication campaigns to reduce stigma against people with drug addiction and HIV/AIDS, as well as vocational trainings and jobs referrals for MMT patients, are needed to maximize the benefits of MMT programs in Vietnam.
Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar
Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). There was a gap between the clients' expectations and what they actually perceived in the clinics. Thus, more attention should be devoted to the clients' views regarding service quality in addiction treatment clinics.
Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan
Background Satisfaction with services represents a key component of the user’s perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. Methods We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Results Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient’s perspective, the results are not as consistent as might be expected. It is not uncommon to find that “highly satisfied” patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. Conclusion User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted – and rarely acted on in the case of nonoptimal results – should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys. PMID:24482571
Gioka, Sophia; Kefaliakos, Antonis; Ioannou, Andriani; Mechili, Aggelos; Diomidous, Marianna
The importance of recognizing the symptoms of Internet addiction constitutes the first step for treatment. Internet use can be pathological, and the percentage of addicted people is increasing while people become dependent on technology and Internet continues to develop. This study is a systematic litterature review. An electronic literature search was conducted using as keywords internet addiction, psychological implications, internet abuse etc. to the following databases: Medline, PubMed and Google Schoolar. The majority of research was conducted in Europe and in North America. We found 20 surveys. 9 were excluded on the basis of screening due to full text articles were not available. The final number of included surveys was 11. Hospitals and clinics have to emerge with outpatient treatment services for Internet addiction recovery, and in some cases there may be a need for addiction rehabilitation centers as admitted from people with Internet addiction into inpatient care.
Rose, J E
The persistence of cigarette smoking despite widespread awareness of adverse health effects results from an underlying addiction to nicotine. Unaided attempts to quit smoking are generally unsuccessful. This article discusses nicotine addition and therapeutic techniques that have been or are being developed to relieve smoking withdrawal symptoms and promote abstinence from smoking. These techniques include nicotine chewing gum, skin patches, nasal sprays, and inhalers, as well as pharmacotherapies such as mecamylamine and clonidine, serotonergic treatments such as buspirone, and antidepressants such as buproprion. A nondrug approach using cigarette substitutes that mimic the airway sensations produced by cigarette smoke is also discussed.
Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.
Hogan, Beth; Hershey, Lewis; Ritchey, Steven
Drug abuse and addiction continues to negatively impact many lives in this country. The United States health care system has grappled with how to best serve this vulnerable population. Since the personal and societal costs of addiction are high, all recent iterations of the United States strategic health plans (such as Healthy People 2010) have prioritized this area for improvement. At the local level, health care providers who care for those with addictions are challenged with shrinking insurance coverage for services, a difficult patient population, lack of treatment options, growing ranks of indigent patients, as well as a plethora of additional management challenges. It is known that successful treatment is integrally linked with patient satisfaction with services. The most critical factors in successful addiction treatment (from a patient's perspective) are (1) their belief that the counselor cares about them and, (2) their belief that they can recover. This paper reports a case study in the use of a patient satisfaction survey as a quality management/service refinement tool within a methadone treatment setting. Results indicate that the use of the survey itself provides patients with a tangible cue supporting the presence of the critical success factors. Further, the use of a survey provides a baseline for future measurements and trending. The paper concludes with a discussion of the marketing and organizational implications of incorporating the patient satisfaction survey into the ongoing delivery program for addiction services.
Spiritualita při léčbě závislosti Spirituality in the Addiction Treatment Lydie Kárová In my work, Spirituality in the Addiction Treatment, I focus on spirituality as a component of personality, which is involved in its formation and development. The work falls into three parts, in the first one I place spirituality into the Czech environment and present its definition, in the second part I look for the role of spirituality in the conception and treatment of addiction and in the third one I p...
Issues and trends in relation to substance misuse normally develop in the transitional phase of adolescence, as young people begin looking towards their peers for direction and are less subject to parental authority. In relation to substance misuse it is observed that risk and protection factors exist in equal measure within different contexts, including within the individual, family, peer group, school and community settings. In response to problems relating to illicit drug use in Ireland the first adult treatment service was established in Dublin in 1969. As an approach to meeting the complex needs of an adolescent drug using population two designated out-patient treatment adolescent services were established in Dublin during the mid-1990s. Working closely with families, carers and significant others improves communication and mobilises resources in ways that enhances protection for young people especially in circumstances where there are a number of family members engaging in substance misuse.
Pedrero-Perez, E J; Rojo-Mota, G; Ruiz-Sanchez de Leon, J M; Llanero-Luque, M; Puerta-Garcia, C
More recent theories of addiction suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a key role in the development or maintenance of addiction. Ultimately, the addiction (with or without substances) is based on the alteration of brain decision-making processes. The neurosciences, particularly those responsible for behavior modification, must take into account the neurobiological processes underlying the observable behavior. Treatments of addiction usually do not take into account these findings, which may be at the base of the low retention rates and high dropout rates of addicted patients. Considered as an alteration of brain functioning, addiction could be addressed successfully through cognitive rehabilitation treatments used in other clinical pathologies such as brain damage or schizophrenia. Although there are few studies, it is suggest that intervention to improve patients' cognitive functioning can improve the efficiency of well-established cognitive-behavioral therapies, such as relapse prevention. This paper reviews the available evidence on cognitive rehabilitation in treating addiction as well as in other pathologies, in order to formulate interventions that may be included in comprehensive rehabilitation programs for people with addictive disorders.
Dewey, Stephen L. (Manorville, NY); Brodie, Jonathan D. (Cos Cob, CT); Ashby, Jr., Charles R. (Miller Place, NY)
The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.
Dewey, S.L.; Brodie, J.D.; Ashby, C.R. Jr.
The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.
Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the ...
Hung, C I; Liu, C Y; Chen, C Y; Yang, C H; Yeh, E K
There have been few studies of the psychiatric characteristics of analgesics addiction. The physician's perceptions that patients were addicted to analgesics might be partially attributable to frustration with poor response to treatment. In this retrospective study, we evaluated the medical records of 20 subjects (15 male and 5 female) who were perceived as having addiction to meperidine by general physicians. The most common medical diagnosis among these patients was chronic pancreatitis (7/20). Among them, five had a past history of suicide attempt and three had self-injury behavior during the index admission. The fact that subjects were perceived as being addicted might be attributable to a vicious cycle of the following factors: 1) chronic intractable pain; 2) poor staff-patient relationship; 3) lower pain threshold or tolerance due to anxiety or depression; 4) patients with a history or tendency of substance abuse; 5) placebo use and inadequate analgesics regimen. The findings of this study suggest that the importance of the following diagnostic and treatment procedures in these patients: 1) suicide risk should be evaluated; 2) comorbid psychiatric diseases should be treated; 3) factors that cause a vicious cycle in pain control should be identified; 4) misconceptions of opiate analgesics among medical staff should be discussed; 5) poor staff-patient relationship should be managed aggressively; and 6) "addiction" is a critical diagnosis that should be avoided if possible.
Teater, Barbra; Hammond, Gretchen Clark
Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…
Factor analysis of treatment outcomes from a UK specialist addiction service: relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation.
Fairhurst, Caroline; Böhnke, Jan R; Gabe, Rhian; Croudace, Tim J; Tober, Gillian; Raistrick, Duncan
To examine the relationship between three outcome measures used by a specialist addiction service (UK): the Leeds Dependence Questionnaire (LDQ), the Social Satisfaction Questionnaire (SSQ) and the 10-item Clinical Outcomes in Routine Evaluation (CORE-10). A clinical sample of 715 service user records was extracted from a specialist addiction service (2011) database. The LDQ (dependence), SSQ (social satisfaction) and CORE-10 (psychological distress) were routinely administered at the start of treatment and again between 3 and 12 months post-treatment. A mixed pre/post-treatment dataset of 526 service users was subjected to exploratory factor analysis. Parallel Analysis and the Hull method were used to suggest the most parsimonious factor solution. Exploratory factor analysis with three factors accounted for 66.2% of the total variance but Parallel Analysis supported two factors as sufficient to account for observed correlations among items. In the two-factor solution, LDQ items and nine of the 10 CORE-10 items loaded on the first factor >0.41, and the SSQ items on factor 2 with loadings >0.63. A two dimensional summary appears sufficient and clinically meaningful. Among specialist addiction service users, social satisfaction appears to be a unique construct of addiction and is not the same as variation due to psychological distress or dependence. Our interpretation of the findings is that dependence is best thought of as a specific psychological condition subsumed under the construct psychological distress. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.
Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.
The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof.
... evidence-based treatment. Medications developed to treat opioid addiction work through the same opioid receptors as the addictive drug, but are safer and less likely to produce the harmful behaviors that characterize addiction. Three types of medications include: (1) agonists, which ...
Grant, Jon E; Schreiber, Liana R N; Odlaug, Brian L
Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made.
Dhuffar, Manpreet K; Griffiths, Mark D
Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.
McConnell, K John; Ridgely, M Susan; McCarty, Dennis
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires commercial group health plans offering coverage for mental health and substance abuse services to offer those services at a level that is no more restrictive than for medical-surgical services. The MHPAEA is notable in restricting the extent to which health plans can use managed care tools on the behavioral health benefit. The only precedent for this approach is Oregon's 2007 state parity law. This study aims to provide evidence on the effect of comprehensive parity on utilization and expenditures for substance abuse treatment services. A difference-in-difference analysis compared individuals in five Oregon commercial plans (n=103,820) from 2005 to 2008 to comparison groups exempt from parity in Oregon (n=19,633) and Washington (n=39,447). The primary outcome measures were annual use and total expenditures. Spending for alcohol treatment services demonstrated statistically significant increase in comparison to the Oregon and Washington comparison groups. Spending on other drug abuse treatment services was not associated with statistically significant spending increases, and the effect of parity on overall spending (alcohol plus other drug abuse treatment services) was positive but not statistically significant from zero. Oregon's experience suggests that behavioral health insurance parity that places restrictions on how plans manage the benefit may lead to increases in expenditures for alcohol treatment services but is unlikely to lead to increases in spending for other drug abuse treatment services. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Samuelsson, Eva; Blomqvist, Jan; Christophs, Irja
AIMS - The objective of the study was to explore perceptions of different addictions among Swedish addiction care personnel. DATA - A survey was conducted with 655 addiction care professionals in the social services, health care and criminal care in Stockholm County. Respondents were asked to rate the severity of nine addictions as societal problems, the individual risk to getting addicted, the possibilities for self-change and the perceived significance of professional treatment in finding a...
Elsalhy, Muhammad; Muramatsu, Taro; Higuchi, Susumu; Mimura, Masaru
The Internet now plays a very important role in our lives. However, for some people, Internet use can lead to a state that appears to meet the DSM definition for a mental disorder. In this review, we briefly discuss definition, symptoms, risk factors, prevalence, comorbidities, and personality traits of people who are susceptible to becoming addicts. In the second section of the article, various types of Internet addiction are discussed, focusing mainly on Internet Gaming Disorder and social networking survices (SNS) addiction. Regarding Internet Gaming Disorder, we discuss various types of the newly emerged Massive Multiplayer Online Games (MMO), as well as theories about why people become addicted to them. We do the same for the SNS Addiction for sites like Facebook and LINE; again, different types, as well as theories about why some people become addicts to such sites are discussed. Finally, preventive measures are introduced, focusing on a number of commonly used treatment methods, perticulary cognitive behavioral therapy and family therapy.
Rosenberg, Kenneth Paul; Carnes, Patrick; O'Connor, Suzanne
There have been several diagnostic labels for persistent, excessive sexual behaviors, often referred in the popular media as sex addiction. Two related diagnoses, Internet addictive disorder and hypersexual disorder, were considered for, but not included in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. However, most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. The authors present the historical context, proposed diagnostic criteria, evaluation protocols, comorbid disorders, speculations about the neuroscience, and treatment recommendations.
Dewey, Stephen L. (Manorville, NY); Brodie, Jonathan D. (Cos Cob, CT); Ashby, Jr., Charles R. (Miller Place, NY)
The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. In one embodiment, the method of the present invention includes administering to the mammal an effective amount of a composition which increases central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of drugs of abuse. The composition includes GVG, gabapentin, valproic acid, progabide, gamma-hydroxybutyric acid, fengabine, cetylGABA, topiramate or tiagabine or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof.
Full Text Available Introduction: The purpose of the present study was to compare of the rate of alexithymia and spiritual intelligence in addicts, addicts under Methadone Treatment, and non-Addicts. Method: A causal-comparative research design was used. The study sample included 30 individuals under Methadone Treatment, 30 drug-dependent Addicted, and 30 non-addicted individuals selected by convenience sampling procedure. Toronto alexithymia scale and King's spiritual intelligence self-report inventory were administered among selected sample. Results: Findings revealed significant differences among addicted individuals and non-addicted adults also among individuals under methadone treatment and non-addicted adults in total alexithymia scores as well as on all three subscale scores. Furthermore, addicted individuals differed from those under methadone treatment in their scores on the subscale pertaining to difficulty in identifying feelings. Results also indicated differences among addicted individuals and those under methadone treatment in total spiritual intelligence and its four component scale scores, while addicted individuals differed from non-addicted individuals in total spiritual intelligence scores and only three of its component scale scores (personal meaning production, transcendental awareness, and conscious state expansion. Conclusion: Findings of this study indicate the advantages of the ability to control, emotional regulation and spiritual intelligence as a defense against addiction. By development of these characteristics addicts can be helped to gain relief from their addiction.
Fanello, Serge; Daoud, Sidi; Panici, Jean Yves; Parot, Elsa; Hitoto, Hicombo; Garnier, François
This study of a cohort of drug addicts receiving buprenorphine maintenance treatment in a district in western France focused on changes in their drug use and their social and work lives. It also looked at the health consequences of their drug use before and after maintenance treatment (mean: four years). From the files of an agency providing services to drug addicts, we randomly selected 180 of the 236 patients receiving buprenorphine maintenance treatment (BMT). Usable questionnaires were returned by 118 subjects (66% response rate). This self-administered questionnaire included 32 items. The respondents accounted for half the population receiving drug maintenance treatment and were representative of the population for age and sex. The mean age was 30 +/- 5 years, mean BMT dose 6,5 mg/day, and mean duration of drug maintenance treatment 47 +/- 27 months. Other drug use diminished during the four years of maintenance treatment: three of every four heroin users had stopped, opiate users dropped from 31% to 5% of the population, and cocaine use followed a similar trend. Benzodiazepine use also fell, but remained relatively frequent (27%, compared with 68% four years earlier). Drinking patterns changed from strongly alcoholic beverages to lower-proof drinks. Arrest rates dropped from 70% to 25%. The percentage of persons seropositive for HIV (4%) and HCV (33%) remained low, but too many subjects had not been screened (35%). Roughly 10% of these subjects had returned to work, mainly those who had cut their drug use most. While our survey reveals some positive points, especially a reduction in illegal drug use, several negative observations appeared, including combined use of cannabis and benzodiazepines, inadequate screening, and misuse of BMD. These results underline how important it is for care providers to focus simultaneously on medical treatment and identification of co-morbidities and to provide social work when necessary. The employment rate remains too low.
... that people who are trying to end their addiction to marijuana can benefit from a treatment program that combines motivational incentives with cognitive-behavioral therapy. "Marijuana remains one of the most widely used ...
Dimitrijević, Ivan; Popović, Nada; Sabljak, Vera; Škodrić-Trifunović, Vesna; Dimitrijević, Nina
In this article we summarized the recent research of the food addiction, diagnosis, treatment and prevention, which is carried out in this area. The concept of food addiction is new and complex, but proven to be very important for understanding and solving the problem of obesity. First part of this paper emphasizes the neurological studies, whose results indicate the similarity of brain processes that are being activated during drug abuse and during eating certain types of food. In this context, different authors speak of "hyper-palatable", industrial food, saturated with salt, fat and sugar, which favor an addiction. In the section on diagnostic and instruments constructed for assessing the degree of dependence, main diagnostic tool is standardized Yale Food Addiction Scale constructed by Ashley Gearhardt, and her associates. Since 2009, when it was first published, this scale is used in almost all researches in this area and has been translated into several languages. Finally, distinguish between prevention and treatment of food addiction was made. Given that there were similarities with other forms of addictive behavior, the researchers recommend the application of traditional addiction treatment.
Wesson, D R; Ling, W; Smith, D E
Addiction medicine specialists and pain specialists can provide better patient care by combining their expertise when treating patients who are addicted to alcohol, street drugs, or prescription medications. Addiction specialists--particularly those whose primary treatment philosophy is drug free--must accept that controlled opiate maintenance is appropriate for some patients, and pain specialists need to increase their sensitivity to the possibility of addiction among their patients. Both pain and addiction are treatable conditions, and optimal care of some patients requires the coordinated services of both an addiction medicine specialist and a pain specialist.
This paper examines a number of outpatient addictions treatment programmes developed in various regions of Kenya. The uptake of outpatient services at four sites between 2007 and 2010 has been examined. A field-based follow-up survey was administered to determine abstinence rates among clients who participated ...
McFarland, Bentson H; Lierman, Walter K; Penner, Norman R; McCamant, Lynn E; Zani, Brigid G
Employee benefits managers arrange addictive disease treatment insurance coverage for the majority of people in the United States but little is known about these decision-makers. Managers were surveyed to learn their opinions about addiction treatment. Subjects were 131 people (61 percent female, 94 percent white, average age 46, average of 14 years in the human resources field). Managers were asked to rank health benefits (physical health, dental, alcohol-drug, vision, mental health, employee assistance program, and pharmaceuticals) on 15 dimensions. Managers ranked alcohol-drug abuse treatment worst on fiveitems and second to the worst on another four of the 15 dimensions. On the item considered most important by the managers, respondents noted that employees often (2.8) ask for improved physical health benefits but rarely do so for alcohol and drug (4.1) benefits (p < .001). Education of workers and payers will be needed to change opinions about treatment of addictive disorders.
Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Mar?n-Navarrete, Rodrigo
Background Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical ...
Continuing education is being provided to professionals in the addiction treatment field to help them develop skills in process improvement and better meet the needs and requests they encounter. Access and retention of individuals seeking addiction treatment have been two of the greatest challenges addiction treatment professionals face.…
Full Text Available Abstract Background After a long and controversial debate methadone maintenance treatment (MMT was first introduced in Germany in 1987. The number of patients in MMT – first low because of strict admission criteria – increased considerably since the 1990s up to some 65,000 at the end of 2006. In Germany each general practitioner (GP, who has completed an additional training in addiction medicine, is allowed to prescribe substitution drugs to opioid dependent patients. Currently 2,700 GPs prescribe substitution drugs. Psychosocial care should be made available to all MMT patients. Results The results of research studies and practical experiences clearly indicate that patients benefit substantially from MMT with improvements in physical and psychological health. MMT proves successful in attaining high retention rates (65 % to 85 % in the first years, up to 50 % after more than seven years and plays a major role in accessing and maintaining ongoing medical treatment for HIV and hepatitis. MMT is also seen as a vital factor in the process of social re-integration and it contributes to the reduction of drug related harms such as mortality and morbidity and to the prevention of infectious diseases. Some 10 % of MMT patients become drug-free in the long run. Methadone is the most commonly prescribed substitution medication in Germany, although buprenorphine is attaining rising importance. Access to MMT in rural areas is very patchy and still constitutes a problem. There are only few employment opportunities for patients participating in MMT, although regular employment is considered unanimously as a positive factor of treatment success. Substitution treatment in German prisons is heterogeneous in access and treatment modalities. Access is very patchy and the number of inmates in treatment is limited. Nevertheless, substitution treatment plays a substantial part in the health care system provided to drug users in Germany. Conclusion In Germany, a
Arria, Amelia M; Mericle, Amy A; Rallo, Deanna; Moe, Jerry; White, William L; Winters, Ken C; O'Connor, Garrett
Children of parents with substance use disorders are at risk for various adverse outcomes, and maladaptive parenting behaviors seem to be an important mediator of this risk. Although numerous research studies have highlighted the promise of parenting interventions in modifying parenting behavior, very little is known about the integration of parenting skills education and interventions into addiction treatment programs. In this study, a convenience sample of 125 addiction treatment programs in the United States was drawn. A key staff member was interviewed to gather basic information about the extent and nature of parenting skills education and interventions offered at their program. In addition, respondents were asked to rate the importance of parenting skills relative to other addiction treatment priorities. Descriptive analyses revealed that 43% reported some form of parenting classes, but few used a structured curriculum. Given the known beneficial influence of effective parenting practices on reducing adverse childhood outcomes, it is surprising that relatively few substance abuse treatment programs have adopted structured parenting skills interventions as part of their standard service offerings. More research is warranted on the extent to which parenting skills interventions are integrated into the continuum of services available to parents with a substance use disorder.
Koshkina, E A; Kirzhanova, V V; Babicheva, L P; Mugantseva, L A
The authors studied changes in the structure of drug addiction services, the dynamics of outpatient and inpatient referrals for drug addiction treatment and effectiveness of drug addiction services in 2011 compared to the preceding period. There was a reduction of availability of drug treatment services due to the reduction of the number of drug addiction units and the depletion of human resource potential. The lack of structural development of rehabilitation sector of drug care services and low rates of its development as well as the decrease in the number of patients seeking treatment are highlighted. It has been concluded that the drug addiction services require reorganization of its regulatory and legal framework and need innovative organizational and management decisions and human resources trained in innovative thinking and technologies.
Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A
We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.
Yau, Yvonne H C; Potenza, Marc N
Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.
Nace, Edgar P; Birkmayer, Florian; Sullivan, Maria A; Galanter, Marc; Fromson, John A; Frances, Richard J; Levin, Frances R; Lewis, Collins; Suchinsky, Richard T; Tamerin, John S; Westermeyer, Joseph
Coercion as a strategy for treatment of addiction is an effective but often negatively perceived approach. The authors review current policies for involuntary commitments and explore coercive dimensions of treating alcohol and drug dependence in the workplace, sports, and through professional licensure. Gender-specific issues in coercion are considered, including evidence for improved treatment retention among pregnant and parenting women coerced via the criminal justice system. Social security disability benefits represent an area where an opportunity for constructive coercion was missed in the treatment of primary or comorbid substance use disorders. The availability of third-party funding for the voluntary treatment of individuals with substance use disorders has decreased. This unmet need, coupled with the evidence for positive clinical outcomes, highlights the call for implementing socially sanctioned mechanisms of coercion.
Full Text Available Drug addiction is a complex neurological dysfunction induced by recurring drug intoxication. Strategies to prevent and treat drug addiction constitute a topic of research interest. Early-stage romantic love is characterized by some characteristics of addiction, which gradually disappear as the love relationship progresses. Therefore, comparison of the concordance and discordance between romantic love and drug addiction may elucidate potential treatments for addiction. This focused review uses the evidences from our recent studies to compare the neural alterations between romantic love and drug addiction, moreover we also compare the behavioral and neurochemical alterations between romantic love and drug addiction. From the behavioral comparisons we find that there are many similarities between the early stage of romantic love and drug addiction, and this stage romantic love is considered as a behavioral addiction, while significant differences exist between the later stage of romantic love and drug addiction, and this stage of romantic love eventually developed into a prosocial behavior. The neuroimaging comparisons suggest that romantic love and drug addiction both display the functional enhancement in reward and emotion regulation network. Except the similar neural changes, romantic love display special function enhancement in social cognition network, while drug addiction display special dysfunction in cognitive control network. The neurochemical comparisons show that there are many similarities in the dopamine (DA system, while significant differences in oxytocin (OT system for romantic love and drug addiction. These indicate that the functional alterations in reward and emotion regulation network and the DA system may be the neurophysiological basis of romantic love as a behavioral addiction, and the functional alterations in social cognition network and the OT system may be the neurophysiological basis of romantic love as a prosocial
Zou, Zhiling; Song, Hongwen; Zhang, Yuting; Zhang, Xiaochu
Drug addiction is a complex neurological dysfunction induced by recurring drug intoxication. Strategies to prevent and treat drug addiction constitute a topic of research interest. Early-stage romantic love is characterized by some characteristics of addiction, which gradually disappear as the love relationship progresses. Therefore, comparison of the concordance and discordance between romantic love and drug addiction may elucidate potential treatments for addiction. This focused review uses the evidences from our recent studies to compare the neural alterations between romantic love and drug addiction, moreover we also compare the behavioral and neurochemical alterations between romantic love and drug addiction. From the behavioral comparisons we find that there are many similarities between the early stage of romantic love and drug addiction, and this stage romantic love is considered as a behavioral addiction, while significant differences exist between the later stage of romantic love and drug addiction, and this stage of romantic love eventually developed into a prosocial behavior. The neuroimaging comparisons suggest that romantic love and drug addiction both display the functional enhancement in reward and emotion regulation network. Except the similar neural changes, romantic love display special function enhancement in social cognition network, while drug addiction display special dysfunction in cognitive control network. The neurochemical comparisons show that there are many similarities in the dopamine (DA) system, while significant differences in oxytocin (OT) system for romantic love and drug addiction. These findings indicate that the functional alterations in reward and emotion regulation network and the DA system may be the neurophysiological basis of romantic love as a behavioral addiction, and the functional alterations in social cognition network and the OT system may be the neurophysiological basis of romantic love as a prosocial behavior. It
Gerard J Connors
Full Text Available Systematic outcome assessment is central to ascertaining the impact of treatment services and to informing future treatment initiatives. This project was designed to be conducted within the clinical operations of 4 private addictions treatment centers. A structured interview was used to assess patients’ alcohol and other drug use and related variables (on treatment entry and at 1, 3, and 6 months following treatment discharge. The primary outcomes were percentage of days abstinent (PDA from alcohol and drugs, PDA from alcohol, and PDA from other drugs. Collateral reports during follow-up also were gathered. A total of 280 patients (56% men across the 4 programs participated. Percentage of days abstinent for each outcome increased significantly from baseline to the 1-month follow-up assessment, and this change was maintained at the 3- and 6-month follow-up assessments. Collateral reports mirrored the patient follow-up reports. Secondary outcomes of patient ratings of urges/cravings, depression, anxiety, and general life functioning all indicated significant improvement from baseline over the course of the follow-up. The results suggest the feasibility of conducting systematic outcome assessment in freestanding private addictions treatment environments.
Beranuy, Marta; Carbonell, Xavier; Griffiths, Mark D.
Online gaming addiction is a relatively under-researched area and there have been few studies examining online gamers in treatment. This paper reports the findings from a qualitative interview study of nine players undergoing treatment for their addictive playing of Massively Multiplayer Online Role Playing Games (MMORPGs). A face-to-face…
Przepiorka, Aneta Małgorzata; Blachnio, Agata; Miziak, Barbara; Czuczwar, Stanisław Jerzy
Internet appearance was one of the main breakthroughs for the mankind in the latest decades. It revolutionized our lives in many aspects and brought about many undeniably positive changes. However, at the same time caused negative consequences. It has led to the emergence of the Internet addiction (IA). The paper is concerned with the issue of treatment of IA. The paper reviews the current findings on the approaches to IA treatment and evaluates their effectiveness. The main focus of the article concentrates on cognitive and pharmacologic treatment. The individual approach to IA treatment is advisable. Among drugs for the management of IA, antidepressants, antipsychotics, opioid receptor antagonists, glutamate receptor antagonists, and psychostimulants may be recommended. Some antiepileptics, and especially valproate, are considered as potential drugs for the treatment of IA. Effective therapy may require an individual approach and best results are expected when psychological and pharmacological treatments are combined. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
Capurso, Noah A
Co-occurring addictive disorders are common, however treatment strategies for this population have not been extensively studied. This is especially the case for behavioral addictions. We present a patient (N = 1) with tobacco use disorder and problematic pornography use treated with naltrexone. Naltrexone treatment resulted in a decrease in pornography viewing and cigarette smoking, however had the adverse effect of anhedonia. A lower dose modestly impacted pornography viewing but not smoking. Relevant literature regarding co-occurring addictions as well as use of naltrexone is reviewed. This report represents the first case of tobacco and pornography co-addiction in the literature and supports the assertion that treatment of one addictive disorder can benefit another in the dually addicted patient. The efficacy of naltrexone for smoking is notable as previous studies of naltrexone in smoking have been disappointing. This case suggests future treatment strategies for comorbid addictions. (Am J Addict 2017;26:115-117). © 2017 American Academy of Addiction Psychiatry.
Some trends in the treatment and prevention of diseases related to alcohol, drugs and gambling are reviewed. Brief intervention is crucially important, considering high prevalence of addictive diseases. Motivation enhancement according to the stage of motivation is used in brief intervention and also during more comprehensive therapy. Psychological and pharmacological management of craving is used more than before. Close and systematic co-operation between professional services and Alcoholics Anonymous and/or other self-helping groups is common and useful. Prevention of addictive diseases includes measures such as taxation, restriction of availability, age limits, restrictions of advertisements, and prevention of drinking under the influence of alcohol and other drugs. Effective school based prevention utilises interactive programmes and training of relevant skills (e.g. refusal skills, relaxation and decision making). Prevention on family level includes appropriate family monitoring and rules, moderate and consistent family discipline and family conflict resolution. Special attention should be paid to the children whose parents are alcohol or drug dependent. These children should, even as adults, abstain from alcohol and other addictive substances.
Lingford-Hughes, A R; Davies, S J C; McIver, S; Williams, T M; Daglish, M R C; Nutt, D J
Alcohol and psycho-active substance misuse has far-reaching social, psychological and physical consequences. Advances in neuroimaging technology have allowed neurobiological theories of addiction to become better characterized. We describe the neurobiology of dependence, withdrawal, abstinence and craving states in alcohol, stimulant and opiate misuse. Structural neuroimaging techniques such as CT and MRI with new analytical approaches such as voxel-based morphometry have shown wide-spread changes in stimulant and opiate abuse and atrophy, particularly in the frontal lobes, in alcoholism. Functional neuroimaging techniques such as PET, SPECT and fMRI reveal altered regional cerebral activity by all drugs of abuse. The neurochemistry of addiction, particularly involving dopamine, serotonin, opiate and GABA, has been studied with PET and SPECT and similarities between all drugs of abuse have been found such as reduced dopaminergic markers. The evidence derived from these advances in neuroimaging is likely to herald the emergence of new biological treatments in this important field.
Passik, Steven D; Kirsh, Kenneth L
A great deal of fear exists in the world of pain management on the part of both healthcare professionals and some patients where issues of abuse, misuse, and addiction are concerned. While it might be easy to consider all pain patients as "drug seekers" or addicts, the reality remains that most pain patients are genuine; we therefore must retain pain management efforts for the many, while being aware and cognizant of the few who have problems such as addiction. To begin to separate these entities, definitions and hallmarks of addiction are explored along with discussion of screening tools that can be employed to help identify problematic patients. In addition, the concepts of dependence and tolerance are defined and separated from old notions of addiction. Finally, issues related to engaging in a multidisciplinary approach are discussed along with caveats regarding prescribing to patients who have histories or ongoing issues of addiction. © 2011 New York Academy of Sciences.
Weinstein, Aviv; Weinstein, Yitzhak
Exercise and sports activity are beneficial both physically and psychologically but excessive exercise may have adverse physiological and psychological effects. There are methodological issues in the definition, diagnosis and etiology of exercise addiction. Several questionnaires and diagnostic tools have been developed and validated and they show high validity and reliability. Exercise addiction has been suggested as having an obsessive-compulsive dimension as well as rewarding aspects that may include it among the behavioral addictions. Biological studies show that in rodents, exercise such as wheel running activates the dopamine reward system and thus contributing to stress reduction. Further evidence suggests that running is associated with endorphins and cannabinoids thus explaining the "runners high" or euphoric feelings that may lead to exercise addiction. Genetic studies suggest that genes which control preference for drugs also control the preference for naturally rewarding behaviors such as exercise. Psychological studies also explain exercise addiction in terms of reward, habituation, social support, stress-relief, avoidance of withdrawal and reduction of anxiety. It has been suggested that exercise addiction is a part of a continuum of sportive activity that develops in stages from the recreational exercise to at-risk exercise, problematic exercise and finally into exercise addiction. Assessment and treatment should take into account the various stages of exercise addiction development, its comorbidity with other psychiatric disorders such as eating disorders or substance use and alcohol disorders. Treatment approaches for exercise addiction are based on the cognitive-behavioral approach but little is known about their effectiveness. A single-case study shows promise of pharmacological treatment for exercise addiction and further studies are required. This review summarizes diagnostic and phenomenology of exercise addiction with emphasis on
Islam, Nazrul; Rahman, Shafiqur
Nicotine addiction remains the leading cause of death and disease in developed and developing nations and a major cause of mortality around the world. Currently, nicotine replacement therapies (NRTs), bupropion, and varenicline are approved by the regulatory agencies as first-line treatments for nicotine addiction. Emerging evidence indicates that varenicline and bupropion have some therapeutic limitations for treating nicotine addiction with oral route of administration. Thus, continued investigation of innovative drug delivery for nicotine addiction remains a critical priority. This review will discuss some novel strategies and future directions for pulmonary drug delivery, an emerging route of administration for smoking cessation. It is anticipated that the advancement of knowledge on pulmonary drug delivery will provide better management for nicotine addiction and other addictive disorders.
Cui, Cai-Lian; Wu, Liu-Zhen; Li, Yi-jing
Over the last four decades, there has been an increasing interest in acupuncture treatment of substance abuse around the world. Three important steps can be identified in this field. Dr. Wen of Hong Kong was the first (1972) to report that acupuncture at four body points and two ear points combined with electric stimulation can relieve opioid withdrawal signs in the addicts. The second major step was made by Dr. M. Smith in New York, the head of the National Acupuncture Detoxification Association (NADA) of the United States, who finalized a protocol (1985), using only ear points without electric stimulation for the treatment of cocaine dependence. The recent advance in this field was made by Dr. Han of the Peking University, Beijing, who characterized a protocol (2005), using electric stimulation of identified frequencies on body points to ameliorate heroin withdrawal signs and reduce relapse of heroin use. In this chapter, the efficacy of acupuncture and related techniques for the treatment of drug dependence in experimental settings and clinical practice will be reviewed, and the possible mechanisms underlying this effect be discussed. © 2013 Elsevier Inc. All rights reserved.
Panhaleux, Nathalie; Mantelet, Corinne
The nurse in an addiction treatment, support and prevention centre works within a multidisciplinary team. She is available to listen to the addicts and support them. Thanks to her specific skills and training, she plays a key role in the follow-up. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
... you might have that are tied to the addiction, such as feelings of low self-worth, a bad situation at work or home, or spending time with people who use drugs. In short, treatment helps you move into a healthy, addiction-free lifestyle—into a way of living referred ...
... and Detoxification Treatment of Opiate Addiction; Proposed Modification of Dispensing Restrictions for... of a patient's responsibility and stability to receive opioid addiction treatment medication. Opioid... addiction. The special authorization is required under federal law because these medications can be abused...
Meurk, Carla; Carter, Adrian; Partridge, Brad; Lucke, Jayne; Hall, Wayne
We investigated whether beliefs about addiction being a 'disease' or 'brain disease', and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction. Data were collected as part of the 2012 Queensland Social Survey, a computer assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted males, one who was addicted to heroin and the other addicted to alcohol. Participants were then asked a series of questions for both characters. There was widespread support for all treatment modalities (alcohol: 80.8-98.0%, heroin: 89.9-97.2%). There was less support for coerced treatment for alcohol than heroin addiction (alcohol: 41%, heroin: 71%, χ(2) = 273.90, p addicted persons in the workplace or at a dinner party. Beliefs that addiction was a 'brain disease' or a 'disease' did not predict any of these attitudes. Beliefs about addiction aetiology were inconsistent predictors of outcomes measured. Age and educational attainment were the most consistent predictors of stigmatising beliefs and beliefs about coercion and punishment. Beliefs that addiction is a 'disease' or a 'brain disease' were not associated with an overall reduction in beliefs about stigma, coercion or punishment. Beliefs in different causes of addiction were not consistent predictors of beliefs about stigma, coercion or punishment.
ANDREIA DE MOURA
Full Text Available Abstract Background In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254 from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66; receiving individual psychiatric counseling (n = 68; receiving both individual psychological and psychiatric counseling (n = 102; and receiving not only individual counseling (i.e., psychology or psychiatry, but also attending group therapy (n = 18. Results Using MANOVA and Wilks’s multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603 = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual’s probability to remain abstinent.
Full Text Available Background: Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men's experiences with addiction and alcohol treatment programs in Thailand. Objective: The aim of this study was to explore men's experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design: Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results: Through men's descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions: The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking.
Young, Kimberly S
Research over the last decade has identified Internet addiction as a new and often unrecognized clinical disorder that impact a user's ability to control online use to the extent that it can cause relational, occupational, and social problems. While much of the literature explores the psychological and social factors underlying Internet addiction, little if any empirical evidence exists that examines specific treatment outcomes to deal with this new client population. Researchers have suggested using cognitive behavioral therapy (CBT) as the treatment of choice for Internet addiction, and addiction recovery in general has utilized CBT as part of treatment planning. To investigate the efficacy of using CBT with Internet addicts, this study investigated 114 clients who suffered from Internet addiction and received CBT at the Center for Online Addiction. This study employed a survey research design, and outcome variables such as client motivation, online time management, improved social relationships, improved sexual functioning, engagement in offline activities, and ability to abstain from problematic applications were evaluated on the 3rd, 8th, and 12th sessions and over a 6-month follow-up. Results suggested that Caucasian, middle-aged males with at least a 4-year degree were most likely to suffer from some form of Internet addiction. Preliminary analyses indicated that most clients were able to manage their presenting complaints by the eighth session, and symptom management was sustained upon a 6-month follow-up. As the field of Internet addiction continues to grow, such outcome data will be useful in treatment planning with evidenced-based protocols unique to this emergent client population.
Greenfield, David N
Internet and video game addiction has been a steadily developing consequence of modern living. Behavioral and process addictions and particularly Internet and video game addiction require specialized treatment protocols and techniques. Recent advances in addiction medicine have improved our understanding of the neurobiology of substance and behavioral addictions. Novel research has expanded the ways we understand and apply well-established addiction treatments as well as newer therapies specific to Internet and video game addiction. This article reviews the etiology, psychology, and neurobiology of Internet and video game addiction and presents treatment strategies and protocols for addressing this growing problem. Copyright © 2017 Elsevier Inc. All rights reserved.
Neale, Joanne; Tompkins, Charlotte N E; Strang, John
Relationships between peers are often considered central to the therapeutic process, yet there is relatively little empirical research either on the nature of peer-to-peer relationships within residential treatment or on how those relationships generate positive behaviour change or facilitate recovery. In this paper, we explore relationships between peers in residential addiction treatment, drawing upon the concept of social capital to frame our analyses. Our study was undertaken during 2015 and 2016 in two English residential treatment services using the same therapeutic community-informed model of treatment. We conducted 22 in-depth interviews with 13 current and 9 former service residents. All interviews were audio-recorded, transcribed verbatim, coded in MAXQDA, and analysed using Iterative Categorisation. Residents reported difficult relationship histories and limited social networks on entry into treatment. Once in treatment, few residents described bonding with their peers on the basis of shared experiences and lifestyles. Instead, interpersonal differences polarised residents in ways that undermined their social capital further. Some senior peers who had been in residential treatment longer acted as positive role models, but many modelled negative behaviours that undermined others' commitment to treatment. Relationships between peers could generate feelings of comfort and connectedness, and friendships developed when residents found things in common with each other. However, residents more often reported isolation, loneliness, wariness, bullying, manipulation, intimidation, social distancing, tensions and conflict. Overall, relationships between peers within residential treatment seemed to generate some positive but more negative social capital; undermining the notion of the community as a method of positive behaviour change. With the caveat that our data have limitations and further research is needed, we suggest that residential treatment providers should
Full Text Available Kathlene Tracy,1,2 Samantha P Wallace3 1Community Research and Recovery Program (CRRP, Department of Psychiatry, New York University School of Medicine, 2New York Harbor Healthcare System (NYHHS, New York, 3Department of Community Health Sciences, State University of New York Downstate School of Public Health, Brooklyn, NY, USA Objective: Peer support can be defined as the process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems. Recently, there has been a dramatic rise in the adoption of alternative forms of peer support services to assist recovery from substance use disorders; however, often peer support has not been separated out as a formalized intervention component and rigorously empirically tested, making it difficult to determine its effects. This article reports the results of a literature review that was undertaken to assess the effects of peer support groups, one aspect of peer support services, in the treatment of addiction.Methods: The authors of this article searched electronic databases of relevant peer-reviewed research literature including PubMed and MedLINE.Results: Ten studies met our minimum inclusion criteria, including randomized controlled trials or pre-/post-data studies, adult participants, inclusion of group format, substance use-related, and US-conducted studies published in 1999 or later. Studies demonstrated associated benefits in the following areas: 1 substance use, 2 treatment engagement, 3 human immunodeficiency virus/hepatitis C virus risk behaviors, and 4 secondary substance-related behaviors such as craving and self-efficacy. Limitations were noted on the relative lack of rigorously tested empirical studies within the literature and inability to disentangle the effects of the group treatment that is often included as a component of other services
Simpson, D. Dwayne; Joe, George W.; Knight, Kevin; Rowan-Szal, Grace A.; Gray, Julie S.
The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (one-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for…
The workplace can be concerned by all types and all levels of addictive practices: consumption of alcohol or psychoactive substances, work addiction, internet addiction and technology addiction. Addictions can be related to multiple factors, both within and outside the workplace. With the employer, responsible for occupational health and safety, the multidisciplinary team of the inter-company occupational health service must today implement a collective and global prevention policy with regard to addictions, in addition to the traditional follow-up. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Kulesza, Magdalena; Hunter, Sarah B; Shearer, Amy L; Booth, Marika
To further our knowledge about feasible targets for improving quality of addiction treatment services, the current study provides preliminary assessment of the relationship between provider stigma and indicators of staff turnover. As predicted, results suggest that higher provider stigma was significantly related to lower ratings of job satisfaction and workplace climate. However, provider stigma was not significantly related to burnout. Our preliminary findings, if replicated, suggest the importance of considering provider stigma as a risk factor for future staff turnover and job dissatisfaction. Promising provider stigma interventions do exist and offer viable opportunity for improving quality of addiction treatment.
Immunotherapy has a great potential of becoming a new therapeutic strategy in the treatment of addiction to psychoactive drugs. It may be used to treat addiction but also to prevent neurotoxic complications of drug overdose. In preclinical studies two immunological methods have been tested; active immunization, which relies on the administration of vaccines and passive immunization, which relies on the administration of monoclonal antibodies. Until now researchers have succeeded in developing vaccines and/or antibodies against addiction to heroin, cocaine, methamphetamine, nicotine and phencyclidine. Their effectiveness has been confirmed in preclinical studies. At present, clinical studies are being conducted for vaccines against nicotine and cocaine and also anti-methamphetamine monoclonal antibody. These preclinical and clinical studies suggest that immunotherapy may be useful in the treatment of addiction and drug overdose. However, there are a few problems to be solved. One of them is controlling the level of antibodies due to variability between subjects. But even obtaining a suitable antibody titer does not guarantee the effectiveness of the vaccine. Additionally, there is a risk of intentional or unintentional overdose. As vaccines prevent passing of drugs through the blood/brain barrier and thereby prevent their positive reinforcement, some addicted patients may erroneously seek higher doses of psychoactive substances to get "high". Consequently, vaccination should be targeted at persons who have a strong motivation to free themselves from drug dependency. It seems that immunotherapy may be an opportunity for effective treatment of drug addiction if directed to adequate candidates for treatment. For other addicts, immunotherapy may be a very important element supporting psycho- and pharmacotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.
Zhu, Weili; Zhang, Yinan; Huang, Yingjie; Lu, Lin
This chapter summarizes recent developments in preclinical and clinical research on Chinese herbal medicines and their neurochemical mechanism of action for the treatment of drug addiction. We searched Chinese and English scientific literature and selected several kinds of Chinese herbal medicines that have beneficial effects on drug addiction. Ginseng (Renshen) may be clinically useful for the prevention of opioid abuse and dependence. Rhizoma Corydalis (Yanhusuo) may be used to prevent relapse to chronic drug dependence. Alkaloids of Uncaria rhynchophylla (Gouteng) appear to have positive effects on methamphetamine and ketamine addiction. Both Salvia miltiorrhiza (Danshen) and Radix Pueraiae (Gegen) have beneficial inhibitory effects on alcohol intake. Sinomenine has been shown to have preventive and curative effects on opioid dependence. l-Stepholidine, an alkaloid extract of the Chinese herb Stephania intermedia (Rulan), attenuated the acquisition, maintenance, and reacquisition of morphine-induced conditioned place preference and antagonized the heroin-induced reinstatement of heroin seeking. Traditional Chinese herbal medicines may be used to complement current treatments for drug addiction, including withdrawal and relapse. As the molecular mechanisms of action of traditional Chinese herbal medicines are elucidated, further advances in their use for the treatment of drug addiction are promising. © 2017 Elsevier Inc. All rights reserved.
This article is exploring different forms of constraint that are exerted in the field of drug addiction treatment. The objective of this article is to establish benchmarks and to stimulate reflection about the ethical and clinical implications of those constraints in the field of drug addiction treatment. This article is presenting a critical review of different forms of constraint that can be exerted in Canada in regard to the treatment of drug addiction. In the first section of the article, a definition of therapeutic intervention is proposed, that includes the dimension of power, which justifies the importance of considering the coercive aspects of treatment. The second section, which represents the core section of the paper, is devoted to the presentation of different levels of constraint that can be distinguished in regard to drug addicts who are under treatment. Three levels of constraint are exposed: judicial constraint, institutional constraint and relational constraint. The coercive aspect of treatment can then be recognized as a combination of all tree levels of constraint. Judicial constraint refers to any form of constraint in which the court or the judge is imposing or recommending treatment. This particular level of constraint can take different forms, such as therapeutic remands, conditions of a probation order, conditions of a conditional sentence of imprisonment, and coercive treatment such as the ones provided through drug courts. Institutional constraint refers to any form of constraint exerted within any institutional setting, such as correctional facilities and programs offered in community. Correctional facilities being limited by their own specific mission, it might have a major impact on the way the objectives of treatment are defined. Those limitations can then be considered as a form of constraint, in which drug users don't have much space to express their personal needs. Finally, relational constraint refers to any form of constraint in
Simpson, D Dwayne; Joe, George W; Dansereau, Donald F; Flynn, Patrick M
For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs-the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969-89), the second focused upon modeling the treatment process and the importance of conceptual frameworks (1989-2009) in explaining the relationships among treatment environment, client attributes, treatment process and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus upon adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug-dependent criminal justice populations. Related issues include the spread of human immunodeficiency virus/acquired immune deficiency syndrome and other infectious diseases, organizational and systems functioning, treatment costs and process related to implementation of evidence-based practices. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
Wood, Thomas E; Englander-Golden, Paula; Golden, David E; Pillai, Vijayan K
The present research tested the effectiveness of adding an interpersonal, interactive, experiential training programme to addictions treatment that enhances motivation, cognitive-behavioural coping skills, social support, and group cohesiveness. The research was conducted in a co-educational, long-term residential treatment facility for addictive disorders (alcohol and other substances, sexual addiction, eating disorders, compulsive shopping, and gambling) and concomitant psychiatric diagnoses. The added training is co-created by participants. They choose challenging situations important in their lives that are played out as 'movies' in which they play and experience all the parts. Motivation for change, skills to implement positive changes, self-efficacy, empathy, positive support, and group cohesiveness are rooted in their own experiences and the feedback they receive from others, as they behave in empowering and disempowering ways. The training resulted in significant increases in empowering communication, self-esteem and quality of group life in the treatment group and in the family. Many of these results have large effect sizes and are consistent with the findings from prior studies. The results obtained in this study suggest that Say It Straight training can be an effective addition to the treatment of addictions in residential treatment. Future research is needed to determine the long-term effects of this training on relapse.
