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Sample records for addiction treatment providers

  1. Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction.

    PubMed

    Russell, Christopher; Davies, John B; Hunter, Simon C

    2011-03-01

    Addiction treatment providers working in the United States (n = 219) and the United Kingdom (n = 372) were surveyed about their beliefs in the disease and choice models of addiction, as assessed by the 18-item Addiction Belief Scale of J. Schaler (1992). Factor analysis of item scores revealed a three-factor structure, labeled "addiction is a disease," "addiction is a choice," and "addiction is a way of coping with life," and factor scores were analyzed in separate hierarchical multiple regression analyses. Controlling for demographic and addiction history variables, treatment providers working in the United States more strongly believe addiction is a disease, whereas U.K.-based providers more strongly believe that addiction is a choice and a way of coping with life. Beliefs that addiction is a disease were stronger among those who provide for-profit treatment, have stronger spiritual beliefs, have had a past addiction problem, are older, are members of a group of addiction professionals, and have been treating addiction longer. Conversely, those who viewed addiction as a choice were more likely to provide public/not-for-profit treatment, be younger, not belong to a group of addiction professionals, and have weaker spiritual beliefs. Additionally, treatment providers who have had a personal addiction problem in the past were significantly more likely to believe addiction is a disease the longer they attend a 12-step-based group and if they are presently abstinent. PMID:21036516

  2. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2000-01-01

    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.

  3. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, S.L.; Brodie, J.D.; Ashby, C.R. Jr.

    2000-05-02

    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.

  4. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2004-12-07

    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.

  5. Psychostimulant addiction treatment

    PubMed Central

    Phillips, Karran A.; Epstein, David H.; Preston, Kenzie L.

    2014-01-01

    Treatment of psychostimulant addiction has been a major, and not fully met, challenge. For opioid addiction, there is strong evidence for the effectiveness of several medications. For psychostimulants, there is no corresponding form of agonist maintenance that has met criteria for regulatory approval or generally accepted use. Stimulant-use disorders remain prevalent and can result in both short-term and long-term adverse consequences. The mainstay of treatment remains behavioral interventions. In this paper, we discuss those interventions and some promising candidates in the search for pharmacological interventions. PMID:24727297

  6. Treatment of internet addiction.

    PubMed

    Huang, Xui-qin; Li, Meng-chen; Tao, Ran

    2010-10-01

    Internet addiction (IA) is a prevalent, highly comorbid, and significantly impairing disorder. Although many psychotherapeutic approaches and psychotropic medications have been recommended and some of the psychotherapeutic approaches and a few pharmacotherapy strategies have been studied, treatment of IA is generally in its early stages. This article reviews theoretical descriptions of psychotherapy and the effects of psychosocial treatment and pharmacologic treatment. We also outline our own treatment model of IA.

  7. Addiction treatment provider attitudes on staff capacity and evidence-based clinical training: results from a national study.

    PubMed

    Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia

    2011-01-01

    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. 

  8. Addiction treatment provider attitudes on staff capacity and evidence-based clinical training: results from a national study.

    PubMed

    Lundgren, Lena; Amodeo, Maryann; Krull, Ivy; Chassler, Deborah; Weidenfeld, Rachel; de Saxe Zerden, Lisa; Gowler, Rebekah; Lederer, Jaime; Cohen, Alexander; Beltrame, Clelia

    2011-01-01

    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.  PMID:21477056

  9. Training the next generation of providers in addiction medicine.

    PubMed

    Rasyidi, Ernest; Wilkins, Jeffery N; Danovitch, Itai

    2012-06-01

    benefits. 5. The equalizer is prescription drug abuse, which is increasing recognition of addiction among populations where it was previously ignored or denied. The first three activities will create a medical office “experience” that is largely unknown but carries the power to change the perception of addiction: patients visiting their primary care physicians, who then screen them for addiction problems and give the same attention to treatment and prevention of addiction problems as they might give to treatment and prevention of cardiovascular disease and other medical issues. The personal experience of the aforementioned medical scene by members of US society may also provide a very positive impact on psychiatrists, including those who specialize in addiction medicine. It is quite possible that the recognition of addiction medicine as a traditional medical subspecialty as well as the integration of addiction throughout medicine will precede any substantive change in the integration of mental health care with the rest of medicine. Yet, any integration of addiction within the entire field of medicine may open a path for mental health to follow. Psychiatrists, including those who are addiction experts, need to be a part of this new medical integration process. Being a part of new treatment models is why we proposed six future skillsets for psychiatrists who specialize in addiction. The selection of these proposed skillsets anticipates an integrated health care team utilizing some form of a patient-centered approach-three are skillsets that are already required, while the last three address new skillsets that will be helpful in working with the integrative health care team model. Whatever form the future of addiction care takes, psychiatrists who specialize in addiction medicine can provide positive and core contributions as expert addiction and mental health consultants including: 1. How does one screen for major depression and/or an anxiety disorder and also determine