Martin P Paulus
Full Text Available There is emerging evidence that individuals with drug addiction have dysfunctions in brain systems that are important for interoceptive processing, which include, among others, the insular and the anterior cingulate cortices. These individuals may not be expending sufficient neural resources to process perturbations of the interoceptive state but may exert over-activation of these systems when processing drug-related stimuli. As a consequence, insufficient detection and processing of interoceptive state changes may result in inadequate anticipation and preparation to adapt to environmental challenges, e.g. adapt to abstinence in the presence of withdrawal symptoms. Here, we integrate interoceptive dysfunction in drug-addicted individuals, with the neural basis for meditation and exercise to develop a heuristic to target the interoceptive system as potential treatments for drug addiction. First, it is suggested that mindfulness-based approaches can modulate both interoceptive function and insular activation patterns. Second, there is an emerging literature that the regulation of physical exercise in the brain involves the insula and anterior cingulate cortex and that intense physical exercise is associated with a state-dependent activation difference in the insula that may provide a window to attenuate the increased interoceptive response drug related stimuli. It is concluded that the conceptual framework of interoceptive dysfunctions in drug addiction and the experimental findings in meditation and exercise provide a useful approach to develop new interventions for drug addiction.
Shidlansik, Lia; Adelson, Miriam; Peles, Einat
Stigma attached to methadone maintenance treatment is very common. The objective of the current article is to evaluate the presence of stigma and its relation to the extent of knowledge about methadone maintenance treatment. The authors conducted a survey among methadone maintenance treatment and non-methadone maintenance treatment addiction therapists from different treatment centers in Israel, including methadone maintenance treatment clinics (Ministry of Health) and non-methadone maintenance treatment addiction facilities (Ministry of Social Services), using an anonymous questionnaire about methadone maintenance treatment stigma and knowledge. There were 63 therapists from methadone maintenance treatment clinics (63%) and 46 therapists from the social services department (SSD) non-methadone maintenance treatment addiction facilities (9.2%) who responded. Methadone maintenance treatment versus social services department personnel were older (42.7 ± 12.8 versus 37.5 ± 8.2 years; p = 0.03), with fewer females (48 versus 75%; p = 0.006), and 50% were social workers compared to 100% social workers in the SSD group (p methadone maintenance treatment personnel compared to the social services department personnel (3 ± 2.5 versus 5.0 ± 3.5; p = 0.0001), while the knowledge score about methadone maintenance treatment was higher among the methadone maintenance treatment personnel (10.3 ± 2.9 versus 7.7 ± 2.8; p methadone maintenance treatment (R = -0.5, p methadone maintenance treatment, with ignorance and stigma against methadone maintenance treatment being more pronounced among social services department personnel. An educational intervention, especially among social services department personnel, may benefit people who use opioids and improve the overall quality of treatment for opioid addiction in Israel.
Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.
Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048
Full Text Available Internet addiction has become a serious mental health condition in many countries. To better understand the clinical implications of Internet addiction, this study tested statistically a new theoretical model illustrating underlying cognitive mechanisms contributing to development and maintenance of the disorder. The model differentiates between a generalized Internet addiction (GIA and specific forms. This study tested the model on GIA on a population of general Internet users. The findings from 1019 users showed that the hypothesized structural equation model explained 63.5% of the variance of GIA symptoms, as measured by the short version of the Internet Addiction Test (s-IAT. Using psychological and personality testing, the results show that a person’s specific cognitions (poor coping and cognitive expectations increased the risk for generalized Internet addiction. These two factors mediated the symptoms of GIA if other risk factors were present such as depression, social anxiety, low self-esteem, low self-efficacy, and high stress vulnerability to name a few areas that were measured in the study. The model shows that individuals with high coping skills and no expectancies that the Internet can be used to increase positive or reduce negative mood are less likely to engage in problematic Internet use, even when other personality or psychological vulnerabilities are present. The implications for treatment include a clear cognitive component to the development of generalized Internet addiction and the need to assess a patient’s coping style and cognitions and improve faulty thinking to reduce symptoms and engage in recovery.
Lozano-Verduzco, Ignacio; Romero-Mendoza, Martha; Marín-Navarrete, Rodrigo
Violence against women is a social and public health issue in Mexico. The aim of this article is to explore violence among an understudied group of women, who attended Mutual-Aid Residential Centers for Addiction Treatment and experienced stigma both as women and addicts. These centers are particular kind of addiction treatment services that stem from 12-step philosophy, but that have been found to manipulate said philosophy and exercise extreme forms of psychological and physical violence. Thirteen semi-structured interviews were carried in 2014 and 2015 out with women who resided in at least one of these centers to understand their experiences of violence prior and during their rehabilitation process. The interview guide covered questions regarding substance use initiations, family violence and dynamics, and rehabilitation experiences. Qualitative data was analyzed using interpretative-phenomenological analysis. Two categories emerged: violence and substance use and abuse, and violence against women in recovery. Results show that all participants experienced violence in their family since childhood, particularly sexual and physical violence. As a result, participants experienced guilt, sadness and shame, which led them to contexts of consumption. Violence continued as they explored alcohol and drug use, even though women felt empowered. Treatment reproduced masculine violence constantly, but women felt that they were in a context that helped them understand their addiction. Even though women felt these centers played a crucial role in their recovery, women's particular needs and experiences are not considered in the treatment program.
Welbel, Marta; Matanov, Aleksandra; Moskalewicz, Jacek; Barros, Henrique; Canavan, Reamonn; Gabor, Edina; Gaddini, Andrea; Greacen, Tim; Kluge, Ulrike; Lorant, Vincent; Esteban Pena, Mercedes; Schene, Aart H.; Soares, Joaquim J. F.; Strassmayr, Christa; Vondrackova, Petra; Priebe, Stefan
Aim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries. Methods: Services providing mental health care and support in deprived areas of 14 EU
Johnson, Byron R; Lee, Matthew T; Pagano, Maria E; Post, Stephen G
Adolescent addiction has emerged as a major public health problem. The greatest increase in alcohol and other drug use disorders can be found among youth. Concurrently, technological advances in policing coupled with aggressive prosecuting and sentencing practices have contributed to the growth of America's correctional system. The assertive response of policing, courts, and corrections, however, have not prevented the dramatic rise of adolescent addiction. Unfortunately, there is no national data tracking addicted youth in the criminal justice system to evaluate what works when it comes to youth with addiction. This article reviews justice system responses to adolescent offenders with addiction, and promising approaches engaging juveniles in programmatic components of Alcoholics Anonymous (AA). This study highlights the role of spirituality, service to others, and social support in maintaining sobriety, reducing arrests, and lowering recidivism for adolescents court-referred to treatment. Recommendations for improving the response to adolescent offenders with addiction are offered.
This paper advocates for the incorporation of a women-specific sexuality curriculum in the addiction treatment process to aid in sexual healing and provide for aftercare issues. Sexuality in addiction treatment modalities is often approached from a sex-negative stance, or that of sexual victimization. Sexual issues are viewed as addictive in and…
Krull, Ivy; Lundgren, Lena; Beltrame, Clelia
Research studies have identified addiction treatment staff who have higher levels of education as having more positive attitudes about evidence-based treatment practices, science-based training, and the usefulness of evidence-based practices. This study examined associations between addiction treatment staff level of education and their perceptions of 3 measures of organizational change: organizational stress, training resources and staffing resources in their treatment unit. The sample included 588 clinical staff from community-based substance abuse treatment organizations who received Substance Abuse and Mental Health Services Administration (SAMHSA) funding (2003-2008) to implement evidence-based practices (EBPs). Bivariate analysis and regression modeling methods examined the relationship between staff education level (no high school education, high school education, some college, associate's degree, bachelor's degree, master's degree, doctoral degree, and other type of degree such as medical assistant, registered nurse [RN], or postdoctoral) and attitudes about organizational climate (stress), training resources, and staffing resources while controlling for staff and treatment unit characteristics. Multivariable models identified staff with lower levels of education as having significantly more positive attitudes about their unit's organizational capacity. These results contradict findings that addiction treatment staff with higher levels of education work in units with greater levels of organizational readiness for change. It cannot be inferred that higher levels of education among treatment staff is necessarily associated with high levels of organizational readiness for change.
Marsch, Lisa A
Technology such as the Internet and mobile phones offers considerable promise for affecting the assessment, prevention, and treatment of and recovery from substance use disorders. Technology may enable entirely new models of behavioral health care within and outside of formal systems of care. This article reviews the promise of technology-based therapeutic tools for affecting the quality and reach of addiction treatment and recovery support systems, as well as the empirical support to date for this approach. Potential models for implementing technology-based interventions targeting substance use disorders are described. Opportunities to optimize the effectiveness and impact of technology-based interventions targeting addiction and recovery, along with outstanding research needs, are discussed.
Van Gordon, William; Shonin, Edo; Griffiths, Mark D.
Background: Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on the guidelines for treating other behavioral (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (...
Parry, Charles; Rich, Eileen; Van Hout, Marie-Claire; Deluca, Paolo
Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector.\\ud Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence.\\ud Method. Twenty addiction treatment providers linked to th...
Sajid, Ayesha; Whiteman, Aaron; Bell, Richard L; Greene, Marion S; Engleman, Eric A; Chambers, R Andrew
Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university-affiliated integrated mental health-addiction treatment clinic. Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long-acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders. There were no group differences post-injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol-only patients. Post-first injection, UDS's positive for opioids declined (p prescriptions (p prescriptions to those patients. (Am J Addict 2016;25:557-564). © 2016 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP).
Dalvand, S; Agahi, C; Spencer, C
A sample survey of 200 addicts attending the Rehabilitation Centre at Shiraz was conducted after the 1979 Iranian Revolution had disrupted both drug supply and addict treatment programmes. The study showed that clinics were, after the revolution, seeing a broader social range of addicts than before; and that action by the authorities was bringing many recently-addicted individuals to clinics. Heroin use predominated among those who were urban residents, whilst villagers were more likely to be opium users. The survey also sought the addicts' perceptions of the reasons for their initiation and addiction.
Full Text Available Substance-use disorders (SUD cause severe problems both globally and locally. Research suggests that multiple addictions create a more complex illness. This study investigated whether in-patients admitted for SUD at three drug treatment centres in Durban, South Africa had other, undiagnosed addictions. It utilised a three-phase concurrent mixed-methods design and initially screened for gambling and sex addiction. Results showed that, of the sample of 123 participants, 54% had either sex or gambling and 24% had both addictions which current treatment programmes neither assessed for nor treated. Recommendations include suggestions to update current assessment and treatment approaches and the need to train professional staff at drug treatment centres.
M. Foster Olive
Full Text Available Glutamate plays a pivotal role in drug addiction, and the N-methyl-D-aspartate (NMDA glutamate receptor subtype serves as a molecular target for several drugs of abuse. In this review, we will provide an overview of NMDA receptor structure and function, followed by a review of the mechanism of action, clinical efficacy, and side effect profile of NMDA receptor ligands that are currently in use or being explored for the treatment of drug addiction. These ligands include the NMDA receptor modulators memantine and acamprosate, as well as the partial NMDA agonist D-cycloserine. Data collected to date suggest that direct NMDA receptor modulators have relatively limited efficacy in the treatment of drug addiction, and that partial agonism of NMDA receptors may have some efficacy with regards to extinction learning during cue exposure therapy. However, the lack of consistency in results to date clearly indicates that additional studies are needed, as are studies examining novel ligands with indirect mechanisms for altering NMDA receptor function.
Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis
This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…
Sorensen, Andrew A.; Leske, M. Cristina
This paper, presented at the American Public Health Association meeting; Chicago, November 1975, discusses a staff training program at a drug addiction treatment facility established for Spanish-speaking (and other) drug addicts. Staff improved counseling skills and knowledge of drug addiction, but changed little in attitudes toward drug use and…
Brewer, Judson A.; Elwafi, Hani M.; Davis, Jake H.
Humans suffer heavily from substance use disorders and other addictions. Despite much effort that has been put into understanding the mechanisms of the addictive process, treatment strategies have remained sub-optimal over the past several decades. Mindfulness training, which is based on ancient Buddhist models of human suffering, has recently shown preliminary efficacy in treating addictions. Interestingly, these early models show remarkable similarity to current models of the addictive proc...
David Miller; Merlene Miller; Kenneth Blum; Rajendra D. Badgaiyan; Marcelo Febo
There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call “Reward Deficiency Syndrome (RDS)”. While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use “aftercare” to refer to any form of program or therapy following primary treatment including 12-Ste...
Brand, Matthias; Laier, Christian; Young, Kimberly S.
Internet addiction (IA) has become a serious mental health condition in many countries. To better understand the clinical implications of IA, this study tested statistically a new theoretical model illustrating underlying cognitive mechanisms contributing to development and maintenance of the disorder. The model differentiates between a generalized Internet addiction (GIA) and specific forms. This study tested the model on GIA on a population of general Internet users. The findings from 1019 users show that the hypothesized structural equation model explained 63.5% of the variance of GIA symptoms, as measured by the short version of the Internet Addiction Test. Using psychological and personality testing, the results show that a person’s specific cognitions (poor coping and cognitive expectations) increased the risk for GIA. These two factors mediated the symptoms of GIA if other risk factors were present such as depression, social anxiety, low self-esteem, low self-efficacy, and high stress vulnerability to name a few areas that were measured in the study. The model shows that individuals with high coping skills and no expectancies that the Internet can be used to increase positive or reduce negative mood are less likely to engage in problematic Internet use, even when other personality or psychological vulnerabilities are present. The implications for treatment include a clear cognitive component to the development of GIA and the need to assess a patient’s coping style and cognitions and improve faulty thinking to reduce symptoms and engage in recovery. PMID:25426088
Book, Sarah W; Thomas, Suzanne E; Dempsey, Jared P; Randall, Patrick K; Randall, Carrie L
Individuals with social anxiety have difficulty participating in group settings. Although it makes intuitive sense that social anxiety could present a challenge in addiction treatment settings, which often involve small groups and encouragement to participate in self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), to our knowledge no study has yet assessed the impact of shyness on the treatment experience. Assessment surveys were given to 110 individuals seeking intensive outpatient substance abuse treatment at three community treatment programs. Established cut-offs for presence of clinically-significant social anxiety indicated a prevalence of 37%. Controlling for depression and worry, social anxiety was a unique predictor of endorsement that shyness interfered with willingness to talk to a therapist, speak up in group therapy, attend AA/NA, and ask somebody to be a sponsor. Socially anxious substance abusers were 4-8 times more likely to endorse that shyness interfered with addiction treatment activities. These findings have clinical and research implications.
Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A
Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members
Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab
This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. A covariance analysis test and independent and dependent t -test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.
Werb, Dan; Strathdee, Steffanie A; Meza, Emilo; Rangel Gomez, Maria Gudelia; Palinkas, Lawrence; Medina-Mora, Maria Elena; Beletsky, Leo
Mexico has experienced disproportionate drug-related harms given its role as a production and transit zone for illegal drugs destined primarily for the USA. In response, in 2009, the Mexican federal government passed legislation mandating pre-arrest diversion of drug-dependent individuals towards addiction treatment. However, this federal law was not specific about how the scale-up of the addiction treatment sector was to be operationalised. We therefore conducted in-depth qualitative interviews with key 'interactors' in fields affected by the federal legislation, including participants from the law enforcement, public health, addiction treatment, and governmental administration sectors. Among 19 participants from the municipal, state and federal levels were interviewed and multiple barriers to policy reform were identified. First, there is a lack of institutional expertise to implement the reform. Second, the operationalisation of the reform was not accompanied by a coordinated action plan. Third, the law is an unfunded mandate. Institutional barriers are likely hampering the implementation of Mexico's policy reform. Addressing the concerns expressed by interactors through the scale-up of services, the provision of increased training and education programmes for stakeholders and a coordinated action plan to operationalise the policy reform are likely needed to improve the policy reform process.
Fayne, M; Silvan, M
For the most part, physician-addict patients are affable, cooperative and tend to be bright, verbal and engaging. However, on a deeper level they experience significant internal obstacles to truly using treatment. The role of the healer adopted after years of training and work experience is not easily exchanged for the role of patient. Furthermore, the armour of defenses and character style that have been built up over a lifetime is resistant to modification. Additionally, most of these patients have not chosen to change. They have been ordered into treatment under considerable duress and are aware that retaining their hard-earned careers is dependent on their successful performance in treatment. Given all these difficulties it is striking that the vast majority of these patients gradually come to experience a genuine and meaningful connection to the group and the therapeutic process. They develop close relationships with their fellow group members and come to use them as a support system, even at times when the group is not in session. They report looking forward to group and missing it when it does not meet. In this context they begin to take risks by sharing on a deeper level and slowly bring to the group issues in their life other than addiction. Their devotion to group is reflected by the fact that when no longer mandated, many continue voluntarily and maintain that the experience is central to their recovery. One of the major reasons recovering physicians are able to make this connection is that behind their fear of interpersonal relationships is a tremendous wish to join with others. Many report profound relief at discovering they are not alone and are able to use group to address their deeply felt sense of shame. For many this is their first experience of such strong feelings of attachment and affiliation to a group of peers. Their prior professional experience did not routinely allow for such relationships and as Smith (1978) has observed, their experience
Hartzler, Bryan; Donovan, Dennis M; Tillotson, Carrie J; Mongoue-Tchokote, Solange; Doyle, Suzanne R; McCarty, Dennis
Adoption of contingency management (CM) by the addiction treatment community is limited to date despite much evidence for its efficacy. This study examined systemic and idiographic staff predictors of CM adoption attitudes via archival data collected from treatment organizations affiliated with the National Drug Abuse Treatment Clinical Trials Network. Multilevel modeling analyses evaluated potential predictors from organizational, treatment unit, and workforce surveys. Among these were individual and shared perceptions of staff concerning aspects of their clinic culture and climate. Modeling analyses identified three systemic predictors (clinic provision of opiate agonist services, national accreditation, and lesser shared perception of workplace stress) and five idiographic predictors (staff with a graduate degree, longer service tenure, managerial position, e-communication facility, and openness to change in clinical procedures). Findings are discussed as they relate to extant literature on CM attitudes and established implementation science constructs, and their practical implications are discussed. Published by Elsevier Inc.
Simpson, D. Dwayne; Joe, George W.; Dansereau, Donald F.; Flynn, Patrick M.
For over 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services, and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs – the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969-1989), the second focused on modeling the treatment process and the importance of conceptual frameworks (1989-2009) in explaining the relationships among treatment environment, client attributes, treatment process, and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus on adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug-dependent criminal justice populations. Related issues include the spread of HIV/AIDS and other infectious diseases, organizational and systems functioning, treatment costs, and process related to implementation of evidence-based practices. PMID:20840168
Van Gordon, William; Shonin, Edo; Griffiths, Mark D
Background Sex addiction is a disorder that can have serious adverse functional consequences. Treatment effectiveness research for sex addiction is currently underdeveloped, and interventions are generally based on the guidelines for treating other behavioral (as well as chemical) addictions. Consequently, there is a need to clinically evaluate tailored treatments that target the specific symptoms of sex addiction. It has been proposed that second-generation mindfulness-based interventions (SG-MBIs) may be an appropriate treatment for sex addiction because in addition to helping individuals increase perceptual distance from craving for desired objects and experiences, some SG-MBIs specifically contain meditations intended to undermine attachment to sex and/or the human body. The current study conducts the first clinical investigation into the utility of mindfulness for treating sex addiction. Case presentation An in-depth clinical case study was conducted involving an adult male suffering from sex addiction that underwent treatment utilizing an SG-MBI known as Meditation Awareness Training (MAT). Following completion of MAT, the participant demonstrated clinically significant improvements in addictive sexual behavior, as well as reductions in depression and psychological distress. The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at 6-month follow-up. Discussion and conclusion The current study extends the literature exploring the applications of mindfulness for treating behavioral addiction, and findings indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.
Full Text Available Ghoncheh Raheb,1,2 Esmat Khaleghi,1 Amir Moghanibashi-Mansourieh,1 Ali Farhoudian,2 Robab Teymouri3 1Department of Social Work, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Purpose: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods: This is an experimental plan (pretest to posttest with a control group; the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30 and control (30 groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. Keywords: social work, intervention, systematic approach, general health, opioid addicts
Guydish, Joseph; Ziedonis, Douglas; Tajima, Barbara; Seward, Greg; Passalacqua, Emma; Chan, Mable; Delucchi, Kevin; Zammarelli, Lucy; Levy, Michael; Kolodziej, Monika; Brigham, Greg
Smoking prevalence among persons in addiction treatment is 3-4 times higher than in the general population. However, treatment programs often report organizational barriers to providing tobacco-related services. This study assessed the effectiveness of a six month organizational change intervention, Addressing Tobacco Through Organizational Change (ATTOC), to improve how programs address tobacco dependence. The ATTOC intervention, implemented in three residential treatment programs, included consultation, staff training, policy development, leadership support and access to nicotine replacement therapy (NRT) medication. Program staff and clients were surveyed at pre- and post-intervention, and at 6 month follow-up. The staff survey measured knowledge of the hazards of smoking, attitudes about and barriers to treating smoking, counselor self-efficacy in providing such services, and practices used to address tobacco. The client survey measured knowledge, attitudes, and tobacco-related services received. NRT use was tracked. From pre- to post-intervention, staff beliefs became more favorable toward treating tobacco dependence (F(1, 163)=7.15, p=0.008), NRT use increased, and tobacco-related practices increased in a non-significant trend (F(1, 123)=3.66, p=0.058). Client attitudes toward treating tobacco dependence became more favorable (F(1, 235)=10.58, p=0.0013) and clients received more tobacco-related services from their program (F(1, 235)=92.86, p<0.0001) and from their counselors (F(1, 235)=61.59, p<0.0001). Most changes remained at follow-up. The ATTOC intervention can help shift the treatment system culture and increase tobacco services in addiction treatment programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Gouzoulis-Mayfrank, Euphrosyne; König, Susanne; Koebke, Stefan; Schnell, Thomas; Schmitz-Buhl, Mario; Daumann, Jörg
Patients with psychosis often develop comorbid addiction, with a lifetime prevalence of ca. 50%. Dual diagnoses are considered hard to treat. Long-term integrated treatment programs might improve such patients' outcomes, at least to a moderate extent, but they have not yet been adequately studied or implemented in Germany to date. 100 dual diagnosis patients participated in a single-center, randomized, controlled trial under standard hospital treatment conditions. They were randomly allotted to two groups. Patients in the intervention group were admitted to a specialized open hospital ward, where they were given integrated treatment, including disorder-specific group therapy. Their treatment was continued with further disorder-specific group therapy in the outpatient setting. Patients in the control group were admitted to an open general psychiatric ward and received treatment as usual, but no disorder-specific treatment either during their hospitalization or in the subsequent outpatient phase. Follow-up examinations were performed three, six, and twelve months after inclusion. The primary outcome was defined as the changes in substance use and abstinence motivation. The secondary outcome consisted of the patients' satisfaction with treatment and with life in general, retention rate, psychopathology, rehospitalizations, and global level of functioning. The patients in the intervention group developed higher abstinence motivation than those in the control group (p = 0.009) and transiently reduced their substance use to a greater extent (p = 0.039 at three months). They were also more satisfied with their treatment (group effect: p = 0.011). Their global level of functioning and their retention rate were also higher, but these differences did not reach statistical significance. Low-threshold, motivational, integrated treatment programs with psycho-educative and behavioral therapeutic elements may be helpful in the treatment of dual diagnosis patients and should be
Wong, Jellena; Marshall, Brandon D. L.; Kerr, Thomas; Lai, Calvin; Wood, Evan
Very little is known about the accessibility and potential barriers to addiction treatment among street youths and young adults. We sought to examine the prevalence and correlates of enrollment in addiction treatment among a cohort of street-involved youths and young adults in Vancouver, Canada. Street-involved youths and young adults who use…
Full Text Available We examined the prevalence of substance use disorders among homeless and vulnerably housed persons in three Canadian cities and its association with unmet health care needs and access to addiction treatment using baseline data from the Health and Housing in Transition Study.In 2009, 1191 homeless and vulnerably housed persons were recruited in Vancouver, Toronto, and Ottawa, Canada. Interviewer administered questionnaires collected data on socio-demographics, housing history, chronic health conditions, mental health diagnoses, problematic drug use (DAST-10≥6, problematic alcohol use (AUDIT≥20, unmet physical and mental health care needs, addiction treatment in the past 12 months. Three multiple logistic regression models were fit to examine the independent association of substance use with unmet physical health care need, unmet mental health care need, and addiction treatment.Substance use was highly prevalent, with over half (53% screening positive for the DAST-10 and 38% screening positive for the AUDIT. Problematic drug use was 29%, problematic alcohol use was lower at 16% and 7% had both problematic drug and alcohol use. In multiple regression models for unmet need, we found that problematic drug use was independently associated with unmet physical (adjusted odds ratio [AOR] 1.95; 95% confidence interval [CI] 1.43-2.64 and unmet mental (AOR 3.06; 95% CI 2.17-4.30 health care needs. Problematic alcohol use was not associated with unmet health care needs. Among those with problematic substance use, problematic drug use was associated with a greater likelihood of accessing addiction treatment compared to those with problematic alcohol use alone (AOR 2.32; 95% CI 1.18-4.54.Problematic drug use among homeless and vulnerably housed individuals was associated with having unmet health care needs and accessing addiction treatment. Strategies to provide comprehensive health services including addiction treatment should be developed and integrated
Xu, Chaoying S.; Chen, Jessica S.; Adelman, Ron A.
Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature sup...
Yau, Yvonne H. C.; Potenza, Marc N.
Addiction professionals and the public are recognizing that certain nonsubstance behaviors—such as gambling, Internet use, video-game playing, sex, eating, and shopping—bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or “behavioral” addictions and has led to the newly introduced diagnostic category “Substance-Related and Addictive Disorders” in DSM-5. At present, only gambling disorder has been placed in thi...
Brand, Matthias; Laier, Christian; Young, Kimberly S.
Internet addiction has become a serious mental health condition in many countries. To better understand the clinical implications of Internet addiction, this study tested statistically a new theoretical model illustrating underlying cognitive mechanisms contributing to development and maintenance of the disorder. The model differentiates between a generalized Internet addiction (GIA) and specific forms. This study tested the model on GIA on a population of general Internet users. The findings...
Bandawar, Mrunal; Narasimha, Venkata Lakshmi; Chand, Prabhat
The expanding use of digital technology in mental health has widened the scope of emerging addiction interventions. This review focus on the use of technological advances in the field of addiction and mental health. We discuss about how these advances has been implemented in addiction treatment and research. Further, we also mention about the utilisation of these services in India.
Full Text Available The administration of dopaminergic medication to treat the symptoms of Parkinson’s disease (PD is associated with addictive behaviors and impulse control disorders. Little is known, however, on how PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavioral addiction patients with and without PD. N = 2,460 treatment-seeking men diagnosed with a behavioral addiction were recruited from a university hospital. Sociodemographic, impulsivity [Barratt Impulsiveness Scale (BIS-11], and personality [Temperament and Character Inventory-Revised (TCI-R] measures were taken upon admission to outpatient treatment. Patients in the PD group were older and had a higher prevalence of mood disorders than patients without PD. In terms of personality characteristics and impulsivity traits, PD patients appeared to present a more functional profile than PD-free patients with a behavioral addiction. Our results suggest that PD patients with a behavioral addiction could be more difficult to detect than their PD-free counterparts in behavioral addiction clinical setting due to their reduced levels of impulsivity and more standard personality traits. As a whole, this suggests that PD patients with a behavioral addiction may have different needs from PD-free behavioral addiction patients and that they could potentially benefit from targeted interventions.
In this research, it was aimed to analyze the social networking addiction of pre-service teachers in terms of various variables and evaluate the relationship between social networking addiction and loneliness and interaction anxiousness. The research was designed according to the relational screening model. The study sample included 349 pre-service teachers studying at Trakya University Faculty of Education in 2012-2013 academic year fall term. The data were obtained using Facebook Addiction ...
Miller, David; Miller, Merlene; Blum, Kenneth; Badgaiyan, Rajendra D; Febo, Marcelo
There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call "Reward Deficiency Syndrome (RDS)". While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use "aftercare" to refer to any form of program or therapy following primary treatment including 12-Step programs. Very few programs actually provide any evidenced-based treatment approaches during this most vulnerable period in recovery. In this trieste we are suggesting that a hypodopaminergic trait (genetic) and/or state (epigenetic) is critical in terms of continued motivation to use/abuse of alcohol or other drugs and can lead to relapse. While there is evidence for the approved FDA drugs to treat drug addiction (e.g. alcohol, opiates, nicotine) these drugs favor a short-term benefit by blocking dopamine. We argue instead for the utilization of long-term benefits that induce "dopamine homeostasis", or in simpler terms "normalcy". We suggest that this could be accomplished through a number of holistic modalities including, but not limited to, dopamine-boosting diets, hyper-oxygenation, heavy metal detoxification, exercise, meditation, yoga, and most importantly, brain neurotransmitter balancing with nutraceuticals such as KB220 variants. We embrace 12-step programs and fellowships but not as a stand-alone modality, especially during aftercare. We also provide some scientific basis for why resting state functional connectivity (rsfMRI) is so important and may be the cornerstone in terms of how to treat RDS. We postulate that since drugs, food, smoking, gambling, and even compulsive sexual behavior could reduce rsfMRI then modalities (following required research), that can restore this impaired cross talk between various brain regions (e.g. Nucleus accumbens, cingulate gyrus
Peles, Einat; Linzy, Shirley; Sason, Anat; Tene, Oren; Adelson, Miriam
Internet addiction is known to be associated with depression. The Internet Addiction Test (IAT) and the Center for Epidemiologic Studies Depression scale (CES-D) for depression were studied among non-selective methadone maintenance treatment patients from the United States (n = 164) and Israel (n = 113). Thirty percent were not exposed to the internet, and 2.9% (n = 8) had an "occasional/frequent problem." The IAT and CES-D scores correlated significantly (p = .03). The non-exposed group was older, less educated, and had more benzodiazepine abusers. Unlike other behavioral addictions that characterized these patients, the internet addiction problem is rare, but should not be ignored.
Rotondi, Nooshin Khobzi; Rush, Brian
Client-based information systems can yield data to address issues of system accountability and planning, and contribute information related to changing patterns of substance use in treatment and, indirectly, general populations. The Drug and Alcohol Treatment Information System (DATIS) monitors the number/types of clients treated in approximately 170 publicly-funded addiction treatment agencies in Ontario. The purpose of this study was to estimate the caseload of addiction treatment agencies, and describe important characteristics of clients, their patterns of service utilization and trends over-time from 2005 to 2010. In 2009-2010, 47,065 individuals were admitted to treatment. Since 2005-2006, there has been an increase in adolescents/youth in treatment, and a decrease in the male-female gender ratio. Alcohol problems predominated, but an increasing proportion of clients used cannabis and prescription opioids. DATIS is an evolving system and an integral component of Ontario's performance measurement system. Linkages with healthcare information systems will allow for longitudinal tracking of client health-related outcomes.
Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly
Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed.
Natalia M Lee
Full Text Available According to their advocates, neurobiological explanations of overeating, or "food addiction", have the potential to impact public understanding and treatment of obesity. In this study, we examine the public's acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity.We conducted an online survey of 479 adults from the US (n = 215 and Australia (n = 264. There was substantial support for the idea of food addiction, particularly among obese participants. Over half favoured treating obesity as a type of addiction. Psychotherapy was believed to be the most effective treatment and educational and support programs were the preferred policies to address food addiction. There was very little support for increasing taxes on obesogenic foods. Despite the strong support for seeing obesity as a form of addiction, respondents still saw obesity as primarily the result of personal choices and emphasized the need for individuals to take responsibility for their eating.Our sample of the general public strongly supported the idea of obesity as a form of food addiction; but this did not translate into support of clinical and public health policies that experts believe are most likely to reduce the prevalence of obesity. The reasons for the apparent disjunction between support for food addiction and a strong emphasis on personal choice for weight warrant further examination.
Lee, Natalia M; Lucke, Jayne; Hall, Wayne D; Meurk, Carla; Boyle, Frances M; Carter, Adrian
According to their advocates, neurobiological explanations of overeating, or "food addiction", have the potential to impact public understanding and treatment of obesity. In this study, we examine the public's acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity. We conducted an online survey of 479 adults from the US (n = 215) and Australia (n = 264). There was substantial support for the idea of food addiction, particularly among obese participants. Over half favoured treating obesity as a type of addiction. Psychotherapy was believed to be the most effective treatment and educational and support programs were the preferred policies to address food addiction. There was very little support for increasing taxes on obesogenic foods. Despite the strong support for seeing obesity as a form of addiction, respondents still saw obesity as primarily the result of personal choices and emphasized the need for individuals to take responsibility for their eating. Our sample of the general public strongly supported the idea of obesity as a form of food addiction; but this did not translate into support of clinical and public health policies that experts believe are most likely to reduce the prevalence of obesity. The reasons for the apparent disjunction between support for food addiction and a strong emphasis on personal choice for weight warrant further examination.
Full Text Available This article focuses on the quantitative grounds for the emergence and spread of addiction among women, its medical, social and psychological problems, impediments for the treatment of addiction among women as well as gender differences concerning drug abuse and its treatment. This article is a translation of a statistical research on addiction among women and a number of other researches. Based on conclusions drawn from the said researches, women become inclined to addiction mostly by their husbands due to their cordial relationships. Moreover, the negative attitudes of peer groups can overshadow girls and women more than boys and men. From the viewpoint of psychological disorders, the relationship between disorders resulting from psychological pressure after an incident and addiction is stronger among girls and women compared to boys and men. Addiction among women in addition to certain ailments such as malnutrition, hypertension and cancer, can expose them to dangerous diseases such as Hepatitis and AIDS. There is more possibility for addicted women to be infected with AIDS and other sexually transmitted diseases compared to men and they are more exposed to female ailments compared to other women. As far as treatment impediments are concerned, women face a greater social stigma due to their addiction compared to men. Social approach considering addicted women as an indecent person is a major impediment for their treatment. Taking care of the child is also another obstacle for their treatment. There is less possibility for women to receive support from their families for quitting their addiction compared to men. Treatment programs also unwantedly may create obstacles for the treatment of women such as financial constraints, administrative bureaucracy, concentration of treatment programs for men and lack of sensitivity towards women’s addiction. The psychological impediments to treatment include internalizing the notion that addiction is a
Lyons, Tara; Shannon, Kate; Pierre, Leslie; Small, Will; Kr?si, Andrea; Kerr, Thomas
Background While considerable research has been undertaken on addiction treatment, the experiences of transgender individuals who use drugs are rarely explored in such research, as too often transgender individuals are excluded entirely or grouped with those of sexual minority groups. Consequently, little is known about the treatment experiences in this population. Thus, we sought to qualitatively investigate the residential addiction treatment experiences of transgender individuals who us...
... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to the...
Li, Xiaofan; Shorter, Daryl; Kosten, Thomas R
Buprenorphine follows the success of methadone as another milestone in the history of treatment for opioid addiction. Buprenorphine can be used in an office-based setting where it is clearly effective, highly accepted by patients and has a favorable safety profile and less abuse potential. However, the adoption of buprenorphine treatment has been slow in the USA. This article first reviews the history of medication-assisted opioid addiction treatment and the current epidemic opioid addiction, followed by a review of the efficacy, pharmacology and clinical prescription of buprenorphine in office-based care. We then explore the possible barriers in using buprenorphine and the ways to overcome these barriers, including new formulations, educational programs and policy regulations that strike a balance between accessibility and reducing diversion. Buprenorphine can align addiction treatment with treatments for other chronic medical illnesses. However, preventing diversion will require graduate and continuing medical education and integrated care models for delivery of buprenorphine to those in need.
Potenza, Marc N
Despite significant advances in our understanding of the biological bases of addictions, these disorders continue to represent a huge public health burden that is associated with substantial personal suffering. Efforts to target addictions require consideration of how the improved biological understanding of addictions may lead to improved prevention, treatment, and policy initiatives. In this article, we provide a narrative review of current biological models for addictions with a goal of placing existing data and theories within a translational and developmental framework targeting the advancement of prevention, treatment, and policy strategies. Data regarding individual differences, intermediary phenotypes, and main and interactive influences of genetic and environmental contributions in the setting of developmental trajectories that may be influenced by addictive drugs or behavior indicate complex underpinnings of addictions. Consideration and further elucidation of the biological etiologies of addictions hold significant potential for making important gains and reducing the public health impact of addictions. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810 in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%, more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education, and employed (>70%. The most commonly reported main drugs of abuse prior to MMT entry were opium (69% and crystalline heroin (24%. The patients’ lifetime drug experience included opium (92%, crystalline heroin (28%, cannabis (16%, amphetamines (15%, and other drugs (33%. Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men.
Book, Sarah W.; Thomas, Suzanne E.; Smith, Joshua P.; Miller, Peter M.
There is increasing interest in the co-occurrence of social anxiety and addiction. Each investigation has a specific vantage point, e.g. the effect social anxiety has in a population with addiction or that of addiction in a population with social anxiety, which could create unique findings. Among comorbid individuals, is social anxiety more severe in people seeking treatment for anxiety, as compared to those seeking treatment for addiction? This report compares social anxiety severity between...
The Department of Defense (DoD) is publishing this final rule to remove the exclusion of drug maintenance programs and allow TRICARE coverage of the substitution of a therapeutic drug, with addictive potential, for a drug of addiction when medically necessary and appropriate as part of a comprehensive treatment plan for an individual with substance use dependence. The current regulation prohibits coverage of drug maintenance programs where one addictive substance is substituted for another. The final rule allows TRICARE to cover, as part of otherwise authorized treatment of substance use disorder, utilization of a specific category of psychoactive agent when medically necessary and appropriate. Removal of the exclusion is based on recognition of the accumulated medical evidence supporting the use of certain pharmacotherapies as one component in the continuum of opioid treatment services. Medication assisted treatment, to include drug maintenance involving substitution of a therapeutic drug with addiction potential, for a drug of addiction, is now generally accepted by qualified professionals to be reasonable and adequate as a component in the safe and effective treatment of substance use disorders treatment services, and thus appropriate for inclusion as a component in the TRICARE authorized substance use disorder treatment for beneficiaries.
Carroll, Marilyn E.; Smethells, John R.
The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, is discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug-abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as (1) using natural consequences such as non-drug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, (2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and (3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments. PMID:26903885
Marilyn E. Carroll
Full Text Available The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, are discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as: 1 using natural consequences such as nondrug rewards (e.g., exercise to maintain abstinence, or using punishment as a consequence for drug use, 2 targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and 3 combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.
Carroll, Marilyn E; Smethells, John R
The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, is discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug-abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as (1) using natural consequences such as non-drug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, (2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and (3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.
van den Brink, Wim; Hendriks, Vincent M.; Blanken, Peter; Koeter, Maarten W. J.; van Zwieten, Barbara J.; van Ree, Jan M.
OBJECTIVE: To determine whether supervised medical prescription of heroin can successfully treat addicts who do not sufficiently benefit from methadone maintenance treatment. DESIGN: Two open label randomised controlled trials. SETTING: Methadone maintenance programmes in six cities in the
Ziedonis, Douglas M.; Zammarelli, Lucy; Seward, Gregory; Oliver, Karen; Guydish, Joseph; Hobart, Marie; Meltzer, Bruce
Compared to the general population, persons entering addiction treatment are three to four times more likely to be tobacco dependent and even addiction treatment staff members are two to three times more likely to be tobacco dependent. In these settings, tobacco use continues to be the norm; however addiction treatment programs are increasingly aware of the need to assess for and treat tobacco dependence. The problem is a cultural issue that is so ingrained that assumptions about tobacco use and dependence in addiction treatment are rarely questioned. Denial, minimization, and rationalization are common barriers to recovery from other addictions; now is the time to recognize how tobacco use and dependence must be similarly approached. This article describes the Addressing Tobacco through Organizational Change (ATTOC) model which has successfully helped many addiction treatment programs to more effectively address tobacco use. The article will review the six core strategies used to implement the ATTOC intervention, the 12-Step approach guiding the model, and describe a case study where the intervention was implemented in one clinic setting. Other treatment programs may use the experience and lessons learned from using the ATTOC organizational change model to better address tobacco use in the context of drug abuse treatment. PMID:18303702
Lee, Natalia M.; Lucke, Jayne; Hall, Wayne D.; Meurk, Carla; Boyle, Frances M.; Carter, Adrian
Background According to their advocates, neurobiological explanations of overeating, or ?food addiction?, have the potential to impact public understanding and treatment of obesity. In this study, we examine the public?s acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity. Methods and Findings We conducted an online survey of 479 adults from the US (n?=?215) and Australia (n?=...
James D. Holt
Full Text Available This article explores the theological underpinning of the nature, aetiology and treatment of addictions within The Church of Jesus Christ of Latter-day Saints. The first section outlines the “plan of salvation” and how this provides the theological framework for the source and solution to addictions. The final section explores addiction against this background in terms of its aetiology, types, consequences and treatment in a Latter-day Saint context. In so doing it builds on the recognition by the Church in recent years that addiction is a problem in the lives of some of its members and that treatment programs coherent with its teachings and beliefs are necessary. The article concludes by suggesting that while addiction may be more openly discussed within a Latter-day Saint context there is a need to keep this dialogue moving forward. This article does not examine Latter-day Saint teaching within the wider context of psychotherapy and other definitions of addiction; rather it explores the place of addiction as understood within the theological and ecclesiological context of Mormonism.
Magill, Molly; Longabaugh, Richard
With the increased need for sanctioning behavioral addiction treatments to guide key stakeholders, focus has shifted to developing and applying criteria for establishing empirically supported treatments (EST). Among the many criteria offered, demonstration of incremental efficacy over a placebo or comparison in at least two independent randomized clinical trials (RCTs) has been the gold standard. While necessary, the present EST criteria are not sufficient. The present work: (i) argues for empirically supported specificity in behavioral addiction treatment, (ii) explores the limitations of empirical support for EST efficacy without evidence of specificity and (iii) discusses implications and recommendations for ultimately raising the bar for status as an EST. The authors review relevant literature on ESTs, evidence-based practice and clinical trial design in the addictions and related disciplines. We clarify that the additional bar of specificity does not denote uniqueness in causal processes and we argue that specificity should not be inferred only via the nature of the experimental contrast. Rather, a treatment has specificity if its active ingredients are identified and validated empirically as predictors of subsequent treatment-related outcomes. Within this new definition, there are implications for clinical research and other key stakeholders. A heightened centrality of empirically supported addiction treatment ingredients moving forward will advance clinical knowledge and evaluation methodology at a far greater pace. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to...
Full Text Available Drug addiction is a serious problem all over the world involving both medical and social issues. The treatment strategy lies in two aspects, promoting detoxification and preventing relapse. The latter is the key for successful treatment. Although surgical measures, like stereotactic ablation of nucleusaccumbens (NAc, had already been proven to be effective for relapse prevention clinically, the application was restricted because of the damage to brain tissues. Deep brain stimulation (DBS, which had been successfully applied in movement disorders, was recently performed in addiction studies on both animals and humankind. Among numbers of brain areas related to addiction, NAc is the hottest target studied and may bring better clinical effect. In addition, combining stimulation of multiple brain targets is currently performed for relapse prevention. The mechanism of DBS for treatment of addiction remains unclear right now, however, DBS may be an experimental method to treat refractory addictive patients. Certainly, lots of problems need to be solved in large sample study before the wide application of DBS for addiction treatment, such as the setting of stimulation parameters, recognition of objective treatment feedback and ethical issues. DOI: 10.3969/j.issn.1672-6731.2015.10.004
Reyre, Aymeric; Jeannin, Raphaël; Largueche, Myriam; Moro, Marie Rose; Baubet, Thierry; Taieb, Olivier
A good therapeutic alliance plays a major role in the healing process. Professionals working in addiction treatment report high levels of psychological distress related to work and this may challenge the establishment of a trustful therapeutic alliance, and lead to a loss of care quality provided to service users. The purpose of this study was to investigate the experience of specialized professionals, its effects on trust and the therapeutic alliance, and the means to restore them. We conducted a qualitative study using a semi-structured questionnaire and a narrative tool. Discourse was extracted from focus groups and individual interviews and analyzed following the Interpretative Phenomenological Analysis method. Twenty-six professionals from three addiction treatment centers in the Paris area were interviewed. The difficulties weighing on the care alliance were described by the participants in terms of their nature, their effects and means to overcome them. Emotional drain leads to a climate of relational distrust and the temptation to desert or over-control patients. Teambuilding, specific training and self-care are viewed as means to restore a therapeutic alliance based on an appropriate type of trust. Distrust deriving from professionals' challenging experiences may lead to worrying consequences. Promoting democratic organization of care structures, specific training, and also responsible self-care on the part of professionals could help to restore a type of trust that helps to establish a therapeutic alliance suited to service user individualities. This could ultimately be beneficial for user care, professional wellbeing and team functioning. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available This study aimed to examine smartphone use patterns, smartphone addiction characteristics, and the predictive factors of the smartphone addiction in middle school students in South Korea. According to the Smartphone Addiction Proneness Scale scores, 563 (30.9% were classified as a risk group for smartphone addiction and 1261 (69.1% were identified as a normal user group. The adolescents used mobile messengers for the longest, followed by Internet surfing, gaming, and social networking service use. The two groups showed significant differences in smartphone use duration, awareness of game overuse, and purposes of playing games. The predictive factors of smartphone addiction were daily smartphone and social networking service use duration, and the awareness of game overuse.
Cha, Seong-Soo; Seo, Bo-Kyung
This study aimed to examine smartphone use patterns, smartphone addiction characteristics, and the predictive factors of the smartphone addiction in middle school students in South Korea. According to the Smartphone Addiction Proneness Scale scores, 563 (30.9%) were classified as a risk group for smartphone addiction and 1261 (69.1%) were identified as a normal user group. The adolescents used mobile messengers for the longest, followed by Internet surfing, gaming, and social networking service use. The two groups showed significant differences in smartphone use duration, awareness of game overuse, and purposes of playing games. The predictive factors of smartphone addiction were daily smartphone and social networking service use duration, and the awareness of game overuse.
Cha, Seong-Soo; Seo, Bo-Kyung
This study aimed to examine smartphone use patterns, smartphone addiction characteristics, and the predictive factors of the smartphone addiction in middle school students in South Korea. According to the Smartphone Addiction Proneness Scale scores, 563 (30.9%) were classified as a risk group for smartphone addiction and 1261 (69.1%) were identified as a normal user group. The adolescents used mobile messengers for the longest, followed by Internet surfing, gaming, and social networking service use. The two groups showed significant differences in smartphone use duration, awareness of game overuse, and purposes of playing games. The predictive factors of smartphone addiction were daily smartphone and social networking service use duration, and the awareness of game overuse. PMID:29435355
Equidad de género en la adherencia al tratamiento de adicciones: Representaciones y prácticas de profesionales y pacientes en un servicio de internación de un hospital público Gender equity within adherence to treatment of addictions: Social representations and practices of professionals and patients in an inpatient service of a public hospital
Full Text Available El objetivo central de este proyecto1 es explorar la equidad de género relativa a la adherencia al tratamiento en un servicio de internación de un hospital público, que atiende pacientes adictos/as a las drogas, así como identificar los modos en los cuales las diferencias entre los géneros se transforman en inequidad en salud. El propósito del proyecto es contribuir en el avance de la equidad de género en el tratamiento de las adicciones a las drogas, visibilizando las inequidades que se presenten, asi como las necesidades en la atención y los modos de enfermar de cada género. Del mismo modo, promoviendo la inclusión de la perspectiva de género en las prácticas de los profesionales, en aras de mejorar los modelos de atención. Se trata de una investigación de carácter exploratorio-descriptivo, en la que se utiliza metodología cualitativa para la recolección y el análisis de la información.The central objective of this project is to explore gender equity in adherence to treatment of an inpatient service of a public hospital, which serves patients addicted to drugs and to identify ways in which gender differences are transformed into health inequities. The project aim's is to contribute to gender equity in the treatment of addictions to drugs, make visible inequities that arise, promote the inclusion of gender in the practices of professionals and manifest the needs and modes of each gender in pursuit of improved models of care. It is an exploratory and descriptive research, which used qualitative methodology to collect and analyze information.
While referring to the theoretical and practical model of R. Harris (2012), this article proposes the use of acceptance and commitment therapy (ACT) in the treatment of sexual addiction. While dependent behaviors begin and may be maintained by refusal of unpleasant emotional states (that is, addict individuals tend to fight or flee negative emotions by replacing eventually painful or otherwise unpleasant states by behaviors providing pleasure), the ACT framework appears as an ally in treatment of addictive behaviors, in that its goal is a fit between patients' behaviors and their values (instead avoidance of unpleasant states avoidance). Within a clinical case of a patient suffering from sexual addiction, we show that using ACT helps (i) to decrease the intensity of sexual addiction (as assessed through QMICA-Se in a pre-post design), (ii) to develop psychological flexibility (AAQ-II), and (iii) to decrease anxious and depressive symptoms of the patient (HADS). Moreover, the patient recognizes to feel himself in the here and now, and also to perform activities related to his own values. Acceptance of this limited form of sexuality now allows him to calmly consider the possibility of meeting a new person. ACT thus appears to provide clinical benefits in treatment of sexual addictions. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Full Text Available Drug addiction can be a devastating and chronic relapsing disorder with social, psychological, and physical consequences, and more effective treatment options are needed. Repetitive transcranial magnetic stimulation (rTMS is a noninvasive brain stimulation technique that has been assessed in a growing number of studies for its therapeutic potential in treating addiction. This review paper offers an overview on the current state of clinical research in treating drug addiction with rTMS. Because of the limited research in this area, all studies (including case reports that evaluated the therapeutic use of rTMS in nicotine, alcohol, or illicit drug addiction were included in this review. Papers published prior to December 2012 were found through an NCBI PubMed search. A total of eleven studies were identified that met review criteria. There is nascent evidence that rTMS could be effective in reducing cocaine craving and nicotine and alcohol craving and consumption and might represent a potential therapeutic tool for treating addiction. Further studies are needed to identify the optimal parameters of stimulation for the most effective treatment of drug addiction, to improve our comprehension of the treatment neurophysiological effects, and to conduct rigorous, controlled efficacy studies with adequate power.
This article describes a research program to develop an operant treatment for cocaine addiction in low-income, treatment-resistant methadone patients. The treatment's central feature is an abstinence reinforcement contingency in which patients earn monetary reinforcement for providing cocaine-free urine samples. Success and failure of this…
Young, Kimberly S
Internet Gaming Disorder, a subtype of Internet Addiction, is now classified in Section 3 of the DSM-5. Cognitive behavioral therapy (CBT) has been suggested in treating Internet addiction as this modality has been shown to be an effective treatment for similar impulse control disorders. Given the daily and necessary use of the Internet and technology in general compared to other compulsive syndromes, a specialized form of CBT has been developed called Cognitive-Behavioral Therapy for Internet Addiction (CBT-IA). CBT-IA is a comprehensive three phase approach that includes behavior modification to control compulsive Internet use, cognitive restructuring to identify, challenge, and modify cognitive distortions that lead to addictive use, and harm reduction techniques to address and treat co-morbid issues associated with the disorder. As the first model of its kind, this study examines 128 clients to measure treatment outcomes using CBT-IA. Clients were evaluated using the Internet Addiction Test (IAT) to classify subjects and were administered twelve weekly sessions of CBT-IA. Treatment outcomes were measured at the end of the twelve weeks, one-month, three months and at six month post-treatment. RESULTS showed that over 95% of clients were able to manage symptoms at the end of the twelve weeks and 78% sustained recovery six months following treatment. RESULTS found that CBT-IA was effective at ameliorating symptoms associated with Internet addiction after twelve weekly sessions and consistently over one-month, three months, and six months after therapy. Further research implications such as investigating long-term outcome effects of the model with larger client populations and treatment differences among the subtypes of Internet addiction or with other cultural populations using CBT-IA are discussed.
Xu, Chaoying S.; Chen, Jessica S.; Adelman, Ron A.
Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits. PMID:26339215
Xu, Chaoying S; Chen, Jessica S; Adelman, Ron A
Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits.
Kassai, Szilvia; Pintér, Judit Nóra; Rácz, József
The work of recovering helpers who work in the addiction rehabilitation centres was studied. The aim was to investigate the process of addicts becoming recovering helpers, and to study what peer help means to them. According to interpretative phenomenological analysis (IPA) design, subjects were selected, data were collected and analysed. 6 (5 males, 1 female), working as recovering helpers at least one year at addiction rehabilitation centres. Semi-structured life interviews were carried out and analysed according to IPA. Emerging themes from the interviews were identified and summarized, then interpreted as central themes: important periods and turning points of the life story interviews: the experience of psychoactive drugs use, the development of the addiction (which became " Turning Point No 1") then the "rock bottom" experience ("Turning Point No 2"). Then the experience of the helping process was examined: here four major themes were identified: the development of the recovering self and the helping self, the wounded helper and the skilled helper, the experience of the helping process. IPA was found to be a useful method for idiographic exploration of the development and the work of the recovering helpers. The work of the recovering helpers can be described as mentoring of the addict clients. Our experiences might be used for the training programs for recovering helpers as well as to adopt their professional role in addiction services.
Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear
Problematic Internet use is a worldwide social issue and it can be found in any age, social, educational, or economic range. In some countries like China and South Korea internet addiction (IA) is considered a public health condition and this governments support research, education and treatment. Internet addiction has been associated with others psychiatric disorders. Panic disorder (PD) and Obsessive Compulsive Disorder (OCD) are anxiety disorders that involve a lot of damages in patient's life. We report a treatment of a patient with Panic Disorder and Obsessive Compulsive Disorder and internet addition involving pharmacotherapy and Cognitive Behavioral Therapy (CBT). The Cognitive Behavioral Therapy was conducted 1 time per week during 10 weeks and results suggest that the treatment was an effective treatment for the anxiety and for the internet addiction.
Full Text Available Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance dependence. Methods Cross-sectional secondary data analysis of self-reported baseline data from alcohol and/or drug-dependent adults enrolled in a randomized clinical trial of a disease management program for substance dependence in primary care. The main independent variable was chronic medical disease status, categorized using the Katz Comorbidity Score as none, single condition of lower severity, or higher severity (multiple conditions or single higher severity condition, based on comorbidity scores determined from self-report. Asthma was also examined in secondary analyses. The primary outcome was any self-reported addiction treatment utilization (excluding detoxification in the 3 months prior to study entry, including receipt of any addiction-focused counseling or addiction medication from any healthcare provider. Logistic regression models were adjusted for sociodemographics, type of substance dependence, recruitment site, current smoking, and recent anxiety severity. Results Of 563 subjects, 184 (33% reported any chronic disease (20% low severity; 13% higher severity and 111 (20% reported asthma; 157 (28% reported any addiction treatment utilization in the past 3 months. In multivariate regression analyses, no significant effect was detected for chronic disease on addiction treatment utilization (adjusted odds ratio [AOR] 0.88 lower severity vs. none, 95% confidence interval (CI: 0.60, 1.28; AOR 1.29 higher severity vs. none, 95% CI: 0.89, 1.88 nor for
Williams, Izaak L
Patients' admission to modern substance use disorder treatment comes with the attendant risk of being discharged from treatment-a widespread practice. This article describes the three mainstream theories of addiction that operate as a reference point for clinicians in reasoning about a decision to discharge a patient from treatment. The extant literature is reviewed to highlight the pathways that patients follow after administrative discharge. Little scientific research has been done to investigate claims and hypotheses about the therapeutic function of AD, which points to the need for empirical ethics to inform clinical addictions practice. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.
Malte, Carol A; Cox, Koriann; Saxon, Andrew J
This study sought to determine whether homeless veterans entering Veterans Affairs (VA) substance use treatment randomized to intensive addiction/housing case management (AHCM) had improved housing, substance use, mental health, and functional outcomes and lower acute health care utilization, compared to a housing support group (HSG) control. Homeless veterans (n = 181) entering outpatient VA substance use treatment were randomized to AHCM and HSG and received treatment for 12 months. AHCM provided individualized housing, substance use and mental health case management, life skills training, and community outreach. The control condition was a weekly drop-in housing support group. Adjusted longitudinal analyses compared groups on baseline to month 12 change in percentage of days housed and functional status, substance use, and mental health outcomes (36-Item Short-Form Health Survey; Addiction Severity Index [ASI]). Negative binomial regression models compared groups on health care utilization. Both conditions significantly increased percentage of days housed, with no differences detected between conditions. In total, 74 (81.3%) AHCM and 64 (71.1%) HSG participants entered long-term housing (odds ratio = 1.9, 95% confidence interval [0.9, 4.0], p = .088). HSG participants experienced a greater decrease in emergency department visits than AHCM (p = .037), whereas AHCM participants remained in substance use treatment 52.7 days longer (p = .005) and had greater study treatment participation (p housing and substance use care. For those veterans not entering or losing long-term housing, different approaches to outreach and ongoing intervention are required. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Zajac, Kristyn; Ginley, Meredith K; Chang, Rocio; Petry, Nancy M
Problems related to excessive use of the Internet and video games have recently captured the interests of both researchers and clinicians. The goals of this review are to summarize the literature on treatment effectiveness for these problems and to determine whether any treatments meet the minimum requirement of an evidence-based treatment as defined by Chambless et al. (1998). Studies of treatments for Internet gaming disorder (IGD) and Internet addiction were examined separately, as past studies have linked IGD to more severe outcomes. The systematic review identified 26 studies meeting predefined criteria; 13 focused on treatments for IGD and 13 on Internet addiction. The results highlighted a paucity of well-designed treatment outcome studies and limited evidence for the effectiveness of any treatment modality. Studies were limited by methodological flaws, including small sample sizes, lack of control groups, and little information on treatment adherence, among other problems. In addition, the field is beset by a lack of consistent definitions of and established instruments to measure IGD and Internet addiction. The results of this review highlight the need for additional work in the area of treatment development and evaluation for IGD and Internet addiction. Attention to methodological concerns identified within this review should improve subsequent research related to treating these conditions, and ultimately outcomes of patients suffering from them. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Dufour, Magali; Nadeau, Louise; Gagnon, Sylvie R
To date, there is no consensus on the diagnostic criteria for Internet addiction (Hinic, 2011; Tonioni & coll., 2012; Weinstein & Lejoyeux, 2010). Nonetheless, some people consider themselves cyberdependent and request treatment services in the addiction rehabilitation centers (ARC) of the province of Quebec. These admissions have led the Health and Social Services Agency of Montreal to ask for the realization of a descriptive study on Internet addiction. 1) Describe the socio-demographical characteristics of cyberdependent individuals receiving treatment in the ARC; 2) Document their associated problems, such as problems related to alcohol and drug abuse, gambling, self-esteem, and symptoms of depression and anxiety. The study was conducted in eight ARC's of the province of Quebec. A convenience sample of 57 people was recruited over a period of 24 months, from 2010 to 2012. To participate in this study, individuals had to be 18 years or older, identify themselves as cyberdependent, and request help for an Internet addiction problem in a public ARC. The Internet Addiction Test (Young, 1998), in its validated French version (Khazaal & coll., 2008), was used to assess the severity of Internet use habits. The associated problems were assessed using the following questionnaires: the Beck Anxiety Inventory (Beck, Epstein, Brown & Steer, 1988); the Beck Depression Inventory, in its validated French version (Bourque & Beaudette, 1982); the DÉBA-Alcool/Drogues/Jeu (Dépistage-évaluation du besoin d'aide), an instrument used to screen and assess the need for help in problems related to alcohol, drugs, and gambling (Tremblay & Blanchette-Martin, 2009), and the Rosenberg's Self-Esteem Scale (Rosenberg, 1965). Fifty-seven people agreed to participate in the study. A large majority of these cyberdependent individuals were male (88%), the mean age was 30 years old, had low incomes and were living with their parents. They consulted following the pressure of their entourage and
Draanen, Jenna van; Corneau, Simon; Henderson, Thomas; Quastel, Adam; Griller, Robin; Stergiopoulos, Vicky
The Toronto Community Addictions Team (TCAT) is an intensive case management intervention designed to serve people with addictions who are frequent service users, thus addressing a health system priority. Questionnaires given to 65 participants at baseline, 3 months, and 6 months and semi-structured interviews of 10 program participants explored participants' outcomes and experiences with the program. Qualitative findings, analyzed using thematic content analysis, suggest that participants value the program's commitment to harm reduction, financial trusteeship, and recovery orientation. Quantitative findings from paired t-tests reveal that participants improved in community functioning and decreased days of problematic substance use and money spent on alcohol and drugs as early as 3 months after program participation. Future research should used a controlled design and explore predictors of positive outcomes in this vulnerable population.
Das, Aswathy; Sharma, Manoj Kumar; Thamilselvan, P; Marimuthu, P
Technology usage has seen an increase among users. The usage varies from social, personal, and psychological reasons. Users are frequently using to overcome mood states as well as to manage the other psychological states. This work is going to explore the information technology use among subjects with a psychiatric disorder. A total of 75 subjects were assessed using background data sheet, internet addiction impairment index, video game use pattern, pornography addiction screening tool and screening for mobile phone use, from in-patient and out-patient setting of tertiary mental health setting. It showed the presence of addiction to mobile, internet, video game, and pornography. Age was found to be negatively correlated with this addiction. Average usage time had been associated with management of mood states. The addiction to information technology had been associated with a delay in initiation of sleep. This work has implication for screening technology addiction among subjects seeking treatment for psychological problems and motivate them to develop the healthy use of technology.
Pedrero-Pérez, Eduardo J; Rojo-Mota, Gloria; Ruiz-Sánchez de León, José M; Fernández-Méndez, Laura M; Morales-Alonso, Sara; Prieto-Hidalgo, Ana
The concept of cognitive reserve has gradually attracted more interest as a greater body of evidence has been collected on its relationship with the resistance of the brain to decline in its functioning when faced with neurological threats or disorders. Although a large amount of research has been conducted on (degenerative, traumatic, psychopathological) conditions, very few studies relate cognitive reserve with substance addiction, a multidimensional process with a clear neurological base. To explore the cognitive reserve of patients undergoing treatment for addiction to drugs of abuse by relating it with their cognitive performance in neuropsychological tests and in activities of daily living. The study involved a sample of 57 patients being treated for substance abuse at a centre set up for this specific purpose. The cognitive reserve questionnaire, the Montreal cognitive assessment and the prefrontal symptoms inventory were administered, and variables related with the addiction were collected. A positive relation was found between the cognitive reserve and the time of abstinence, and a negative one was seen with the severity of the addiction. Significant differences were observed according to the cognitive reserve in neuropsychological performance (especially in certain cognitive domains) and in daily activities. The cognitive reserve appears as a variable related to addiction and the cognitive deficits that accompany it. It is thus a potential target for rehabilitation activities and is linked to the environmental enrichment paradigm, as a strategy for enhancing resistance against the cognitive impairment that favours and maintains the addiction, and for lowering the reinforcing potential of the behaviour of consuming.
Full Text Available Objective: To conduct the first systematic literature review of clinical trials of N-acetylcysteine (NAC for the treatment of substance abuse disorders and addictive behaviors. Methods: A search of the MEDLINE, Embase and PsycINFO databases was conducted. The inclusion criteria for the review were clinical trials that used NAC in the treatment of a disorder related to substance use and/or addictive behaviors, limited to texts in English, Spanish, or French. The selected studies were evaluated with respect to type of trial, sample size, diagnostic input, intervention, length of follow-up, outcome variables, and results. Results: Nine studies analyzing a total of 165 patients met the eligibility criteria and were included in qualitative analysis. These studies evaluated the role of NAC in cocaine dependence (three studies, cannabis dependence (two studies, nicotine dependence (two studies, methamphetamine addiction (one study, and pathological gambling (one study. Five of these trials were double-blind, randomized, and placebo-controlled. Conclusions: The studies analyzed suggest a potential role for NAC in the treatment of addiction, especially of cocaine and cannabis dependence. These results are concordant with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction.
Charles D H Parry
Full Text Available Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. Method. Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions. Results. While many participants had received training in pharmacological management of individuals with opioid dependence, only two had received specific training on codeine management. Between half and two-thirds of the treatment settings they worked in provided detoxification, pharmacotherapy, psychosocial treatment and aftercare. Very few treatment settings offered long-term treatment for codeine misuse and dependence. Participants indicated that over half of their codeine patients entered treatment for intentional misuse for intoxication, and dependence resulting from excessive or long-term use. The main barriers to patients entering treatment were seen as denial of having a problem, not being ready for change, mental health problems, stigma, and affordability of treatment. Participants identified a need for further training in how to manage withdrawal and detoxification, treatment modalities including motivational interviewing, and relapse prevention. Conclusions. Gaps in training among treatment providers need to centre on how to manage withdrawal from codeine use and detoxification, motivational interviewing and relapse prevention. Interventions are needed to address barriers to entering treatment, including user denial.
Walter, M; Dürsteler, K M; Petitjean, S A; Wiesbeck, G A; Euler, S; Sollberger, D; Lang, U E; Vogel, M
Addictive disorders are chronic relapsing conditions marked by compulsive and often uncontrolled use of psychotropic substances or stimuli. In this review, we present and discuss the current specific psychosocial interventions for addictive disorders and their effectiveness. In particular cognitive behavioral therapy, motivational interviewing, relapse prevention, the community reinforcement approach, and contingency management were found to be effective. For these psychotherapeutic treatments, mostly moderate effect sizes have been found. Their effectiveness seems to be highest in cannabis dependence. Empirical evidence for dependence on "hard" drugs is largest for contingency management, while for alcohol dependence motivational interviewing and the community reinforcement approach show the largest effect sizes. Presumably, combinations of different approaches as well as online interventions will bring further progress in the psychosocial treatment of addictive disorders in the future. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Background and Objectives: Addicts are among the socially disadvantaged people whose quality of life has been changed and damaged due to drug abuse. This in turn has influenced their physical, psychological and social health. Addiction is a phenomenon that has long existed in different human societies; and now again, it is still expanding despite the scientific advances and indisputable increase in people’s level of understanding and awareness. As such, this study aimed to examine the relationship between religious orientation and quality of life of the addicts. Methods: This is a descriptive-correlational study in which Alport religious orientation questionnaire and SF-12 quality of life questionnaire were used for data collection and analysis. The population consisted of the addicted men who had referred to 8 drug treatment centers in the city of Qom in 2013-14, out of whom 190 subjects were selected. The data were analyzed using SPSS software and correlation coefficient test. Results: The findings showed that there was a significant relationship between religious orientation and quality of life of addicts (p<0/05. Conclusion: The findings suggest that external religious orientation in people being treated from the drug addiction can be used as a defense and supporting mechanism to improve the quality of life in them. Therefore, the likelihood of successful treatment will be increased by strengthening the external religious orientation.
Itziar Iruarrizaga Díez
Full Text Available In Spain, the importance and relevance of substance dependence and other addictive behaviours has generated great interest among the scientific community. Since its creation in 1992, Psychosocial Intervention. Journal on Equality and Quality of Life has transmitted the needs and training demands of psychologists, paying special attention to those aspects related to prevention, health outcomes and psychosocial factors involved in the onset and maintenance of drug addiction, psychosocial intervention and the treatment of addictive behaviours. As an introduction to this report on the Scientific evidence in the study and treatment of addictive behaviours, all topics covered by this journal throughout the years will be addressed.
... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Persons Eligible for Supplemental Security Income to Other Agencies Referral for Treatment of Alcoholism... drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will be...
Schulte, S J; Meier, P S; Stirling, J; Berry, M
Dually diagnosed clients are described as one of the most challenging treatment populations, often leading to staff frustration, helplessness and negative attitudes. As yet it is unclear whether dual diagnosis (DD)-specific competency and therapeutic optimism among staff are related to client outcomes. The study used a 3-month follow-up design involving 124 DD clients starting treatment at 6 UK addiction services. Practitioners (n = 46) treating these clients were assessed regarding their DD specialisation levels. Cox regression analyses were performed to examine predictors of clients' 3-month retention rates. Staff reported a median of 7 years work experience with DD clients, and 80% had received co-morbidity-specific training. Practitioners provided high average ratings on both the DD competency and the therapeutic optimism scale. Nevertheless, 78% of the sample indicated additional support needs in dealing with this client group. Higher levels of DD competencies among staff predicted better client retention. The increased provision of support packages for practitioners is vital for improving competency levels in dealing with DD clients, which in turn may lead to improved client outcomes. 2010 S. Karger AG, Basel.
Lyons, Tara; Shannon, Kate; Pierre, Leslie; Small, Will; Krüsi, Andrea; Kerr, Thomas
While considerable research has been undertaken on addiction treatment, the experiences of transgender individuals who use drugs are rarely explored in such research, as too often transgender individuals are excluded entirely or grouped with those of sexual minority groups. Consequently, little is known about the treatment experiences in this population. Thus, we sought to qualitatively investigate the residential addiction treatment experiences of transgender individuals who use illicit drugs in a Canadian setting. In-depth semi-structured interviews were conducted with 34 transgender individuals in Vancouver, Canada between June 2012 and May 2013. Participants were recruited from three open prospective cohorts of individuals who use drugs and an open prospective cohort of sex workers. Theory-driven and data-driven approaches were used to analyze the data and two transgender researcher assistants aided with the coding and the interpretation of data in a process called participatory analysis. Fourteen participants had previous experience of addiction treatment and their experiences varied according to whether their gender identity was accepted in the treatment programs. Three themes emerged from the data that characterized individuals' experiences in treatment settings: (1) enacted stigma in the forms of social rejection and violence, (2) transphobia and felt stigma, and (3) "trans friendly" and inclusive treatment. Participants who reported felt and enacted stigma, including violence, left treatment prematurely after isolation and conflicts. In contrast, participants who felt included and respected in treatment settings reported positive treatment experiences. The study findings demonstrate the importance of fostering respect and inclusivity of gender diverse individuals in residential treatment settings. These findings illustrate the need for gender-based, anti-stigma policies and programs to be established within existing addiction treatment programs
Treatment of chemical addiction includes preparation for treatment, formal treatment and aftercare. The latter appears to be a neglected area in service delivery to chemically addicted adolescents, contributing to the high relapse potential following treatment. The current qualitative study aimed at both exploring and ...
Kourgiantakis, Toula; Ashcroft, Rachelle
Introduction Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evid...
Anderson, RaeAnn E; Hruska, Bryce; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L
Poly-substance use and psychiatric comorbidity are common among individuals receiving substance detoxification services. Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are the most common co-occurring psychiatric disorders with substance use disorder (SUD). Current treatment favors a one-size-fits-all approach to treating addiction focusing on one substance or one comorbidity. Research examining patterns of substance use and comorbidities can inform efforts to effectively identify and differentially treat individuals with co-occurring conditions. Using latent class analysis, the current study identified four patterns of PTSD, MDD, and substance use among 375 addiction treatment seekers receiving medically supervised detoxification. The four identified classes were: 1) a PTSD-MDD-Poly SUD class characterized by PTSD and MDD occurring in the context of opioid, cannabis, and tobacco use disorders; 2) an MDD-Poly SUD class characterized by MDD and alcohol, opioid, tobacco, and cannabis use disorders; 3) an alcohol-tobacco class characterized by alcohol and tobacco use disorders; and 4) an opioid-tobacco use disorder class characterized by opioid and tobacco use disorders. The observed classes differed on gender and clinical characteristics including addiction severity, trauma history, and PTSD/MDD symptom severity. The observed classes likely require differing treatment approaches. For example, people in the PTSD-MDD-Poly SUD class would likely benefit from treatment approaches targeting anxiety sensitivity and distress tolerance, while the opioid-tobacco class would benefit from treatments that incorporate motivational interviewing. Appropriate matching of treatment to class could optimize treatment outcomes for polysubstance and comorbid psychiatric treatment seekers. These findings also underscore the importance of well-developed referral networks to optimize outpatient psychotherapy for detoxification treatment-seekers to enhance long
Nabitz, U.; van den Brink, W.; Jansen, P.G.W.
Objective. The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. Setting. The setting is the Jellinek Centre based in
Jamieson, John; Mazmanian, Dwight; Penney, Alexander; Black, Nancy; Nguyen, An
An existing database was used to compare problem gamblers (N = 138) who presented for treatment of their gambling problem to two other groups: alcohol and/or drug addiction clients who also had a gambling problem (N = 280) or who did not have a gambling problem (N = 2178). Clients with gambling as their primary problem were more likely to be…
Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo
Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001 ; Roman and Johnson, 2002 ; Willenbring et al., 2004 ). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported practice (ESP) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors' perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors was also difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified.
Full Text Available Unstable housing and homelessness is prevalent among injection drug users (IDU. We sought to examine whether accessing addiction treatment was associated with attaining stable housing in a prospective cohort of IDU in Vancouver, Canada.We used data collected via the Vancouver Injection Drug User Study (VIDUS between December 2005 and April 2010. Attaining stable housing was defined as two consecutive "stable housing" designations (i.e., living in an apartment or house during the follow-up period. We assessed exposure to addiction treatment in the interview prior to the attainment of stable housing among participants who were homeless or living in single room occupancy (SRO hotels at baseline. Bivariate and multivariate associations between the baseline and time-updated characteristics and attaining stable housing were examined using Cox proportional hazard regression models.Of the 992 IDU eligible for this analysis, 495 (49.9% reported being homeless, 497 (50.1% resided in SRO hotels, and 380 (38.3% were enrolled in addiction treatment at the baseline interview. Only 211 (21.3% attained stable housing during the follow-up period and of this group, 69 (32.7% had addiction treatment exposure prior to achieving stable housing. Addiction treatment was inversely associated with attaining stable housing in a multivariate model (adjusted hazard ratio [AHR]=0.71; 95% CI: 0.52-0.96. Being in a partnered relationship was positively associated with the primary outcome (AHR=1.39; 95% CI: 1.02-1.88. Receipt of income assistance (AHR=0.65; 95% CI: 0.44-0.96, daily crack use (AHR=0.69; 95% CI: 0.51-0.93 and daily heroin use (AHR=0.63; 95% CI: 0.43-0.92 were negatively associated with attaining stable housing.Exposure to addiction treatment in our study was negatively associated with attaining stable housing and may have represented a marker of instability among this sample of IDU. Efforts to stably house this vulnerable group may be occurring in contexts
Delić, Mirjana; Kajdiž, Karmen; Pregelj, Peter
Many patients with opioid addiction continue to use opioids during and after treatment, and their career of drug taking is usually punctuated by repeated treatment admissions and relapses. Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. The most widely used system of traits is called the Five-Factor Model (FFM). Studies have shown that persons who use heroin are consistently depicted as high on Neuroticism and higher Extroversion, also they are described as more impulsive and less sociable. Those who maintain abstinence are characterized by a higher Agreeableness and Conscientiousness. Treatment programs for opioid addiction vary substantially in treatment processes, and an early identification of patients traits that address their strengths and weaknesses within specific treatment settings could be useful in decreasing the possibility of relapse.
João Maurício Castaldelli-Maia
Full Text Available Objective: To analyze the predictors of smoking cessation treatment outcomes in a sample with a high rate of medical and psychiatric disorders and addictions. Methods: Analysis of predictors of success of a 6-week treatment provided by an addiction care unit (CAPS-AD to 367 smokers in Brazil from 2007 to 2010. Forty variables were collected at baseline. Success was defined as abstinence from smoking for a period of at least 14 consecutive days, including the last day of treatment. Twenty variables were selected for the logistic regression model. Results: The only condition correlated with successful treatment after logistic regression was smoking one's first cigarette 5 minutes or more after waking (beta = 1.85, 95% confidence interval [95%CI] = 1.11-3.10, p = 0.018. Subjects with hypertension and alcohol use disorders and those who were undergoing psychiatric treatment showed success rates comparable to or greater than the average success rate of the sample (34.2-44.4%. Conclusions: These findings support the importance of the variable time to first cigarette in treatment outcomes for a sample with a high rate of clinical and psychiatric disorders. Good success rates were observed for pharmacological treatment, which was combined with group therapy based on cognitive-behavioral concepts and integrated into ongoing treatment of other addictions and psychiatric disorders.
Penka, S; Krieg, S; Hunner, Ch; Heinz, A
Due to cultural and social barriers, immigrants seldom frequent centers for information, counseling, and treatment of addictive disorders. We examine cultural differences in the explanatory models of addictive behavior among Turkish and German youths in Germany with statistical devices that map the concepts associated with problems of addiction. Relevant differences were found between the disorder concepts of Turkish and German youth. German but not Turkish youths classified eating disorders among severe addictive disorders and associated them with embarrassment and shame. Concerning substance abuse, German but not Turkish youths clearly differentiated between illegal drug abuse and the abuse of alcohol and nicotine. Nearly half of all Turkish youths rejected central medical concepts such as "physical dependence" or "reduced control of substance intake" as completely inadequate to characterize problems of addictive behavior. Preventive information programs must consider these differences and use concepts that are accepted and clearly associated with addictive behavior by immigrant populations.
Schoenthaler, Stephen J; Blum, Kenneth; Braverman, Eric R; Giordano, John; Thompson, Ben; Oscar-Berman, Marlene; Badgaiyan, Rajendra D; Madigan, Margaret A; Dushaj, Kristina; Li, Mona; Demotrovics, Zsolt; Waite, Roger L; Gold, Mark S
The connection between religion/spirituality and deviance, like substance abuse, was first made by Durkheim who defined socially expected behaviors as norms. He explained that deviance is due in large part to their absence (called anomie), and concluded that spirituality lowers deviance by preserving norms and social bonds. Impairments in brain reward circuitry, as observed in Reward Deficiency Syndrome (RDS), may also result in deviance and as such we wondered if stronger belief in spirituality practice and religious belief could lower relapse from drugs of abuse. The NIDA Drug Addiction Treatment Outcome Study data set was used to examine post hoc relapse rates among 2,947 clients who were interviewed at 12 months after intake broken down by five spirituality measures. Our main findings strongly indicate, that those with low spirituality have higher relapse rates and those with high spirituality have higher remission rates with crack use being the sole exception. We found significant differences in terms of cocaine, heroin, alcohol, and marijuana relapse as a function of strength of religious beliefs (x 2 = 15.18, p = 0.028; logistic regression = 10.65, p = 0.006); frequency of attending religious services (x 2 = 40.78, p theory. Stronger spiritual/religious beliefs and practices are directly associated with remission from abused drugs except crack. Much like the value of having a sponsor, for clients who abuse drugs, regular spiritual practice, particularly weekly attendance at the religious services of their choice is associated with significantly higher remission. These results demonstrate the clinically significant role of spirituality and the social bonds it creates in drug treatment programs.
Full Text Available Employees who abuse Internet privileges have become a major concern among today's employers. Employees misuse Internet at the workplace due to the overcrowded schedule, pressures at work, etc. Internet for private purposes is also used as a release or escape from work, escape from the reality of the workplace or due to poor organizational climate; it can be used as an efficient use of time at work but it can also be excessively used when the employees are not monitored. The survey results show that there is a correlation between Internet addiction and misuse of the Internet in the workplace. Electronic monitoring has a strong impact on the abuse of the Internet. More electronic monitoring will decrease the abuse of the internet services in the workplace and vice versa. Organizational climate, relations in the working organization, the Internet policy and demographic factors do not affect the abuse of Internet services in the workplace.
Mendelevich, Vladimir D
This article provides an overview of a sociological study of the views of 338 drug addiction treatment professionals. A comparison is drawn between the bioethical approaches of Russian and foreign experts from 18 countries. It is concluded that the bioethical priorities of Russian and foreign experts differ significantly. Differences involve attitudes toward confidentiality, informed consent, compulsory treatment, opioid agonist therapy, mandatory testing of students for psychoactive substances, the prevention of mental patients from having children, harm reduction programs (needle and syringe exchange), euthanasia, and abortion. It is proposed that the cardinal dissimilarity between models for providing drug treatment in the Russian Federation versus the majority of the countries of the world stems from differing bioethical attitudes among drug addiction treatment experts.
Mendelevich Vladimir D
Full Text Available Abstract This article provides an overview of a sociological study of the views of 338 drug addiction treatment professionals. A comparison is drawn between the bioethical approaches of Russian and foreign experts from 18 countries. It is concluded that the bioethical priorities of Russian and foreign experts differ significantly. Differences involve attitudes toward confidentiality, informed consent, compulsory treatment, opioid agonist therapy, mandatory testing of students for psychoactive substances, the prevention of mental patients from having children, harm reduction programs (needle and syringe exchange, euthanasia, and abortion. It is proposed that the cardinal dissimilarity between models for providing drug treatment in the Russian Federation versus the majority of the countries of the world stems from differing bioethical attitudes among drug addiction treatment experts.
... substitution of a therapeutic drug with addictive potential for a drug of addiction (e.g. the [[Page 81900... the accumulated medical evidence supporting certain maintenance programs as one component of the continuum of care necessary for the effective treatment of substance dependence. Current medical evidence...
... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to... alcoholism is a contributing factor material to the determination of disability (as described in § 404.1535...
Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Davoli, Marina; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Faggiano, Fabrizio; Maremmani, Angelo Giovanni Icro; Maremmani, Icro
Background The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychop...
Bruijnzeel, Adriaan W
The mildly euphoric and cognitive enhancing effects of nicotine play a role in the initiation of smoking, while dysphoria and anxiety associated with smoking cessation contribute to relapse. After the acute withdrawal phase, smoking cues, a few cigarettes (i.e., lapse), and stressors can cause relapse. Human and animal studies have shown that neuropeptides play a critical role in nicotine addiction. The goal of this paper is to describe the role of neuropeptide systems in the initiation of nicotine intake, nicotine withdrawal, and the reinstatement of extinguished nicotine seeking. The reviewed studies indicate that several drugs that target neuropeptide systems diminish the rewarding effects of nicotine by preventing the activation of dopaminergic systems. Other peptide-based drugs diminish the hyperactivity of brain stress systems and diminish withdrawal-associated symptom severity. Blockade of hypocretin-1 and nociceptin receptors and stimulation of galanin and neurotensin receptors diminishes the rewarding effects of nicotine. Both corticotropin-releasing factor type 1 and kappa-opioid receptor antagonists diminish dysphoria and anxiety-like behavior associated with nicotine withdrawal and inhibit stress-induced reinstatement of nicotine seeking. Furthermore, blockade of vasopressin 1b receptors diminishes dysphoria during nicotine withdrawal, and melanocortin 4 receptor blockade prevents stress-induced reinstatement of nicotine seeking. The role of neuropeptide systems in nicotine-primed and cue-induced reinstatement is largely unexplored, but there is evidence for a role of hypocretin-1 receptors in cue-induced reinstatement of nicotine seeking. Drugs that target neuropeptide systems might decrease the euphoric effects of smoking and improve relapse rates by diminishing withdrawal symptoms and improving stress resilience.
This article, based on ethnographic fieldwork including twelve months of participant observation and 428 interviews with 84 converts and leaders in Pentecostal ministries founded and run by former addicts in Puerto Rico, describes redefined masculinity as a treatment for addiction. Industrial disinvestment and resulting unemployment and drug trade in urban North and Latin America have led to narcotic addiction among Latino and African American men and attendant homicide, infection, and incarceration. Pentecostal-evangelical street ministries are prevalent in these regions. Their alternative vision of masculine honor and power addresses a cultural crisis of men's social space. They replace the unachievable ideal of the male breadwinner with an image of male spiritual power. In place of the violence of the drug trade, they cultivate male domesticity and responsibility for the home. In place of a deleterious drug economy, they offer the social and cultural capital of ministry networks and biblical knowledge. Yet the trajectories of ministry converts reveal the limits, as well as the promise, of evangelist masculinity as a treatment for addiction. In the course of building leadership among their converts, the ministries create their own, internal hierarchies, fall short of the spiritual democracy they espouse, and lead to relapse among those left at the bottom. Copyright © 2011 Elsevier Ltd. All rights reserved.
D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah
This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.
Rezapour, Tara; DeVito, Elise E; Sofuoglu, Mehmet; Ekhtiari, Hamed
Addiction, as a brain disorder, can be defined with two distinct but interacting components: drug dependency and neurocognitive deficits. Most of the therapeutic interventions in addiction medicine, including pharmacological or psychosocial therapies, that are in clinical use have been mainly focused on directly addressing addictive behaviors, especially drug use and urges to use drugs. In the field of addiction treatment, it is often presumed that drug users' neurocognitive deficits will reverse following abstinence. However, in many cases, neurocognitive deficits are not fully ameliorated following sustained abstinence, and neurocognitive function may further deteriorate in early abstinence. It can be argued that many cognitive functions, such as sustained attention and executive control, are essential for full recovery and long-term abstinence from addiction. Recent advances in cognitive neuroscience have provided scientific foundations for neurocognitive rehabilitation as a means of facilitating recovery from drug addiction. Neurocognitive rehabilitation for drug addicted individuals could be implemented as part of addiction treatment, with highly flexible delivery methods including traditional "paper and pencil" testing, or computer-based technology via laptops, web-based, or smartphones in inpatient and outpatient settings. Despite this promise, there has been limited research into the potential efficacy of neurocognitive rehabilitation as a treatment for drug addiction. Further, many questions including the optimum treatment length, session duration, and necessary treatment adherence for treatment efficacy remain to be addressed. In this chapter, we first introduce cognitive rehabilitation as one of the potential areas to bridge the gap between cognitive neuroscience and addiction medicine, followed by an overview of current challenges and future directions. © 2016 Elsevier B.V. All rights reserved.
Quanbeck, Andrew R; Gustafson, David H; Marsch, Lisa A; McTavish, Fiona; Brown, Randall T; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E; Atwood, Amy K; McDowell, Helene
Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods - pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance - with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of
Guillou-Landréat, Morgane; Grall-Bronnec, Marie; Vénisse, Jean-Luc
Each addictive disorder has specific characteristics. It is essential to consider them in order to improve the treatment. However, the combination of behavioral addictions and substance use disorders is valid, as showed by the next version of the DSM. During the treatment, it is important to evaluate cross, but also longitudinal, considering the current problematic behavior, but also the problematic behaviors that occurred in the past and that may occur in the future. There is indeed a significant risk of switching addiction. The relapse prevention must consider this risk and be inclusive. Copyright © 2012. Published by Elsevier Masson SAS.
Full Text Available The treatment of addiction to opiates, apart from psychological and social problems, has presented up to now a therapeutic prohlem. Various methods are used and each has its disadvantages. Residual symptoms of abstinence from opiates are present in all methods and there is a prolonged period of convalescence which seems to be one of the causes of relapses to addiction. Vitamin E however- has given remarkable results in aiding recovery from the withdrawal symptoms. With vitamin E the period of treatment is shortened, abstinence symptoms are bearable and the convalescent period is eliminated. Patients treated with vitamin E solely are in good health and spirits and appear contented. This treatment also seems to reduce 1he number of relapses. The administration of vitamin E after a complete withdrawal from opium probably compensates Some of the opium's effects on the nervous system, and remedies the hypoxia of the tissues, thus restoring the patient to a normal physiological state.
Mora-Ríos, Jazmín; Ortega-Ortega, Miriam; Medina-Mora, Maria Elena
Social rejection of drug use is greater than that directed at other psychiatric conditions, like depression and anxiety, which may lead to social exclusion of substance users and prevent them from seeking and receiving treatment. The objective of this study is to investigate the stigma and discrimination related to addiction in treatment centers in Mexico City. Data are from a broad mixed methods study. The present study is a qualitative analysis of 35 in-depth interviews of drug users, family members, and providers, using guidelines for the exploration of experiences of stigma and discrimination related to substance abuse. A thematic analysis was carried out using specialized software (Atlas.ti 6.2.23). The common practices of stigma and discrimination (e.g., judging, mockery, inappropriate comments, overprotection, and hostile looks), were identified in participant testimonies. The narratives provide evidence of varied conditions of social and gender inequality, as well as experience of violence and abuse, that refer to a structural context of discrimination surrounding addiction, and that constitute obstacles to treatment. The findings allow for a description of the stigmatization process surrounding addiction as a shared problem that requires the implementation of coordinated treatment strategies. They also suggest the need for more comprehensive policies of inclusion, based on human rights, which favor prevention and treatment.
Karrari, P.; Mehrpour, O.
Objective: To evaluate the pattern of use of opioid and other illegal drugs in patients seeking addiction treatment in Birjand, eastern Iran. Methods: The prospective study was conducted from March 21, 2009 to March 21, 2010, and comprised all patients referred to the seven addiction treatment centres in Birjand. Data was obtained through pre-designed questionnaires and it was analysed using SPSS 16. Results: Of the 700 substance users referred to the 7 centres and who volunteered to participate, 632 (90.3%) were males and 68 (9.7%) were females. The male/female ratio was approx 9.3/1. Mean age was 34+-10.2 (range: 10-75) years. The type of drugs used included traditional drugs (n= 342; 48.9%) and newer modern drugs (n=314; 44.9 %). The mean age of the first experience with drugs was 21.91+-7.1 (range=0-60) years. There was significant different between the type of drugs used and the place of residence (p<0.019), age (p<0.0001), martial status (p<0.0001), occupation (p<0.006) and education (p<0.017). Conclusion: The prevalence of illicit drug addiction was quite high. There seemed to have been a change in the pattern of drug use and in the type of illegal drugs used in the study area, from traditional drugs to new and modern drugs. As such, identifying risk factors related to addiction and the prevention of addiction should be one of the most important health priorities for the authorities. (author)
Pagano, Maria E; Wang, Alexandra R; Rowles, Brieana M; Lee, Matthew T; Johnson, Byron R
The developmental need to fit in may lead to higher alcohol and other drug use among socially anxious youths which exacerbates the drink/trouble cycle. In treatment, youths with social anxiety disorder (SAD) may avoid participating in therapeutic activities with risk of negative peer appraisal. Peer-helping is a low-intensity, social activity in the 12-step program associated with greater abstinence among treatment-seeking adults. This study examined the influence of SAD on clinical severity at intake, peer-helping during treatment, and outcomes in a large sample of adolescents court-referred to residential treatment. Adolescents (N = 195; 52% female, 30% Black) aged 14 to 18 were prospectively assessed at treatment admission, treatment discharge, and 6 months after treatment discharge. Data were collected using rater-administered assessments, youth reports, clinician reports, medical charts, and electronic court records. The influence of SAD on peer-helping and outcomes was examined using hierarchical linear regression and event history methods. Forty-two percent of youths reported a persistent fear of being humiliated or scrutinized in social situations, and 15% met current diagnostic criteria for SAD. SAD onset preceded initial use for two-thirds of youths with SAD and substance dependency. SAD youths presented for treatment with greater clinical severity in terms of earlier age of first use (p networks in the transition back into the community. Copyright © 2015 by the Research Society on Alcoholism.