  10. Process Improvement Education with Professionals in the Addiction Treatment Field

    ERIC Educational Resources Information Center

    Pulvermacher, Alice

    2006-01-01

    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.…

  11. [Cognitive remediation in addictions treatment].

    PubMed

    Pedrero-Perez, E J; Rojo-Mota, G; Ruiz-Sanchez de Leon, J M; Llanero-Luque, M; Puerta-Garcia, C

    2011-02-01

    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. PMID:21287493

  12. [Cognitive remediation in addictions treatment].

    PubMed

    Pedrero-Perez, E J; Rojo-Mota, G; Ruiz-Sanchez de Leon, J M; Llanero-Luque, M; Puerta-Garcia, C

    2011-02-01

    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.

  13. Assessment and treatment of addictions in primary care.

    PubMed

    Ravetti, L M

    2000-01-01

    Most clinicians are faced with the challenge of providing care and treatment for patients who experience the chronic relapsing brain disease known as addiction. The purpose of this article is to increase awareness of techniques and tools available to primary care clinicians (PCCs) for assessing and treating addictions in the office or clinic setting. A review of the history, physical examination, laboratory tests, and diagnostics relevant to addictive illness will help PCCs to hone their skills in addiction management. Addiction screening instruments and brief interventions used in primary care are presented. Adjunct therapies designed to promote the biopsychosocial and spiritual well-being of patients who are addicted have shown promise. PMID:11271125

  14. Treatment of addiction and addiction-related behavior

    SciTech Connect

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2003-01-01

    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.

  15. Naltrexone: A Pan-Addiction Treatment?

    PubMed

    Aboujaoude, Elias; Salame, Wael O

    2016-08-01

    Addiction is a major public health problem with few efficacious and safe treatments. The goal of this review is to provide an evidence-based assessment of the therapeutic role of the opioid antagonist naltrexone across the addiction spectrum-substance-based and behavioral. The PubMed database was searched for randomized, placebo-controlled clinical trials that investigated the oral or intramuscular long-acting formulation of naltrexone in substance use disorders or behavioral addictions such as pathological gambling, kleptomania, and trichotillomania. Thirty-nine efficacy studies were retrieved, covering alcohol use disorder (n = 22), opioid use disorder (n = 6), nicotine use disorder (n = 5), stimulant use disorder (n = 2), gambling disorder (n = 2), trichotillomania (n = 1), and kleptomania (n = 1). Despite the very different presentations within and between both addiction categories, the data, as a whole, show consistency in favor of naltrexone's relative efficacy and safety. Given the potential benefit and good tolerability revealed in the studies, the high morbidity associated with addiction, and the dearth of alternate treatments, naltrexone would seem like an underutilized treatment option. Further, naltrexone's seemingly broad anti-addiction efficacy supports a shared role for brain opioid pathways in the pathophysiology of addiction, broadly defined. More studies investigating the efficacy and tolerability of naltrexone and other opioid modulators are warranted. Studies should also further examine the effect of combining psychotherapy with naltrexone, as well as the potential role of naltrexone in treating comorbid addictions. PMID:27401883

  16. Behavioral Therapy, Incentives Enhance Addiction Treatment

    MedlinePlus

    ... Issue Past Issues Research News From NIH Behavioral Therapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents For ... their addiction to marijuana can benefit from a treatment program that combines motivational incentives with cognitive-behavioral ...

  17. Pharmacogenetic Treatments for Drug Addiction

    PubMed Central

    Haile, Colin N.; Kosten, Thomas R.; Kosten, Therese A.