Lin, Lewei Allison; Bohnert, Amy S B; Price, Amanda M; Jannausch, Mary; Bonar, Erin E; Ilgen, Mark A
Studies from pain treatment settings indicate that poor acceptance of pain may be an important and modifiable risk factor for higher severity of opioid use. However, the degree to which pain acceptance relates to opioid use severity in the addiction treatment population is unknown. In this study of addiction treatment patients with co-morbid pain, we examined correlates of severity of opiate (heroin and prescription opioid) use, with a particular focus on the role of pain acceptance. Patients in residential addiction treatment with comorbid pain (N=501) were stratified into low, moderate and high severity of opiate use. Demographic and clinical characteristics were compared across opiate severity categories. 72% (N=360) of the participants had symptoms that were consistent with an opiate use disorder. Younger age, Caucasian race, female gender, cocaine use and lower pain acceptance were associated with higher severity of opiate use, whereas pain intensity was not. Controlling for demographic and other risk factors, such as substance use and pain intensity, higher pain acceptance was associated with lower odds of severe prescription opioid (AOR 0.50, 95% CI 0.38-0.68 for a one SD increase in pain acceptance) and heroin use (AOR 0.57, 95% CI 0.44-0.75 for a one SD increase in pain acceptance). Problematic opiate use is common in addictions treatment patients with chronic pain. Lower pain acceptance is related to greater opiate use severity, and may be an important modifiable target for interventions to successfully treat both pain and opiate use disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Chun, JongSerl; Shim, HaiSun; Kim, Soyoun
This study comprehensively examined the effects of treatment interventions for Internet addiction among adolescents in South Korea through a meta-analysis. We analyzed 70 domestic master's theses and journal articles that reported on controlled studies and involved pre- and post-test analyses in the design. The dates of these publications fall between 2000 and 2015. The total effect size, calculated by random-effect analysis (g), revealed that interventions for the treatment of Internet addiction were effective (ES = 1.838). Meta-ANOVAs revealed differences between groups based on a theoretical model, intervention group size, and intervention duration. Integrative therapy produced larger effect sizes (ES = 2.794) compared to other treatment models such as cognitive behavioral therapy and reality therapy. Effect sizes for interventions, including nine to 12 people (ES = 2.178), were larger than those of interventions including more or fewer participants. Finally, treatment interventions that lasted 8 or more weeks revealed larger effect sizes (ES = 2.294) compared to shorter interventions. The study findings suggest directions for the development and effective operation of future Internet addiction interventions among Korean adolescents. Increasing the effectiveness of these interventions requires an integrative theoretical model, an intervention group size of nine to 12 participants, and a long-term intervention.
Ghafarinezhad, Alireza; Rajabizadeh, Ghodratollah; Shahriari, Vahid
Drug abuse is a major public health problem. Some believe that when dissociation fails to defend against emotional, physical, or sexual trauma, the person will find relief from unpleasant thoughts and emotions in opium use. On the other hand, personality disorders are considered as important predictors of treatment outcomes in drug abusers. Due to lack of adequate research in this regard, we evaluated dissociative disorders and personality traits of opium addicts on methadone treatment. This cross-sectional analytic study included 111 non-psychotic subjects on methadone treatment (case group) and 69 non-addicts (control group). After recording demographic characteristics, Dissociative Experiences Scale (DES) and Millon Multiaxial Inventory III were applied to assess dissociative symptoms and clinical personality patterns of all participants. Dissociative symptoms were significantly more common in the case group than in the control group (P = 0.044). While hysterionic personality disorder was more frequent in the control group (P = 0.008), sadistic, antisocial, and schizotypal personality disorders were significantly more common in the case group (P = 0.008, 0.002, and 0.023, respectively). We found relations between history of drug dependence, dissociative symptoms, and personality disorders. Therefore, the mentioned disorders need to be kept in mind while planning addiction treatment modalities and identifying high risk groups.
Krejci, Jonathan; Ziedonis, Douglas
Despite resistance from some treatment providers, medications play an increasingly important role in the treatment of substance dependence disorders. Goals of pharmacotherapy are discussed in terms of a four-stage model of treatment: acute withdrawal, protracted withdrawal, abstinence, and maintenance. The greatest controversy centers on the use of medications during the abstinence and maintenance phases of recovery. Particularly controversial, despite considerable supporting scientific data, is the lon -term use of agonists such as methadone. Occupational physicians and other non-prescribing staff can play a crucial role by supporting the responsible use of medications, maintaining contact with other medical and psychosocial treatment providers, enlisting support for medication compliance in patients' personal and professional support systems, advocating for comprehensive and humane patient care, and being alert to signs of medication misuse.
Full Text Available Alcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The field of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfiram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that genetic variation is a significant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the findings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.
Delgadillo, Jaime; Payne, Scott; Gilbody, Simon; Godfrey, Christine; Gore, Stuart; Jessop, Dawn; Dale, Veronica
Anxiety disorders are the most common mental health problems and often co-exist with substance use. Little evidence exists to support the use of brief screening tools for anxiety disorders in routine addictions treatment. This is the first study to test the validity and reliability of GAD-7 and GAD-2 in an outpatient drugs treatment population. A sample of 103 patients completed brief screening questionnaires and took part in structured diagnostic assessments using CIS-R. A subgroup of 60 patients completed retests after 4 weeks. The results of brief questionnaires were compared to those of gold-standard diagnostic interviews using Receiver Operating Characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires. A GAD-7 score ≥ 9 had a sensitivity of 80% and specificity of 86% for any anxiety disorder, also displaying adequate temporal stability at repeated measurements (intra-class correlation=0.85) and high internal consistency (Cronbach's alpha=0.91). A GAD-2 score ≥ 2 had 94% sensitivity and 53% specificity, with adequate internal consistency (0.82). GAD-7 adequately detected the presence of an anxiety disorder in drug and alcohol users; although this study was limited by sample size to determine its reliability for specific diagnoses. Results in this small sample suggest that GAD-7 may be a useful screening tool in addiction services, although replication in a larger sample is warranted. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Davis, Alan K; Nickelsen, Tetiana; Zucker, Robert A; Bonar, Erin E; Walton, Maureen A
We examined whether acceptability of nonabstinence treatment outcome goals varied as a function of a patient's severity of diagnosis (ICD-10 harmful use vs. dependence syndrome; World Health Organization, 1992), finality of outcome goal (intermediate vs. final), and type of substance (e.g., tobacco, alcohol, cannabis), among addiction treatment providers in Ukraine. We surveyed 44% of Ukrainian treatment providers (n = 446/1023; Mage = 40.4, SD = 8.6; Male = 67%; MYears Of Experience = 10.2, SD = 7.2). For tobacco use, most respondents (78%-93%) rated nonabstinence as acceptable, regardless of diagnostic severity or finality of outcome goal (i.e., intermediate, final). Most respondents also rated nonabstinence as acceptable as an intermediate or final goal for patients with harmful use of alcohol (70% to 86%) or cannabis (71% to 93%); however, nonabstinence was less commonly indicated by respondents as an intermediate goal for patients with a dependence syndrome (alcohol = 52%; cannabis = 68%). Regarding other drug use, although most rated nonabstinence acceptable as an intermediate goal for patients with harmful use of opioids (68%) or sedatives (64%), fewer rated nonabstinence acceptable as a final goal (26% to 33%), particularly for patients with a dependence syndrome (10% to 27%). Very few providers (5% to 15%) rated nonabstinence acceptable for other substances. Patients in Ukraine who wish to moderate cannabis or tobacco use will find that their provider is typically accepting of this goal; however, providers are mixed regarding whether alcohol and opioid moderation is appropriate, particularly for those with dependence. Findings support education and research efforts to better understand how provider and patient alignment regarding goals impact patient outcomes following substance use treatment in Ukraine. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Jennifer M Loftis
Full Text Available Relapse rates following current methamphetamine abuse treatments are very high (∼40-60%, and the neuropsychiatric impairments (e.g., cognitive deficits, mood disorders that arise and persist during remission from methamphetamine addiction likely contribute to these high relapse rates. Pharmacotherapeutic development of medications to treat addiction has focused on neurotransmitter systems with only limited success, and there are no Food and Drug Administration approved pharmacotherapies for methamphetamine addiction. A growing literature shows that methamphetamine alters peripheral and central immune functions and that immune factors such as cytokines, chemokines, and adhesion molecules play a role in the development and persistence of methamphetamine induced neuronal injury and neuropsychiatric impairments. The objective of this study was to evaluate the efficacy of a new immunotherapy, partial MHC/neuroantigen peptide construct (RTL551; pI-A(b/mMOG-35-55, in treating learning and memory impairments induced by repeated methamphetamine exposure. C57BL/6J mice were exposed to two different methamphetamine treatment regimens (using repeated doses of 4 mg/kg or 10 mg/kg, s.c.. Cognitive performance was assessed using the Morris water maze and CNS cytokine levels were measured by multiplex assay. Immunotherapy with RTL551 improved the memory impairments induced by repeated methamphetamine exposure in both mouse models of chronic methamphetamine addiction. Treatment with RTL551 also attenuated the methamphetamine induced increases in hypothalamic interleukin-2 (IL-2 levels. Collectively, these initial results indicate that neuroimmune targeted therapies, and specifically RTL551, may have potential as treatments for methamphetamine-induced neuropsychiatric impairments.
Capon, Hannah; Hall, Wayne; Fry, Craig; Carter, Adrian
Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to individuals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies. mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users. Copyright © 2016 Elsevier B.V. All rights reserved.
Loftis, Jennifer M.; Wilhelm, Clare J.; Vandenbark, Arthur A.; Huckans, Marilyn
Relapse rates following current methamphetamine abuse treatments are very high (∼40–60%), and the neuropsychiatric impairments (e.g., cognitive deficits, mood disorders) that arise and persist during remission from methamphetamine addiction likely contribute to these high relapse rates. Pharmacotherapeutic development of medications to treat addiction has focused on neurotransmitter systems with only limited success, and there are no Food and Drug Administration approved pharmacotherapies for methamphetamine addiction. A growing literature shows that methamphetamine alters peripheral and central immune functions and that immune factors such as cytokines, chemokines, and adhesion molecules play a role in the development and persistence of methamphetamine induced neuronal injury and neuropsychiatric impairments. The objective of this study was to evaluate the efficacy of a new immunotherapy, partial MHC/neuroantigen peptide construct (RTL551; pI-Ab/mMOG-35-55), in treating learning and memory impairments induced by repeated methamphetamine exposure. C57BL/6J mice were exposed to two different methamphetamine treatment regimens (using repeated doses of 4 mg/kg or 10 mg/kg, s.c.). Cognitive performance was assessed using the Morris water maze and CNS cytokine levels were measured by multiplex assay. Immunotherapy with RTL551 improved the memory impairments induced by repeated methamphetamine exposure in both mouse models of chronic methamphetamine addiction. Treatment with RTL551 also attenuated the methamphetamine induced increases in hypothalamic interleukin-2 (IL-2) levels. Collectively, these initial results indicate that neuroimmune targeted therapies, and specifically RTL551, may have potential as treatments for methamphetamine-induced neuropsychiatric impairments. PMID:23460798
Internet addiction is defined as uncontrolled and harmful use of Internet, which manifests in three forms: gaming, various sexual activities and excessive use of emails, chats or SMS messaging. Several studies have found that abuse of alcohol and other substances, depression and other health problems are associated with Internet addiction. In boys and men depression may be more a consequence of the addiction than a cause for it. ADHD seems to be a significant background factor for developing the condition. Because it is almost impossible to lead a life without Internet and computers nowadays, it is unrealistic to aim towards full abstinence. Treatment has generally followed the guidelines adapted for pathological gambling.
M.A. Goossensen (Anne)
textabstractThe core of this study is related to the insight that the population of opiate addicls is quite an invisible group. Some paris of this group can be identified at treatment institutions and in prisons. However, a large pari of the opiate addicls is hard to detect. This is because
Chavoustie, Steven; Frost, Michael; Snyder, Ole; Owen, Joel; Darwish, Mona; Dammerman, Ryan; Sanjurjo, Victoria
Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations. Areas covered: This review describes the development of and preliminary data from clinical trials of an implantable buprenorphine formulation. Efficacy and safety data from comparative studies with other administrations of buprenorphine, including tablets and sublingual film, will be described. Key premises of the Risk Evaluation and Mitigation Strategy program for safely administering buprenorphine implants, which all prescribing physicians must complete, are also discussed. Expert commentary: Long-acting implantable drug formulations that offer consistent drug delivery and lower risk of misuse, diversion, or accidental pediatric exposure over traditional formulations represent a promising development for the effective treatment of opioid use disorder.
Pagano, Maria E.; Wang, Alexandra R.; Rowles, Brieana M.; Lee, Matthew T.; Johnson, Byron R.
The developmental need to fit in may lead to higher alcohol and other drug use among socially anxious youths which exacerbates the drink/trouble cycle. In treatment, youths with social anxiety disorder (SAD) may avoid participating in therapeutic activities with risk of negative peer appraisal. Peer-helping is a low-intensity, social activity in…
Ragia, Georgia; Manolopoulos, Vangelis G
From the earliest times to the present, alcohol has evolved as part of life and culture. For most adults, moderate alcohol use is harmless, however, it lies at one end of a range that moves through alcohol abuse to alcohol addiction. Alcohol addiction is a serious and chronic psychiatric disorder that, on top of its heavy consequences on health, also brings significant social and economic losses to individuals and society at large. Pharmacotherapy of alcohol addiction exists, but its effectiveness varies significantly among individuals. Genomic and nongenomic factors are significant contributors to interindividual variation in the clinical presentation of alcohol problems and the response to a given treatment. In addition, emerging evidence suggests pharmacoepigenomics of alcohol addiction as a novel promising area for improvement of alcohol addiction management.
Chemical dependency, commonly known as substance abuse and use disorders, continues to plague residents of the United States. Because treatment has expanded beyond the walls of the acute care hospital, advanced practice nurses play a pivotal role in caring for clients addicted to various substances. This article describes how an advanced practice nurse in collaboration with the medical director and a director of nursing at a residential treatment center in southern New Jersey oversaw the development of an evidence-based detoxification treatment protocol for alcohol dependency, emphasizing the critical role of nurses in assuring that clinical practice is rooted in current evidence. Copyright © 2013 Elsevier Inc. All rights reserved.
Amodeo, Maryann; Storti, Susan A.; Larson, Mary Jo
Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001; Roman and Johnson, 2002; Willenbring et al., 2004). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported treatment (EST) for addicti...
Maremmani, Icro; Pani, Pier Paolo; Pacini, Matteo; Bizzarri, Jacopo V; Trogu, Emanuela; Maremmani, Angelo Gi; Gerra, Gilberto; Perugi, Giulio; Dell'Osso, Liliana
Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Using the Self-Report Symptom Inventory (SCL-90), we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females) aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence. A total of 150 (14.2%) patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4%) had somatisation symptoms, 205 (19.4%) interpersonal sensitivity and psychotic symptoms, 235 (22.3%) panic symptomatology, 208 (19.7%) violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology. This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.
Full Text Available Abstract Background Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Methods Using the Self-Report Symptom Inventory (SCL-90, we studied the psychopathological dimensions of 1,055 patients with heroin addiction (884 males and 171 females aged between 16 and 59 years at the beginning of treatment, and their relationship to age, sex and duration of dependence. Results A total of 150 (14.2% patients with heroin addiction showed depressive symptomatology characterised by feelings of worthlessness and being trapped or caught; 257 (24.4% had somatisation symptoms, 205 (19.4% interpersonal sensitivity and psychotic symptoms, 235 (22.3% panic symptomatology, 208 (19.7% violence and self-aggression. These dimensions were not correlated with sex or duration of dependence. Younger patients with heroin addiction were characterised by higher scores for violence-suicide, sensitivity and panic anxiety symptomatology. Older patients with heroin addiction showed higher scores for somatisation and worthlessness-being trapped symptomatology. Conclusions This study supports the hypothesis that mood, anxiety and impulse-control dysregulation are the core of the clinical phenomenology of addiction and should be incorporated into its nosology.
Pretlow, Robert A; Stock, Carol M; Allison, Stephen; Roeger, Leigh
The aim of this study was to test a weight loss program for young people based on an addiction treatment approach. A pilot study (n=43) was conducted of a 20-week child/adolescent obesity intervention based on an addiction treatment model (staged, incremental withdrawal from problem foods, snacking/grazing, and excessive amounts at meals) and implemented by a server-integrated smartphone app with health professional support. The primary outcome was standardized %overBMI measured at four time points. Secondary outcomes were participants' self-ratings of self-esteem, control over food, and the degree they turned to food when stressed. User satisfaction data were collected with an online questionnaire. Latent growth modeling techniques were used to identify independent variables and possible mediating treatment process variables associated with weight change. Mean age of participants was 16 years (range, 10-21), 65% girls, and 84% Caucasian. Twenty-seven (63%) completed the program. There was a significant decrease in %overBMI over time of 7.1. There were significant improvements in participant ratings of self-esteem, control over food, and a reduction in turning to food when stressed. Males, younger participants, and participants with higher levels of program compliance achieved better weight loss. Participants who reported that calling obesity an addiction made their guilt worse experienced poorer weight loss. Females were more likely than males to report "addiction guilt," and this partly mediated the overall gender effect. The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys.
Full Text Available BackgroundEmotion (dysregulation as well as the interventions for improving these difficulties are receiving a growing attention in the literature. The aim of the present paper was to conduct a systematic review about the efficacy of mindfulness-based interventions (MBIs in both substance and behavioral addictions (BAs.MethodA literature search was conducted using Cochrane, PubMed, and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis.ResultsMindfulness-based interventions were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others and BAs (namely, gambling disorder. These treatments were successful for reducing dependence, craving, and other addiction-related symptoms by also improving mood state and emotion dysregulation. The most commonly used MBI approaches were as follows: Mindfulness-Based Relapse Prevention, Mindfulness Training for Smokers, or Mindfulness-Oriented Recovery Enhancement, and the most frequent control group in the included studies was Treatment as Usual (TAU. The most effective approach was the combination of MBIs with TAU or other active treatments. However, there is a lack of studies showing the maintenance of the effect over time. Therefore, studies with longer follow-ups are needed.ConclusionThe revised literature shows support for the effectiveness of the MBIs. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs, or other addictions.
Tomori, Cecilia; Go, Vivian F; Tuan, Le Nhan; Huong, Nguyen Mai; Binh, Nguyen Thanh; Zelaya, Carla E; Celentano, David D; Dat, Do Tuan; Quan, Vu Minh
Amid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or "06 centers", for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from "06 centers" and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population. In-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from "06 centers" in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n=22) and through peer referral from self-help groups for PWID (n=21). Interviews were audiotaped, transcribed, translated, entered into Atlas.TI qualitative data analysis software and analyzed for key themes. The interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants' social isolation and exacerbated their struggles with addiction. Families were participants' primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability. Our study suggests that PWID released from "06 centers" would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with
Cunningham John A
Full Text Available Abstract A sample of service providers at addictions agencies' in Ontario were interviewed by telephone to assess attitudes toward, anticipated internal and external barriers to implementing, and expected benefits of four harm reduction strategies: needle exchange, moderate drinking goals, methadone treatment, and provision of free condoms to clients. Respondents were also asked to define harm reduction, list its most important elements, and describe what they find most troubling and most appealing about harm reduction. Attitudes toward harm reduction in general and the services provided at each agency were also assessed. Results indicated that the service providers surveyed had positive attitudes toward each of the four harm reduction strategies and harm reduction in general, and the majority of respondents were aware of the benefits associated with each strategy. Almost all of the agencies surveyed allowed for moderate drinking outcomes in the treatment of alcohol problems, and most agencies provided free condoms to clients. In terms of barriers, anticipated negative community reaction to needle exchange, methadone treatment, and free condoms was a major concern for the majority of respondents. Lack of staff, of funding, or anticipated staff resistance were also cited as potential barriers to introducing these strategies. In the case of methadone maintenance, the unavailability of a qualified physician was listed as the primary constraint. Implications for future efforts directed at encouraging the adoption of these strategies and suggestions for future research are discussed.
Full Text Available The causes of drug abuse and criminal behavior are closely linked. Not surprisingly, there is a high percentage of prisoners who during sentence execution abuse or are dependent on drugs. Antisocial personality disorder can be considered a common predictor of committing criminal offenses and drug abuse. A review of studies has revealed a high prevalence of inmates who use drugs while serving a sentence. Also, prison environment represents only a new context of the continuum of drug abuse by inmates. There are different theoretical approaches in explaining this phenomenon. Treatment programs based on empirically validated principles that guarantee the effectiveness, may be one strategy for solving the problem of drug abuse in prisons, with multiple positive effects.
Book, Sarah W; Thomas, Suzanne E; Smith, Joshua P; Miller, Peter M
There is increasing interest in the co-occurrence of social anxiety and addiction. Each investigation has a specific vantage point, e.g., the effect social anxiety has in a population with addiction or that of addiction in a population with social anxiety, which could create unique findings. Among comorbid individuals, is social anxiety more severe in people seeking treatment for anxiety, as compared to those seeking treatment for addiction? This report compares social anxiety severity between subjects in two studies--one involving socially anxious individuals (n=38) seeking treatment for addictions; the other (n=41) subjects with social anxiety and an alcohol use disorder, seeking treatment for social anxiety. Baseline severity scores on the Liebowitz Social Anxiety Scale for social anxiety were compared between the groups. No significant differences were found. For both groups, social anxiety was largely in the severe range. The results suggest that clinicians should attend to social anxiety symptom severity in patients with co-occurring social anxiety and addiction, regardless of the condition for which treatment is sought. Copyright © 2012 Elsevier Ltd. All rights reserved.
Malav Suchin Trivedi
Full Text Available Alcohol and other drugs of abuse, including psychostimulants and opioids, can induce epigenetic changes: a contributing factor for drug addiction, tolerance and associated withdrawal symptoms. DNA methylation is the major epigenetic mechanism and it is one of more than 200 methylation reactions supported by methyl donor S-adenosylmethionine (SAM. The levels of SAM are controlled by cellular redox status via the folate and vitamin B12-dependent enzyme methionine synthase (MS, for example; under oxidative conditions MS is inhibited, diverting its substrate homocysteine (HCY to the transsulfuration pathway. Alcohol, dopamine and morphine, can alter intracellular levels of glutathione (GSH-based cellular redox status, subsequently affecting S-adenosylmethionine (SAM levels and DNA methylation status. In this discussion, we compile this and other existing evidence in a coherent manner to present a novel hypothesis implicating the involvement of redox-based epigenetic changes in drug addiction. Next, we also discuss how gene priming phenomenon can contribute to maintenance of redox and methylation status homeostasis under various stimuli including drugs of abuse. Lastly, based on our hypothesis and some preliminary evidence, we discuss a mechanistic explanation for use of metabolic interventions / redox-replenishers as symptomatic treatment of alcohol addiction and associated withdrawal symptoms. Hence, the current review article strengthens the hypothesis that neuronal metabolism has a critical bidirectional coupling with epigenetic changes in drug addiction and we support this claim via exemplifying the link between redox-based metabolic changes and resultant epigenetic consequences under the effect of drugs of abuse.
The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements-technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms-has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services-namely access, quality, and cost -is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research.
Crnić Katarina B.
Full Text Available Introduction: Opiate dependence is a serious, chronic and recurrent psychiatric disorder, whose prevalence reach epidemic proportions. This also contributes to a significant increase in mortality, associated with overdose with opiates, as well as the rise in other health and social problems of the society. The methods and availability of treatment do not correspond to increased treatment needs, and treatment success is limited by the characteristics of the disorder, or numerous risk factors, which contribute to a high percentage of recidivism. Good clinical practice guidelines have defined treatment recommendations that include high and low-demanding programs. The personalized and integrative approaches are emphasized. Case report: The patient aged 41 years, intravenous-use opiate addict from his adolescences, with numerous psychological, health and social complications of addiction, is a participant in institutional treatment, following a court order as a measure of obligatory treatment, due to criminal offenses related to addiction. The history of the disease refers to numerous unsuccessful attempts to heal and short-term abstinence in the past, mainly in penal institutions. The patient meets all the criteria defined by the guidelines for inclusion in the buprenorphine maintenance program started in the year 2013. During the four-year treatment, the doses of the drug were adapted as needed; two heroin relapses and many in-risk situations for relapse were registered. The treatment continued with close monitoring of the patient's condition and, with appropriate psychosocial interventions, contribute to keeping the patient in treatment and preventing the development of new complications of addiction, as well an improving the quality of his life. Discussion: Pharmacological treatment of opioid dependence relies on agents belonging to groups of antagonists, agonists and partial agonists of opiate receptors. The earlier programs with abstinence as a
Prevention of addictive diseases should be complex and systematic and it should include training of social skills, decision-making skills, family intervention, etc. Similarly, effective treatment is usually long-term, systematic and complex. Physical exercise and yoga can be useful components of comprehensive prevention and treatment programmes. On the other hand, competitive professional sport rather increases the number of risk factors for substance-related problems. Practical experience with the use of yoga in substance dependent patients and pathological gambles are mentioned. One of the advantages of yoga is the integration of physical exercise and relaxation.
Battaini, F.; Govoni, S.; Mauri, A.; Civelli, L.; Trabucchi, M.
The binding of 3 H-ouabain to human erythrocytes was analyzed in a population of hospitalized male ethanol addicted patients under long term digitalis treatment. In the non-alcoholic patient group the long term digitalis treatment induced an increase in Bmax and Kd values; such modification was not observed in the alcoholic patients. Chronic alcohol intake itself induced an increase in 3 H-ouabain kinetic parameters. These observations confirm that ouabain binding to human erythrocytes is subject to pharmacological and toxicological regulation and that adaptive changes in peripheral tissues can be useful in predicting possible parallel modifications in other less accessible tissues. 22 references, 1 table
Vo, Hoa T; Robbins, Erika; Westwood, Meghan; Lezama, Debra; Fishman, Marc
Despite the well-known effectiveness and widespread use of relapse prevention medications such as extended release naltrexone (XR-NTX) and buprenorphine for opioid addiction in adults, less is known about their use in younger populations. This was a naturalistic study using retrospective chart review of N = 56 serial admissions into a specialty community treatment program that featured the use of relapse prevention medications for young adults (19-26 years old) with opioid use disorders. Treatment outcomes over 24 weeks included retention and weekly opioid-negative urine tests. Patients were of mean age 23.1, 70% male, 86% Caucasian, 82% with history of injection heroin use, and treated with either buprenorphine (77%) or XR-NTX (23%). The mean number of XR-NTX doses received was 4.1. Retention was approximately 65% at 12 weeks and 40% at 24 weeks, and rates of opioid-negative urine were 50% at 12 weeks and 39% at 24 weeks, with missing samples imputed as positive. There were no statistically significant differences in retention (t = 1.87, P = .06) or in rates of weekly opioid-negative urine tests (t = 1.96, P = .06) between medication groups, over the course of 24 weeks. The XR-NTX group had higher rates of weekly negative urine drug tests for other nonopioid substances (t = 2.83, P buprenorphine group. Males were retained in treatment longer and had higher rates of opioid-negative weeks compared with females. These results suggest that relapse prevention medications including both buprenorphine and XR-NTX can be effectively incorporated into standard community treatment for opioid addiction in young adults with good results. Specialty programming focused on opioid addiction in young adults may provide a promising model for further treatment development.
Szczegielniak, Anna; Bracik, Joanna; Mróz, Sylwia; Urbański, Marcin; Cichobłaziński, Leszek; Krysta, Krzysztof; Pyrkosz, Katarzyna; Chudy, Norbert; Krupka-Matuszczyk, Irena
The aim of this study was to estimate the level of knowledge about Brief Solution Focused Therapy (BSFT) among therapists and patients during treatment and identification of existing barriers to the introduction of the method. 64 therapists were examined in total; 37 women (57%) and 27 males (43%). The study involved also 191 patients, 160 men (83.77%) and 31 women (16.23%). All the surveys were anonymous and were collected in health centers within the province of Silesia. More than 2/3 of therapists have heard of the method, but do not know the specifics of it. The most important sources of knowledge are other therapists, literature, and mass media. According to the respondents the most important barriers to alcohol addiction treatment include cultural barriers, such as embarrassment or fear of stigmatization. Younger Patients and those treated for a shorter period, state that they know the name of the current method of treatment to a lesser extent than other subgroups. About 10% of people have not heard about the BSFT method of treatment. The level of knowledge about the BSFT method suggests the need to promote this model among both therapists and patients. An introduction of BSFT can improve the treatment of alcohol addiction.
Latypov, Alisher B
This paper reviews the development of early Soviet drug treatment approaches by focusing on the struggle for disciplinary power between leading social and mental hygienists and clinical psychiatrists as a defining moment for Soviet drug treatment speciality that became known as "narcology." From this vantage point, I engage in the examination of the rise and fall of various treatment methods and conceptualizations of addiction in Russian metropolitan centres and look at how they were imported (or not) to other Soviet republics. As clinical psychiatrists appeared as undisputed victors from the battle with social and mental hygienists, the entire narcological arsenal was subdued in order to serve the needs of mainstream psychiatry. However, what that 'mainstream' would be, was not entirely clear. When, in 1934, Aleksandr Rapoport insisted on the need for re-working narcological knowledge in line with the Marxist approach, he could only raise questions and recognise that there were almost no "dialectically illuminated scientific data" to address these questions. The maintenance treatment of opiate users, which emerged as the most effective one based on the results of a six-year study published in 1936, was definitely not attuned to the political and ideological environment of the late 1930s. Maintenance was rather considered as a temporary solution, in the absence of radical therapeutic measures to free Soviet society from "narkomania." As the Great Terror swept across the Soviet Union, Stalin's regime achieved its objective of eliminating drug addiction from the surface of public life by driving opiate users deep underground and incarcerating many of them in prisons and the Gulag camps. In the final section, I briefly discuss the changing perceptions of drug use during the World War II and outline subsequent transformations in Soviet responses to the post-war opiate addiction [Additional file 1].
Full Text Available Zainab Samaan,1–4 Monica Bawor,3,4 Brittany B Dennis,2,3 Carolyn Plater,5 Michael Varenbut,5 Jeffrey Daiter,5 Andrew Worster,5,6 David C Marsh,5,7 Charlie Tan,8 Dipika Desai,3 Lehana Thabane,2,9,10 Guillaume Pare11 1Department of Psychiatry and Behavioural Neurosciences, 2Department of Clinical Epidemiology and Biostatistics, 3Population Genomics Program, Chanchlani Research Centre, 4MiNDS Neuroscience Program, McMaster University, Hamilton, Ontario, Canada; 5Ontario Addiction Treatment Centres, Richmond Hill, Ontario, Canada; 6Department of Medicine, McMaster University, Hamilton, Ontario, Canada; 7Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada; 8Michael G. DeGroote School of Medicine, McMaster University, 9Biostatistics Unit, Centre for Evaluation of Medicine, 10System Linked Research Unit, 11Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada Introduction: Treatment of opioid addiction with methadone is effective; however, it is known to produce interindividual variability. This may be influenced in part by genetic variants, which can increase the initial risk of developing opioid addiction as well as explain differences in response to treatment. This pilot study aimed to assess the feasibility of conducting a full-scale genetic analysis to identify genes that predict methadone treatment outcomes in this population. Methods: This was a cross-sectional observational study of patients admitted to a methadone maintenance treatment program for opioid addiction. We obtained demographic and clinical characteristics in addition to blood and urine samples, for the assessment of treatment outcomes. Results: The recruitment process yielded 252 patients, representing a 20% recruitment rate. We conducted genetic testing based on a 99.6% rate of provision of DNA samples. The average retention in treatment was 3.4 years, and >50% of the participants reported psychiatric and
Patricia Maria da Silva Roggi
Full Text Available Objective: The craving is a strong desire to consume a psychotropic substance and is one of the symptoms of withdrawal syndrome in drug addiction. As a theoretical construct, craving is complex and described by different authors, which results in various theoretical models, but there is a consensus on the importance of its treatment. This paper conducted a literature review to identify and describe the most widely used techniques of Cognitive Behavior Therapy for the management of craving and to verify the impact of applying these techniques on outcome variables, specifically the craving. Method: Searches were conducted in the databases of PubMed and PsycInfo using the following descriptors in association: “craving”, “cognitive therapy” “behavior therapy” and “cognitive behavior therapy”. Results: 198 papers were found, out of which thirty four were selected for analysis. The cognitive behavior therapy treatment includes various techniques such as Relapse Prevention, Psychoeducational, Humor and Stress Management, Motivational Interviewing, Exposure to the Relapse Prevention and Relaxation techniques. The manual for Project MATCH is one of the most cited and used for the treatment of drug addicts. Cue Exposure Therapy (CET, Attentional Bias Modification (ABM and newer “mindfulness” therapeutic methods are studied, and have shown promising results, but still need to be further investigated. Conclusion: Various treatments have been proposed and have allowed the achievement of significant improvements in the reduction of craving.
Pisapia, Jared M; Halpern, Casey H; Muller, Ulf J; Vinai, Piergiuseppe; Wolf, John A; Whiting, Donald M; Wadden, Thomas A; Baltuch, Gordon H; Caplan, Arthur L
The success of deep brain stimulation (DBS) for movement disorders and the improved understanding of the neurobiologic and neuroanatomic bases of psychiatric diseases have led to proposals to expand current DBS applications. Recent preclinical and clinical work with Alzheimer's disease and obsessive-compulsive disorder, for example, supports the safety of stimulating regions in the hypothalamus and nucleus accumbens in humans. These regions are known to be involved in addiction and overeating associated with obesity. However, the use of DBS targeting these areas as a treatment modality raises common ethical considerations, which include informed consent, coercion, enhancement, threat to personhood, and manipulation of the reward center. Pilot studies for both of these conditions are currently investigational. If these studies show promise, then there is a need to address the ethical concerns related to the initiation of clinical trials including the reliability of preclinical evidence, patient selection, study design, compensation for participation and injury, cost-effectiveness, and the need for long-term follow-up. Multidisciplinary teams are necessary for the ethical execution of such studies. In addition to establishing safety and efficacy, the consideration of these ethical issues is vital to the adoption of DBS as a treatment for these conditions. We offer suggestions about the pursuit of future clinical trials of DBS for the treatment of addiction and overeating associated with obesity and provide a framework for addressing ethical concerns related to treatment.
Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia
This national study of addiction-treatment organizations' implementation of evidence-based practices examines: (1) organizational/leadership factors associated with director (n = 212) attitudes regarding staff resistance to organizational change, and (2) organizational/staff factors associated with staff (n = 312) attitudes regarding evidence-based clinical training. Linear regression analyses, controlling for type of treatment unit, leadership/staff characteristics and organizational readiness to change, identified that directors who perceived their organization needed more guidance and had less staff cohesion and autonomy rated staff resistance to organizational change significantly higher. Staff with higher levels of education and greater agreement that their organization supported change had greater preference for evidence-based trainings. Federal addiction treatment policy should both promote education and training of treatment staff and organizational development of treatment CBOs. © American Academy of Addiction Psychiatry.
Das, Saibal; Barnwal, Preeti; Maiti, Tanay; Ramasamy, Anand; Mondal, Somnath; Babu, Dinesh
The nature of addiction depends on various factors. The tendency to have already used several addictive substances and to seek high sensation experiences as a result of specific personality traits may lead to extreme and peculiar forms of addictions. Even belonging to specific social and cultural background may lead to such forms of addiction such as intentional snake bite and willful envenomation. In this article, we have discussed the peculiarities and practical insight of such addiction to snake venom. The possible molecular mechanism behind such venom-mediated reinforcement has also been highlighted. Finally, we have stressed upon the treatment and de-addiction measures.
Klimas, Jan; Rieb, Launette; Bury, Gerard; Muench, John; O?Toole, Thomas; Rieckman, Traci; Cullen, Walter
peer-reviewed Background: The Affordable Care Act (2010) brings an opportunity to increase the integration of addiction treatment into the health care system. With the anticipated expansion of addiction care services in primary care, challenges, such as workforce training, can be expected. This presentation discusses challenges and opportunities for addiction medicine training of primary care professionals in Ireland, Canada and Portland, OR. Objectives: To explore ideas for integratin...
Lyne, John Paul
A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.
To document the evolution over 40 years (from 1973 to 2013) of Coolmine Therapeutic Community (Ireland's first voluntary drug treatment service) against a background of broader drug policy developments in the Republic of Ireland and elsewhere during this period. Data were gathered by means of archival research within Coolmine, complemented by semi-structured interviews with former clients, current and former Coolmine management and staff, and representatives of outsider stakeholder interests. Coolmines's history has three phases: (1) an early and uncontentious phase, in which external authorities provided financial support for Coolmine without questioning its work practices or outcomes; (2) a middle, controversial phase, in which Coolmine struggled for survival in an external policy environment now dominated by harm reduction strategies; and (3) a final phase in which, through the use of conventional corporate governance, Coolmine management sought to repair its damaged reputation by introducing evidence-based clinical practices. Coolmine Therapeutic Community was established when drug treatment services in Ireland were in their infancy, and its changing fortunes over subsequent decades reflected changing perceptions of what constitutes appropriate addiction treatment-and in particular the role to be played by former addicts within addiction treatment systems-as well as changing perceptions of funding relationships between statutory authorities and voluntary providers of health and social services. © 2015 Society for the Study of Addiction.
Pallesen, Ståle; Lorvik, Ingjerd Meen; Bu, Eli Hellandsjø; Molde, Helge
This study investigated the effects of a manualized therapy for video game addiction in 12 males, ages 14-18 yr. The manual was based on cognitive-behavioral therapy, short-term strategic family therapy, solution-focused therapy, and motivational interviewing. Treatment response was reported by the patients, their mothers, and the therapists. The patients reported moderate (but statistically non-significant) improvement from pre- to post-treatment. The mothers, however, reported large effects and statistically significant improvement from pre- to post-treatment. The therapists reported marked or moderate treatment response in six of the 12 patients. The ratings of change by mothers converged well with the views of change of both the patients and therapists, whereas the convergence of views on change between the two latter sources was far lower.
Della Valle, R M; Baldoni, A; De Rossi, M; Ferri, F
In this paper we will describe the SeCD (Service for the Care of Drug addicts) electronic folder, a specific application of CADMIO  (Computer Aided Design for Medical Information Objects) system. CADMIO is a system for the definition, construction and management of multimedia clinical folders. The Ser.T. (Servizio per la Tossicodipendenza/Service for Drug Addicts) has earned a very special place within the Italian clinical structures as well as any service for drug addicts has done in the rest of the world. Such a structure has special needs and the characteristics of its medical folders are very different from any other folder. Actually, a Ser.T. has to keep updated the patient situation either from the clinical point of view as well as the psychiatric one. Moreover, it must keep track of the clinician subjective considerations about the patient psychic state and his situation in regard of the law. So, we had to redesign some of the features of the existing CADMIO application, to accommodate such highly not structured data into objects easily manipulated by an informative system. The objectives we hope to achieve were mainly two: To show that a well designed adaptive system can be easily exploited to support even very complex and poorly structured data types and actions To design data structures able to accommodate medical, psychiatric and administrative data in an homogeneous manner.
Full Text Available Background: Given the chronic and relapsing nature of addiction diseases and the various life domains they affect, the interest for quality of life research in the field of drug abuse has grown rapidly. Aim: Evaluation and comparison of quality of life in opioid addicts who are on methadone maintenance therapy for no longer than 2 years, from 2 to 5 years, or more than 5 years. Methods: A cross-sectional study was conducted in May 2013. Data were obtained by anonymous survey of 78 patients who were involved in methadone maintenance treatment. Patients were divided into three groups (n = 26 depending on the length of treatment. Quality of life of the patients was assessed by WHOQOLBREF (World Health Organization Quality of Life questionnaire. Results: Patients who are treated with methadone for 2 years or less, reported higher scores in almost all aspects of quality of life. Higher scores in the physical, social and environment domains were recorded in patients who had been treated from 2 to 5 years than the patients who had been treated for more than 5 years. However, these differences were not statistically significant. The most common side effects during the therapy were constipation (32.1%, sweating (32.1% and difficulty of falling in and maintaining sleep (30.8%. Conclusion: Patients did not show statistically significant difference of quality of life in relation to the length of methadone maintenance treatment.
Ruchi M. Sanghani
Full Text Available Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors’ scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.
Sanghani, Ruchi M; Moler, Alexander K
Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors' scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients.
... 34 Education 1 2010-07-01 2010-07-01 false Drug and alcohol addicts. 104.53 Section 104.53... ASSISTANCE Health, Welfare, and Social Services § 104.53 Drug and alcohol addicts. A recipient to which this... or treatment against a drug or alcohol abuser or alcoholic who is suffering from a medical condition...
Becker, Sara J; Squires, Daniel D; Strong, David R; Barnett, Nancy P; Monti, Peter M; Petry, Nancy M
Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multisite opioid addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the predetermined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, whereas putative mediators were measured at baseline, 3 months, and 12 months. Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed.
Buck, Tina; Sales, Amos
This paper provides an overview of addiction related to substance abuse. It provides basic information, prevalence, diagnostic criteria, assessment tools, and treatment issues for eating disorders, compulsive gambling, sex addictions, and work addictions. Eating disorders such as anorexia nervosa and bulimia nervosa, especially affect adolescents.…
Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsomporn, Jureerat; Östlund, Gunnel
The high prevalence of alcohol consumption, together with its associated health risk factors, has long-term negative impacts on both society and the economy in Thailand. The aim of this study was to explore the experiences of healthcare providers working with people experiencing alcohol addiction and the treatment programs in a Thai hospital. Qualitative study was applied in this study by conducting focus group interviews with 32 interdisciplinary healthcare providers, most of which were nurses. Content analysis was applied to analyze the verbatim-transcribed data. Two main topics emerged: (1) the collaborative practices related to alcohol treatment, and (2) the fit of the program, including how the treatment program functions. Obstacles were identified and formulated from several sub-categories. The findings included obstacles linked to the imported (Western) program and the patriarchal structure in Thai culture, which seem to intersect and reinforce each other.
French, Michael T; Salomé, Helena J; Sindelar, Jody L; McLellan, A Thomas
To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment. A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines. Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates. The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission. The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se. This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.
Park, Sung Yong; Kim, Sun Mi; Roh, Sungwon; Soh, Min-Ah; Lee, Sang Hoon; Kim, Hyungjin; Lee, Young Sik; Han, Doug Hyun
Neuroimaging studies have demonstrated dysfunction in the brain reward circuit in individuals with online gaming addiction (OGA). We hypothesized that virtual reality therapy (VRT) for OGA would improve the functional connectivity (FC) of the cortico-striatal-limbic circuit by stimulating the limbic system. Twenty-four adults with OGA were randomly assigned to a cognitive behavior therapy (CBT) group or VRT group. Before and after the four-week treatment period, the severity of OGA was evaluated with Young's Internet Addiction Scale (YIAS). Using functional magnetic resonance imaging, the amplitude of low-frequency fluctuation (ALFF) and FC from the posterior cingulate cortex (PCC) seed to other brain areas were evaluated. Twelve casual game users were also recruited and underwent only baseline assessment. After treatment, both CBT and VRT groups showed reductions in YIAS scores. At baseline, the OGA group showed a smaller ALFF within the right middle frontal gyrus and reduced FC in the cortico-striatal-limbic circuit. In the VRT group, connectivity from the PCC seed to the left middle frontal and bilateral temporal lobe increased after VRT. VRT seemed to reduce the severity of OGA, showing effects similar to CBT, and enhanced the balance of the cortico-striatal-limbic circuit. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Liester, Mitchell B
Lysergic acid diethylamide (LSD) is a semisynthetic compound with strong psychoactive properties. Chemically related to serotonin, LSD was initially hypothesized to produce a psychosislike state. Later, LSD was reported to have benefits in the treatment of addictions. However, widespread indiscriminate use and reports of adverse affects resulted in the classification of LSD as an illicit drug with no accepted medical use. This article reviews LSD's storied history from its discovery, to its use as a research tool, followed by its widespread association with the counterculture movement of the 1960s, and finally to its rebirth as a medicine with potential benefits in the treatment of addictions. LSD's pharmacology, phenomenology, effects at neurotransmitter receptors, and effects on patterns of gene expression are reviewed. Based upon a review of the literature, it is concluded that further research into LSD's potential as a treatment for addictions is warranted.
Klous, Marjolein G.; Rook, Elisabeth J.; Hillebrand, Michel J. X.; van den Brink, Wim; van Ree, Jan M.; Beijnen, Jos H.
In preparation for a treatment program concerning the medical coprescription of heroin and methadone to treatment-resistant addicts in the Netherlands, we studied a novel strategy for monitoring co-use of illicit (nonprescribed) heroin. A deuterated analogue of heroin was added (1:20) to
Dijkgraaf, Marcel G. W.; van der Zanden, Bart P.; de Borgie, Corianne A. J. M.; Blanken, Peter; van Ree, Jan M.; van den Brink, Wim
Objective To determine the cost utility of medical co-prescription of heroin compared with methadone maintenance treatment for chronic, treatment resistant heroin addicts. Design Cost utility analysis of two pooled open label randomised controlled trials. Setting Methadone maintenance programmes in
Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Davoli, Marina; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Faggiano, Fabrizio; Maremmani, Angelo Giovanni Icro; Maremmani, Icro
The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychopathological profiles of patients entering a TC versus an OAT treatment and at the correlation between gender and the observed psychopathology. A confirmatory factor analysis was performed on the results of SCL-90 filled by 1,195 patients with heroin dependence entering TC treatment. It replicates the extraction method previously used on 1,055 OAT patients with heroin addiction by using a principal component factor analysis (PCA). The association between the kind of treatment received (TC or OAT), gender, and the psychopathological dimensions was assessed through logistic regression and general linear model (GLM) analysis. The PCA carried out on the SCL-90 results of patients entering a TC yielded a five-factor solution, confirming the same dimensions observed in patients entering an OAT: 'worthlessness and being trapped', 'somatization', 'sensitivity-psychoticism', 'panic anxiety', and 'violence-suicide'. The logistic regression analysis showed a statistically significant association between 'somatization' and 'violence-suicide' severity score and OAT. GLM analysis showed that psychopathological factorial scores for 'worthlessness-being trapped', 'somatic symptoms', and 'panic anxiety' dimensions were more severe in OAT vs TC male patients and in TC vs OAT female ones. 'Violence suicide' followed the same severity pattern for males, but did not differ in TC vs OAT females, while 'sensitivity-psychoticism' did not differ in OAT vs TC patients. The five dimensions did not differ in OAT
Woody, George E.; Poole, Sabrina A.; Subramaniam, Geetha; Dugosh, Karen; Bogenschutz, Michael; Abbott, Patrick; Patkar, Ashwin; Publicker, Mark; McCain, Karen; Potter, Jennifer Sharpe; Forman, Robert; Vetter, Victoria; McNicholas, Laura; Blaine, Jack; Lynch, Kevin G.; Fudala, Paul
Context The usual treatment for opioid-addicted youth is detoxification and counseling. Extended medication-assisted therapy may be more helpful. Objective To evaluate the efficacy of continuing buprenorphine-naloxone for 12 weeks vs detoxification for opioid-addicted youth. Design, Setting, and Patients Clinical trial at 6 community programs from July 2003 to December 2006 including 152 patients aged 15 to 21 years who were randomized to 12 weeks of buprenorphine-naloxone or a 14-day taper (detox). Interventions Patients in the 12-week buprenorphine-naloxone group were prescribed up to 24 mg per day for 9 weeks and then tapered to week 12; patients in the detox group were prescribed up to 14 mg per day and then tapered to day 14. All were offered weekly individual and group counseling. Main Outcome Measure Opioid-positive urine test result at weeks 4, 8, and 12. Results The number of patients younger than 18 years was too small to analyze separately, but overall, patients in the detox group had higher proportions of opioid-positive urine test results at weeks 4 and 8 but not at week 12 ( χ22 = 4.93, P = .09). At week 4, 59 detox patients had positive results (61%; 95% confidence interval [CI] = 47%-75%) vs 58 12-week buprenorphine-naloxone patients (26%; 95% CI = 14%-38%). At week 8, 53 detox patients had positive results (54%; 95% CI = 38%-70%) vs 52 12-week buprenorphine-naloxone patients (23%; 95% CI = 11%-35%). At week 12, 53 detox patients had positive results (51%; 95% CI = 35%-67%) vs 49 12-week buprenorphine-naloxone patients (43%; 95% CI = 29%-57%). By week 12, 16 of 78 detox patients (20.5%) remained in treatment vs 52 of 74 12-week buprenorphine-naloxone patients (70%; χ12 = 32.90, P < .001). During weeks 1 through 12, patients in the 12-week buprenorphine-naloxone group reported less opioid use ( χ12 = 18.45, P < .001), less injecting ( χ12 = 6.00, P = .01), and less nonstudy addiction treatment ( χ12 = 25.82, P < .001). High levels of opioid use
Garrido-Fernández, Miguel; Marcos-Sierra, Juan A; López-Jiménez, Ana; Ochoa de Alda, Iñigo
In this study, we evaluate the efficacy of multi-family therapy at reducing the addiction severity and at improving the psychological and family dynamics of opiate addicts receiving methadone treatment at a public treatment center. The study compares multi-family therapy with a reflecting team (MFT-RT) and a standard treatment following a methadone maintenance treatment program. The results show that multi-family therapy with a reflecting team effectively reduces the addiction severity in several of the areas evaluated and noted that this effect is superior to standard treatment. The psychotherapy patients showed improvement in the areas of employment and social support; their drug use diminished and their psychiatric condition improved. At the same time, they needed a lower daily dose of methadone. In addition, the group undergoing standard treatment showed a noteworthy deterioration in their medical condition. Both groups showed a significant increase in their alcohol use. When applied to family treatments, the systemic-constructivist approach by the reflecting team offers combined techniques that can help improve care for the families of patients with addiction problems. © 2016 American Association for Marriage and Family Therapy.