    2009-01-01

    Background Pharmacogenetics uses genetic variation to predict individual differences in response to medications and holds much promise to improve treatment of addictive disorders. Objectives To review how genetic variation affects responses to cocaine, amphetamine, and methamphetamine and how this information may guide pharmacotherapy. Methods We performed a cross-referenced literature search on pharmacogenetics, cocaine, amphetamine, and methamphetamine. Results We describe functional genetic variants for enzymes dopamine-beta-hydroxylase (DβH), catechol-O-methyltransferase (COMT), and dopamine transporter (DAT1), dopamine D4 receptor, and brain-derived neurotrophic factor (BDNF). A single nucleotide polymorphism (SNP; C-1021T) in the DβH gene is relevant to paranoia associated with disulfiram pharmacotherapy for cocaine addiction. Individuals with variable number tandem repeats (VNTR) of the SLC6A3 gene 3′-untranslated region polymorphism of DAT1 have altered responses to drugs. The 10/10 repeat respond poorly to methylphenidate pharmacotherapy and the 9/9 DAT1 variant show blunted euphoria and physiological response to amphetamine. COMT, D4 receptor, and BDNF polymorphisms are linked to methamphetamine abuse and psychosis. Conclusions Disulfiram and methylphenidate pharmacotherapies for cocaine addiction are optimized by considering polymorphisms affecting DβH and DAT1 respectively. Altered subjective effects for amphetamine in DAT1 VNTR variants suggest a ‘protected’ phenotype. Scientific Significance Pharmacogenetic-based treatments for psychostimulant addiction are critical for successful treatment. PMID:19462300

  18. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2005-05-10

    The present invention relates to the use of a composition that increases central nervous system GABA levels in a mammal, for the treatment of addiction to drugs of abuse and modification of behavior associated with addiction to drugs of abuse in said mammal.

  19. Classic hallucinogens in the treatment of addictions.

    PubMed

    Bogenschutz, Michael P; Johnson, Matthew W

    2016-01-01

    Addictive disorders are very common and have devastating individual and social consequences. Currently available treatment is moderately effective at best. After many years of neglect, there is renewed interest in potential clinical uses for classic hallucinogens in the treatment of addictions and other behavioral health conditions. In this paper we provide a comprehensive review of both historical and recent clinical research on the use of classic hallucinogens in the treatment of addiction, selectively review other relevant research concerning hallucinogens, and suggest directions for future research. Clinical trial data are very limited except for the use of LSD in the treatment of alcoholism, where a meta-analysis of controlled trials has demonstrated a consistent and clinically significant beneficial effect of high-dose LSD. Recent pilot studies of psilocybin-assisted treatment of nicotine and alcohol dependence had strikingly positive outcomes, but controlled trials will be necessary to evaluate the efficacy of these treatments. Although plausible biological mechanisms have been proposed, currently the strongest evidence is for the role of mystical or other meaningful experiences as mediators of therapeutic effects. Classic hallucinogens have an excellent record of safety in the context of clinical research. Given our limited understanding of the clinically relevant effects of classic hallucinogens, there is a wealth of opportunities for research that could contribute important new knowledge and potentially lead to valuable new treatments for addiction. PMID:25784600

  20. Classic hallucinogens in the treatment of addictions.

    PubMed

    Bogenschutz, Michael P; Johnson, Matthew W

    2016-01-01

    Addictive disorders are very common and have devastating individual and social consequences. Currently available treatment is moderately effective at best. After many years of neglect, there is renewed interest in potential clinical uses for classic hallucinogens in the treatment of addictions and other behavioral health conditions. In this paper we provide a comprehensive review of both historical and recent clinical research on the use of classic hallucinogens in the treatment of addiction, selectively review other relevant research concerning hallucinogens, and suggest directions for future research. Clinical trial data are very limited except for the use of LSD in the treatment of alcoholism, where a meta-analysis of controlled trials has demonstrated a consistent and clinically significant beneficial effect of high-dose LSD. Recent pilot studies of psilocybin-assisted treatment of nicotine and alcohol dependence had strikingly positive outcomes, but controlled trials will be necessary to evaluate the efficacy of these treatments. Although plausible biological mechanisms have been proposed, currently the strongest evidence is for the role of mystical or other meaningful experiences as mediators of therapeutic effects. Classic hallucinogens have an excellent record of safety in the context of clinical research. Given our limited understanding of the clinically relevant effects of classic hallucinogens, there is a wealth of opportunities for research that could contribute important new knowledge and potentially lead to valuable new treatments for addiction.