Lipscomb, Jane A; London, M; Chen, Y M; Flannery, K; Watt, M; Geiger-Brown, J; Johnson, J V; McPhaul, K
To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low
Carmody, T P
Although smoking-cessation rates have continued to increase, the vast majority of smokers who quit eventually relapse. Between 1974 and 1985, over 1.3 million smokers quit during each of those years. However, 75% to 80% of those individuals resumed smoking within six months. This article describes the dynamic phenomenon of smoking relapse within the context of cyclical episodes of smoking and quitting during an individual's lifetime. Theories of the determinants of smoking relapse are reviewed and methods designed to prevent relapse are described. Smoking relapse is discussed in terms of three aspects of tobacco addiction: (1) biological-addiction mechanisms, (2) conditioning processes, and (3) cognitive-social learning factors. The major determinants of smoking relapse are reviewed, including nicotine withdrawal, stress, weight gain, social influences, conditioning factors, causal attributions, and environmental variables. A transtheoretical-developmental model is explored in the longitudinal investigation of the natural history of slips (lapses) and relapse episodes. Relapse prevention interventions are described that emphasize self-awareness, self-regulation, self-efficacy, affect regulation, social support, and lifestyle balance. Recent developments in pharmacological adjuncts to treatment are also examined. It is concluded that innovative relapse prevention methods need to be designed for hard-core smokers with histories of cessation failures, substance abuse and/or psychiatric impairment. These and other recommendations for future research on smoking relapse and relapse prevention are discussed.
Carter, Adrian; Hendrikse, Joshua; Lee, Natalia; Yücel, Murat; Verdejo-Garcia, Antonio; Andrews, Zane; Hall, Wayne
There is a growing view that certain foods, particularly those high in refined sugars and fats, are addictive and that some forms of obesity can usefully be treated as a food addiction. This perspective is supported by a growing body of neuroscience research demonstrating that the chronic consumption of energy-dense foods causes changes in the brain's reward pathway that are central to the development and maintenance of drug addiction. Obese and overweight individuals also display patterns of eating behavior that resemble the ways in which addicted individuals consume drugs. We critically review the evidence that some forms of obesity or overeating could be considered a food addiction and argue that the use of food addiction as a diagnostic category is premature. We also examine some of the potential positive and negative clinical, social, and public policy implications of describing obesity as a food addiction that require further investigation.
Grant, Jon E; Potenza, Marc N; Weinstein, Aviv; Gorelick, David A
Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions. Inform the discussion on the relationship between psychoactive substance and behavioral addictions. We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
Kim, Theresa W; Bernstein, Judith; Cheng, Debbie M; Lloyd-Travaglini, Christine; Samet, Jeffrey H; Palfai, Tibor P; Saitz, Richard
Screening, brief intervention and 'referral to treatment' programs have been promoted widely as US federal policy. Little is known about the efficacy of the RT component (referral to treatment) of brief intervention for motivating patients with unhealthy drug use identified by screening to use addiction treatment. This study aimed to compare receipt of addiction treatment following two types of brief intervention for drug use versus a no-intervention control group among primary care patients screening positive for drug use. Secondary analyses from a single-site randomized controlled trial. Massachusetts, USA. A total of 528 adults with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) drug-specific scores ≥ 4. Random assignment to: (1) a 10-15-minute brief negotiated interview (BNI) conducted by health educators (n = 174), (2) a 30-45-minute adaptation of motivational interviewing by Masters-level counselors (MOTIV) (n = 177) or (3) no BI (n = 177). All received a list of treatment and mutual help resources; both intervention protocols included dedicated staff for treatment referrals. Receipt of any addiction treatment within 6 months after study entry, assessed in a state-wide database and hospital electronic medical record linked to trial data. Among 528 participants, the main drugs used were marijuana (63%), cocaine (19%) and opioids (17%); 46% met past-year drug dependence criteria (short form Composite International Diagnostic Interview); and 10% of MOTIV, 18% of BNI and 17% of control participants had any addiction treatment receipt within 6 months after study entry. There was no significant difference in addiction treatment receipt for BNI versus control [adjusted odds ratio (AOR) = 1.11; 95% confidence interval (CI) = 0.57, 2.15, Hochberg adjusted P = 0.76]. The MOTIV group had lower odds of linking to treatment (AOR = 0.36, 95% CI = 0.17, 0.78, Hochberg adjusted P = 0.02) compared with the no BI group. Brief
Kabli, Noufissa; Liu, Ben; Seifert, Tricia
Objective. To examine academic service-learning pedagogy on student learning and perceptions of drug misuse and addiction. Design. Third- and fourth-year pharmacology students were exposed to an academic service-learning pedagogy that integrated a community service experience with lectures, in-class discussions and debates, group projects, a final paper, and an examination. Reflective writing assignments throughout the course required students to assimilate and apply what they had learned in the classroom to what they learned in their community placement. Assessment. Changes in students’ responses on pre- and post-course survey instruments reflected shifts toward higher-order thinking. Also, subjective student-learning modalities shifted toward learning by writing. Students’ perspectives and attitudes allowed improved context of issues associated with drug misuse and harm reduction models. Conclusion. Academic service-learning pedagogy contributes to developing adaptable, well-rounded, engaged learners who become more compassionate and pragmatic in addressing scientific and social questions relating to drug addiction. PMID:23610481
Audra L. Stinchcomb
Full Text Available Transdermal systems are attractive methods of drug administration specifically when treating patients for drug addiction. Current systems however are deficient in therapies that allow variable flux values of drug, such as nicotine for smoking cessation or complex dosing regimens using clonidine when treating opioid withdrawal symptoms. Through the use of functionalized carbon nanotube (CNT membranes, drug delivery to the skin can be controlled by applying a small electrical bias to create a programmable drug delivery system. Clearly, a transdermal patch system that can be tailored to an individual’s needs will increase patient compliance as well as provide much more efficient therapy. The purpose of this paper is to discuss the applicability of using carbon nanotube membranes in transdermal systems for treatment of drug abuse.
Caroline L. Strasinger
Full Text Available Transdermal systems are attractive methods of drug administration specifically when treating patients for drug addiction. Current systems however are deficient in therapies that allow variable flux values of drug, such as nicotine for smoking cessation or complex dosing regimens using clonidine when treating opioid withdrawal symptoms. Through the use of functionalized carbon nanotube (CNT membranes, drug delivery to the skin can be controlled by applying a small electrical bias to create a programmable drug delivery system. Clearly, a transdermal patch system that can be tailored to an individual's needs will increase patient compliance as well as provide much more efficient therapy. The purpose of this paper is to discuss the applicability of using carbon nanotube membranes in transdermal systems for treatment of drug abuse.
Full Text Available This paper introduces the means of dramatherapy intervention at two sites - at the Centre for secondary prevention and treatment of addictions Military Hospital in Olomouc and Toxicological rehabilitation department 17B (community Mandala Psychiatric Hospital in Kroměříž. The first workplace has a detoxifying and short-term intervention program (month, while the Mandala is implemented medium-term dramatherapy program (up to a half-year. The second part gives the results of the investigation, which was focused on finding differences (relations between the client and the perception of the benefits of the concept dramatherapy intervention at the aforementioned sites - nvestigation did not show differences between evaluation intervention customers of both institutions.
L-F. Pau (Louis-François)
textabstractThis paper links communications and media usage to social and household economics boundaries. It highlights that in present day society, communications and media are a necessity, but not always affordable, and that they furthermore open up for addictive behaviours which raise additional
About one third of the economical costs, which are due to death, sickness and life quality deficits in higher developed industrial countries, are caused by pollutants such as nicotine, alcohol and false eating habits. Within a period of one year 183,000 people in Germany die on tobacco associated sickness effects, 73,000 on direct or indirect aftermath of alcohol usage and a proportional amount of mostly adipoptic people on the hereoff resulting sickness effects. These risk trias, decided by every person mainly for himself by his own behaviour or mis-behaviour, are even aggravated by the free enterprise sanctioned drug politics of the highly profitable mega markets of the tobacco-, alcohol- and fast-food-industry. Health orientated drug politic, which is based on independence and solidarity and an exhaustive primary prevention within the scope of early nationalization authorities can therefore only have a limited effect. Even though, standardized, therapeutic short interventions used by hazardous alcohol- and drug usage, the qualified detoxification on addiction illness and an way to little used meanwhile time- and cost optimized withdrawal treatment have been proven to be quite effective. Exhaustive established ambulant smoking-withdrawal treatment programs are of special importance, because with continuously sinking of first contact, nicotine is know to be the "gate way drug" with the strongest addiction potential among all legalized and non-legalized drugs. In canon of mean while worldwide (except for Germany) started drug-control politics one will be able to start a health orientated drug politic in the future, which is including especially the drug economic aspects for the benefit of all as well as for the national budgets.
Full Text Available Halley M Pontes, Daria J Kuss, Mark D Griffiths International Gaming Research Unit, Psychology Division, Nottingham Trent University, Nottingham, UK Abstract: Research into Internet addiction (IA has grown rapidly over the last decade. The topic has generated a great deal of debate, particularly in relation to how IA can be defined conceptually as well as the many methodological limitations. The present review aims to further elaborate and clarify issues that are relevant to IA research in a number of areas including: definition and characterization, incidence and prevalence rates, associated neuronal processes, and implications for treatment, prevention, and patient-specific considerations. It is concluded that there is no consensual definition for IA. Prevalence rates among nationally representative samples across several countries vary greatly (from 1% to 18.7%, most likely reflecting the lack of methodological consistency and conceptual rigor of the studies. The overlaps between IA and other more traditional substance-based addictions and the possible neural substrates implicated in IA are also highlighted. In terms of treatment and prevention, both psychological and pharmacological treatments are examined in light of existing evidence alongside particular aspects inherent to the patient perspective. Based on the evidence analyzed, it is concluded that IA may pose a serious health hazard to a minority of people. Keywords: Internet addiction, review, behavioral addictions, prevalence, neuronal processes, treatment
Full Text Available Objective: This study has been done to determine the impact of life skills training on enhancement of self-esteem and marital satisfaction among addicts in treatment period. Method: The research design was semi experimental pretest-posttest with witness group. For each group 12men addicts in treatment period in Qazvin city were selected by available sampling. Rosenberg self-esteem and Enrich marital satisfaction questionnaires were administered among selected samples. Training workshop was conducted on role playing, questioning and answering which was taught by psychology professors in experimental group. Results: Results showed life skills training improved self-esteem and marital satisfaction of addicts in treatment period. Conclusion: Life skills training have a positive impact on self-esteem and marital satisfaction of individuals especially on addicts in treatment period, also life skills training in the field of smoking prevention enhances individuals’ skills (such as self-esteem, marital satisfaction, etc…. Life skills training empower person to actualize his knowledge, attitudes and values, and enable him to have motivation for healthy behavior which this will have significant impact on his relationship with his wife.
Blom, Björn; Dukes, Kimberly A; Lundgren, Lena; Sullivan, Lisa M
Data from large-scale registers is often underutilized when evaluating addiction treatment programs. Since many programs collect register data regarding clients and interventions, there is a potential to make greater use of such records for program evaluation. The purpose of this article is to discuss the value of using large-scale registers in the evaluation and program planning of addiction treatment systems and programs. Sweden is used as an example of a country where register data is both available and is starting to be used in national evaluation and program planning efforts. The article focuses on possibilities, limitations and practicalities when using large-scale register data to conduct evaluations and program planning of addiction treatment programs. Main conclusions are that using register data for evaluation provides large amounts of data at low cost, limitations associated to the use of register data may be handled statistically, register data can answer important questions in planning of addiction treatment programs, and more accurate measures are needed to account for the diversity of client populations. Copyright © 2014 Elsevier Ltd. All rights reserved.
Guerrero, Erick G; Kim, Ahraemi
Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Response inhibition has been a core issue in addictive behavior. Many previous studies have found that response inhibition abilities are damaged in those with drug dependence. However, whether heroin addicts who are treated with methadone maintenance have an abnormal response inhibition ability is not clear. In order to investigate the response inhibition functions in heroin addicts who were treated with methadone maintenance, electroencephalography (EEG was used to examine 14 heroin addicts treated with methadone maintenance (HDM, 17 heroin addicts (HD, and 18 healthy controls (HC in an equiprobability Go∖NoGo task. The reaction times (RTs for the Go stimuli in the HD group were slower than those in the HDM and HC groups. Event-related potential (ERP measurements showed that NoGo stimuli elicited larger N2 amplitudes than Go stimuli in the HDM and HC groups. However, for the HD group, the N2 amplitudes were similar for the two conditions. In addition, the HDM and HD groups were associated with longer P3 latencies. Our results demonstrated that methadone maintenance treatment might ease the deficits in response inhibition that result from long-term drug abuse. However, compared to normal people, HDM patients have serious problems evaluating and inhibiting inappropriate behaviors.
Santos, Veruska Andrea; Freire, Rafael; Zugliani, Morená; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia
The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (Paddiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (Panxiety, the correlation between scores was .724. This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the
population is very poor, and it has no high influence on the safety of haloperidol treatment; therefore, there are no reasons to take this polymorphism into account in patients with alcohol addiction who receive haloperidol. Keywords: haloperidol, CYP3A5*, CYP3A, cortisol, alcohol use disorder
Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia
Drawing on the analyses of qualitative interview accounts of people who inject heroin in Kenya, we describe the narration of addiction treatment access and recovery desire in conditions characterised by a 'poverty of drug treatment opportunity'. We observe the performance of addiction recovery narrative in the face of heavy social constraints limiting access to care. Fee-based residential rehabilitation ('rehab') is the only treatment locally available and inaccessible to most. Its recovery potential is doubted, given normative expectations of relapse. Treating drug use is a product of tightly bounded agency. Individuals enact strategies to maximise their slim chances of treatment access ('access work'), develop self-care alternatives when these fail to materialise and ration their care expectations. The use of rehab as a primary means of respite and harm reduction rather than recovery and the individuation of care in the absence of an enabling recovery environment are key characteristics of drug treatment experience. The recent incorporation of 'harm reduction' into policy discourses may trouble the primacy of recovery narrative in addiction treatment and in how treatment desires are voiced. The diversification of drug treatments in combination with social interventions enabling their access are fundamental.
Full Text Available Background and Aims: The aim of this study was to assess the oral health behaviors in women with addiction history. Materials and Methods: A cross-sectional study was carried out in women drug treatment centers under the supervision of Welfare Organization of Tehran province in Iran. Data collection process was conducted in three centers including a questionnaire with an interview format, clinical examination, and Chi-Square test and MANOVA for statistical analysis. Results: The mean age of 95 women participating in this study was less than forty, whereas the age of starting drugs was twenty two. A majority of the patients were unemployed (71% and more than that of two-third did not have a diploma education. Almost half of dentate participants had never or rarely brushed their teeth. Most of them had never used dental floss, while more than half had three or more times snacks or sweet drinks and more than three-fourth were daily smokers. The MANOVA analysis showed that the type of clinic to be visited, age, used stimulant, drug dependency length, the last time a dentist being visited and the brushing period had a statistically significant relationship with Decayed Teeth (DT, Missing Teeth (MT and Filled Teeth (FT (P<0.05. Conclusion: Women with the prior drug addiction history had an unpromising oral health status which was obvious in their self-perceived oral health. Taking the appropriate preventive and therapeutic actions aiming for promoting oral health status of them seems to be necessary.
Full Text Available Abstract Background Studies on the ‘self-medication hypothesis’ have focused on substance abuse as an attempt to alleviate emotional suffering. Methods We have investigated concomitant substances of abuse in 150 bipolar heroin addicts clustered according to their clinical presentation at treatment entry (depressive episode, hypomanic episode, manic episode and mixed episode. Bipolar heroin addicted patients were chosen because they tend to have a concomitant poly-substance abuse and because, as compared with patients suffering for other mental illnesses, they more clearly reveal a variety of identifiable affective states. Results Patients with a depressive episode more frequently used non-prescribed anxiolytic-hypnotics. They were found to use cocaine-amphetamines more frequently during a hypomanic episode, whereas the use of cannabis and cocaine-amphetamines occurred more frequently during a manic episode. The associated use of alcohol, cocaine-amphetamines and cannabinoids was more frequently encountered during a mixed episode. Limitations: apart from the difficulty in determining whether the substance use modifies the mood or the mood state determines the substance used, this is a report on a retrospective analysis, rather than a study specifically designed to elucidate the issue; in addition, no information was available on the temperament of our subjects. Assessments of the same subject in various clinical presentations would have provided a better level of information. Conclusions Besides one expected result – the prominent use of CNS stimulants during a depressive phase of bipolar patients – this study supports the hypothesis that mood elation is a pleasurable, rewarding experience that, in bipolar patients, can be started or prolonged by means of CNS stimulant drugs. Stimulant use was, therefore, more prevalent during the ‘up’ rather than the ‘down’ phase of the illness.
Vidrine, Jennifer Irvin; Spears, Claire Adams; Heppner, Whitney L.; Reitzel, Lorraine R.; Marcus, Marianne T.; Cinciripini, Paul M.; Waters, Andrew J.; Li, Yisheng; Nguyen, Nga Thi To; Cao, Yumei; Tindle, Hilary A.; Fine, Micki; Safranek, Linda V.; Wetter, David W.
Objective To compare the efficacy of Mindfulness-Based Addiction Treatment (MBAT) to a Cognitive Behavioral Treatment (CBT) that matched MBAT on treatment contact time, and a Usual Care (UC) condition that comprised brief individual counseling. Method Participants (N=412) were 48.2% African-American, 41.5% non-Latino White, 5.4% Latino and 4.9% other, and 57.6% reported a total annual household income < $30,000. The majority of participants were female (54.9%). Mean cigarettes per day was 19.9 (SD= 10.1). Following the baseline visit, participants were randomized to UC (n = 103), CBT (n = 155), or MBAT (n = 154). All participants were given self-help materials and nicotine patch therapy. CBT and MBAT groups received eight two-hour in person group counseling sessions. UC participants received four brief individual counseling sessions. Biochemically verified smoking abstinence was assessed 4 and 26 weeks after the quit date. Results Logistic random effects model analyses over time indicated no overall significant treatment effects, (completers only: F(2,236) = 0.29, p=.749; intent-to-treat: F(2,401) = 0.9, p=.407). Among participants classified as smoking at the last treatment session, analyses examining the recovery of abstinence revealed a significant overall treatment effect, F(2,103)=4.41, p=.015 (MBAT vs. CBT: OR=4.94, 95% CI: 1.47 to 16.59, p=.010, Effect Size =.88; MBAT vs. UC: OR=4.18, 95% CI: 1.04 to 16.75, p=.043, Effect Size =.79). Conclusions Although there were no overall significant effects of treatment on abstinence, MBAT may be more effective than CBT or UC in promoting recovery from lapses. PMID:27213492
Full Text Available Cannabis is one of the most widely used illicit substance among users of stimulants such as cocaine and amphetamine. Interestingly, recent accumulating evidence points toward the involvement of the endocannabinoid system (ECBS in the neurobiological processes related to stimulant addiction. This article presents an up-to-date review with deep-insights into the pivotal role of the ECBS in the neurobiology of stimulant addiction and the effects of its modulation on addictive behaviors. The aims of this article are to: 1 review the role of cannabis use and ECBS modulation in the neurobiological substrates of psychostimulant addiction and 2 evaluate the potential of cannabinoid-based pharmacological strategies to treat stimulant addiction. A growing number of studies support a critical role of the ECBS and its modulation by synthetic or natural cannabinoid in various neurobiological and behavioral aspects of stimulants addiction. Thus, cannabinoids modulate brain reward systems closely involved in stimulants addiction, and provide further evidence that the cannabinoid system could be explored as a potential drug discovery target for treating addiction across different classes of stimulants.
M. Kooyman (Martien)
textabstractTherapeutic communities for addicts developed since the Sixties without a clear theory on what made them therapeutic. There have also been some doubts on their long term outcome results. Part I of this book describes how therapeutic communities for addicts have roots in the self-help
Vogel, Joanne E.
Sex addictions have become an increasing concern since the growth of the sex industry, sex in advertising, and the ease of Internet access to sex. This article uses the foundational principles of Relational-Cultural Theory (RCT) to conceptualize sexual addiction and its relational impact. Particular attention is paid to the principles of…
Sandhu, Daya Singh
The dilemma of relapse exists for a number of addictive behaviors, and mental health authorities agree that keeping addictive behaviors off permanently is much more difficult than treating the behaviors initially. Several relapse prevention models have been posited and environmental, physiological, behavioral, cognitive, and affective factors have…
Full Text Available Increasing evidence suggests that binge eating-related disorders could be related to addiction-like eating patterns due to the addictive potential of hyperpalatable foods. Subsequently, important implications have been derived for treatment of those disorders and even political actions. However, studies on the prevalence of food addiction are rare. Few recent studies investigated addictive eating in children, adolescents, and adults. This mini-review presents these first attempts to assess addictive eating and how prevalent addictive eating patterns were in the respective studies. It is concluded that the prevalence of food addiction is increased in obese individuals and even more so in obese patients with binge eating disorder. However, prevalence of food addiction is not sufficient to account for the obesity epidemic. Conversely, an arguably high prevalence of food addiction can also be found in under-, normal-, and overweight individuals. Future studies may investigate which factors are associated with addictive eating in non-obese individuals.
Kelly, Thomas M; Daley, Dennis C; Douaihy, Antoine B
This quality improvement program evaluation investigated the effectiveness of contingency management for improving retention in treatment and positive outcomes among patients with dual disorders in intensive outpatient treatment for addiction. The effect of contingency management was explored among a group of 160 patients exposed to contingency management (n = 88) and not exposed to contingency management (no contingency management, n = 72) in a six-week partial hospitalization program. Patients referred to the partial hospitalization program for treatment of substance use and comorbid psychiatric disorders received diagnoses from psychiatrists and specialist clinicians according to the Diagnostic and Statistical Manual of the American Psychiatric Association. A unique application of the contingency management "fishbowl" method was used to improve the consistency of attendance at treatment sessions, which patients attended 5 days a week. Days attending treatment and drug-free days were the main outcome variables. Other outcomes of interest were depression, anxiety and psychological stress, coping ability, and intensity of drug cravings. Patients in the contingency management group attended more treatment days compared to patients in the no contingency management group; M = 16.2 days (SD = 10.0) versus M = 9.9 days (SD = 8.5), respectively; t = 4.2, df = 158, p Psychological stress and drug craving were inversely associated with drug-free days in bivariate testing (r = -.18, p associated with drug-free days in multivariate testing (B =.05, SE =.01, β =.39, t = 4.9, p psychological stress and drug cravings should be emphasized in intensive dual diagnosis group therapy.
Full Text Available Kenneth M Dürsteler,1,2 Eva-Maria Berger,1 Johannes Strasser,1 Carlo Caflisch,2 Jochen Mutschler,2 Marcus Herdener,2 Marc Vogel1 1Center for Addictive Disorders, Psychiatric University Clinics Basel, Basel, Switzerland; 2Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland Background: Cocaine use continues to be a public health problem, yet there is no proven effective pharmacotherapy for cocaine dependence. A promising approach to treating cocaine dependence may be agonist-replacement therapy, which is already used effectively in the treatment of opioid and tobacco dependence. The replacement approach for cocaine dependence posits that administration of a long-acting stimulant medication should normalize the neurochemical and behavioral perturbations resulting from chronic cocaine use. One potential medication to be substituted for cocaine is methylphenidate (MPH, as this stimulant possesses pharmacobehavioral properties similar to those of cocaine. Aim: To provide a qualitative review addressing the rationale for the use of MPH as a cocaine substitute and its clinical potential in the treatment of cocaine dependence. Methods: We searched MEDLINE for clinical studies using MPH in patients with cocaine abuse/dependence and screened the bibliographies of the articles found for pertinent literature. Results: MPH, like cocaine, increases synaptic dopamine by inhibiting dopamine reuptake. The discriminative properties, reinforcing potential, and subjective effects of MPH and cocaine are almost identical and, importantly, MPH has been found to substitute for cocaine in animals and human volunteers under laboratory conditions. When taken orally in therapeutic doses, its abuse liability, however, appears low, which is especially true for extended-release MPH preparations. Though there are promising data in the literature, mainly from case reports and
Simonovska, Natasa; Chibishev, Andon; Babulovska, Aleksandra; Pereska, Zanina; Jurukov, Irena; Glasnovic, Marija
The program of our Clinic includes, not only treatment of acute intoxication with opioids and other drugs, but also comprehends clinical investigations and treatment of the somatic complications of this population. For the first time in our country our Clinic offers to this population the alternative way of treatment with Buprenorfin. The Clinic started with this protocol on August 1, 2009. During a period of two years, the treatment with Buprenorfine has been initiated in 353 patients, of which 211 regularly attend the medical check ups. This model is used according to the national clinical guidelines and procedures for the use of buprenorfine in the treatment of opioid dependence The dose of this medicament depends on the evolution of the withdrawal symptoms. We have used the objective and subjective opioid withdrawal scale for the observation of these symptoms (OOWS ; SOWS – Handelsman et al 1987). This protocol starts with a complete clinical investigations, (i.e. where all patients undergo the inclusion and exclusion criteria with a written consent). Afterwards, the patients are hospitalized and start with a Buprenorfin teratment. After period of 7-10 days hospitalization they come to our Clinic, like outpatients for a regular controls. We have precise evidence for every patient who comes for control (e.g. medical record with all biochemical and toxicological screenings). All patients are recommended a tight cooperation with psychiatrists who are specialized to treat the problematic drug addictions. PMID:23678303
Sussman, Steve; Moran, Meghan B.
Background and aims: The most popular recreational pastime in the U.S. is television viewing. Some researchers have claimed that television may be addictive. We provide a review of the definition, etiology, prevention and treatment of the apparent phenomenon of television addiction. Methods: Selective review. Results: We provide a description of television (TV) addiction, including its negative consequences, assessment and potential etiology, considering neurobiological, cognitive and social/cultural factors. Next, we provide information on its prevention and treatment. Discussion and conclusions: We suggest that television addiction may function similarly to substance abuse disorders but a great deal more research is needed. PMID:25083294
Webb, Ian C
Reward-related learning, including that associated with drugs of abuse, is largely mediated by the dopaminergic mesolimbic pathway. Mesolimbic neurophysiology and motivated behavior, in turn, are modulated by the circadian timing system which generates ∼24-h rhythms in cellular activity. Both drug taking and seeking and mesolimbic dopaminergic neurotransmission can vary widely over the day. Moreover, circadian clock genes are expressed in ventral tegmental area dopaminergic cells and in mesolimbic target regions where they can directly modulate reward-related neurophysiology and behavior. There also exists a reciprocal influence between drug taking and circadian timing as the administration of drugs of abuse can alter behavioral rhythms and circadian clock gene expression in mesocorticolimbic structures. These interactions suggest that manipulations of the circadian timing system may have some utility in the treatment of substance abuse disorders. Here, the literature on bidirectional interactions between the circadian timing system and drug taking is briefly reviewed, and potential chronotherapeutic considerations for the treatment of addiction are discussed.
Silva, M R; Pereira, J C; Costa, R R; Dias, J A; Guimarães, M D C; Leite, I C G
This study aimed to evaluate the risk factors for tuberculosis (TB) treatment default in a priority city for disease control in Brazil. A cohort of TB cases diagnosed from 2008 to 2009 was followed up from patients' entry into three outpatient sites, in Juiz de Fora, Minas Gerais (Brazil), until the recording of the outcomes. Drug addiction, alcoholism and treatment site appeared to be independently associated with default. Current users of crack as the hardest drug (odds ratio (OR) 12·25, 95% confidence interval (CI) 3·04-49·26) were more likely to default than other hard drug users (OR 5·67, 95% CI 1·34-24·03), former users (OR 4·12, 95% CI 1·11-15·20) and those not known to use drugs (reference group). Consumers at high risk of alcoholism (OR 2·94, 95% CI 1·08-7·99) and those treated in an outpatient hospital unit (OR 8·22, 95% CI 2·79-24·21%) also were more likely to default. Our results establish that substance abuse was independently associated with default. National TB programmes might be more likely to achieve their control targets if they include interventions aimed at improving adherence and cure rates, by diagnosing and treating substance abuse concurrently with standard TB therapy.
Grabbe, Linda; Ball, Janell; Hall, Joanne M
This research explored the understanding of trauma from the perspective of women who had experienced abuse and neglect in childhood. The goal was to better conceptualize potential avenues or interventions for prevention and treatment. Qualitative description of the accounts of eight women who were childhood trauma survivors and in treatment for addiction. Open-ended interviews focused on key events or experiences during childhood and adolescence and the use of drugs and alcohol. Four levels of betrayal fit the accounts the participants gave as the dominant theme in their narratives. "Primary betrayal" referred to the direct victimization by a perpetrator; "secondary betrayal" referred to the complicity, denial, or indifference of another adult to the child's victimization; "tertiary betrayal" referred to failures of responsible individuals in community settings to protect the child; and "quaternary betrayal" represented self-betrayals. Substance misuse was an adolescent self-betrayal that provided initial solace yet ultimately threatened the integrity of the girls. We found an almost complete lack of support in family and community settings for the participants. These findings on betrayal inform health care for trauma survivors and can be a framework for preventing violence against children. Interventions for child and adolescent trauma survivors are critical to prevent the life-long health sequelae of childhood trauma. Pivotal times to engage these survivors include periods when they may be accessed in school and healthcare settings. © 2016 Sigma Theta Tau International.
S Ali HosseiniAlmadani
Full Text Available Introduction: The purpose of this study was comparing of resiliency, identity styles, spirituality, and perceived social support in addicts, non-addicts, and recovered addicts. Method: In this causal-comparative study, by available sampling, 30 addicts, 30 non-addicts, and 30 recovered addicts were selected of adolescents. All participants completed the resiliency, identity styles, spirituality, and perceived social support questionnaires. Results: The results of comparing of identity styles indicated that on informational and normative styles, non-addicts had significantly higher scores than addicts and recovered addicts. On avoidant/disoriented style, non addicts had significantly lower levels than two other addict groups. The results of comparing of resiliency showed that non-addicts had significantly higher scores than two other groups. Also recovered addicts were significantly more resilient than addicts. In comparing of spirituality component, non addicts and recovered addicts had significantly higher scores than addicts. By Comparing of perceived social support, non-addicts and recovered addicts had significantly higher levels than addicts. Conclusion: According to the results of this study, participating in NA groups and perception of social support increased the resiliency of recovered addicts. Also, identity is relatively consistent component that by participating in treatment process, does not change significantly.
Hammond, Christopher J.; Mayes, Linda C.; Potenza, Marc N.
Psychoactive substance and nonsubstance/behavioral addictions are major public health concerns associated with significant societal cost. Adolescence is a period of dynamic biologic, psychological, and behavioral changes. Adolescence is also associated with an increased risk for substance use and addictive disorders. During adolescence, developmental changes in neural circuitry of reward processing, motivation, cognitive control, and stress may contribute to vulnerability for increased levels of engagement in substance use and nonsubstance addictive behaviors. Current biologic models of adolescent vulnerability for addictions incorporate existing data on allostatic changes in function and structure of the midbrain dopaminergic system, stress-associated neuroplasticity, and maturational imbalances between cognitive control and reward reactivity. When characterizing adolescent vulnerability, identifying subgroups of adolescents at high risk for addictive behaviors is a major goal of the addiction field. Genetics, epigenetics, and intermediate phenotypes/endophenotypes may assist in characterizing children and adolescents at risk. Improved understanding of the neurobiology of adolescence and addiction vulnerability has the potential to refine screening, enhance prevention and intervention strategies, and inform public policy. PMID:25022184
Smyth, Bobby P; Lyons, Suzi; Cullen, Walter
New psychoactive substances (NPS) have hedonic effects that may lead to dependence. Headshops selling NPS increased in number in Ireland from late 2009. Legislation was enacted in May and August of 2010 that caused their closure. It is unknown whether such events impact the rate of NPS use disorders. We conducted a population-based study using the Irish national database of episodes of addiction treatment between 2009 and 2012. We examined trends in the rate of NPS-related treatment episodes among young adults. Joinpoint trend analysis software was used to identify significant changes in trend. Of the 31 284 episodes of addiction treatment commenced by adults aged 18 to 34 years, 756 (2.4%) were NPS related. In 2012, the 12-month moving average rate had fallen 48% from its peak in 2010, from 9.0/100 000 to 4.7/100 000. Joinpoint analysis indicated that the rate of NPS related episodes increased by 218% (95% confidence interval 86 to 445, P = 0.001) every 4 months until the first third of 2010. From that point, the rate declined by 9.8% (95% confidence interval -14.1 to -5.4, P = 0.001) per 4-month period. There was no significant trend change in the rate of non-NPS related treatment episodes. Over the 2 years after the enactment of prohibition-styled legislation targeting NPS and headshops, the rate of NPS related addiction treatment episodes among young adults declined progressively and substantially. We found no coinciding trend change in the rate of episodes linked to other drug groups. [Smyth BP, Lyons S, Cullen W. Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence fromnational addiction treatment data. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Liester, Mitchell B; Prickett, James I
Ayahuasca is a medicinal plant mixture utilized by indigenous peoples throughout the Amazon River basin for healing purposes. The "vine of the soul" or "vine of death," as it is known in South America, contains a combination of monoamine oxidase inhibitors and N,N-dimethyltryptamine (DMT). When ingested together, these medicines produce profound alterations in consciousness. Increasingly, ayahuasca is being utilized to treat addictions. However, the mechanism of action by which ayahuasca treats addictions remains unclear. We offer four hypotheses to explain possible biochemical, physiological, psychological, and transcendent mechanisms by which ayahuasca may exert its anti-addiction effects.
Didelot, Mary J.; Hollingsworth, Lisa; Buckenmeyer, Janet A.
Internet addiction (IA) is both the most rapidly growing addiction and the least understood addiction (Watson, 2005). For counselors, treatment issues surrounding the disease are also growing. At the forefront is the lack of understanding concerning treatment protocol to manage the challenging recovery and maintenance stages after IA behavior has…
Ilgen, Mark A; Price, Amanda M; Burnett-Zeigler, Inger; Perron, Brian; Islam, Khairul; Bohnert, Amy S B; Zivin, Kara
Despite the substantial prevalence of alcohol use disorders (AUDs), prior research indicates that most people with AUDs never utilize either formal or informal treatment services. Several prior studies have examined the characteristics of individuals with AUDs who receive treatment; however, limited longitudinal data are available on the predictors of receiving AUD services in treatment-naive individuals with AUDs. This study utilized data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to identify adults in Wave 1 who met criteria for an AUD within the last 12 months and reported no prior lifetime alcohol treatment (N = 2760). These individuals were surveyed again at Wave 2, approximately 3-4 years later (N = 2170). This study examined the Wave 1 demographic and psychiatric conditions that were associated with receipt of AUD treatment services between Waves 1 and 2. In multivariable analyses, use of AUD treatment services between Waves 1 and 2 was significantly more likely among those who were male, non-Caucasian, younger, had lower income, and who had health insurance. Additionally, those who met criteria for a baseline drug use disorder, anxiety disorder or a personality disorder were more likely to receive AUD treatment. Treatment was more often utilized in those who had more severe baseline psychopathology and in those with fewer economic resources. These findings highlight the need to broaden the types of care available to individuals with AUDs to increase the appeal of AUD services. Published by Elsevier Ireland Ltd.
Bramness, Jørgen G; Clausen, Thomas; Duckert, Fanny; Ravndal, Edle; Waal, Helge
The Norwegian Centre for Addiction Research (SERAF) at the University of Oslo is a newly established, clinical addiction research centre. It is located at the Oslo University Hospital and has a major focus on opioid dependency, investigating Norwegian opioid maintenance treatment (OMT), with special interest in OMT during pregnancy, mortality, morbidity and criminality before, during and after OMT and alternatives to OMT, such as the use of naltrexone implants. The well-developed health registries of Norway are core assets that also allow the opportunity for other types of substance abuse research. This research includes health services, abuse of prescription drugs and drugs of abuse in connection with traffic. The centre also focuses upon comorbidity, investigating the usefulness and limitations of psychometric instruments, drug abuse in different psychiatric treatment settings and internet-based interventions for hazardous alcohol consumption. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.
Wakeman, Sarah E; Rich, Josiah D
The United States leads the world in creating prisoners. This epidemic of incarceration is largely due to the "War on Drugs," which has resulted in criminalization of the disease of addiction. Half of prisoners have an active substance use disorder yet a minority receives formal treatment. Opioid agonist maintenance is among the most effective treatments for opioid use disorder. Maintenance treatment reduces illicit opioid use, crime, recidivism, and cost, yet few correctional facilities provide this lifesaving treatment. Increased access to opioid agonist maintenance as well as reexamination of drug policy is necessary to address this costly and morbid incarceration epidemic.
Maaß, C; Wettermann, A; Schläfke, D
The forensic clinic for addiction treatment in Rostock is a forensic institution for patients who committed crimes under the influence of psychotropic substances. Regardless of the severity of the offence, patients receive different kinds of treatment depending on the therapy program. Criminal recidivism can be seen as one of the most important factors to validate success in treatment. Due to this purpose, an extensive recidivism study including all former patients from 2001 to 2012 was conducted at our clinic. The criminal court records as well as clinic-intern databases of 38 patients for whom homicide is the offence of referral and 38 patients with nonviolent crimes were analyzed for this study. The general recidivism rate for homicide delinquents was 47.7 %, but only 21 % of the examined patients were convicted to a new prison sentence. 7 homicide patients and 8 of the nonviolent group didn't finish the therapy successfully. Alcohol dependency was more common among the homicide patients. In addition, the average IQ was significantly lower than the comparison group. Compared to the nonviolent patients, homicide delinquents also got registered with a greater proportion of violent crimes during their criminal career. © Georg Thieme Verlag KG Stuttgart · New York.
Pizzimenti, C L; Lattal, K M
Understanding the interaction between fear and reward at the circuit and molecular levels has implications for basic scientific approaches to memory and for understanding the etiology of psychiatric disorders. Both stress and exposure to drugs of abuse induce epigenetic changes that result in persistent behavioral changes, some of which may contribute to the formation of a drug addiction or a stress-related psychiatric disorder. Converging evidence suggests that similar behavioral, neurobiological and molecular mechanisms control the extinction of learned fear and drug-seeking responses. This may, in part, account for the fact that individuals with post-traumatic stress disorder have a significantly elevated risk of developing a substance use disorder and have high rates of relapse to drugs of abuse, even after long periods of abstinence. At the behavioral level, a major challenge in treatments is that extinguished behavior is often not persistent, returning with changes in context, the passage of time or exposure to mild stressors. A common goal of treatments is therefore to weaken the ability of stressors to induce relapse. With the discovery of epigenetic mechanisms that create persistent molecular signals, recent work on extinction has focused on how modulating these epigenetic targets can create lasting extinction of fear or drug-seeking behavior. Here, we review recent evidence pointing to common behavioral, systems and epigenetic mechanisms in the regulation of fear and drug seeking. We suggest that targeting these mechanisms in combination with behavioral therapy may promote treatment and weaken stress-induced relapse. © 2015 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.
Carroll, Marilyn E.; Smethells, John R.
The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, are discussed as major determinants of drug addiction. Behavioral dyscontro...
Cartwright, William S
Researchers have been at the forefront of applying new costing methods to drug abuse treatment programs and innovations. The motivation for such work has been to improve costing accuracy. Recent work has seen applications initiated in establishing charts of account and cost accounting for service delivery. As a result, researchers now have available five methods to apply to the costing of drug abuse treatment programs. In all areas of costing, there is room for more research on costing concepts and measurement applications. Additional work would be useful in establishing studies with activity-based costing for both research and managerial purposes. Studies of economies of scope are particularly relevant because of the integration of social services and criminal justice in drug abuse treatment. In the long run, managerial initiatives to improve the administration and quality of drug abuse treatment will benefit directly from research with new information on costing techniques.
A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING. The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud’s concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted. Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness. PMID:24062657
Godoy, R; Callejas, F J; Cruz, J; Tornero, A I; Tárraga, P J; Rodríguez-Montes, J A
To determine whether or not nicotine addiction treatment was less effective in psychiatric than in the healthy population. A retrospective, descriptive and comparative cohort study was conducted in Albacete University Hospital during years 2008-2012 on all patients that attended the Tobacco Cessation Unit. The statistical tests used were Chi-squared, likelihood ratio, and the Student t test. Statistical significance P≤.05. The study included a total of 1,484 patients, of which 48.6% were female. The mean age was 46.8 years, and the mean age of starting smoking was 17.6 years. The mean number of previous attempts to quit was 1.48, and mean number of cigarettes smoked was 25.39. They had a mean Fagerström score of 6.04, a Richmond score of 8.13, and a mean carbon monoxide level of 16.65ppm. Most patients were referred from Primary Care (38.7%) and Chest Diseases department (33%), and the type of tobacco smoked was "light" in 75.8%. There was 15% with chronic obstructive pulmonary disease, 8% with asthma, and 9.4% with obstructive sleep apnoea syndrome. Furthermore, there was respiratory disease in 28.7%, cardiovascular disease in 4.6%, and both in 3.5%. Hiatus hernia was present in 7.2%, thyroid disease in 3.8%, hypertension in 19%, diabetes in 10.7%, and dyslipidaemia in 29.4%, Drugs were used by 7.1%, and 12.6% consumed alcohol. There was 39.3% psychiatric comorbidity (PC), and were comparable except in gender, age of onset, Fagerström, Richmond, source of referral, asthma, hiatus hernia, thyroid disease, hypertension, as well as drugs and treatment. Drug treatment was completed by 22.3% in the PC group, with no significant difference. There were differences in success (P=.008), but not in failure and relapse rates. Anti-smoking treatment in psychiatric patients is effective. An increase in the probability of treatment success is observed in patients without psychiatric comorbidity. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria
Markus, W.; Hornsveld, H.K.
The use of tobacco, alcohol, and illicit drugs is widespread and has significant negative consequences for the individual, their families, and the communities to which they belong. A substantial number of users develop an addiction disorder. Cure-oriented addiction treatment is challenging regarding
Amaro, Hortensia; Magno-Gatmaytan, Cielo; Meléndez, Michael; Cortés, Dharma E; Arevalo, Sandra; Margolin, Arthur
Spiritual Self-Schema (3-S) is a weekly 8-session, mindfulness-based, manual-guided, individual intervention targeting addiction and human immunodeficiency virus (HIV) risk behaviors that integrates cognitive behavioral strategies with Buddhist principles and clients' religious/spiritual beliefs. 3-S is efficacious for reducing drug use and HIV risk behaviors among mixed-gender, methadone-maintained outpatients. The study goal was to conduct a preliminary evaluation of 3-S therapy among urban, low-income Latinas (n = 13) in residential addiction treatment. Data gathered via in-person interviews (baseline, 8 and 20 weeks postentry) showed high rates of 3-S acceptability and positive changes in a number of outcomes relevant to recovery from addiction and to HIV prevention, including impulsivity, spirituality, motivation for change, and HIV prevention knowledge. The study findings are promising; however, a controlled study with longer follow-up is needed to rigorously assess the efficacy of 3-S therapy with Latinas in substance abuse treatment.
Diana M. DiNitto
Full Text Available Few social workers specialize in addictions practice. That number may grow in the years ahead due to demographic changes in the population, an expanding definition of addiction, and other factors. Social workers in all areas of practice see clients with addictions and their family members, but there is a large gap in the numbers who need treatment and receive it. The social work workforce of the future must be better equipped to develop and identify prevention and treatment services that are both appealing to clients and effective. These services may need to be offered in other setting where clients are seen. There is also much work to be done in the years ahead in the political environment to make treatment available and to see that individuals with addictions are treated fairly. Substantial research is being conducted on genetics and the brain chemistry of addiction. Psychosocial factors are also believed to play a substantial role in the development of addictions, thus ensuring social workers place in the addictions field in the years ahead.
Gerassi, Lara B
More than 50% of women entering substance use treatment in the U.S. reported having traded sex for money or drugs. Women's participation in addiction treatment and related services is essential to their recovery and increased safety, stabilization, and quality of life. This paper's aim is to explore the barriers related to accessing detox facilities and essential services including substance use treatment and residential services for women impacted by commercial sexual exploitation (CSE). Data are drawn from a larger, community-based, grounded theory study. In-depth interview data were collected from 30 adult women who traded sex as adults (through maximum variation and snowball sampling), as well as 20 service providers who come into contact with adult women who trade sex (through nominations and purposive sampling). Finding suggest that women often encountered sobriety requirements, which created barriers to accessing addiction treatment or residential services. Some organizations' policies required evicting women if they were caught using, which created additional challenges for women who relapsed. Women wanted to avoid becoming "dopesick" on the streets or at home, which partially contributed to them needing to maintain their addiction. Consequently, some returned to sex trading, thus increasing their risk of trafficking. Some women engaged in creative strategies, such as claiming they were suicidal, in order to access the detox facilities in hospitals. Some women indicated they were only able to detox when they were forced to do so in jail or prison, often without medical assistance. Implications to improve health care delivery for this population are discussed.
Sherba, R Thomas; Coxe, Kathryn A; Gersper, Beth E; Linley, Jessica V
This qualitative study of over 800 participants focused on the employment experiences of consumers of substance abuse treatment programs to provide a better understanding of what employment services are offered and what needs treatment agencies have in the area of employment services, examining barriers and facilitators from both the consumer and provider perspectives. Data were collected via a mixed research methodology of focus groups and surveys from July 2015 through June 2016 in a large Midwestern U.S. state. Employment is a challenge for persons with substance use disorders. Only a quarter of this study's large sample of substance abuse treatment consumers reported being cur-rently employed; and of those consumers who reported no current employment, greater than half reported that their current unemployment was due to their substance use. Persons receiving substance abuse treatment face many challenges in obtaining and maintaining employment. Treatment providers identified several barriers to implementation of employment services. They named an array of resources as needed, including increased funding for supportive employment programs and staff appropriate to the delivery of employment services. Some providers believed employment services to fall outside of their scope of practice. Data generated through this study may inform policy to invest resources in employment services within substance abuse treatment settings. Copyright © 2018 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Addressing substance use disorders effectively requires a long-term approach. Substance abuse treatment is typically of short duration; referring patients to Twelve Step based self-help groups (TSGs – e.g. Narcotics Anonymous, represents a promising complementary recovery resource. Clinicians' attitudes and referral practices towards the TSGs have mainly been studied in countries with high integration of the 12-step philosophy in their substance abuse services and where the TSGs are widely available, such as the US. In Norway, there are currently 294 weekly TSG meetings (6 per 100,000 inhabitants. This study describes clinicians' attitudes and referral practices to TSGs in Norway where health authorities seek to promote self-help participation, but where the treatment culture is unfamiliar with 12-step fellowships. Methods Data collected by a self-administered questionnaire, adapted from established US and UK instruments. Information covered the attitudes, knowledge and referral practices towards TSGs among addiction treatment professionals in Norway in mid 2008. Results The return rate was 79.7% (n = 291. Participants had moderately positive attitude scores towards TSGs, but referral to these groups among Norwegian addiction professionals was low, as was the level of knowledge about TSGs. More than six out of ten did not refer any patients to TSGs in the previous week. Local variation with more referrals to TSGs in the county with the one established 12-step treatment facility was observed. Respondents' integration of the 12-steps in their own treatment work, higher self-efficacy for making a successful referral, and greater TSG knowledge were associated with referring patients. Conclusion Low referral rates to TSGs point to the need for education and training to raise the awareness and knowledge about it among addiction professionals unfamiliar with these 12-step fellowships. Training should focus on the usefulness of
Eördögh, Erika; Hoyer, Mária; Szeleczky, Gábor
Aim of review: To overview the new studies on food addiction and highlighting the analogies and differences between food and drug addiction. Recent studies on food addiction have demonstrated that the neurobiological circuits involved in the development of drug addiction also play a role in food consumption, and that the uptake of nutrients by the organism is under the control of numerous complicated peripheral and central signal-transducing networks. In addition, it has also been shown that addiction and/or craving may develop toward certain foods and nutrients, too. The most recent investigations about the neurobiological systems motivating the obtaining behavior have suggested that the acquired drive toward energy rich, rewarding food contributes to the appearance of obesity as an endemic. This report presents the definition of substance use disorders and describes the results of the neurobiological approaches in the study of addiction supporting the concept that food addiction is a real phenomenon. The subsequent description of the central and peripheral signaling pathways of food consumption demonstrates that while both food (nutrients) and drugs with abuse potential exert their effect on the same central neurobiological networks, the action of the peripheral signaling systems make it more difficult to understand the regulation of food intake and thus the treatment of pathological eating behavior. The presentation of the evidences of food addiction obtained in animal experiments and with imaging methods and the subsequent overview of the results achieved in the surveys of pathologic eating patterns and in the new clinical and behavioral assessment of human food addiction point to the conclusion that the pharmacological and behavioral therapy methods applied to the treatment of substance abuse disorders may also prove useful in the management of obesity.
Hebebrand, Johannes; Albayrak, Özgür; Adan, Roger; Antel, Jochen; Dieguez, Carlos; de Jong, Johannes; Leng, Gareth; Menzies, John; Mercer, Julian G; Murphy, Michelle; van der Plasse, Geoffrey; Dickson, Suzanne L
"Food addiction" has become a focus of interest for researchers attempting to explain certain processes and/or behaviors that may contribute to the development of obesity. Although the scientific discussion on "food addiction" is in its nascent stage, it has potentially important implications for treatment and prevention strategies. As such, it is important to critically reflect on the appropriateness of the term "food addiction", which combines the concepts of "substance-based" and behavioral addiction. The currently available evidence for a substance-based food addiction is poor, partly because systematic clinical and translational studies are still at an early stage. We do however view both animal and existing human data as consistent with the existence of addictive eating behavior. Accordingly, we stress that similar to other behaviors eating can become an addiction in thus predisposed individuals under specific environmental circumstances. Here, we introduce current diagnostic and neurobiological concepts of substance-related and non-substance-related addictive disorders, and highlight the similarities and dissimilarities between addiction and overeating. We conclude that "food addiction" is a misnomer because of the ambiguous connotation of a substance-related phenomenon. We instead propose the term "eating addiction" to underscore the behavioral addiction to eating; future research should attempt to define the diagnostic criteria for an eating addiction, for which DSM-5 now offers an umbrella via the introduction on Non-Substance-Related Disorders within the category Substance-Related and Addictive Disorders. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael
Excessive and potentially addictive use of the Internet among children and adolescents has emerged as a major concern in recent times. Internet addiction is often conceptualized as an impulse control disorder, with features similar to pathological gambling. However, there remains considerable debate about the core components, etiological processes, course, and maintaining factors of the disorder. This article presents a case study of a 16-year-old male with generalized pathological Internet use. Critical issues relevant to case conceptualization, assessment, and choice of therapy are examined. Although the evidence base is limited in this emerging area of clinical psychology, we provide a summary of empirically supported cognitive-behavioral techniques for Internet addiction. © 2012 Wiley Periodicals, Inc.
Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treat...
This dissertation on Harm Reduction approach in the prevention of drug addictions deals with tertiary drug prevention. It aims to show the importance of how much information about this topic students at comprehensive schools get and have. The theoretical part provides some information about the consequences of drug addiction in general, about drug prevention, substitution treatment, Harm Reduction approach and the services involved. The practical part presents the results of a survey which ai...
Full Text Available Objective: This study was aimed to assess the effectiveness of cognitive- behavioral group therapy on improvement of quality of life in opiate patients under methadone maintenance treatment. Method: This was a semi experimental study using control group also pre-test, post-test and follow-up. Thirty six patients on MMT were selected between the entire opiate addicts referred to Iranian national center for addiction studies within judgmental sampling and were randomly assigned into experimental and control groups. They were all administered the WHOQOL-BREF. In experimental group, cognitive behavior group therapy was performed in 8 sessions and the control group was registered in the waiting list for the CBGT. Findings: Data analysis revealed that the mean WHOQOL-BREF score in the experimental group had significant higher increase when compared with that of the control group. But it wasn’t significant in follow up. Conclusion: Results demonstrated the effectiveness of cognitive–behavior group therapy On improvement of quality of life of opiate addicts on MMT in short term but didn’t seem to be effective in long term.
Weiss, Roger D; Potter, Jennifer Sharpe; Griffin, Margaret L; Provost, Scott E; Fitzmaurice, Garrett M; McDermott, Katherine A; Srisarajivakul, Emily N; Dodd, Dorian R; Dreifuss, Jessica A; McHugh, R Kathryn; Carroll, Kathleen M
Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS). POATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences. At Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use. Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Miller, Roxanne Greitz
While most school districts utilize a drug abuse resistance curriculum, as science teachers, it is our responsibility to understand the science behind drug addiction in order to most effectively educate our students against drug abuse. In the last two decades, increases in scientific technology have permitted significant discoveries surrounding…
Ismail, Ismaliza; Wahab, Suzaily; Sidi, Hatta; Das, Srijit; Lin, Loo Jiann; Razali, Rosdinom
Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated. However, kratom has been reported to be abused together with other illicit substances with high risk of potential addiction. There are also anecdotes of an adverse effect and toxicity of kratom, i.e. tremor, fatigue, seizure, and death. Different countries have distinctive regulation and policy on the plantation and use of this plant when most of the countries banned the use of it because of its addiction problems and side effects. The aim of this review is to highlight on the potential use of kratom, a unique 'herbs" as a substitution therapy for chronic pain and opioid addiction, based on the neurobiological perspective of pain and the underlying mechanism of actions of drug addiction. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Meade, Christina S; Towe, Sheri L; Watt, Melissa H; Lion, Ryan R; Myers, Bronwyn; Skinner, Donald; Kimani, Stephen; Pieterse, Desiree
Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
... more confident as a nonsmoker, dealing with your nicotine addiction is easier. Some prescription medicines help people stop ... tobacco. Those cravings have less to do with nicotine addiction and more to do with the habit of ...
... Staying Safe Videos for Educators Search English Español Gambling Addiction KidsHealth / For Teens / Gambling Addiction What's in ... So what's the story with gambling? What Is Gambling? Gambling means taking part in any activity or ...
Sprenkle, Douglas H.
Views treatment of sexual addiction within context of addiction and family therapy. Presents a case of sexual addiction and explicates an intervention model which emphasizes the importance of family participation in the treatment. (Author/NB)
Girczys-Połedniok, Katarzyna; Pudlo, Robert; Jarząb, Magdalena; Szymlak, Agnieszka
Cocaine use leads to health, social and legal problems. The aim of this paper is to discuss cocaine action, addicts characteristics, use patterns and consequences, as well as addiction treatment methods. A literature review was based on the Medline, PubMed, Polish Medical Bibliography databases and the Silesian Library resources. The Police and Central Statistical Office statistics, as well as the World Health Organization, the European Monitoring Centre for Drugs and Drug Addiction and the National Office for Combating Drug Addiction reports were used. Cocaine leads to mood improvement, appetite decrease, physical and intellectual activity enhancement, euphoria, inflated self-esteem, social networking ease and increased sexual desire. Cocaine hydrochloride is mainly used intranasaly, but also as intravenous and subcutaneous injections. Cocaine use and first addiction treatment fall in later age compared to other psychoactive substances. There is a high men to women ratio among addicts. There is a relationship between cocaine addiction, the presence of other disorders and genetic predisposition to addiction development. Polish reports indicate higher popularity of cocaine among people with a high economic and social status. Although Poland is a country with the low percentage of cocaine use, its popularity is growing. The consequences of cocaine use concern somatic and mental health problems, socioeconomic and legal conditions. The drug plays a role in crimes and traffic accidents. Because of the risks associated with cocaine use, it has been listed in a register of drugs attached to the Act on Counteracting Drug Addiction. Addiction treatment includes psychological, pharmacological and harm reduction strategies. Med Pr 2016;67(4):537-544. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
This study examined the relationship between treatment retention, and drug severity level in a therapeutic community setting for drug and alcohol treatment. Treatment retention is significant because length of time in treatment has been shown to correlate with success after treatment that impacts everyone. The design of this study was exploratory, descriptive, and cross-sectional. Data were collected in 2000 from a convenience sample of 18 to 25 year-old, primarily low-income and minority addicts who were currently in a therapeutic community in New Jersey, USA. The participants were then tracked for 90 days as to their status in the program and staff completed a motivation measure. Results indicated that severity of addiction was significant to treatment retention.
Brands, Bruna; Corea, Larry; Strike, Carol; Singh, Veeran-Anne S.; Behrooz, Renee C.; Rush, Brian
Concerns about methamphetamine/crystal methamphetamine (MA) have featured prominently in the Canadian media and on addiction treatment agency agendas. We examined MA admissions at addiction treatment agencies to determine if a service gap existed. In 2006, all addiction treatment agencies (n = 124) in Ontario, Canada were invited to complete an…
Ibañez Cuadrado, Angela
The addictions are common chronic psychiatric diseases which represent a serious worldwide public-health problem. They have a high prevalence and negative effects at individual, family and societal level, with a high sanitary cost. Epidemiological genetic research has revealed that addictions are moderately to highly heritable. Also the investigation has evidenced that environmental and genetic factors contribute to individual differences in vulnerability to addictions. Advances in the neurobiology of addiction joined to the development of new molecular genetic technologies, have led to the identification of a variety of underlying genes and pathways in addiction process, leading to the description of common molecular mechanisms in substance and behaviour dependencies. Identifying gene-environment interactions is a crucial issue in future research. Other major goal in genetic research is the identification of new therapeutic targets for treatment and prevention.
Thorens, Gabriel; Achab, Sophia; Billieux, Joël; Khazaal, Yasser; Khan, Riaz; Pivin, Edward; Gupta, Vishal; Zullino, Daniel
Controversies remain about the validity of the diagnosis of problematic Internet use. This might be due in part to the lack of longitudinal naturalistic studies that have followed a cohort of patients who self-identify as having Internet-related problems. This retrospective study included 57 patients who consulted the Geneva Addiction Outpatient Clinic from January 1, 2007, to January 1, 2010. Patients underwent an initial clinical psychiatric evaluation that included collection of data on socio-demographics, method of referral, specific Internet usage, psychiatric diagnosis, and Internet Addiction Test (IAT) and Clinical Global Impression Scale (CGI) scores. Treatment consisted of individual psychotherapeutic sessions. Of these patients, 98% were male and 37% were 18 years or younger. Most patients were online gamers (46% playing massively multiplayer online role-playing games). The mean IAT score was 52.9 (range 20-90). Sixty-eight percent of patients had a co-morbid psychiatric diagnosis, with social phobia being the most prevalent (17.8%). Patients who remained in treatment (dropout rate 24%) showed an overall improvement of symptoms: 38.6% showed significant or average improvement on their CGI score, 26.3% showed minimal improvement, and 14% showed no change. Our results support the hypothesis that there are specific types of Internet use, with online gaming mainly affecting young male patients. As Internet addiction is not yet an official diagnosis, better instruments are needed to screen patients and to avoid false-negative and false-positive diagnoses. Successful care should integrate the treatment of co-morbid symptoms and involve families and relatives in the therapeutic process.
Pan, Yue; Gerasimov, Madina R; Kvist, Trine
Vigabatrin, a GABA aminotransferase (GABA-AT) inactivator, is used to treat infantile spasms and refractory complex partial seizures and is in clinical trials to treat addiction. We evaluated a novel GABA-AT inactivator (CPP-115) and observed that it does not exhibit other GABAergic or off...... at 1/300-1/600th the dose of vigabatrin. It also blocks expression of cocaine-induced conditioned place preference at a dose 1/300th that of vigabatrin. Electroretinographic (ERG) responses in rats treated with CPP-115, at doses 20-40 times higher than those needed to treat addiction in rats, exhibited...... reductions in ERG responses, which were less than the reductions observed in rats treated with vigabatrin at the same dose needed to treat addiction in rats. In conclusion, CPP-115 can be administered at significantly lower doses than vigabatrin, which suggests a potential new treatment for addiction...
van den Brink Wim
Full Text Available Abstract Background Cocaine, particularly in its base form ('crack', has become one of the drugs of most concern in the Netherlands, being associated with a wide range of medical, psychiatric and social problems for the individual, and with significant public order consequences for society. Available treatment options for cocaine dependent users are limited, and a substantial part of the cocaine dependent population is not reached by the addiction treatment system. Psychosocial interventions for cocaine dependence generally show modest results, and there are no registered pharmacological treatments to date, despite the wide range of medications tested for this type of dependence. The present study (Cocaine Addiction Treatments to improve Control and reduce Harm; CATCH investigates the possibilities and problems associated with new pharmacological treatments for crack dependent patients. Methods/Design The CATCH-study consists of three separate randomised controlled, open-label, parallel-group feasibility trials, conducted at three separate addiction treatment institutes in the Netherlands. Patients are either new referrals or patients already in treatment. A total of 216 eligible outpatients are randomised using pre-randomisation double-consent design and receive either 12 weeks treatment with oral topiramate (n = 36; Brijder Addiction Treatment, The Hague, oral modafinil (n = 36; Arkin, Amsterdam, or oral dexamphetamine sustained-release (n = 36; Bouman GGZ, Rotterdam as an add-on to cognitive behavioural therapy (CBT, or receive a 12-week CBT only (controls: n = 3 × 36. Primary outcome in these feasibility trials is retention in the underlying psychosocial treatment (CBT. Secondary outcomes are acceptance and compliance with the study medication, safety, changes in cocaine (and other drug use, physical and mental health, social functioning, and patient satisfaction. Discussion To date, the CATCH-study is the first study in the Netherlands
Kourgiantakis, Toula; Ashcroft, Rachelle
Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice. This is a scoping review using the five-stage framework developed by Arksey and O'Malley. We will include published and unpublished empirical studies focusing on any type of family interventions in addiction treatment between 2000 and the present in English or French. A reviewer will search for literature that meets the inclusion criteria through the following electronic databases: MEDLINE, PsycINFO and Social Services Abstracts. For a comprehensive search, we will also hand-search reference lists, web sites and key journals. Data will be charted and sorted using a thematic analysis approach. This review will be the first to examine all forms of family-focused practices for both substance use and problem gambling treatment for adults. It will provide information about existing service provisions and gaps in practice. This review can be used to start moving towards the development of best practices for families in addiction treatment. The results will be disseminated through a peer-reviewed journal and at mental health and addiction conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Introduction Families are significantly impacted by addictions and family involvement in treatment can reduce the harms and can also improve treatment entry, treatment completion and treatment outcomes for the individual coping with an addiction. Although the benefits of family-focused practices in addictions have been documented, services continue to have an individual focus and research on this topic is also limited. The objective of this study is to map the extent, range and nature of evidence available examining family interventions in addictions and identify gaps to guide future research, policy and practice. Methods and analysis This is a scoping review using the five-stage framework developed by Arksey and O’Malley. We will include published and unpublished empirical studies focusing on any type of family interventions in addiction treatment between 2000 and the present in English or French. A reviewer will search for literature that meets the inclusion criteria through the following electronic databases: MEDLINE, PsycINFO and Social Services Abstracts. For a comprehensive search, we will also hand-search reference lists, web sites and key journals. Data will be charted and sorted using a thematic analysis approach. Ethics and dissemination This review will be the first to examine all forms of family-focused practices for both substance use and problem gambling treatment for adults. It will provide information about existing service provisions and gaps in practice. This review can be used to start moving towards the development of best practices for families in addiction treatment. The results will be disseminated through a peer-reviewed journal and at mental health and addiction conferences. PMID:29331973
Cowan, Jennifer A; Devine, Carol M
To determine the effect of an educational and environmental intervention on diet, body mass index, and waist circumference of men in substance addiction treatment. One hundred three racially/ethnically diverse men in 6 urban substance addiction residential treatment facilities in Upstate New York participated in weekly nutrition and food classes and food environment changes to increase healthful food choices. The main outcomes of this controlled, quasi-experimental, pre-post evaluation study were diet, body mass index, and waist circumference. Forty-three (42%) participants with complete data reported significantly greater intakes of fruits and vegetables, lower intakes of calories from sweets and desserts, and a reduction in waist circumference (P ≤ .05) following the intervention, compared to the control period. An educational and environmental intervention can be effective in promoting positive dietary behavior and reducing waist circumference among men in residential treatment. These results need to be confirmed in a larger, randomized trial. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Leonardi, Andrea; Fioravanti, Paolo; Scavelli, Sonia; Velicogna, Francesco
The 2005 EMCDDA (European Monitoring Centre for Drugs and Drug Addiction, Annual report 2005: the state of the drugs problem in Europe, from http://ar2005.emcdda.europa.eu/en/home-en.html?CFID=5556438&CFTOKEN=9393b63b806e64c7-FB015A79-E157-F9DE-99626FADD9F4C983&jsessionid=2e30185a01447c413a1e) annual report remarks the dearth of options…
Aswathy Das; Manoj Kumar Sharma; P Thamilselvan; P Marimuthu
Background: Technology usage has seen an increase among users. The usage varies from social, personal, and psychological reasons. Users are frequently using to overcome mood states as well as to manage the other psychological states. This work is going to explore the information technology use among subjects with a psychiatric disorder. Materials and Methods: A total of 75 subjects were assessed using background data sheet, internet addiction impairment index, video game use pattern, pornogra...
Pisapia, Jared M.; Halpern, Casey H.; Muller, Ulf J.; Vinai, Piergiuseppe; Wolf, John A.; Whiting, Donald M.; Wadden, Thomas A.; Baltuch, Gordon H.; Caplan, Arthur L.
The success of deep brain stimulation (DBS) for movement disorders and the improved understanding of the neurobiologic and neuroanatomic bases of psychiatric diseases have led to proposals to expand current DBS applications. Recent preclinical and clinical work with Alzheimer’s disease and obsessive-compulsive disorder, for example, supports the safety of stimulating regions in the hypothalamus and nucleus accumbens in humans. These regions are known to be involved in addiction and overeating...
Gola, Mateusz; Wordecha, Małgorzata; Sescousse, Guillaume; Lew-Starowicz, Michał; Kossowski, Bartosz; Wypych, Marek; Makeig, Scott; Potenza, Marc N; Marchewka, Artur
Pornography consumption is highly prevalent, particularly among young adult males. For some individuals, problematic pornography use (PPU) is a reason for seeking treatment. Despite the pervasiveness of pornography, PPU appears under-investigated, including with respect to the underlying neural mechanisms. Using functional magnetic resonance imaging (fMRI), we examined ventral striatal responses to erotic and monetary stimuli, disentangling cue-related 'wanting' from reward-related 'liking' among 28 heterosexual males seeking treatment for PPU and 24 heterosexual males without PPU. Subjects engaged in an incentive delay task in the scanner, in which they received erotic or monetary rewards preceded by predictive cues. Blood-oxygen-level-dependent responses to erotic and monetary cues were analyzed and examined with respect to self-reported data on sexual activity collected over the 2 preceding months. Men with and without PPU differed in their striatal responses to cues predicting erotic pictures but not in their responses to erotic pictures. PPU subjects when compared with control subjects showed increased activation of ventral striatum specifically for cues predicting erotic pictures but not for cues predicting monetary gains. Relative sensitivity to cues predicting erotic pictures vs monetary gains was significantly related to the increased behavioral motivation to view erotic images (suggestive of higher 'wanting'), severity of PPU, amount of pornography use per week, and number of weekly masturbations. Our findings suggest that, similar to what is observed in substance and gambling addictions, the neural and behavioral mechanisms associated with the anticipatory processing of cues specifically predicting erotic rewards relate importantly to clinically relevant features of PPU. These findings suggest that PPU may represent a behavioral addiction and that interventions helpful in targeting behavioral and substance addictions warrant consideration for adaptation
Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.
Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M
This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.
Saunders, Elizabeth C; McGovern, Mark P; Lambert-Harris, Chantal; Meier, Andrea; McLeman, Bethany; Xie, Haiyi
Previous research has been inconclusive about whether adding psychosocial treatment to medication assisted treatment (MAT) improves outcomes for patients with co-occurring psychiatric and opioid use disorders. This study evaluated the impact of MAT and psychosocial therapies on treatment outcomes for patients with co-occurring opioid use disorders and PTSD. Patients meeting criteria for PTSD and substance use disorders were randomly assigned to one of three treatment conditions: Standard Care (SC) alone, Integrated Cognitive Behavioral Therapy (ICBT) plus SC, or Individual Addiction Counseling (IAC) plus SC. Substance use and psychiatric symptoms were assessed at baseline and 6 months. Only patients with opioid use disorders were included in the present analyses (n = 126). Two-way ANOVAS and logistic regression analyses were used to examine associations between treatment conditions and MAT, for substance use and psychiatric outcomes. MAT patients receiving ICBT had significantly decreased odds of a positive urine drug screen, compared to non-MAT patients receiving SC alone (OR = .07, 95% CI = .01, .81, p = .03). For PTSD symptoms, a significant MAT by psychosocial treatment condition interaction demonstrated that MAT patients had comparable declines in PTSD symptoms regardless of psychosocial treatment type (F(2, 88) = 4.74, p = .011). Non-MAT patients in ICBT had significantly larger reductions in PTSD. For patients with co-occurring opioid use disorders and PTSD, MAT plus ICBT is associated with more significant improvement in substance use. For non-MAT patients, ICBT is most beneficial for PTSD symptoms. © American Academy of Addiction Psychiatry.
Polonsky, Maxim; Azbel, Lyuba; Wickersham, Jeffrey A.; Taxman, Faye S.; Grishaev, Evgeny; Dvoryak, Sergey; Altice, Frederick L.
Background Ukraine is experiencing one of the most volatile HIV epidemics globally, fueled primarily by people who inject drugs (PWIDs), and a parallel incarceration epidemic. Opioid substitution therapy (OST) is internationally recognized as one of the most effective forms of treatment for opioid dependence and is among the most effective HIV prevention strategies available, yet efforts to adopt it in Ukraine’s Criminal Justice System (CJS) have been thwarted. Methods To understand the reluctance of the Ukrainian CJS to adopt OST despite the overwhelming evidence pointing to its health benefits and improved criminal justice outcomes, we conducted the first survey of Ukrainian prison administrative, medical and custodial staff (N=243) attitudes towards addiction in general, OST, and people living with HIV/AIDS (PLWHA) in representative regions of Ukraine. Results Results revealed that Ukrainian CJS workers’ attitudes toward OST, PLWHA, and drug addiction were universally negative, but differed substantially along geographic and occupational lines. Whereas geographic and cultural proximity to the European Union drove positive attitudes in the west, in the southern region we observed an identifiability effect, as workers who worked directly with prisoners held the most positive attitudes. We also found that knowledge mediated the effect of drug intolerance on OST attitudes. Conclusion In Ukraine, adoption of OST is more influenced by ideological biases and prejudices than by existing scientific evidence. By elucidating existing attitudes among CJS personnel, this assessment will help direct subsequent interventions to address the barriers to implementing evidence-based HIV prevention treatments. PMID:25620732
Nestler, E J
Addiction can be viewed as a form of drug-induced neural plasticity. One of the best established molecular mechanisms of addiction is the upregulation of the cAMP second messenger pathway, which occurs in many neuronal cell types in response to chronic administration of opiates or other drugs of abuse. This upregulation and the resulting activation of the transcription factor CREB appear to mediate aspects of tolerance and dependence. In contrast, induction of another transcription factor, termed delta FosB, exerts the opposite effect and may contribute to sensitized responses to drug exposure. Knowledge of these mechanisms could lead to more effective treatments for addictive disorders.
Dávid, Balázs; Körmendi, Attila
Among behavioural addictions, addiction towards social media sites are identified, which are subtypes of compulsive internet usage. Among these, the most significant is the so-called Facebook addiction. Scientific experts agree, that this new phenomenon hasn't been known in detail yet, so it needs intensified scientific exploration. Different aspects of the personality are inclined to raise the probability of developing Facebook addiction. Neurotic and narcissistic traits of the personality are modifying the characteristic of Facebook use, and by this tendency, risk the individual for developing addiction. Our study aimed at measuring Facebook addiction properly, moreover to identifiy the maladaptive characteristics of Facebook use which are salient in the addiction. Our sample consisted of 117 secondary school students. To measure Facebook addiction we used the Hungarian translated version of the Bergen Facebook Addiction Scale. To examine the special neurotic and narcissistic signs of Facebook usage we have developed our own questionniare. We measured neurotic personality traits with the MMPI "Psychasthenia" scale and we measured narcissism with the NPI-16. According to our results, narcissism and neurotic personality traits influence the use of Facebook and the maladaptive usage mediates the addiction.
Hayashi, Susan W.; Suzuki, Marcia; Hubbard, Susan M.; Huang, Judy Y.; Cobb, Anita M.
Evaluated the Addiction Technology Transfer Centers (ATTCs) of the Center for Substance Abuse Treatment (CSAT) as a means of diffusion of innovations, focusing on use of the Treatment Improvement Protocols (TIPs). Qualitative studies at 6 ATTCs that included 57 interviews show that the CSAT is at the forefront of providing resources to the…
Nithin N Bhaskar
Full Text Available Introduction: Studies in different countries, demonstrated high caries prevalence, poor gingival health, poor motivation and oral hygiene practices with substance abusers. The substances may be natural or synthetic, the use of which has a psychoactive effect and alters or modifies the functions of a living organism. Aim: To assess the oral health status and treatment needs of substance abusers attending de-addiction centers in Bangalore. Materials and Methods: A cross-sectional study was conducted among 426 substance abusers admitted in the wards who were randomly selected from 5 selected de-addiction centers from April 2009 to September 2009. The study population consisted of four groups namely alcohol, nicotine, alcohol + nicotine and other drugs group from the selected de-addiction centers. The oral health status of the patients was determined based on the WHO proforma1997. Descriptive statistics, Pearson′s Chi-square test and ANOVA tests were applied. Results: The study population consisted of 426 male subjects in the age group of 16-65 years old with an average of 36.35 years. Alcohol + nicotine group had significantly more temporomandibular joint clicking than other groups (P < 0.05. Ninety-Six oral mucosal lesions were found in the study. Alcohol group had significantly higher mean CPI code 3 (pockets 4-5 mm than the other groups (P < 0.05. The prevalence of decayed, missing, filled teeth in the study population was 83.33%. The mean DMFT of the study population is 4.15 ± 3.74 standard deviation. The mean DMFT of the Alcohol group was significantly higher than the other combinations group (P < 0.01. Conclusions: The oral health status of substance abusers was poor. There were a large number of oral mucosal lesions noted in them. The dental caries status and periodontal status was the worst in the alcohol group.
Design paper: The CapOpus trial: a randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis
Hjorthøj, Carsten; Fohlmann, Allan; Larsen, Anne-Mette
: The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. DESIGN: The trial is designed as a randomized, parallel-group, observer-blinded clinical...... trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1) specialized addiction treatment plus treatment as usual or 2......) treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient.The primary outcome measure will be changes in amount...
Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu31Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Valley Care Medical Center, Panorama City, CA, USA; 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients’ progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none. The resulting Treatment Effectiveness Assessment (TEA elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients’ sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.Keywords: substance use disorders, global treatment progress, brief instrument, patient-centered
Lichtenstein, Mia Beck; Christiansen, Erik; Elklit, Ask
Exercise addiction is characterized by excessive exercise patterns with potential negative consequences such as overuse injuries. The aim of this study was to compare eating disorder symptoms, quality of life, personality traits and attachments styles in exercisers with and without indications...... of exercise addiction. A case-control study with 121 exercisers was conducted. The exercisers were categorized into an addiction group (n=41) or a control group (n=80) on the basis of their responses to the Exercise Addiction Inventory. The participants completed the Eating Disorder Inventory 2, the Short......-Form 36, the NEO Personality Inventory Revised and the Adult Attachment Scale. The addiction group scored higher on eating disorder symptoms, especially on perfectionism but not as high as eating disorder populations. The characteristic personality traits in the addiction group were high levels...
Suchman, Nancy E
Not all mothers with histories of substance use struggle as parents, but many of them do. Research has shown that, although quality of caregiving varies widely, as a group, mothers with histories of chronic substance use are at greater risk than mothers with no substance use history for losing custody of their young children (Grant et al., 2011; Choi & Ryan, 2006; Department of Health and Human Services, 1999). In observational studies, mothers with substance use disorders have demonstrated lower levels of sensitivity and responsiveness to their young children's emotional cues and marked oscillation between intrusive, over-controlling behavior and passive withdrawal (Hans et al., 1999; Burns et al., 1997). Recent developments in the neuroscience of addiction and parenting may help to explain the marked absence of sensitivity and the dramatic juxtaposition of parenting behaviors.
Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio
Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed. © The Author(s) 2015.
Full Text Available Background and Objectives: Addiction and its complications is one of the major problems in the world and various types of psychotherapy approaches are used for its treatment. Among these approaches, cognitive-behavioral therapies have been widely used for the treatment of addiction in recent decades. The aim of this study was to estimate the effect of cognitive-behavioral therapies on the treatment of addicts in Iran by systematic review and meta-analysis method. Methods: Meta-analysis method was used, without limitation, to investigate all internal databases as well as Medlib, Sid, Magiran, Google Scholar, PubMed, Scopuse, Iranmedex, and ISI. Finally, 12 out of 63 articles were entered into the meta-analysis. Meta-regression was used to investigate the heterogeneity of the studies. Results: In this study, 12 articles were investigated, which increased to 25 studies, including therapeutic approaches. In 6 studies, no significant difference was observed in the experimental group before and after intervention, and in the remaining 19 studies the difference was significant. Combination of the results of 25 studies and using a random effects model of meta-analysis showed that cognitive-behavioral therapy was effective in the treatment of addiction (p<0.001. The standardized effect size in the experimental group before and after cognitive-behavioral therapy, was estimated to be -2.08 and its 95% confidence interval was -1.57 to -2.58. The standardized effect size in control and experimental groups after cognitive-behavioral therapy was estimated 0.40 and its 95% confidence interval was 0.10 to 0.70. Conclusion: Given that cognitive-behavioral therapy is effective in reducing addiction and its symptoms, this method can be used as a common treatment of addiction.
Christensen, Richard C; Hodgkins, Candace C; Garces, Lorrie K; Estlund, Kathleen L; Miller, M David; Touchton, Reginald
This paper examines an empirical investigation of the lifetime prevalence of trauma (defined as sexual and/or physical abuse) in a cohort of adults enrolled in a federally funded initiative that provides treatment for homeless persons suffering the effects of comorbid substance use and serious mental illness, and considers the impact of this information on clinical programming. Data collected from homeless individuals with co-occurring disorders admitted to the Seeking Treatment and Recovery (STAR) Program during a one year period (n=78) were analyzed for a history of trauma events. Of those individuals evaluated, 79.5% (62/78) acknowledged a history of either physical and/or sexual abuse at some time in their lifetimes. Of this population, 100% of the homeless women (27/27) with co-occurring disorders had experienced a life-altering traumatic event while 68.6% (35/51) of the homeless men also reported trauma histories. We describe the trauma-based interventions made in the STAR Program that have the potential for replication in other initiatives committed to serving homeless individuals with co-occurring disorders.
Ray, Rajat; Dhawan, Anju; Chopra, Anita
The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
Osuch, Elizabeth; Vingilis, Evelyn; Ross, Erin; Forster, Christeen; Summerhurst, Carolyn
Cannabis use is common in youth and there is evidence that the co-occurrence of cannabis use (and other substance use) with mental illnesses predicts poorer outcomes, including suicide. The main purposes of this study were to: (i) identify rates of cannabis use and substance use disorder risk, and (ii) predictors for cannabis use among youth seeking help for mood and/or anxiety concerns in a sample population prescreened to exclude primary substance use disorders; and (iii) to determine if there was an association between cannabis use and functional impairment in this sample. We investigated substance use risk as well as hypothesized predictors of cannabis use and functional impairment including demographic characteristics, socioeconomic status, trait coping style, age of onset of several risk behaviors, current use of common addictive substances, level of functional impairment, and current psychiatric symptom severity. Results showed that approximately half of the participants were at moderate to high risk for a substance use disorder, and just over 4% appeared to have a primary substance use disorder. They also suggested an association between cannabis use and gender (male), age of first cannabis use, recent cigarette use, and functional impairment. Independently, functional impairment was predicted by inattentive coping style, depression severity, and total cannabis use score. These results confirm a high risk for addictive disorders and an association between cannabis use and functional impairment in this sample. These results support the need for substance use treatment programs to optimize care wherever youth with primary mood and/or anxiety concerns are seen.
To establish the differential criteria for Binge Eating Disorder (BED) and Food Addiction (FA). We performed a detailed analysis of comparative diagnostic criteria for BED and Substance use disorder contained in the Diagnostic and Statistical Manual of Mental Disorders DSM-V. We applied the diagnostic criteria for both disorders to scientific publications on the issue of excessive eating in obese people, during the years 2005-2016, available on PubMed. We isolated specific similarities and differences between Binge Eating Disorder and Food Addiction. We formulated differential criteria for BED and FA. In BED as well as FA the following characteristics are apparent: preoccupation with food, excessive eating, loss of control over the amount of food and manner of eating, inability to change behavior, continuing behavior despite negative consequences, increased impulsiveness and emotional imbalance. Differences between BED and FA relate to the function of food, reaction to omitted food, psychological mechanisms of coping with excessive eating and body image, the issue of tolerance, withdrawal syndrome and the correlation between excessive eating and other areas of life. The criteria of differentiation between BED and FA concern the following: function of food, eating circumstances, reaction to the unavailability of food, awareness of the problem. Appropriate diagnosis of these disorders and their differentiation increases the chances of adequate treatment of obese patients.
Hardy, Raven; Fani, Negar; Jovanovic, Tanja; Michopoulos, Vasiliki
Food addiction is characterized by poorly controlled intake of highly-palatable, calorically-dense, foods. While previous studies indicate that risk factors for food addiction are similar to substance use disorders (SUD), these studies have looked at food addiction and SUD in independent samples, limiting the ability to directly compare food addiction to SUD. The present study was conducted to assess rates of posttraumatic stress disorder (PTSD), depression, childhood and adult trauma exposure, as well as presence and severity of emotion dysregulation, in a sample of women (N = 229) who either meet criteria for no addiction, food addiction only or SUD only. The prevalence of food addiction was 18.3% and the prevalence of SUD was 30.6% in this sample. Women with food addiction and women with SUD endorsed more depression and PTSD symptoms when compared with individuals with no addiction. Individuals with food addiction and SUD had higher total emotion dysregulation scores, specifically with difficulties in goal directed behaviors, non-acceptance of emotional responses, impulse control, limited access to emotion regulation strategies, and lack of emotional clarity, when compared to individuals with no addiction (all p's 0.05). However, women with SUD endorsed higher levels of total childhood (p < 0.01) and adulthood trauma (p < 0.01) as compared with women with no addiction or food addiction. These results suggest that women with food addiction and those with SUD share similar psychological characteristics and risk factors, with the exception of trauma histories. These findings have implications for the detection of risk for and treatment of these disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.
Kim, Sunny Jung; Marsch, Lisa A; Acosta, Michelle C; Guarino, Honoria; Aponte-Melendez, Yesenia
A growing line of research has shown positive treatment outcomes from technology-based therapy for substance use disorders (SUDs). However, little is known about the effectiveness of technology-based SUD interventions for persons who already had numerous prior SUD treatments. We conducted a secondary analysis on a 12-month trial with patients (N=160) entering methadone maintenance treatment (MMT). Patients were randomly assigned to either standard MMT treatment or a model in which half of standard counseling sessions were replaced with a computer-based intervention, called Therapeutic Education System (standard+TES). Four treatment history factors at baseline, the number of lifetime SUD treatment episodes, detoxification episodes, and inpatient/outpatient treatment episodes were categorized into three levels based on their tertile points, and analyzed as moderators. Dependent variables were urine toxicology results for opioid and cocaine abstinence for 52-weeks. The standard+TES condition produced significantly better opioid abstinence than standard treatment for participants with 1) a moderate or high frequency of lifetime SUD treatment episodes, and 2) those with all three levels (low, moderate and high) of detoxification and inpatient/outpatient treatment episodes, pspeople with 1) a moderate or high frequency of lifetime SUD treatment episodes, 2) a high level of detoxification episodes, and 3) a moderate or high level of inpatient treatment history, pstechnology-based behavioral therapy as part of treatment can be more effective than MMT alone, even among patients with a history of multiple addiction treatment episodes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Drug dependence is a recognized medical condition and therefore, right to health applies in the same way to drug dependence as it does to any other health condition. The human rights in patient care framework - which refers to the application of basic human rights principles in the delivery of health care services - was used to explore the experiences of equality in the dignity and rights protected by Polish law within four different specialist drug treatment settings in Poland. The views of patients and staff were examined and compared. Focus group interviews were conducted in 12 drug treatment facilities: three inpatient therapeutic communities, three outpatient programs, three opioid substitution programs and three harm reduction programs (drop-in/needle exchange/support). Interviews were conducted with a total of 43 staff and 73 patients. All interviews were audio-recorded with participants' prior consent and transcribed verbatim. Data were analysed according to the problem-centred interview methodology, using CAQDA. Patients described instances of abuse of their rights regarding dignity, privacy, confidentiality, personalized treatment, and respect of patient's time, right to information and to complain. Those accounts were complemented by the perspective of professionals working in drug treatment. Patients of Polish opioid substitution programs reported experiencing more humiliation and disenfranchisement than patients in other drug treatment settings. Drug testing and control, fuelled by prejudices of health professionals, are leading to discriminatory practices in substitution treatment and damaging the chances of therapeutic success. The concept of epistemic injustice illuminates the reasons behind discrimination against patients on opioid substitution programs, who are seen as continuously sick and their illness perceived as a mark of moral, social and epistemic failure. Copyright © 2017 Elsevier B.V. All rights reserved.
Stahler, Gerald J; Mennis, Jeremy; Baron, David A
Addiction represents one of the greatest public health problems facing the United States. Advances in addiction research have focused on the neurobiology of this disease. We discuss potential new breakthroughs in understanding the other side of gene-environment interactions-the environmental context or "exposome" of addiction. Such research has recently been made possible by advances in geospatial technologies together with new mobile and sensor computing platforms. These advances have fostered interdisciplinary collaborations focusing on the intersection of environment and behavior in addiction research. Although issues of privacy protection for study participants remain, these advances could potentially improve our understanding of initiation of drug use and relapse and help develop innovative technology-based interventions to improve treatment and continuing care services.
Joolaee, Soodabeh; Fereidooni, Zhila; Fatemi, Naeemeh Seyed; Meshkibaf, Mohammad Hassan; Mirlashri, Jila
Addiction is one of the majore problems that affect everyone in the society especially the spouses of addicted men who have to face a large number of problems which are the consequences of their husband’s addiction. This qualitative study was conducted to explore the needs and expectations of women who are living with their addicted husband in Iran. Twenty-four spouses of addicted men participated in this study. The participants were interviewed and each interview was analyzed via the content analysis method. The results of this study showed that the women’s difficulties were related to their approach to the treatment, or their husbands’ response to the treatment, financial constraints and emotional and informational needs. Moreover, these Iranian women expected more stringent control by the government on the phenomenon of addiction and drug trafficking with a view of having a drug-free country. The needs and expectations of the wives of addicted men are context-based and should be assessed separately between individuals, families, and communities. In addition to the addicted person, it is vitally important that the health of the family members of drug addicts be taken into account and for whom supportive services be provided. PMID:25169001
Full Text Available Objective: The aim of this study was the Study of effectiveness of Marlaat’s cognitive behavior intervention and group treatment based on change stages for recovery and relapse rates in male heroin crack addictions. Method: In a experimental research design, 45 men addictions, who were diagnosed as the dependence of the heroin crack on the basis of DSM-IV-TR criteria, were chosen after successfully detoxified. They were divided two experimental groups (30 participants and a control group (15 participants that have been selected by random sampling. The first experimental group was undergone group treatment based on change stages underwent 16 sessions of 1.5 hours, totally 24 hours and the second experimental groups who were undergone Marlaat’s cognitive behavior intervention has been held 15 sessions of 2 hours, totally 24 hours. The control group were just received MMT without any psychotherapy. All participants were assessed by structured interview, urine test, before treatment, after treatment and after 3 months follow up. Results: Results showed that both psychotherapy treatments were affected on recovery and relapse rates. Conclusion: It seems that psychological problems and conflicts before addiction and after addiction could be caused for individuals’ tendency to narcotics consumption. Therefore, applying of psychotherapy could be useful in relapse prevention.
Nakayama, Hideki; Higuchi, Susumu
Internet technologies have made a rapid progress, bringing convenience to daily life. On the other hand, internet use disorder and internet addiction (IA) have become reportedly serious health and social problems. In 2013, internet gaming disorder criteria have been proposed in the section of Conditions for Further Study of DSM-5. Existing epidemiological studies by questionnaire methods have reported that the prevalence of IA ranges between 2.8% and 9.9% among youths in Japan. Attention deficit hyperactivity disorder (ADHD), sleeping disorders, depression, obsessive compulsive disorder, and phobic anxiety disorder are extremely common comorbid mental disorders with IA. Some psychotherapies (e.g., cognitive behavioral therapy, motivational interviewing) and medical treatments (e.g., antidepressant drugs, methylphenidate) for comorbid mental disorders as well as rehabilitation (e.g., treatment camp) are effective for IA remission. However, some serious cases of IA may be difficult to treat, and prevention is very important. In future, the prevention, rehabilitations and treatments for IA will be more required in Japan.
Katarzyna Girczys-Połedniok; Robert Pudlo; Magdalena Jarząb; Agnieszka Szymlak
Cocaine use leads to health, social and legal problems. The aim of this paper is to discuss cocaine action, addicts characteristics, use patterns and consequences, as well as addiction treatment methods. A literature review was based on the Medline, PubMed, Polish Medical Bibliography databases and the Silesian Library resources. The Police and Central Statistical Office statistics, as well as the World Health Organization, the European Monitoring Centre for Drugs and Drug Addiction and the N...
ŢOGOE GRETI DANIELA
Full Text Available The theme of our research is the ways of keeping accounting entities that are the object of the provision of services in the accounting profession. This paper aims to achieve a parallel between the ways of organizing financial records - accounting provided by freelancers and companies with activity in the financial - accounting. The first step in our scientific research is to establish objectives chosen area of scientific knowledge. Our scientific approach seeks to explain through a thorough and detailed approach as different sides (conceptual and practical looking projections of accounting issues related to regulatory developments and practices in the field. This paper addresses various concepts, accounting treatments, and books and accounting documents used both freelancers in providing accounting services and legal persons authorized accounting profession. In terms of methodology and research perspective, the whole scientific approach combined with quantitative and qualitative research theoretical perspective (descriptive-conceptual with practice perspective (empirical analyzing the main contributions of various authors (Romanian and foreign to knowledge in the field. Following the survey believe that the amendments to the national legislation will support entities providing accounting services, by cutting red tape on Administrative Burdens, and consequently will increase profitability and increase service quality.