  1. Principles of Drug Addiction Treatment: A Research-Based Guide.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    This booklet can function as a resource for counselors, counselors in training, or anyone else who works with or knows someone who is addicted to drugs. It begins by identifying 13 principles of effective treatment for drug abusers. It then provides answers to 11 frequently asked questions regarding drug addiction treatment. Next it discusses drug…

  2. Phenomenology and treatment of behavioural addictions.

    PubMed

    Grant, Jon E; Schreiber, Liana R N; Odlaug, Brian L

    2013-05-01

    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.

  3. [Safety of nicotine addiction treatment].

    PubMed

    Korzeniowska, Katarzyna; Cieślewicz, Artur; Jabłecka, Anna

    2013-01-01

    Not all smoking addicts can succeed in quitting smoking with willpower only. These people may use nicotine replacement therapy (patches, gums, lozenges, sublingual tablets, inhalers), medicines (bupropion, varenicline and cytisine) and psychological aid. Each drug, besides its therapeutic effect, creates the risk of adverse reactions which number and severity is not always accepted by the patient. The aim of the study was to analyze adverse effects of bupropion, varenicline and cytisine formulations reported by patients. From July 2011 to June 2013 Regional Centre for Monitoring Adverse Drug Reactions (Department of Clinical Pharmacology, Department of Cardiology, Poznan University of Medical Sciences) recorded 32 suspected adverse reactions to the use of drugs for the treatment of nicotine addiction (12 after the preparation of cytisine and varenicline, 8 after preparations of bupropion). High determination caused that none of the patients withdrew from the therapy because of adverse effects.

  4. Treatment of addiction to ethanol and addictive-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2001-01-01

    The present invention provides a highly efficient method for treating alcohol addiction and for changing addiction-related behavior of a mammal suffering from alcohol addiction. The method includes administering to a mammal 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 increase central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of alcohol.

  5. [Addiction].

    PubMed

    Besson, J; Eap, C B; Khazaal, Y; Montagrin, Y; Rihs-Middel, M; Simon, O; Tissot, H; Tomei, A; Zumwald, C; Zullino, D

    2008-01-01

    This year review emphasizes four aspects coming from addiction psychiatry: 1. Initiation and maintenance of cannabis use. 2. Methadone and heart toxicity. 3. Suicidal behaviour in gambling. 4. Treatment of addictive disorders via internet: present and future perspectives. PMID:18251208

  6. Treatment of addiction and addiction-related behavior

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2003-07-15

    The present invention provides a method for changing addiction-related behavior of a mammal suffering from addiction to a combination of abused drugs. The method includes administering to the mammal an effective amount of gamma vinylGABA (GVG) or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof, wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of the combination of abused drugs.

  7. Treatment of PCP addiction and PCP addiction-related behavior

    SciTech Connect

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2002-01-01

    The present invention provides a method for changing addiction-related behavior of a mammal suffering from addiction to phencyclidine (PCP). The method includes administering to the mammal an effective amount of gamma vinylGABA (GVG) or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof, wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of PCP.

  8. [Addiction].

    PubMed

    Besson, Jacques; Grivel, Jeremy; Tomei, Alexander; Falcheri, Jean-Phillipe; Rougemont-Bücking, Ansgar; Khazaal, Yasser

    2014-01-15

    The news in addiction medicine in 2013 are presented according to the new version of the DSM (DSM-5); new data on cannabinoid, highlight hypotheses on self-medication; a current status about treatment of the addiction via the internet is shown; and new therapeutic perspectives emerge from the knowledge on traumatic antecedents in addictive populations.

  9. [Vaccines for the treatment of drug addiction].

    PubMed

    Zorzoli, Ermanno; Marino, Maria Giulia; Bagnato, Barbara; Franco, Elisabetta

    2016-01-01

    The treatment of drug addiction is a very wide-ranging sector within modern medicine. The use of immunotherapy in this context represents an innovative approach. The purpose of this paper is to illustrate, through a literature review, the main avenues of research and the results obtained with immunotherapy in the treatment of drug addiction. PMID:27077562

  10. Pharmacogenetics of alcohol, nicotine and drug addiction treatments.

    PubMed

    Sturgess, Jessica E; George, Tony P; Kennedy, James L; Heinz, Andreas; Müller, Daniel J