Mitchell, Ann M; Puskar, Kathryn; Hagle, Holly; Gotham, Heather J; Talcott, Kimberly S; Terhorst, Lauren; Fioravanti, Marie; Kane, Irene; Hulsey, Eric; Luongo, Peter; Burns, Helen K
Preparing nursing students to apply an evidence-based screening and brief intervention approach with patients has the potential to reduce patients' risky alcohol and drug use. Responding to Mollica, Hyman, and Mann's article published in 2011, the current article describes implementation results of an Addiction Training for Nurses program of Screening, Brief Intervention, and Referral to Treatment (SBIRT) embedded within an undergraduate nursing curriculum. Results reveal that students in other schools of nursing would benefit from similar, significant training on substance use disorders and SBIRT. Training satisfaction surveys (N = 488) indicate students were satisfied with the quality of the training experience. More than 90% of students strongly agreed or agreed that the training was relevant to their nursing careers and would help their patients. Additional clinical practice and skill development may increase students' reported effectiveness in working with the topic area of substance use and SBIRT. Copyright 2013, SLACK Incorporated.
Bartlett, Nicholas; Garriott, William; Raikhel, Eugene
Recent years have seen the emergence of a 'global mental health' agenda, focused on providing evidence-based interventions for mental illnesses in low- and middle-income countries. Anthropologists and cultural psychiatrists have engaged in vigorous debates about the appropriateness of this agenda. In this article, we reflect on these debates, drawing on ethnographic fieldwork on the management of substance use disorders in China, Russia, and the United States. We argue that the logic of 'treatment gaps,' which guides much research and intervention under the rubric of global mental health, partially obscures the complex assemblages of institutions, therapeutics, knowledges, and actors framing and managing addiction (as well as other mental health issues) in any particular setting.
M Haj Hosseini
Full Text Available Objective: This study aimed at comparing addicts' quality of life and psychological disorders based on two methods, i.e. an educational method (Narcotics Anonymous and a medical method (Methadone Maintenance Treatment. Method: An ex post facto research design was used in this study. Using purposive sampling, the number of 217 male addict (110 NA, 107 MMT was selected from Shahrekord City. Quality of Life Questionnaire and Depression, Anxiety, and Stress Scale (DASS-42 were utilized to collect data. Results: According to the results of multivariate analysis of covariance, in terms of life quality, status of NA group members was more desirable as compared with the MMT group. Considering the three psychological disorders, NA group members were in a better condition than the methadone treatment group. An increase in the membership duration in NA was associated with lower level of depression and physical pain and higher level of general health and positive emotions. Conclusion: Therapeutic community approach was revealed to be more adequate in improving the quality of life and reducing psychological disorders, and may be considered as a desired method of treatment.
Fu, Qining; Meng, Xiyun; Li, Fenghe; Wang, Xuehu; Cheng, Jun; Huang, Wen; Ren, Wei; Zhao, Yu
PurposeExplore the application of endovascular covered stent-graft (SG) placement in femoral pseudoaneurysms in intravenous drug addicts.Materials and MethodsWe evaluated a consecutive series of pseudoaneurysm in intravenous drug addicts treated with SGs from August 2010 to December 2013.Results15 patients with 16 arterial pseudoaneurysms were enrolled in this study. All were males with a mean age of 36.9 years. Hemorrhage was the most common reason (93.8 %) for seeking medical care, and 3 of these patients were in hemorrhagic shock at admission. All patients received broad-spectrum antibiotics, and debridement and drainage were implemented after SG placement. 7 of the 13 cases which had microbiologic results showed mixed infections, while gram-negative bacteria were the major pathogens. Except for 2 patients, who were lost to follow-up, two new pseudoaneurysms formed due to delayed debridement, and one stent thrombosis occurred, none of the remaining cases had SG infection or developed claudication.ConclusionsSG placement controls massive hemorrhage rapidly, gives enough time for subsequent treatment for pseudoaneurysms due to intravenous drug abuse, and reduces the incidence of postoperative claudication. With appropriate broad-spectrum antibiotics and early debridement, the incidence of SG infection is relatively low. It is an effective alternative especially as temporary bridge measure for critical patients. However, the high cost, uncertain long-term prospects, high demand for medical adherence, and the risk of using the conduits for re-puncture call for a cautious selection of patients. More evidence is required for the application of this treatment
Fu, Qining, E-mail: email@example.com; Meng, Xiyun, E-mail: firstname.lastname@example.org; Li, Fenghe, E-mail: email@example.com; Wang, Xuehu, E-mail: firstname.lastname@example.org; Cheng, Jun, E-mail: email@example.com; Huang, Wen, E-mail: firstname.lastname@example.org; Ren, Wei, E-mail: email@example.com; Zhao, Yu, E-mail: firstname.lastname@example.org [The First Affiliated Hospital of Chongqing Medical University, Department of Vascular Surgery (China)
PurposeExplore the application of endovascular covered stent-graft (SG) placement in femoral pseudoaneurysms in intravenous drug addicts.Materials and MethodsWe evaluated a consecutive series of pseudoaneurysm in intravenous drug addicts treated with SGs from August 2010 to December 2013.Results15 patients with 16 arterial pseudoaneurysms were enrolled in this study. All were males with a mean age of 36.9 years. Hemorrhage was the most common reason (93.8 %) for seeking medical care, and 3 of these patients were in hemorrhagic shock at admission. All patients received broad-spectrum antibiotics, and debridement and drainage were implemented after SG placement. 7 of the 13 cases which had microbiologic results showed mixed infections, while gram-negative bacteria were the major pathogens. Except for 2 patients, who were lost to follow-up, two new pseudoaneurysms formed due to delayed debridement, and one stent thrombosis occurred, none of the remaining cases had SG infection or developed claudication.ConclusionsSG placement controls massive hemorrhage rapidly, gives enough time for subsequent treatment for pseudoaneurysms due to intravenous drug abuse, and reduces the incidence of postoperative claudication. With appropriate broad-spectrum antibiotics and early debridement, the incidence of SG infection is relatively low. It is an effective alternative especially as temporary bridge measure for critical patients. However, the high cost, uncertain long-term prospects, high demand for medical adherence, and the risk of using the conduits for re-puncture call for a cautious selection of patients. More evidence is required for the application of this treatment.
Full Text Available Internet addiction is regarded as a growing health concern in many parts of the world with prevalence rates of 1-2% in Europe and up to 7% in some Asian countries. Clinical research has demonstrated that Internet addiction is accompanied with loss of interests, decreased psychosocial functioning, social retreat, and heightened psychosocial distress. Specialized treatment programs are needed to face this problem that has recently been added to the appendix of the DSM-5. While there are numerous studies assessing clinical characteristics of patients with Internet addiction, the knowledge about the effectiveness of treatment programs is limited. Although a recent meta-analysis indicates that those programs show effects, more clinical studies are needed here. To add knowledge, we conducted a pilot study on the effects of a standardized cognitive-behavioral therapy program for IA. 42 male adults meeting criteria for Internet addiction were enrolled. Their IA-status, psychopathological symptoms, and perceived self-efficacy expectancy were assessed before and after the treatment. The results show that 70.3% of the patients finished the therapy regularly. After treatment symptoms of IA had decreased significantly. Psychopathological symptoms were reduced as well as associated psychosocial problems. The results of this pilot study emphasize findings from the only meta-analysis conducted so far.
Wölfling, K; Beutel, M E; Dreier, M; Müller, K W
Internet addiction is regarded as a growing health concern in many parts of the world with prevalence rates of 1-2% in Europe and up to 7% in some Asian countries. Clinical research has demonstrated that Internet addiction is accompanied with loss of interests, decreased psychosocial functioning, social retreat, and heightened psychosocial distress. Specialized treatment programs are needed to face this problem that has recently been added to the appendix of the DSM-5. While there are numerous studies assessing clinical characteristics of patients with Internet addiction, the knowledge about the effectiveness of treatment programs is limited. Although a recent meta-analysis indicates that those programs show effects, more clinical studies are needed here. To add knowledge, we conducted a pilot study on the effects of a standardized cognitive-behavioral therapy program for IA. 42 male adults meeting criteria for Internet addiction were enrolled. Their IA-status, psychopathological symptoms, and perceived self-efficacy expectancy were assessed before and after the treatment. The results show that 70.3% of the patients finished the therapy regularly. After treatment symptoms of IA had decreased significantly. Psychopathological symptoms were reduced as well as associated psychosocial problems. The results of this pilot study emphasize findings from the only meta-analysis conducted so far.
Heidari, Mohammad; Ghodusi, Mansureh
Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran. The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter's Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software. According to the results, in the 12 th day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson's correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages. It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life.
Maremmani, Icro; Pani, Pier Paolo; Pacini, Matteo; Bizzarri, Jacopo V; Trogu, Emanuela; Maremmani, Angelo GI; Gerra, Gilberto; Perugi, Giulio; Dell'Osso, Liliana
Abstract Background Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role. Psychopathological symptoms in patients with heroin addiction are generally considered to be part of the drug addict's personality, or else to be related to the presence of psychiatric comorbidity, raising doubts about whether patients with long-term abuse of opioids actually possess specific psychopathological dimensions. Methods Using the Self-Report Symptom Inventory (SCL-90),...
Fattore, Liana; Melis, Miriam; Fadda, Paola; Fratta, Walter
Gender-dependent differences in the rate of initiation and frequency of misuse of addicting drugs have been widely described. Yet, men and women also differ in their propensity to become addicted to other rewarding stimuli (e.g., sex, food) or activities (e.g., gambling, exercising). The goal of the present review is to summarize current evidence for gender differences not only in drug addiction, but also in other forms of addictive behaviours. Thus, we first reviewed studies showing gender-dependent differences in drug addiction, food addiction, compulsive sexual activity, pathological gambling, Internet addiction and physical exercise addiction. Potential risk factors and underlying brain mechanisms are also examined, with particular emphasis given to the role of sex hormones in modulating addictive behaviours. Investigations on factors allowing the pursuit of non-drug rewards to become pathological in men and women are crucial for designing gender-appropriate treatments of both substance and non-substance addictions. Copyright © 2014 Elsevier Inc. All rights reserved.
Böning, J; Meyer, G; Hayer, T
Extensive coherent clinical, psychopathological, neurobiological and genetic similarities with substance-related addictions justify the forthcoming classification of gambling addiction under the new category "Substance Use and Addictive Disorders" in the DSM-5. Thus, gambling addiction can be regarded as the prototype of behavioral addiction. In general it should be kept in mind that isolated gambling forms are associated with varying addictive potential due to specific situational and structural game characteristics. High rates of indebtedness, suicidality, social isolation and gambling-related crime often accompany pathological gambling. As a consequence gambling addiction represents a mental disorder with a significant economic burden. In Germany 12-month prevalence rates for problem gambling in adulthood range from 0.24 % to 0.64 % and for pathological gambling from 0.20 % to 0.56 %. Because gambling products rank among the so-called demeriting (i.e. potentially harmful) social activities, player and youth protection measures to prevent gambling disorders and associated crime should be best regulated as a state monopoly.
Solal, J F; Schneider, M C
Destitute drug addicts have not deliberately chosen to be socially excluded; it's more the consequence of a sanitary and social policy which has given a greater importance to the treatment of addiction than to the drug addict's health. Facing Aids, physicians, with their pragmatic attitude, have reversed this drift. On the streets, the drug addict holds handicaps concurrently; medicinal addiction leads to harder sevrance and substitution. Having access to social rights allows to regain an identity, compulsory for an access to health care; but public hospitals have to make casier both the admission and the stay of patients whose therapeutic observance is dependent on a preliminary substitution. Drug addiction and precarity represent a double social challenge that a democratic society must take up without any segregation.
Lai, Carlo; Altavilla, Daniela; Mazza, Marianna; Scappaticci, Silvia; Tambelli, Renata; Aceto, Paola; Luciani, Massimiliano; Corvino, Stefano; Martinelli, David; Alimonti, Flaminia; Tonioni, Federico
The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving. The aim was to test the neural correlate in response to the Internet cue in patients with IA. Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed. sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group. These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms.
Flynn, M; Houtjes, W; Merks, A; van Mierlo, A; van de Wetering, B
Patients with mental illnesses have been found to shorter life expectancy due to an increased risk of heart disease. Some medication used to treat mental illnesses have been linked to weight gain and other physical change that make patients susceptible to heart disease. In order to reduce this risk it is important that health professionals regularly measure and monitor signs of these physical changes. This research has found that measuring both waist circumference and blood pressure of patients is a safe and reliable way to way to monitor patients. To identify if combined blood pressure and waist circumference measurements are reliable predictor of metabolic syndrome, a descriptive correlational design was used to examine the sensitivity and specificity of screening techniques used to detect metabolic syndrome. Data were collected regarding waist circumference, body mass index, blood pressure, fasting blood glucose, triglycerides and high-density lipoproteins. Blood pressure and waist circumference measurements demonstrated high significance, sensitivity and specificity as screening instruments for metabolic syndrome. Combined waist circumference and blood pressure measurements may be clinically useful for a quick and reliable detection of metabolic syndrome in patients with addiction and comorbid mental health problems. © 2014 John Wiley & Sons Ltd.
Gustafson, David H; Landucci, Gina; McTavish, Fiona; Kornfield, Rachel; Johnson, Roberta A; Mares, Marie-Louise; Westergaard, Ryan P; Quanbeck, Andrew; Alagoz, Esra; Pe-Romashko, Klaren; Thomas, Chantelle; Shah, Dhavan
improve recovery for people with alcohol dependence. It offers an adaptive and extensive menu of services and can attend to patients nearly as constantly as addiction does. This suggests the possibility of increasing both the effectiveness of, and access to, treatment for opioid dependence. ClinicalTrials.gov, NCT02712034 . Registered on 14 March 2016.
Saunders, Elizabeth C.; McGovern, Mark P.; Lambert-Harris, Chantal; Meier, Andrea; McLeman, Bethany; Xie, Haiyi
Background and Objectives Previous research has been inconclusive about whether adding psychosocial treatment to medication assisted treatment (MAT) improves outcomes for patients with co-occurring psychiatric and opioid use disorders. This study evaluated the impact of MAT and psychosocial therapies on treatment outcomes for patients with co-occurring opioid use disorders and PTSD. Methods Patients meeting criteria for PTSD and substance use disorders were randomly assigned to one of three treatment conditions: Standard Care (SC) alone, Integrated Cognitive Behavioral Therapy (ICBT) plus SC, or Individual Addiction Counseling (IAC) plus SC. Substance use and psychiatric symptoms were assessed at baseline and 6 months. Only patients with opioid use disorders were included in the present analyses (n = 126). Two-way ANOVAS and logistic regression analyses were used to examine associations between treatment conditions and MAT, for substance use and psychiatric outcomes. Results MAT patients receiving ICBT had significantly decreased odds of a positive urine drug screen, compared to non-MAT patients receiving SC alone (OR = .07, 95% CI = .01, .81, p = .03). For PTSD symptoms, a significant MAT by psychosocial treatment condition interaction demonstrated that MAT patients had comparable declines in PTSD symptoms regardless of psychosocial treatment type (F(2, 88) = 4.74, p = .011). Non-MAT patients in ICBT had significantly larger reductions in PTSD. Conclusions and Scientific Significance For patients with co-occurring opioid use disorders and PTSD, MAT plus ICBT is associated with more significant improvement in substance use. For non-MAT patients, ICBT is most beneficial for PTSD symptoms. PMID:26388539
Etheridge, Rose M.; Smith, Jeff C.; Rounds-Bryant, Jennifer L.; Hubbard, Robert L.
Compared treatment needs and services received in six areas based on the Treatment Outcome Prospective Study and the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A). Found a general decline in services received that was only partially offset by significant decreases in some self-reported service needs in DATOS-A. Unmet needs…
Hunter, Sarah B; Paddock, Susan M; Zhou, Annie; Watkins, Katherine E; Hepner, Kimberly A
The study goal was to determine whether client attributes were associated with outcomes from group cognitive behavioral therapy for depression (GCBT-D) as delivered in community-based addiction treatment settings. Data from 299 depressed residential clients assigned to receive either usual care (N = 159) or usual care plus GCBT-D (N = 140) were examined. Potential moderators included gender, race/ethnicity, education, referral status, and problem substance use. Study outcomes at 6 months post-baseline included changes in depressive symptoms, mental health functioning, negative consequences from substance use, and percentage of days abstinent. Initial examination indicated that non-Hispanic Whites had significantly better outcomes than other racial/ethnic groups on two of the four outcomes. After correcting for multiple testing, none of the examined client attributes moderated the treatment effect. GCBT-D appears effective; however, the magnitude and consistency of treatment effects indicate that it may be less helpful among members of racial/ethnic minority groups and is worthy of future study.
... to your doctor about dosage. What is drug dependence? Drug dependence is when the way your body works ... medicine. What is the difference between drug tolerance, dependence, and addiction? Drug tolerance and dependence are a normal part of ...
Spears, Claire Adams; Hedeker, Donald; Li, Liang; Wu, Cai; Anderson, Natalie K; Houchins, Sean C; Vinci, Christine; Hoover, Diana Stewart; Vidrine, Jennifer Irvin; Cinciripini, Paul M; Waters, Andrew J; Wetter, David W
To examine cognitive and affective mechanisms underlying mindfulness-based addiction treatment (MBAT) versus cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation. Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks postquit, participants completed measures of emotions, craving, dependence, withdrawal, self-efficacy, and attentional bias. Biochemically confirmed 7-day smoking abstinence was assessed at 4 and 26 weeks postquit. Although the parent study did not find a significant treatment effect on abstinence, mixed-effects regression models were conducted to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on abstinence were tested. Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were no other significant differences between MBAT and CBT. Compared with those receiving UC, MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as well as higher self-efficacy for managing negative affect without smoking. Indirect effects of MBAT versus UC on abstinence occurred through each of these mechanisms. Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence. Results help to shed light on similarities and differences between mindfulness-based and other active smoking cessation treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Bordnick, Patrick S; Carter, Brian L; Traylor, Amy C
Virtual reality (VR), a system of human–computer interaction that allows researchers and clinicians to immerse people in virtual worlds, is gaining considerable traction as a research, education, and treatment tool. Virtual reality has been used successfully to treat anxiety disorders such as fear of flying and post-traumatic stress disorder, as an aid in stroke rehabilitation, and as a behavior modification aid in the treatment of attention deficit disorder. Virtual reality has also been employed in research on addictive disorders. Given the strong evidence that drug-dependent people are highly prone to use and relapse in the presence of environmental stimuli associated with drug use, VR is an ideal platform from which to study this relationship. Research using VR has shown that drug-dependent people react with strong craving to specific cues (e.g., cigarette packs, liquor bottles) as well as environments or settings (e.g., bar, party) associated with drug use. Virtual reality has also been used to enhance learning and generalization of relapse prevention skills in smokers by reinforcing these skills in lifelike environments. Obesity researchers and treatment professionals, building on the lessons learned from VR research in substance abuse, have the opportunity to adapt these methods for investigating their own research and treatment questions. Virtual reality is ideally suited to investigate the link between food cues and environmental settings with eating behaviors and self-report of hunger. In addition, VR can be used as a treatment tool for enhancing behavior modification goals to support healthy eating habits by reinforcing these goals in life–like situations. PMID:21527092
Ong, Say How; Tan, Yi Ren
In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families.
Blanken, Peter; Hendriks, Vincent M.; van Ree, Jan M.; van den Brink, Wim
Aims To describe 4-year treatment retention and treatment response among chronic, treatment-resistant heroin-dependent patients offered long-term heroin-assisted treatment (HAT) in the Netherlands. Design Observational cohort study. Setting and intervention Out-patient treatment in specialized
Full Text Available This paper aimed to collect and unite facts known about the effect of methadone treatment on QTc interval prolongation that could determine precipitating factors in the development of heart arrhythmias and their consequences (Torsade de Pointes and sudden cardiac death, and to raise the methadone treatment safety level.
Ironically, the brain disease model's ascendance in the U.S. corresponds with epidemic rises in opiate addiction, both painkillers (Brady et al., 2016 and heroin (CDC, n.d., as well as heroin, painkiller, and tranquilizer poisoning deaths (Rudd et al., 2016. More to the point, the conceptual and treatment goal of eliminating choice in addiction and recovery is not only futile, but iatrogenic. Indeed, the National Institute on Alcohol Abuse and Alcoholism's epidemiological surveys, while finding natural recovery for both drug and alcohol disorders to be typical, has found a decline in natural recovery rates (Dawson et al., 2005 and a sharp increase in AUDs (Grant et al., 2015.
Asadikaram, Gholamreza; Sirati-Sabet, Majid; Asiabanha, Majid; Shahrokhi, Nader; Jafarzadeh, Abdollah; Khaksari, Mohammad
Chronic opioid treatment in animal models has shown to alter hematological parameters. The aim of this study was to evaluate the biological effects of opium on the number of peripheral blood cells and red blood cells (RBCs) indices in diabetic rats. Peripheral blood samples were collected from diabetic, opium-addicted, diabetic opium-addicted and normal male and female rats and hematological parameters were measured. The mean number of white blood cells (WBCs) was significantly higher in diabetic opium-addict females compared to diabetic non-addict female group. In both male and female, the mean number of neutrophils was significantly higher and the mean number of lymphocytes was lower in diabetic opium-addicted rats than those observed in diabetic non-addicted group. In diabetic opium-addicted male group the mean counts of RBC significantly increased as compared with diabetic male group. However, in diabetic addicted female, the mean number of RBCs was significantly lower than diabetic non-addicted female group. In both males and females, the mean number of platelets was significantly lower in diabetic addict rats compared to diabetic non-addict group. Generally, the results indicated that opium addiction has different effects on male and female rats according to the number of WBC, RBC and RBC indices. It could also be concluded that in the opium-addicts the risk of infection is enhanced due to the weakness of immune system as a result of the imbalance effect of opium on the immune cells.
Kleinjan, M.; Engels, R.C.M.E.
An overview of the prevalence, health consequences, and determinants of adolescents’ substance use is provided in this article on adolescence and addictions. Additionally, prevention and treatment efforts and the effectiveness are discussed. The emphasis is on alcohol, smoking, and cannabis use.
Rawson, Richard A; Woody, George; Kresina, Thomas F; Gust, Steven
Over the past decade, the amount and variety of addiction research around the world has increased substantially. Researchers in Australia, Canada, United Kingdom, United States, and western Europe have significantly contributed to knowledge about addiction and its treatment. However, the nature and context of substance use disorders and the populations using drugs are far more diverse than is reflected in studies done in Western cultures. To stimulate new research from a diverse set of cultural perspectives, the National Institute on Drug Abuse (NIDA) has promoted the development of addiction research capacity and skills around the world for over 25 years. This review will describe the programs NIDA has developed to sponsor international research and research fellows and will provide some examples of the work NIDA has supported. NIDA fellowships have allowed 496 individuals from 96 countries to be trained in addiction research. The United Arab Emirates and Saudi Arabia have recently developed funding to support addiction research to study, with advice from NIDA, the substance use disorder problems that affect their societies. Examples from Malaysia, Tanzania, Brazil, Russian Federation, Ukraine, Republic of Georgia, Iceland, China, and Vietnam are used to illustrate research being conducted with NIDA support. Health services research, collaboratively funded by the U.S. National Institutes of Health and Department of State, addresses a range of addiction service development questions in low- and middle-income countries. Findings have expanded the understanding of addiction and its treatment, and are enhancing the ability of practitioners and policy makers to address substance use disorders.
Resnick, Sheilagh M; Griffiths, Mark D
The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic. Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered. Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the "reliability" service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions. The paper relies on self-report methods from a relatively small number of individuals. There have been limited research studies measuring alcohol treatment service quality in the private sector.
Nerín, I; Crucelaegui, A; Más, A; Villalba, J A; Guillén, D; Gracia, A
To assess a comprehensive smoking prevention and treatment program in an electrical appliances company with 1600 employees. The program included smoking restrictions with the designation of smoking areas and the offer of smoking cessation treatment for the smokers affected. Study variables were age, sex, nicotine dependence (Fagerström Test), carbon monoxide in expired air, adherence to therapy, and smoking abstinence at 1 week, 1 month, 3 months (end of treatment), and 6 months. Successful smoking abstinence was defined as continuous abstinence from the beginning of treatment. Smoking prevalence was 34.8% and 19.5% of smokers requested treatment (77.4% men and 22.6% women). Mean (SD) age was 41.3 (10.3) years. Mean score of nicotine dependence was 5.3 (2.6) and the mean quantity of carbon monoxide in expired air was 35.6 (23.7) ppm. Adherence to therapy was good in 80% of patients. Rate of abstinence was 57.5% at 6 months, signifying a 4% reduction in prevalence. Workplace smoking cessation programs reduce prevalence and facilitate the establishment of smoking restrictions at the worksite. Companies are convenient settings for the implementation of programs aimed at smoking prevention and treatment.
The transfer of new technologies (e.g., evidence-based practices) into substance abuse treatment organizations often occurs long after they have been developed and shown to be effective. Transfer is slowed, in part, due to a lack of clear understanding about all that is needed to achieve full implementation of these technologies. Such misunderstanding is exacerbated by inconsistent terminology and overlapping models of an innovation, including its development and validation, dissemination to the public, and implementation or use in the field. For this reason, a workgroup of the Addiction Technology Transfer Center (ATTC) Network developed a field-driven conceptual model of the innovation process that more precisely defines relevant terms and concepts and integrates them into a comprehensive taxonomy. The proposed definitions and conceptual framework will allow for improved understanding and consensus regarding the distinct meaning and conceptual relationships between dimensions of the technology transfer process and accelerate the use of evidence-based practices. Copyright © 2011 Elsevier Inc. All rights reserved.
Full Text Available Cocaine use leads to health, social and legal problems. The aim of this paper is to discuss cocaine action, addicts characteristics, use patterns and consequences, as well as addiction treatment methods. A literature review was based on the Medline, PubMed, Polish Medical Bibliography databases and the Silesian Library resources. The Police and Central Statistical Office statistics, as well as the World Health Organization, the European Monitoring Centre for Drugs and Drug Addiction and the National Office for Combating Drug Addiction reports were used. Cocaine leads to mood improvement, appetite decrease, physical and intellectual activity enhancement, euphoria, inflated self-esteem, social networking ease and increased sexual desire. Cocaine hydrochloride is mainly used intranasaly, but also as intravenous and subcutaneous injections. Cocaine use and first addiction treatment fall in later age compared to other psychoactive substances. There is a high men to women ratio among addicts. There is a relationship between cocaine addiction, the presence of other disorders and genetic predisposition to addiction development. Polish reports indicate higher popularity of cocaine among people with a high economic and social status. Although Poland is a country with the low percentage of cocaine use, its popularity is growing. The consequences of cocaine use concern somatic and mental health problems, socioeconomic and legal conditions. The drug plays a role in crimes and traffic accidents. Because of the risks associated with cocaine use, it has been listed in a register of drugs attached to the Act on Counteracting Drug Addiction. Addiction treatment includes psychological, pharmacological and harm reduction strategies. Med Pr 2016;67(4:537–544
Ma, Jennie Z; Johnson, Bankole A; Yu, Elmer; Weiss, David; McSherry, Frances; Saadvandi, Jim; Iturriaga, Erin; Ait-Daoud, Nassima; Rawson, Richard A; Hrymoc, Mark; Campbell, Jan; Gorodetzky, Charles; Haning, William; Carlton, Barry; Mawhinney, Joseph; Weis, Dennis; McCann, Michael; Pham, Tony; Stock, Christopher; Dickinson, Ruth; Elkashef, Ahmed; Li, Ming D
As reported previously, 140 methamphetamine-dependent participants at eight medical centers in the U.S. were assigned randomly to receive topiramate (N=69) or placebo (N=71) in a 13-week clinical trial. The study found that topiramate did not appear to reduce methamphetamine use significantly for the primary outcome (i.e., weekly abstinence from methamphetamine in weeks 6-12). Given that the treatment responses varied considerably among subjects, the objective of this study was to identify the heterogeneous treatment effect of topiramate and determine whether topiramate could reduce methamphetamine use effectively in a subgroup of subjects. Latent variable analysis was used for the primary and secondary outcomes during weeks 6-12 and 1-12, adjusting for age, sex, and ethnicity. Our analysis of the primary outcome identified 30 subjects as responders, who either reduced methamphetamine use consistently over time or achieved abstinence. Moreover, topiramate recipients had a significantly steeper slope in methamphetamine reduction and accelerated to abstinence faster than placebo recipients. For the secondary outcomes in weeks 6-12, we identified 40 subjects as responders (who had significant reductions in methamphetamine use) and 65 as non-responders; topiramate recipients were more than twice as likely as placebo recipients to be responders (odds ratio=2.67; p=0.019). Separate analyses of the outcomes during weeks 1-12 yielded similar results. Methamphetamine users appear to respond to topiramate treatment differentially. Our findings show an effect of topiramate on the increasing trend of abstinence from methamphetamine, suggesting that a tailored intervention strategy is needed for treating methamphetamine addiction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.
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Knudsen, Hannah K; Roman, Paul M
Drawing on diffusion theory to further knowledge about evidence-based practices (EBPs) in the treatment of substance use disorders (SUDs), this study describes the perceived importance of innovation attributes in adoption decisions within a national sample of SUD treatment organizations. Face-to-face interviews were conducted with leaders of 307 organizations. A typology differentiated organizations reporting: (1) adoption of a treatment innovation in the past year ("recent adoption"), (2) plans to adopt an innovation in the upcoming year ("planned adoption"), or (3) no actual or planned adoption ("non-adoption"). About 30.7% of organizations reported recent adoption, 20.5% indicated planned adoption, and 48.8% were non-adopters. Leaders of organizations reporting recent adoption (n=93) or planned adoption (n=62) rated the importance of innovation attributes, including relative advantage, compatibility, complexity, and observability, on these adoption decisions using a Likert scale that ranged from 0 to 5. Innovation attributes most strongly endorsed were consistency with the program's treatment philosophy (mean=4.47, SD=1.03), improvement in the program's reputation with referral sources (mean=4.00, SD=1.33), reputational improvement with clients and their families (mean=3.98, SD=1.31), and reductions in treatment dropout (mean=3.75, SD=1.54). Innovation characteristics reflecting organizational growth and implementation costs were less strongly endorsed. Adopters and planners were generally similar in their importance ratings. There were modest differences in importance ratings when pharmacological innovations were compared to psychosocial interventions. These findings are consistent with diffusion theory and suggest that efforts to link EBPs with client satisfaction and potential reputational benefits may enhance the diffusion of EBPs. Attention to these attributes when developing and evaluating SUD treatment interventions may enhance efforts to increase
Gawin, Frank H.
The clinical characteristics of cocaine addiction, cocaine abstinence symptoms, and the short-term and long-term neurochemical actions of cocaine are discussed. The relative therapeutic value of various medications and treatment programs are discussed. (KR)
Gifford, Elizabeth; Humphreys, Keith
To discuss the contributions and future course of the psychological science of addiction. The psychology of addiction includes a tremendous range of scientific activity, from the basic experimental laboratory through increasingly broad relational contexts, including patient-practitioner interactions, families, social networks, institutional settings, economics and culture. Some of the contributions discussed here include applications of behavioral principles, cognitive and behavioral neuroscience and the development and evaluation of addiction treatment. Psychology has at times been guilty of proliferating theories with relatively little pruning, and of overemphasizing intrapersonal explanations for human behavior. However, at its best, defined as the science of the individual in context, psychology is an integrated discipline using diverse methods well-suited to capture the multi-dimensional nature of addictive behavior. Psychology has a unique ability to integrate basic experimental and applied clinical science and to apply the knowledge gained from multiple levels of analysis to the pragmatic goal of reducing the prevalence of addiction.
Inescu Cismaru, A; Andrianne, R; Triffaux, F; Triffaux, J-M
Sexual addiction or sexual dependence is characterized by hypersexuality, impaired regulation of sexual desire and sexual compulsivity, including having sex with uncontrolled excessive frequency (5 to 15 sexual acts per day for more than 6 months, from 15 years old). Between 3% and 6% of the adult population (> or =18 years) would have the characteristics of sexual addiction, disorder prevalent in the male population. The addictive processes affect three behavioral domains : motivation-reward, affect regulation and behavioral inhibition. Sex addiction is usually accompanied by other addictions, such as abuse of drugs or alcohol or sex toys that enhance sexual performance. Psychiatric comorbidities can be found : anxiety disorders, mood disorders. Several forms of treatment have been tried, using medication, cognitive-behavioral therapy and psychotherapy sessions alternated with exposure therapy in virtual reality. In this article, we will discuss the multiple definitions of hypersexuality and the possibilities of therapeutic approaches.
Vanderschuren, Louk J M J; Ahmed, Serge H
It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to extinction, increased motivation for drugs, preference for drugs over nondrug rewards, and resistance to punishment. The fact that addiction-like behavior can occur and be studied in animals gives us the exciting opportunity to investigate the neural and genetic background of drug addiction, which we hope will ultimately lead to the development of more effective treatments for this devastating disorder.
Hudson, Patricia E.
A treatment program that integrates spirituality and therapy for sex abusers who are Roman Catholic priests or brothers is described. Selections from an interview with the program director cover definitions, philosophy, women as therapists, daily activity, candidates, and the spiritual dimension. Measures of success and after-care are discussed.…
Conway, Kevin P.; Levy, Janet; Vanyukov, Michael; Chandler, Redonna; Rutter, Joni; Swan, Gary E.; Neale, Michael
Drug addiction research requires but lacks a valid and reliable way to measure both the risk (propensity) to develop addiction and the severity of manifest addiction. This paper argues for a new measurement approach and instrument to quantify propensity to and severity of addiction, based on the testable assumption that these constructs can be mapped onto the same dimension of liability to addiction. The case for this new direction becomes clear from a critical review of empirical data and the current instrumentation. The many assessment instruments in use today have proven utility, reliability, and validity, but they are of limited use for evaluating individual differences in propensity and severity. The conceptual and methodological shortcomings of instruments currently used in research and clinical practice can be overcome through the use of new technologies to develop a reliable, valid, and standardized assessment instrument(s) to measure and distinguish individual variations in expression of the underlying latent trait(s) that comprises propensity to and severity of drug addiction. Such instrumentation would enhance our capacity for drug addiction research on linkages and interactions among familial, genetic, psychosocial, and neurobiological factors associated with variations in propensity and severity. It would lead to new opportunities in substance abuse prevention, treatment, and services research, as well as in interventions and implementation science for drug addiction. PMID:20462706
Kuss, Daria J
In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that
Kuss, Daria J
In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual’s context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that
Bohnert, Amy S B; Eisenberg, Anna; Whiteside, Lauren; Price, Amanda; McCabe, Sean Esteban; Ilgen, Mark A
Differences between those who engage in nonmedical prescription opioid use for reasons other than pain relief and those who engage in nonmedical use for reasons related to pain only are not well understood. Adults in a residential treatment program participated in a cross-sectional self-report survey. Participants reported whether they used opioids for reasons other than pain relief (e.g., help sleep, improve mood, or relieve stress). Within those with past-month nonmedical opioid use (n=238), logistic regression tested differences between those who reported use for reasons other than pain relief and those who did not. Nonmedical use of opioids for reasons other than pain relief was more common (66%) than nonmedical use for pain relief only (34%), and those who used for reasons other than pain relief were more likely to report heavy use (43% vs. 11%). Nonmedical use for reasons other than pain relief was associated with having a prior overdose (odds ratio [OR]=2.54, 95% CI: 1.36-4.74) and use of heroin (OR=4.08, 95% CI: 1.89-8.79), barbiturates (OR=6.44, 95% CI: 1.47, 28.11), and other sedatives (OR=5.80, 95% CI: 2.61, 12.87). Individuals who reported nonmedical use for reasons other than pain relief had greater depressive symptoms (13.1 vs. 10.5) and greater pain medication expectancies across all three domains (pleasure/social enhancement, pain reduction, negative experience reduction). Among patients in addictions treatment, individuals who report nonmedical use of prescription opioids for reasons other than pain relief represent an important clinical sub-group with greater substance use severity and poorer mental health functioning. Published by Elsevier Ltd.
Yung, Kathryn; Eickhoff, Erin; Davis, Diane L; Klam, Warren P; Doan, Andrew P
Internet addiction disorder (IAD) is characterized by the problematic use of online video games, computer use, and mobile handheld devices. While not officially a clinical diagnosis according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals with IAD manifest severe emotional, social, and mental dysfunction in multiple areas of daily activities due to their problematic use of technology and the internet. We report a 31year-old man who exhibited problematic use of Google Glass™. The patient has a history of a mood disorder most consistent with a substance induced hypomania overlaying a depressive disorder, anxiety disorder with characteristics of social phobia and obsessive compulsive disorder, and severe alcohol and tobacco use disorders. During his residential treatment program at the Navy's Substance Abuse and Recovery Program (SARP) for alcohol use disorder, it was noted that the patient exhibited significant frustration and irritability related to not being able to use his Google Glass™. The patient exhibited a notable, nearly involuntary movement of the right hand up to his temple area and tapping it with his forefinger. He reported that if he had been prevented from wearing the device while at work, he would become extremely irritable and argumentative. Over the course of his 35-day residential treatment, the patient noted a reduction in irritability, reduction in motor movements to his temple to turn on the device, and improvements in his short-term memory and clarity of thought processes. He continued to intermittently experience dreams as if looking through the device. To our knowledge, this is the first reported case of IAD involving problematic use of Google Glass™. Published by Elsevier Ltd.
Antonio, Nelson; Diehl, Alessandra; Niel, Marcelo; Pillon, Sandra; Ratto, Lilian; Pinheiro, Maria Carolina; Silveira, Dartiu; Otani, Thais Zelia; Otani, Victor; Cordeiro, Quirino; Ushida, Ricardo
To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST) score greater than 6 points in the subgroups analyzed. A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71) and 0.37 (95CI 0.15-0.91). The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02) and 2.67 (95CI 0.98-7.25). We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012), but not in the alcohol group. Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.
Full Text Available Summary Objective: To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. Method: All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST score greater than 6 points in the subgroups analyzed. Results: A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71 and 0.37 (95CI 0.15-0.91. The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02 and 2.67 (95CI 0.98-7.25. We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012, but not in the alcohol group. Conclusion: Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.
Discusses the potential of self-help/mutual-aid groups as a way to reduce the demand for professional substance-abuse treatment and proposes a model that combines the two approaches for cost-effective and therapeutically effective networks of services. (SLD)
Marazziti, Donatella; Presta, Silvio; Baroni, Stefano; Silvestri, Stefano; Dell'Osso, Liliana
Although addictive syndromes have been traditionally related to substance-use disorders, during the last few decades a novel addictive group, including the so-called "behavioral or no-drug addictions," has been recognized and has attracted increasing attention for its relevant social impact. This group includes pathological gambling, compulsive shopping, TV/Internet/social network/videogame addictions, workaholism, sex and relationship addictions, orthorexia, and overtraining syndrome. Substance and behavioral addictions show similar phenomenological features, such as craving, dependence, tolerance, and abstinence, and perhaps they share a common possible pathophysiology. It is, however, controversial whether all or at least some of them should be considered real disorders or just normal, albeit extreme, behaviors. The aim of this article is to review current data on pharmacological treatment of behavioral addictions. As no specific and validated treatment algorithms are currently available, only an improved knowledge on their psychopathological, clinical, and neurobiological features may have relevant implications for more focused preventive and therapeutic strategies.
Resnick, Sheilagh M.; Griffiths, Mark D.
In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…
Palacios, Jose M; Pazos, Angel; Hoyer, Daniel
This paper is a personal account on the discovery and characterization of the 5-HT 2C receptor (first known as the 5-HT 1C receptor) over 30 years ago and how it translated into a number of unsuspected features for a G protein-coupled receptor (GPCR) and a diversity of clinical applications. The 5-HT 2C receptor is one of the most intriguing members of the GPCR superfamily. Initially referred to as 5-HT 1C R, the 5-HT 2C R was discovered while studying the pharmacological features and the distribution of [ 3 H]mesulergine-labelled sites, primarily in the brain using radioligand binding and slice autoradiography. Mesulergine (SDZ CU-085), was, at the time, best defined as a ligand with serotonergic and dopaminergic properties. Autoradiographic studies showed remarkably strong [ 3 H]mesulergine-labelling to the rat choroid plexus. [ 3 H]mesulergine-labelled sites had pharmacological properties different from, at the time, known or purported 5-HT receptors. In spite of similarities with 5-HT 2 binding, the new binding site was called 5-HT 1C because of its very high affinity for 5-HT itself. Within the following 10 years, the 5-HT 1C R (later named 5-HT 2C ) was extensively characterised pharmacologically, anatomically and functionally: it was one of the first 5-HT receptors to be sequenced and cloned. The 5-HT 2C R is a GPCR, with a very complex gene structure. It constitutes a rarity in the GPCR family: many 5-HT 2C R variants exist, especially in humans, due to RNA editing, in addition to a few 5-HT 2C R splice variants. Intense research led to therapeutically active 5-HT 2C receptor ligands, both antagonists (or inverse agonists) and agonists: keeping in mind that a number of antidepressants and antipsychotics are 5-HT 2C R antagonists/inverse agonists. Agomelatine, a 5-HT 2C R antagonist is registered for the treatment of major depression. The agonist Lorcaserin is registered for the treatment of aspects of obesity and has further potential in addiction
Han, Doug Hyun; Hwang, Jun Won; Renshaw, Perry F
Bupropion has been used in the treatment of patients with substance dependence based on its weak inhibition of dopamine and norepinephrine reuptake. We hypothesized that 6 weeks of bupropion sustained release (SR) treatment would decrease craving for Internet game play as well as video game cue-induced brain activity in patients with Internet video game addiction (IAG). Eleven subjects who met criteria for IAG, playing StarCraft (>30 hr/week), and eight healthy comparison subjects (HC) who had experience playing StarCraft (Internet addiction were evaluated by Beck Depression Inventory, self-report of craving on a 7-point visual analogue scale, and Young's Internet Addiction Scale, respectively. In response to game cues, IAG showed higher brain activation in left occipital lobe cuneus, left dorsolateral prefrontal cortex, and left parahippocampal gyrus than HC. After a 6 week period of bupropion SR, craving for Internet video game play, total game play time, and cue-induced brain activity in dorsolateral prefrontal cortex were decreased in the IAG. We suggest that bupropion SR may change craving and brain activity in ways that are similar to those observed in individuals with substance abuse or dependence. PsycINFO Database Record 2010 APA, all rights reserved.
Barry, Danielle; Clarke, Megan; Petry, Nancy M
Obesity is a major public health problem and notoriously difficult to treat. There are many parallels between obesity/overeating and addictions to alcohol and drugs. This paper discusses similarities between obesity and addictive disorders, including common personality characteristics, disruptive behavior syndromes, and brain mechanisms. Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention and treatment of obesity.
Barry, Danielle; Clarke, Megan; Petry, Nancy M.
Obesity is a major public health problem and notoriously difficult to treat. There are many parallels between obesity/overeating and addictions to alcohol and drugs. This paper discusses similarities between obesity and addictive disorders, including common personality characteristics, disruptive behavior syndromes, and brain mechanisms. Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention and treatment of obesity. PMID:19874165
Design paper: The CapOpus trial: A randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis
Full Text Available Abstract Background A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis. Objectives The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. Design The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1 specialized addiction treatment plus treatment as usual or 2 treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient. The primary outcome measure will be changes in amount of cannabis consumption over time. Other outcome measures will be psychosis symptoms, cognitive functioning, quality of life, social functioning, and cost-benefit analyses. Trial registration ClinicalTrials.gov NCT00484302.
A. V. Rudakova
Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.
Full Text Available Abstract Background In the last few years, excessive internet use and computer gaming have increased dramatically. Salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse have been defined as diagnostic criteria for internet addiction (IA and computer addiction (CA in the scientific community. Despite a growing number of individuals seeking help, there are no specific treatments of established efficacy. Methods/design This clinical trial aims to determine the effect of the disorder-specific manualized short-term treatment of IA/CA (STICA. The cognitive behavioural treatment combines individual and group interventions with a total duration of 4 months. Patients will be randomly assigned to STICA treatment or to a wait list control group. Reliable and valid measures of IA/CA and co-morbid mental symptoms (for example social anxiety, depression will be assessed prior to the beginning, in the middle, at the end, and 6 months after completion of treatment. Discussion A treatment of IA/CA will establish efficacy and is desperately needed. As this is the first trial to determine efficacy of a disorder specific treatment, a wait list control group will be implemented. Pros and cons of the design were discussed. Trial Registration ClinicalTrials (NCT01434589
Jäger, Susanne; Müller, Kai W; Ruckes, Christian; Wittig, Tobias; Batra, Anil; Musalek, Michael; Mann, Karl; Wölfling, Klaus; Beutel, Manfred E
In the last few years, excessive internet use and computer gaming have increased dramatically. Salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse have been defined as diagnostic criteria for internet addiction (IA) and computer addiction (CA) in the scientific community. Despite a growing number of individuals seeking help, there are no specific treatments of established efficacy. This clinical trial aims to determine the effect of the disorder-specific manualized short-term treatment of IA/CA (STICA). The cognitive behavioural treatment combines individual and group interventions with a total duration of 4 months. Patients will be randomly assigned to STICA treatment or to a wait list control group. Reliable and valid measures of IA/CA and co-morbid mental symptoms (for example social anxiety, depression) will be assessed prior to the beginning, in the middle, at the end, and 6 months after completion of treatment. A treatment of IA/CA will establish efficacy and is desperately needed. As this is the first trial to determine efficacy of a disorder specific treatment, a wait list control group will be implemented. Pros and cons of the design were discussed. ClinicalTrials (NCT01434589).
Sangho KIM; Donghyun PARK
It is intuitively plausible that the demand for cinema services may be partly driven by addiction or habit. Yet there is almost no empirical literature which tests for whether cinema demand is addictive. We estimate addiction models for cinema demand using Korean time series data from 1963 to 2004. Our estimation results indicate that (i) addictive behavior characterizes the demand for cinema services, (ii) this behavior is rational, and (iii) habit is one of most important determinants of ci...
Samadzadeh, Gholam Reza; Rigi, Tahereh; Ganjali, Ali Reza
Surveying valuable and most recent information from internet, has become vital for researchers and scholars, because every day, thousands and perhaps millions of scientific works are brought out as digital resources which represented by internet and researchers can't ignore this great resource to find related documents for their literature search, which may not be found in any library. With regard to variety of documents presented on the internet, search engines are one of the most effective search tools for finding information. The aim of this study is to evaluate the three criteria, recall, preciseness and importance of the four search engines which are PubMed, Science Direct, Google Scholar and federated search of Iranian National Medical Digital Library in addiction (prevention and treatment) to select the most effective search engine for offering the best literature research. This research was a cross-sectional study by which four popular search engines in medical sciences were evaluated. To select keywords, medical subject heading (Mesh) was used. We entered given keywords in the search engines and after searching, 10 first entries were evaluated. Direct observation was used as a mean for data collection and they were analyzed by descriptive statistics (number, percent number and mean) and inferential statistics, One way analysis of variance (ANOVA) and post hoc Tukey in Spss. 15 statistical software. P Value search engines had different operations with regard to the evaluated criteria. Since P Value was 0.004 search engines. PubMed, Science Direct and Google Scholar were the best in recall, preciseness and importance respectively. As literature research is one of the most important stages of research, it's better for researchers, especially Substance-Related Disorders scholars to use different search engines with the best recall, preciseness and importance in that subject field to reach desirable results while searching and they don't depend on just one
Full Text Available Background Drug abuse is a major problem in the communities and has many harmful effects on human body. Objectives The current study aimed to compare the efficacy of matrix method on anxiety and attitude of male crack abusers referred to addiction treatment centers in Tonkabon, Iran, in 2014. Patients and Methods The current semi -experimental study included 1,000 males referred to addiction treatment centers in Tonkabon with crack abuse history in 2014. Based on Morgan sample volume formula, 278 males with anxiety and higher attitude to drug abuse were randomly selected from 1,000 males referred to addiction treatment centers in Tonkabon. Then, 30 subjects were reselected out of them and equally assigned into two groups of experimental and control, 15 subjects in each group. The experimental group received 24 sessions of 30 - 60 minutes matrix treatment method in group, but the control group received no training. At the end of training period the post-test was carried out. The research findings confirmed the efficacy of matrix method on anxiety and attitude to crack abuse among those referring to the addition treatment center. Results The single covariance analysis of ANCOVA indicated that the value of Eta about 72% of variance of anxiety variable and about 76% of variance of drug abuse variable are taken in to account for variable of group. The intervention was effective in reducing anxiety and attitude to crack in males. Evaluating the adjusted mean showed the effectiveness of matrix method on anxiety and attitude to crack abuse in males. Conclusions The research result showed that matrix method affected the reduction of methamphetamine and attitude to crack abuse in males referred to the addition treatment center.
Bryan R. Garner
Full Text Available This study examined the extent to which changes over time in clinicians’ responses to measures of work attitude (eg, job satisfaction and psychological climate (eg, supervisor support could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians ( N = 96 being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction.
Rita de Cássia dos Santos Canabarro
Full Text Available This article analyzes the various discursive positions found in the phenomenon of addiction. The relations these discursive positions establish with the discourses of the master, the hysteric, the university and the capitalist are discussed. By analyzing material from clinical listening at a public outpatient drug and alcohol rehab center, it was seen that addiction can be described in different discourses. This article shows that the shift of focus from the symptom to the discursive position of the subject is an indicator for the clinical treatment of addiction.
Sep 17, 2014 ... Aim: To determine financial barriers that impede the utilization of screening and treatment services for breast cancer ... poor socioeconomic status (SES) groups utilized screening services and treatment more frequently than the very poor .... through possible refusal to continue with the study, incorrect.
Kraus, Mark L
No other health or social problem impacts our society so widely and profoundly as substance abuse. Investment in Connecticut's substance abuse service system is an investment in improved health and wellness its cities as well as its citizens. Since 2004 Connecticut's addiction treatment and recovery community have worked together to reduce the pain and suffering of those individuals with addiction disorders. The State of Connecticut is a national leader in addiction medicine scientific research and education, emergencyroom care, and public policy; and the Community of Addiction Recovery (CCAR) has emerged as a national leader for the recovery movement. As Chairperson ofthe CSMS's Committee on Alcohol and Other Drug Dependency Education, I am proud of the accomplishments of the Committee and the work of our statewide addiction medicine/psychiatryleaders and recovery community. I am equally proud and appreciative of the ongoing relationship of the CSMS, the addiction treatment and recovery community with DMHAS. Under the leadership of Commissioner Thomas Kirk, DMHAS has opened its arms to embrace the communities' providers. The work of these leaders is presented here to give readers an update on Addiction Medicine/Psychiatry in the State of Connecticut 2008.
... is an Investigational HIV Drug? What is a Therapeutic HIV Vaccine? What is a Preventive HIV Vaccine? HIV/ ... Exposure Prophylaxis (PEP) Pre-Exposure Prophylaxis (PrEP) HIV Treatment HIV Treatment: The Basics Just Diagnosed: Next Steps After ...
Bowen, Michael T; Neumann, Inga D
Drugs that act on the brain oxytocin (OXT) system may provide a much-needed treatment breakthrough for substance-use disorders. Targeting the brain OXT system has the potential to treat addiction to all major classes of addictive substance and to intervene across all stages of the addiction cycle. Emerging evidence suggests that OXT is able to interfere with such a wide range of addictive behaviours for such a wide range of addictive substances by rebalancing core neural systems that become dysregulated over the course of addiction. By improving our understanding of these interactions between OXT and the neural substrates of addiction, we will not only improve our understanding of addiction, but also our ability to effectively treat these devastating disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.
Li, Ming D; Wang, Ju; Niu, Tianhua; Ma, Jennie Z; Seneviratne, Chamindi; Ait-Daoud, Nassima; Saadvandi, Jim; Morris, Rana; Weiss, David; Campbell, Jan; Haning, William; Mawhinney, David J; Weis, Denis; McCann, Michael; Stock, Christopher; Kahn, Roberta; Iturriaga, Erin; Yu, Elmer; Elkashef, Ahmed; Johnson, Bankole A
Developing efficacious medications to treat methamphetamine dependence is a global challenge in public health. Topiramate (TPM) is undergoing evaluation for this indication. The molecular mechanisms underlying its effects are largely unknown. Examining the effects of TPM on genome-wide gene expression in methamphetamine addicts is a clinically and scientifically important component of understanding its therapeutic profile. In this double-blind, placebo-controlled clinical trial, 140 individuals who met the DSM-IV criteria for methamphetamine dependence were randomized to receive either TPM or placebo, of whom 99 consented to participate in our genome-wide expression study. The RNA samples were collected from whole blood for 50 TPM- and 49 placebo-treated participants at three time points: baseline and the ends of weeks 8 and 12. Genome-wide expression profiles and pathways of the two groups were compared for the responders and non-responders at Weeks 8 and 12. To minimize individual variations, expression of all examined genes at Weeks 8 and 12 were normalized to the values at baseline prior to identification of differentially expressed genes and pathways. At the single-gene level, we identified 1054, 502, 204, and 404 genes at nominal P values treatment of methamphetamine addicts significantly modulates the expression of genes involved in multiple biological processes underlying addiction behavior and other physiological functions.
Suchman, Nancy E; DeCoste, Cindy L; McMahon, Thomas J; Dalton, Rachel; Mayes, Linda C; Borelli, Jessica
Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering From the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of parent education (PE), a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and posttreatment and 3-month follow-up. Mother-child interaction quality was assessed again at 12-month follow-up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at posttreatment and 3-month follow-up. At 12-month follow-up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.
Rawson, Richard A; Rieckmann, Traci; Gust, Steven W
New scientific knowledge and effective, evidence-based interventions have provided health leaders and policymakers a remarkable paradigm to guide the development of addiction treatment services around the world. The definition of addiction as a brain disease, validated screening and assessment tools, medication-assisted treatment, and effective behavioral treatments have served as vehicles for both the United States and other countries to guide the transformation of their substance abuse treatment systems. Seeking to expand international research and infrastructure, the National Institute on Drug Abuse (NIDA)'s International Program has engaged international investigators and institutions in addiction research to promote dissemination of addiction science globally. This paper presents three mixed-methods case studies to exemplify the use of advancements in evidence-based practice in addiction treatment as guides and tools for the creation or further development of treatment systems in three countries, Vietnam, Lebanon, and Abu Dhabi. Results indicate that a framework of evidence-based medicine and empirical science creates a necessary platform from which objective conversations about addictions may begin. Other facilitative factors that help create treatment programs internationally include: a receptive and supportive government, support from international donors and technical experts, networking and interest from other international organizations, and often a synergistic and concerted effort by multiple entities and partners. Despite substantial differences in the circumstances that generated these initiatives and the varying scope of the services, common themes across these efforts have been the implementation of science-based approaches to systems transformation and support for a public health approach to addressing drug abuse and addiction.
Stumbo, Scott P; Ford, James H; Green, Carla A
A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of
Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.
There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…
Marsch, Lisa A; Dallery, Jesse
The clinical community has a growing array of psychosocial interventions with a strong evidence base available for the treatment of SUDs. Considerable opportunity exists for leveraging technology in the delivery of evidence-based interventions to promote widespread reach and impact of evidence-based care. Data from this line of research to date are promising, and underscore the potential public health impact of technology-based therapeutic tools. To fully realize the potential of technology-delivered interventions, several areas of inquiry remain important. First, scientifically sound strategies should be explored to ensure technology-based interventions are optimally designed to produce maximal behavior change. Second, efficient and effective methods should be identified to integrate technology-based interventions into systems of care in a manner that is most responsive to the needs of individual users. Third, payment, privacy, and regulatory systems should be refined and extended to go beyond electronic medical records and telehealth/distance care models, and support the deployment of technology-based systems to enhance the quality, efficiency and cost-effectiveness of care. Fourth, the mechanisms underlying behavior change derived from technology-based treatments should be explicated, including new mechanisms that may be tapped via novel, technology-based tools. Such work will be critical in isolating mechanisms that are useful in predicting treatment response, and in ensuring that key ingredients are present in technology-based interventions as they are made widely available.
Toward early estimation and treatment of addiction vulnerability: radial arm maze and N-acetyl cysteine before cocaine sensitization or nicotine self-administration in neonatal ventral hippocampal lesion rats.
Rao, Kalyan N; Sentir, Alena M; Engleman, Eric A; Bell, Richard L; Hulvershorn, Leslie A; Breier, Alan; Chambers, R Andrew
Prefrontal cortical (PFC)-hippocampal-striatal circuits, interconnected via glutamatergic signaling, are dysfunctional in mental illnesses that involve addiction vulnerability. In healthy and neurodevelopmentally altered rats, we examined how Radial Arm Maze (RAM) performance estimates addiction vulnerability, and how starting a glutamatergic modulating agent, N-acetyl cysteine (NAC) in adolescence alters adult mental illness and/or addiction phenotypes. Rats with neonatal ventral hippocampal lesions (NVHL) vs. SHAM-operated controls were randomized to NAC vs. saline in adolescence followed by cognitive testing (RAM) in early adulthood and then cocaine behavioral sensitization (experiment 1; n = 80) or nicotine self-administration (experiment 2; n = 12). In experiment 1, NVHL rats showed over-consumption of food (Froot-Loops (FL)) baiting the RAM with poor working memory (low-arm entries to repeat (ETR)), producing an elevated FL to ETR ratio ("FLETR"; p nicotine-induced reinstatement after extinction of nicotine self-administration (R 2 = 0.47, p nicotine seeking during extinction and reinstatement. These findings demonstrate the utility of animal models of mental illness with addiction vulnerability for developing novel diagnostic measures of PFC-hippocampal-striatal circuit dysfunction that may reflect addiction risk. Such tests may direct pharmacological treatments prior to adulthood and addictive drug exposure, to prevent or treat adult addictions.
Rovaris, Diego L; Mota, Nina R; Bertuzzi, Guilherme P; Aroche, Angelita P; Callegari-Jacques, Sidia M; Guimarães, Luciano S P; Pezzi, Júlio C; Viola, Thiago W; Bau, Claiton H D; Grassi-Oliveira, Rodrigo
The aim of this study was to analyze hypotheses-driven gene-environment and gene-gene interactions in smoked (crack) cocaine addiction by evaluating childhood neglect and polymorphisms in mineralocorticoid and glucocorticoid receptor genes (NR3C2 and NR3C1, respectively). One hundred thirty-nine crack/cocaine-addicted women who completed 3 weeks of follow-up during early abstinence composed our sample. Childhood adversities were assessed using the Childhood Trauma Questionnaire (CTQ), and withdrawal symptoms were assessed using the Cocaine Selective Severity Assessment (CSSA) scale. Conditional logistic regression with counterfactuals and generalized estimating equation modeling were used to test gene-environment and gene-gene interactions. We found an interaction between the rs5522-Val allele and childhood physical neglect, which altered the risk of crack/cocaine addiction (Odds ratio = 4.0, P = 0.001). Moreover, a NR3C2-NR3C1 interaction (P = 0.002) was found modulating the severity of crack/cocaine withdrawal symptoms. In the post hoc analysis, concomitant carriers of the NR3C2 rs5522-Val and NR3C1 rs6198-G alleles showed lower overall severity scores when compared to other genotype groups (P-values ≤ 0.035). This gene-environment interaction is consistent with epidemiological and human experimental findings demonstrating a strong relationship between early life stress and the hypothalamic-pituitary-adrenal (HPA) axis dysregulation in cocaine addiction. Additionally, this study extended in crack/cocaine addiction the findings previously reported for tobacco smoking involving an interaction between NR3C2 and NR3C1 genes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Schippers, Gerard M.; Schramade, Mark; Walburg, Jan A.
The Dutch substance abuse treatment system is in the middle of a major reorganization. The goal is to improve outcomes by redesigning all major primary treatment processes and by implementing a system of regular monitoring and feedback of clinical outcome data. The new program includes implementing
Santos, Veruska Andrea; Freire, Rafael; Zugliani, Moren?; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia
Background The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent men...
... symptoms of someone with a drug use problem? How Does Drug Use Become an Addiction? What Makes Someone More Likely to Get Addicted to Drugs? Does Addiction Run in Families? Why Is It So Hard to ...
Li, Nan; Wang, Jing; Wang, Xue-lian; Chang, Chong-wang; Ge, Shun-nan; Gao, Li; Wu, He-ming; Zhao, Hai-kang; Geng, Ning; Gao, Guo-dong
Opiate addiction remains intractable in a large percentage of patients, and relapse is the biggest hurdle to recovery because of psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiments, our institute started the clinical trial for the treatment of drug addicts' psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000. The short-term outcomes were encouraging and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually led to halting the surgery for addiction by the Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow-up study showed that the 5-year nonrelapse rate was 58% and the quality of life was significantly improved. Patients had several kinds of side effects, but the incidence rate was relatively low. The patients gradually recovered more than 5 years after the surgery. The side effects did not severely influence an individual's life or work. Nationwide surgery showed that the nonrelapse rate was 50% in the sample of 150 cases, from 1167 patients overall who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has a significant impact on treatment efficacy and requires further study. Because ablation is irreversible, the NAc surgery for addiction should be performed with cautiousness, and deep brain stimulation (DBS) is an ideal alternative. Copyright © 2013 Elsevier Inc. All rights reserved.
... Substance Abuse Prevention and Treatment Block Grant § 96.131 Treatment services for pregnant women. (a) The.... Programs which serve an injecting drug abuse population and who receive Block Grant funds shall give preference to treatment as follows: (1) Pregnant injecting drug users; (2) Pregnant substance abusers; (3...
DuPont, R L
Panic disorder and addiction are occasionally comorbid--4.5% of addicted patients have panic disorder, and 16% of panic disorder patients are comorbid for addiction to alcohol and other drugs. Despite these relatively low rates of comorbidity, the treatment of these two disorders is commonly confounded by issues of comorbidity, as many physicians avoid using benzodiazepines to treat panic disorder out of inappropriate fear of addiction, and not a few physicians treat panic disorder thinking that they will thereby end comorbid addiction. Sound clinical practice calls for clear identification of both panic disorder and addiction and fully effective treatments of the diseases from which the patients suffer.
Full Text Available Objective: This study aimed at comparing the degree of public health and social support in addicted and non-addicted people. Method: This study was causative-comparative and all addicts who had referred to addiction treatment centers in city of Khoy in 2012 constituted its population. From among this population, 60 addicts through convenience sampling method were selected and then peered with 60 normal subjects by age, gender, and education. The measurement tools were Goldberg Public Health (Ghq-28 and Social Support (Fleming questionnaires. Results: The results showed That Addicts enjoy a lower degree of Mental Health and Social Support. Conclusion: Providing social support for the addicts under treatment programs is one of the important factors in withdrawal from drug use.
Lenoir, Magalie; Noble, Florence
Addictions are multifactorial, and there are no experimental models replicating all aspects of this pathology. The development of animal models reproducing the clinical symptoms of addictions allows significant advances in the knowledge of the neurobiological processes involved in addiction. Preclinical data highlight different neuroadaptations according to the routes of administration, speeds of injection and frequencies of exposure to drugs of abuse. The neuroadaptations induced by an exposure to drugs of abuse follow dynamic processes in time. Despite significant progresses in the knowledge of neurobiology of addictions allowing to propose new therapeutic targets, the passage of new drugs in clinical is often disappointing. The lack of treatment efficacy reported in clinical trials is probably due to a very important heterogeneity of patients with distinct biological and genetic factors, but also with different patterns of consumption that can lead to different neuroadaptations, as clearly observed in preclinical studies. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Menecier, Pascal; Fernandez, Lydia
Addictive behavior still persists among the elderly, mainly concerning substance abuse, such as alcohol, tobacco or psychotropic drugs and addictive practices such as gambling. Illegal substances or cyber-addictions appear much less often. The environment (place of residence or care) and/or economic factors may influence behavior and practices. The incidence of somatic illness or psychiatric disorders, such as cognitive impairment among the elderly patients, complicates even further the presentation of addictive disorders and their treatment. The age factor does not seem to lessen the suffering felt by the patient and care is required in an equal manner for all ages. Prevention (maintenance of personal autonomy and quality of life throughout the ageing process) plays an essential role along with the offer of care. The lack of scientific data such as the absence of validation for adult care among the elderly, leave wide scope for epidemiological, clinical and theoretical research. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Crnić Katarina A.B.
Full Text Available Topic: Comorbidities, simultaneous occurrence of two or more disorders are common in psychiatry; therefore the concept of dual diagnosis was established due to new ethiopatogenetic dilemmas and principles of diagnosis and treatment of these conditions. The most common are comorbid affective disorders and comorbidity of drug addictions and affective disorders. Topic position in medical public: Epidemiological studies show a high percentage of comorbidity of drug addictions and depression. Various studies show that about one-third of individuals with depression have addiction, and often some other psychiatric disorders are present, such as personality disorder, anxiety, and bipolar affective disorder. Comorbid disorders exacerbate one another; have tendencies to chronicity and treatment resistance. The problem of adequate diagnosis is common; other diagnosis is neglected, leading to inadequate treatment and poor outcomes. Researches of possible causes of addiction and depression comorbidity follow different theoretical assumptions. One favor genetically determined vulnerability, the others are addressing to the impact of trauma in the formative stages of personality development. Widespread is the theoretical assumption on the deficit functioning of the same regions of the CNS and the same neurotransmitters system. In previous studies the preclinical ones dominate, which are theoretically placed in the context of the CNS of a man. Most of the research are related to dysfunction of the serotonergic and dopaminergic systems, whose influence on addiction and depression are clear, and recent studies show the importance of neuromodulators and their receptors, for example, the role of natural opioid dynorphin and 'kappa' receptors in the mesolimbic reward system. Further action: The better diagnosis would require proper screening of patients entering addiction treatments for affective disorders and vice versa. Treatment have to be combined; in addition
Rømer Thomsen, Kristine; Fjorback, Lone; Møller, Arne
The incentive sensitization theory is a promising model for understanding the mechanisms underlying drug addiction, and has received support in animal and human studies. So far the theory has not been applied to the case of behavioral addictions like Gambling Disorder, despite sharing clinical...... symptoms and underlying neurobiology. We examine the relevance of this theory for Gambling Disorder and point to predictions for future studies. The theory promises a significant contribution to the understanding of behavioral addiction and opens new avenues for treatment....
Bryson, Ethan O.; Silverstein, Jeffrey H.
Despite substantial advances in our understanding of addiction and the technology and therapeutic approaches used to fight this disease, addiction still remains a major issue in the anesthesia workplace and outcomes have not appreciably changed. While alcoholism and other forms of impairment such as addiction to other substances and mental illness impact anesthesiologists at similar rates to other professions, as recently as 2005, the drug of choice for anesthesiologists entering treatment wa...
Political economy of decentralising HIV and AIDS treatment services to primary healthcare facilities in three Nigerian states. Chinyere Mbachu, Obinna Onwujekwe, Nkoli Ezumah, Olayinka Ajayi, Olusola Sanwo, Benjamin Uzochukwu ...
U.S. Environmental Protection Agency — This GIS dataset contains data on wastewater treatment plants, based on EPA's Facility Registry Service (FRS), EPA's Integrated Compliance Information System (ICIS)...
Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert
This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…
Full Text Available Daria J KussPsychology Research and Behavior Management, Birmingham City University, Birmingham, UKAbstract: In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive
Johnson, Pennie; Cashwell, Craig S; Cress, Jim; Barber, Tim; Dunn, Mary Clayton
Pastors may understand that sex addiction exists and are frequently faced with people who need non-clinical and clinical services for the addiction. However, the pastoral counselors have no quick reliable method of assessing them. The purpose of this article is to define sexual addiction and provide information about a tool called PATHOS that can be used in clinical and non-clinical settings to identify potential sex addicts.
Daruši Dragana J.
Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the
Shannon, Kate; Bright, Vicki; Duddy, Janice; Tyndall, Mark W
Many HIV-infected women are not realizing the benefits of highly active antiretroviral therapy (HAART) despite significant advancements in treatment. Women in Vancouver's Downtown Eastside (DTES) are highly marginalized and struggle with multiple morbidities, unstable housing, addiction, survival sex, and elevated risk of sexual and drug-related harms, including HIV infection. Although recent studies have identified the heightened risk of HIV infection among women engaged in sex work and injection drug use, the uptake of HIV care among this population has received little attention. The objectives of this study are to evaluate the needs of women engaged in survival sex work and to assess utilization and acceptance of HAART. During November 2003, a baseline needs assessment was conducted among 159 women through a low-threshold drop-in centre servicing street-level sex workers in Vancouver. Cross-sectional data were used to describe the sociodemographic characteristics, drug use patterns, HIV/hepatitis C virus (HCV) testing and status, and attitudes towards HAART. High rates of cocaine injection, heroin injection, and smokeable crack cocaine use reflect the vulnerable and chaotic nature of this population. Although preliminary findings suggest an overall high uptake of health and social services, there was limited attention to HIV care with only 9% of the women on HAART. Self-reported barriers to accessing treatment were largely attributed to misinformation and misconceptions about treatment. Given the acceptability of accessing HAART through community interventions and women specific services, this study highlights the potential to reach this highly marginalized group and provides valuable baseline information on a population that has remained largely outside consistent HIV care.
Cherry, Andrew L.
Treatments for people with the co-occurring disorders of mental illness and substance use (abuse or dependence) have been evolving and improving since the mid 1980s. During this period substance abuse treatment programs reported between 50 and 75% of the people they served also had a mental health problem. At the same time, mental health programs…
Mohammad Nemat Shahi
Full Text Available Background and Objective. Drug dependence is one of the serious problems around the world. Saffron is one of those beneficial medicinal plants which is embedded with a similar mechanism to methadone (e.g., inhibition of serotonin reuptake. Thus, it can be helpful in reducing the withdrawal symptoms. The aim of this study was to reduce the daily dose of methadone usage and reduce its side effects using saffron in the form of medicinal supplements. Methodology. This study was categorized as a clinical trial. Accordingly, 44 clients of addiction treatment centers in Sabzevar parish were randomly selected to participate in this study in 2016–2017. While the experimental group was treated with methadone syrup and self-made saffron capsules, the control group received methadone syrup and placebo capsules. Results. The results showed that the use of saffron and methadone alleviated the symptoms of withdrawal syndrome (p<0.001. Conclusion. Having reviewed the research participants, it was indicated that the introduction of saffron alleviated the symptoms of withdrawal syndrome in patients undergoing maintenance treatment for opioid addiction. Thus, it seems rational to make use of saffron in combination with methadone in order to alleviate the symptoms of withdrawal syndrome.
Ait-Daoud, Nassima; Blevins, Derek; Khanna, Surbhi; Sharma, Sana; Holstege, Christopher P
Gender-related alcohol and drug abuse problems are related not only to biological differences, but also to social and environmental factors, which can influence the clinical presentation, consequences of use, and treatment approaches. Women are becoming the fastest-growing population of substance abusers in the United States. Given that women experience a more rapid progression of their addiction than men, it is important that we understand and address the differences to help develop prevention and treatment programs that are tailored for women, incorporating trauma assessment and management, identification and intervention for medical and psychiatric comorbidities, financial independence, pregnancy, and child care. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available This paper sets out to clarify the unique features of exercise addiction. It begins by examining how this addiction can be distinguished from compulsions and impulse control disorders both of which, like an addiction, involve excessive behavior that creates adverse effects. Assessment of exercise addiction also requires that clinicians be attuned to other forms of excessive behavior, especially eating disorders that can co-occur with exercise. Finally in an effort to clarify exercise addiction, this paper uses the four phases of addiction to examine the attributes of exercise that define it as a healthy habit distinct from an addiction. The paper ends with a discussion of the implications of these topics for effective assessment and treatment.
Earp, Brian D.; Wudarczyk, Olga A.; Foddy, Bennett; Savulescu, Julian
Recent research suggests that romantic love can be literally addictive. Although the exact nature of the relationship between love and addiction has been described in inconsistent terms throughout the literature, we offer a framework that distinguishes between a narrow view and a broad view of love addiction. The narrow view counts only the most extreme, harmful forms of love or love-related behaviors as being potentially addictive in nature. The broad view, by contrast, counts even basic social attachment as being on a spectrum of addictive motivations, underwritten by similar neurochemical processes as more conventional addictions. We argue that on either understanding of love-as-addiction, treatment decisions should hinge on considerations of harm and well-being rather than on definitions of disease. Implications for the ethical use of anti-love biotechnology are considered. PMID:28381923
Cañellas, Francesca; de Lecea, Luis
While it is well known that there is an interaction between sleep disorders and substance abuse, it is certainly more complex than was previously thought. There is a positive relationship both between having a substance use disorder and suffering from a sleep disorder, and vice versa. The effects on sleep depend on the substance used, but it has been shown that both during use and in withdrawal periods consumers have various sleep problems, and basically more fragmented sleep. We know that sleep problems must be taken into account to prevent addiction relapses. Recent research shows that the hypocretinergic system defined by neuropeptide hypocretin / orexin (Hcrt / ox), located in the lateral hypothalamus and involved in, among other things, the regulation of the sleep-wake cycle, may play an important role in addictive behaviors. Different studies have demonstrated interactions between the hypocretinergic system, acute response to stress circuits and reward systems. We also know that selective optogenetic activation of the hypocretinergic system increases the probability of transition from sleep to wakefulness, and is sufficient for initiating an addictive compulsive behavior relapse. Hypocretinergic system activation could explain the hyperarousal associated with stress and addiction. Improved knowledge of this interaction would help us to understand better the mechanisms of addiction and find new strategies for the treatment of addictions.
Full Text Available The specificity of accounting and taxation services in tourism business is the result of the peculiarity of tourism product offered to customers and it consequently must take into consideration two aspects of accounting in tourism and hospitality companies. Firstly, it should be determined which activity is dominant in a tourism and hospitality company. Secondly, it is possible to identify the services of tourism and hospitality companies by complying with the laws and regulations on tax, accounting and tourism. In regard to the above mentioned criterion, all the services of tourism companies can be divided into two major groups: the services of travel intermediaries as well as tourism companies which organize tours by themselves (unique, quasi-unique and non-unique tourism service. Unlike the hospitality business which provides accommodation and meals either individually or as a package, a unique tourism service is always offered within tourism offer, whereas a part of it (unique service can be provided in addition to the hospitality service too. This paper will clearly show how to provide unique tourism services independently, taking into consideration specific accounting and tax treatment different from situations when the unique tourism service is provided as a part of the hotel or hospitality service.
U.S. Department of Health & Human Services — NAHDAP acquires, preserves and disseminates data relevant to drug addiction and HIV research. By preserving and making available an easily accessible library of...
Analyzing the relationship between social networking addiction, interaction anxiousness and levels of loneliness of pre-service teachers Öğretmen adaylarının sosyal ağ bağımlılığı, etkileşim kaygısı ve yalnızlık düzeyi arasındaki ilişkinin incelenmesi
Öğretmen adaylarının sosyal ağ bağımlılığı, etkileşim kaygısı ve yalnızlık düzeyi arasındaki ilişkinin incelenmesi
In this research, it was aimed to analyze the social networking addiction of pre-service teachers in terms of various variables and evaluate the relationship between social networking addiction and loneliness and interaction anxiousness. The research was designed according to the relational screening model. The study sample included 349 pre-service teachers studying at Trakya University Faculty of Education in 2012-2013 academic year fall term. The data were obtained using Facebook Addiction ...
Resnick, Sheilagh M.; Griffiths, Mark D.
The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…
The least poor and poor socioeconomic status (SES) groups utilized screening services and treatment more frequently than the very poor and poorest SES groups (P = 0.034). There was no significant difference in the utilization of the different treatment options among the different socioeconomic groups with the exception of ...
Cullen, A J; Barnett, A; Komesaroff, P A; Brown, W; O'Brien, K S; Hall, W; Carter, A
The concept of food addiction is increasingly used in the academic literature and popular media to explain some forms of overweight and obesity. However, there is limited evidence on how this term is understood by and impacts overweight and obese individuals. This qualitative study investigated the views of overweight and obese individuals on food addiction, and its likely impact upon stigma, treatment-seeking, and support for public policies to reduce overeating. Semi-structured interviews were conducted with 23 overweight and obese individuals (M age = 38, M BMI = 33, 74% female) and analysed thematically. The concept of food addiction was consistent with many participants' personal experiences, and was accompanied by high perceptions of control and personal responsibility. Some participants believed "sugar" or "fat" addiction to be more accurate. Others were reluctant to be described as an "addict" owing to perceived negative connotations and the belief that it would increase self-stigma. Food addiction was seen as a motivator for seeking psychological services, but not pharmaceutical or surgical treatments. In light of food addiction being perceived as plausible and relevant, participants supported targeted public health policies (e.g., taxes, regulations for junk food container sizes) but did not believe these would affect their own purchasing or consumption behaviours. Education for interpreting food labels and reducing the costs of healthy foods were endorsed, leading to positive changes in food-related behaviours. This research suggests discretionary use of the food addiction label in a supportive and educational manner to minimise stigma while encouraging treatment-seeking. Copyright © 2017 Elsevier Ltd. All rights reserved.
Jacobson, Jodi M; Sacco, Paul
Fourteen million U.S. workers meet the diagnostic criteria for substance dependence, costing millions in lost productivity. Prior research suggests that employees who follow through with their Employee Assistance Program's (EAP) recommendations are more likely to participate and remain engaged in alcohol and other drug (AOD) treatment programs. This study identified rates of lifetime EAP service use for AOD problems and compared adults who reported using EAP services for AOD problems with those who used services other than EAP. Researchers analyzed a subset of participants from the National Epidemiologic Survey of Alcohol and Related Conditions who reported having received help for an AOD problem (NESARC, 2001-2002). Statistical analyses tested for differences in sociodemographic variables, lifetime mental health and substance abuse disorders, and health disability between EAP services users and users of other types of services. Among adults who sought services for AOD problems (n= 2,272), 7.58% (n= 166) reported using EAP services for these problems at some point during their lives. Major depressive disorder (lifetime), a drug use disorder (lifetime), and Black race/ethnicity were associated with a greater likelihood that someone would seek EAP services for help with their AOD problem. Results provide a foundation for researchers to understand who uses EAP services for AOD problems. Health and mental health professionals should increase their knowledge of EAP services to improve continuity of care for employees with AOD problems. EAPs are in a unique position to reach out to vulnerable employees in the workplace and engage them in treatment. Copyright © American Academy of Addiction Psychiatry.
Chung, Yong-An; Kim, Dae-Jin
Addiction to illicit drugs in one of today's most important social issues. Most addictive drugs lead to irreversible parenchymal changes in the human brain. Neuroimaging data bring to light the pharmacodynamics and pharmacokinetics of the abused drugs, and demonstrate that addiction is a disease of the brain. Continuous researches better illustrate the neurochemical alterations in brain function, and attempt to discover the links to consequent behavioral changes. Newer hypotheses and theories follow the numerous results, and more rational methods of approaching therapy are being developed. Substance abuse is on the rise in Korea, and social interest in the matter as well. On the other hand, diagnosis and treatment of drug addiction is still very difficult, because how the abused substance acts in the brain, or how it leads to behavioral problems in not widely known. Therefore, understanding the mechanism of drug addiction can improve the process of diagnosing addict patients, planning therapy, and predicting the prognosis . Neuroimaging approaches by nuclear medicine methods are expected to objectively judge behavioral and neurochemical changes, and response to treatment. In addition, as genes associated with addictive behavior are discovered, functional nuclear medicine images will aid in the assessment of individuals. Reviewing published literature on neuroimaging regarding nuclear medicine is expected to be of assistance to the management of drug addict patients. What's more, means of applying nuclear medicine to the care of drug addict patients should be investigated further
Weinstein, Aviv; Lejoyeux, Michel
Problematic Internet addiction or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that lead to impairment or distress. Currently, there is no recognition of internet addiction within the spectrum of addictive disorders and, therefore, no corresponding diagnosis. It has, however, been proposed for inclusion in the next version of the Diagnostic and Statistical Manual of Mental Disorder (DSM). To review the literature on Internet addiction over the topics of diagnosis, phenomenology, epidemiology, and treatment. Review of published literature between 2000-2009 in Medline and PubMed using the term "internet addiction. Surveys in the United States and Europe have indicated prevalence rate between 1.5% and 8.2%, although the diagnostic criteria and assessment questionnaires used for diagnosis vary between countries. Cross-sectional studies on samples of patients report high comorbidity of Internet addiction with psychiatric disorders, especially affective disorders (including depression), anxiety disorders (generalized anxiety disorder, social anxiety disorder), and attention deficit hyperactivity disorder (ADHD). Several factors are predictive of problematic Internet use, including personality traits, parenting and familial factors, alcohol use, and social anxiety. Although Internet-addicted individuals have difficulty suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for Internet addiction. Due to the lack of methodologically adequate research, it is currently impossible to recommend any evidence-based treatment of Internet addiction.
Zhang, Yi; von Deneen, Karen M; Tian, Jie; Gold, Mark S; Liu, Yijun
Obesity has become a serious epidemic and one of the leading global health problems. However, much of the current debate has been fractious, and etiologies of obesity have been attributed to eating behavior (i.e. fast food consumption), personality, depression, addiction or genetics. One of the interesting new hypotheses for explaining the development of obesity involves a food addiction model, which suggests that food is not eaten as much for survival as pleasure and that hedonic overeating is relevant to both substance-related disorders and eating disorders. Accumulating evidence has shown that there are a number of shared neural and hormonal pathways as well as distinct differences in these pathways that may help researchers discover why certain individuals continue to overeat despite health and other consequences, and becomes more and more obese. Functional neuroimaging studies have further revealed that pleasant smelling, looking, and tasting food has reinforcing characteristics similar to drugs of abuse. Many of the brain changes reported for hedonic eating and obesity are also seen in various types of addictions. Most importantly, overeating and obesity may have an acquired drive similar to drug addiction with respect to motivation and incentive craving. In both cases, the desire and continued satisfaction occur after early and repeated exposure to stimuli. The acquired drive for eating food and relative weakness of the satiety signal would cause an imbalance between the drive and hunger/reward centers in the brain and their regulation. In the current paper, we first provide a summary of literature on food addition from eight different perspectives, and then we proposed a research paradigm that may allow screening of new pharmacological treatment on the basis of functional magnetic resonance imaging (fMRI).
Banz, Barbara C; Yip, Sarah W; Yau, Yvonne H C; Potenza, Marc N
Recent progress has been made in our understanding of nonsubstance or "behavioral" addictions, although these conditions and their most appropriate classification remain debated and the knowledge basis for understanding the pathophysiology of and treatments for these conditions includes important gaps. Recent developments include the classification of gambling disorder as a "Substance-Related and Addictive Disorder" in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and proposed diagnostic criteria for Internet Gaming Disorder in Section 3 of DSM-5. This chapter reviews current neuroscientific understandings of behavioral addictions and the potential of neurobiological data to assist in the development of improved policy, prevention, and treatment efforts. © 2016 Elsevier B.V. All rights reserved.
Kozel, Nicholas J.; Brown, Barry S.
Questionnaires eliciting opinions concerning seven aspects of real or potential counselor responsibility in addiction treatment were given to ex-addict counselors, nonaddict counselors, program administrators, and clients in treatment. Ex-addict and non-addict counselors working in the same programs come to have a common view of the counseling…
Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha
Background Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., ?service users?), especially those with co-occurring issues, as well as their family members. Methods We conducted structured interviews with 73 service users and 41 family members of serv...
Murphy, Jeanne; Goodman, Daisy; Johnson, M Christina; Terplan, Mishka
The federal response to the opioid use disorder crisis has included a mobilization of resources to encourage office-based pharmacotherapy with buprenorphine, an effort culminating in the 2016 Comprehensive Addiction and Recovery Act, signed into law as Public Law 114-198. The Comprehensive Addiction and Recovery Act was designed to increase access to treatment with special emphasis on services for pregnant women and follow-up for infants affected by prenatal substance exposure. In this effort, the Comprehensive Addiction and Recovery Act laudably expands eligibility for obtaining a waiver to prescribe buprenorphine to nurse practitioners and physician assistants. However, certified nurse-midwives and certified midwives, who care for a significant proportion of pregnant and postpartum women and attend a significant proportion of births in the United States, were not included in the Comprehensive Addiction and Recovery Act legislation. In this commentary, we argue that an "all-hands" approach to providing office-based medication-assisted treatment for opioid use disorder is essential to improving access to treatment. Introduced in the House of Representatives in September 2017, the Addiction Treatment Access Improvement Act (H.R. 3692) would allow midwives to apply for the federal waiver to prescribe buprenorphine and is supported by the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives. We support this change and encourage the U.S. Congress to act quickly to allow midwives to prescribe medication-assisted treatment for pregnant women with opioid use disorder.
Viney, Linda L.; And Others
Interviewed drug addicts (N=60) in treatment and recorded descriptions of their lives. Compared their scores on a measure of anxiety with those of two other groups of people matched for sex and age. The chief element differentiating the groups was shame. Addicts expressed more guilt, loneliness, and vague worries. (BH)
Andreassen, Cecilie Schou; Pallesen, Ståle
Research into frequent, excessive, and compulsive social network activity has increased the last years, in which terms such as "social network site addiction" and "Facebook addiction" have been used interchangeably. The aim of this review is to offer more knowledge and better understanding of social network site addiction (SNS-addiction) among researchers as well as clinicians by presenting a narrative overview of the research field in terms of definition, measurement, antecedents, consequences, and treatment as well as recommendations for future research efforts. Seven different measures of SNS-addiction have been developed, although they have to a very little extent been validated against each other. The small number of studies conducted so far on this topic suggests that SNS-addiction is associated with health-related, academic, and interpersonal problems/issues. However such studies have relied on a simple cross-sectional study design. It is therefore hard to draw any conclusions about potential causality and long-term effects at this point, beyond hypothetical speculations. Empirical studies suggest that SNS-addiction is caused by dispositional factors (e.g., personality, needs, self-esteem), although relevant explanatory socio-cultural and behavioral reinforcement factors remain to be empirically explored. No well-documented treatment for SNS-addiction exists, but knowledge gained from Internet addiction treatment approaches might be transferable to SNS-addiction. Overall, the research on this topic is in its infancy, and as such the SNS-addiction construct needs further conceptual and empirical exploration. There is a great demand for studies using careful longitudinal designs and studies which include objective measures of both behavior and health based on broad representative samples.
Powell, Michael; Newgent, Rebecca A.
This article describes the development and psychometrics of the Juvenile Addiction Risk Rating. The Juvenile Addiction Risk Rating is a brief screening of addiction potential based on 10 risk factors predictive of youth alcohol and drug-related problems that assists examiners in more accurate treatment planning when self-report information is…
Jones, Karyn Dayle; Minatrea, Neresa B.
With an increase in Internet use has come the potential problem of excessive Internet usage or "Internet addiction." It is important that counselors recognize the signs and symptoms of Internet addiction. The purpose of this article is to present the characteristics, the consequences, and the emerging treatment approaches of Internet addiction.…
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Drug and alcohol addicts. 17.251 Section... Drug and alcohol addicts. A recipient that operates a general hospital or outpatient facility may not discriminate in admission or treatment against a drug or alcohol abuser or addict who is suffering from a...
Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.
McClung, Colleen A.
Drug addiction is a devastating disease that affects millions of individuals worldwide. Through better understanding of the genetic variations that create a vulnerability for addiction and the molecular mechanisms that underlie the progression of addiction, better treatment options can be created for those that suffer from this condition. Recent studies point to a link between abnormal or disrupted circadian rhythms and the development of addiction. In addition, studies suggest a role for spe...
Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M
Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.
Full Text Available Entry into the crypt William Burroughs shared with his mother opened and shut around a failed re-enactment of William Tell’s shot through the prop placed upon a loved one’s head. The accidental killing of his wife Joan completed the installation of the addictation machine that spun melancholia as manic dissemination. An early encryptment to which was added the audio portion of abuse deposited an undeliverable message in WB. Wil- liam could never tell, although his corpus bears the in- scription of this impossibility as another form of pos- sibility. James Godley is currently a doctoral candidate in Eng- lish at SUNY Buffalo, where he studies psychoanalysis, Continental philosophy, and nineteenth-century litera- ture and poetry (British and American. His work on the concept of mourning and “the dead” in Freudian and Lacanian approaches to psychoanalytic thought and in Gothic literature has also spawned an essay on zombie porn. Since entering the Academy of Fine Arts Karlsruhe in 2007, Valentin Hennig has studied in the classes of Sil- via Bächli, Claudio Moser, and Corinne Wasmuht. In 2010 he spent a semester at the Dresden Academy of Fine Arts. His work has been shown in group exhibi- tions in Freiburg and Karlsruhe.
Fernandez-Montalvo, Javier; Lopez-Goni, Jose J.; Arteaga, Alfonso
This study explored the prevalence of violent behaviors in patients who are addicted to drugs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Information on violent behaviors, sociodemographic factors, consumption factors (assessed by the European version of the Addiction Severity Index…
Mann, K; Fauth-Bühler, M; Seiferth, N; Heinz, A
The numbers of persons with a prevalence for behavioral addiction are rising especially among the young. Psychiatrists and psychotherapists are still awaiting indications for diagnostic classification and treatment approaches. We discuss the nosological aspects and suggest categorizing gambling and excessive computer and internet use as behavioral addictions. In specific cases the addiction model can also be applied for excessive sexual behavior, compulsive buying and obesity.
The easy access which modern teenagers have to new technologies favours their excessive use of video games, as they seek to escape potential existential difficulties. This harmful aspect should not mask the creative potential of games for the majority of teenagers. Treatment for young people with a gaming addiction is based on psychotherapy and takes into account the family dimension of the problem. This article presents an interview with Marc Valleur, a psychiatrist and head physician at Marmottan hospital specialising in the care and support of people with addictions.
Demet Gulec Oyekcin
Full Text Available Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some studies still emphasizes the differences between two. The aim of this article was to review clinical and biological aspects of etiological perspectives of food addiction via available clinical, preclinical and genetic studies.
Becker, Jill B
Women exhibit more rapid escalation from casual drug taking to addiction, exhibit a greater withdrawal response with abstinence, and tend to exhibit greater vulnerability than men in terms of treatment outcome. In rodents, short-term estradiol intake in female rats enhances acquisition and escalation of drug taking, motivation for drugs of abuse, and relapse-like behaviors. There is also a sex difference in the dopamine response in the nucleus accumbens. Ovariectomized female rats exhibit a smaller initial dopamine increase after cocaine treatment than castrated males. Estradiol treatment of ovariectomized female rats enhances stimulated dopamine release in the dorsolateral striatum, but not in the nucleus accumbens, resulting in a sex difference in the balance between these two dopaminergic projections. In the situation where drug-taking behavior becomes habitual, dopamine release has been reported to be enhanced in the dorsolateral striatum and attenuated in the nucleus accumbens. The sex difference in the balance between these neural systems is proposed to underlie sex differences in addiction.
Isralowitz, Richard; Bar Hamburger, Rachel
There are an estimated 25,000 heroin addicts in Israel and nearly one out of every five is a woman. Also, about one fourth of the addict population immigrated to Israel from the former Soviet Union (mostly from Russia and the Ukraine) since 1989. In this study, native born and immigrant female addicts were interviewed to develop an understanding of their background characteristics, patterns of drug use, and attitudes based on group status. Results show that the two groups of women are similar in many respects; however, differences do exist. Russian-speaking women tend to be better educated and have a greater concern about their personal health and maintaining custody of their children. Additionally, immigrant women are more inclined to use heroin and other substances while receiving treatment and are more likely to have a father who abuses alcohol. Discussion is given to the study findings as well as issues relevant to the formation of policy regarding services to female addicts in the country.
Lynch, Kevin; Curtis, Brenda
Background Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. Objective The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery. Methods We conducted a cross-sectional survey of patients in 4 intensive outpatient substance use disorder treatment facilities in Philadelphia, PA, USA. Logistic regressions were used to examine associations among variables. Results Survey participants (N=259) were mostly male (72.9%, 188/259), African American (62.9%, 163/259), with annual incomes less than US $10,000 (62.5%, 161/259), and averaged 39 (SD 12.24) years of age. The vast majority of participants (93.8%, 243/259) owned a mobile phone and about 64.1% (166/259) owned a mobile phone with app capabilities, of which 85.1% (207/243) accessed the internet mainly through their mobile phone. There were no significant differences in age, gender, ethnicity, or socio-economic status by computer usage, internet usage, number of times participants changed their phone, type of mobile phone contract, or whether participants had unlimited calling plans. The sample was grouped into 3 age groups (Millennials, Generation Xers, and Baby Boomers). The rates of having a social media account differed across these 3 age groups with significant differences between Baby Boomers and both Generation Xers and Millennials (PMillennials (P<.001). The majority of respondents (70.1%, 181/259) said they would prefer to use a relapse prevention app on their phone or receive SMS (short message service) relapse prevention text messages (72.3%, 186