    2011-07-01

    The numerous premature deaths, medical complications and socio-economic repercussions of drug and alcohol addiction suggest that improvements in treatment strategies for addictive disorders are warranted. The use of pharmacogenetics to predict response to medication, side effects and appropriate dosages is relatively new in the field of drug addiction. However, increasing our understanding of the genetic factors influencing these processes may improve the treatment of addiction in the future. We examined the available scientific literature on pharmacogenetic advancements in the field of drug addiction with a focus on alcohol and tobacco to provide a summary of genes implicated in the effectiveness of pharmacotherapy for addiction. In addition, we reviewed pharmacogenetic research on cocaine and heroin dependence. Thus far, the most promising results were obtained for polymorphisms in the OPRM1 and CYP2A6 genes, which have been effective in predicting clinical response to naltrexone in alcoholism and nicotine replacement therapy in smoking, respectively. Opinions differ as to whether pharmacogenetic testing should be implemented in the clinic at this time because clinical utility and cost-effectiveness require further investigation. However, the data summarized in this review demonstrate that pharmacogenetic factors play a role in response to addiction pharmacotherapy and have the potential to aid in the personalization of addiction treatments. Such data may lead to improved cessation rates by allowing physicians to select medications for individuals based, at least in part, on genetic factors that predispose to treatment success or failure rather than on a trial and error basis. PMID:21362114

  11. Evaluation and treatment of sex addiction.

    PubMed

    Rosenberg, Kenneth Paul; Carnes, Patrick; O'Connor, Suzanne

    2014-01-01

    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.

  12. Pharmacological maintenance treatments of opiate addiction.

    PubMed

    Bell, James

    2014-02-01

    For people seeking treatment, the course of heroin addiction tends to be chronic and relapsing, and longer duration of treatment is associated with better outcomes. Heroin addiction is strongly associated with deviant behaviour and crime, and the objectives in treating heroin addiction have been a blend of humane support, rehabilitation, public health intervention and crime control. Reduction in street heroin use is the foundation on which all these outcomes are based. The pharmacological basis of maintenance treatment of dependent individuals is to minimize withdrawal symptoms and attenuate the reinforcing effects of street heroin, leading to reduction or cessation of street heroin use. Opioid maintenance treatment can be moderately effective in suppressing heroin use, although deviations from evidence-based approaches, particularly the use of suboptimal doses, have meant that treatment as delivered in practice may have resulted in poorer outcomes than predicted by research. Methadone treatment has been 'programmatic', with a one-size-fits-all approach that in part reflects the perceived need to impose discipline on deviant individuals. However, differences in pharmacokinetics and in side-effects mean that many patients do not respond optimally to methadone. Injectable diamorphine (heroin) provides a more reinforcing medication for some 'nonresponders' and can be a valuable option in the rehabilitation of demoralized, socially excluded individuals. Buprenorphine, a partial agonist, is a less reinforcing medication with different side-effects and less risk of overdose. Not only is it a different medication, but also it can be used in a different paradigm of treatment, office-based opioid treatment, with less structure and offering greater patient autonomy.

  13. Pharmacological maintenance treatments of opiate addiction

    PubMed Central

    Bell, James

    2014-01-01

    For people seeking treatment, the course of heroin addiction tends to be chronic and relapsing, and longer duration of treatment is associated with better outcomes. Heroin addiction is strongly associated with deviant behaviour and crime, and the objectives in treating heroin addiction have been a blend of humane support, rehabilitation, public health intervention and crime control. Reduction in street heroin use is the foundation on which all these outcomes are based. The pharmacological basis of maintenance treatment of dependent individuals is to minimize withdrawal symptoms and attenuate the reinforcing effects of street heroin, leading to reduction or cessation of street heroin use. Opioid maintenance treatment can be moderately effective in suppressing heroin use, although deviations from evidence-based approaches, particularly the use of suboptimal doses, have meant that treatment as delivered in practice may have resulted in poorer outcomes than predicted by research. Methadone treatment has been ‘programmatic’, with a one-size-fits-all approach that in part reflects the perceived need to impose discipline on deviant individuals. However, differences in pharmacokinetics and in side-effects mean that many patients do not respond optimally to methadone. Injectable diamorphine (heroin) provides a more reinforcing medication for some ‘nonresponders’ and can be a valuable option in the rehabilitation of demoralized, socially excluded individuals. Buprenorphine, a partial agonist, is a less reinforcing medication with different side-effects and less risk of overdose. Not only is it a different medication, but also it can be used in a different paradigm of treatment, office-based opioid treatment, with less structure and offering greater patient autonomy. PMID:23210630

  14. Strategies for Incorporating Women-Specific Sexuality Education into Addiction Treatment Models

    ERIC Educational Resources Information Center

    James, Raven

    2007-01-01

    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…

  15. A Canadian perspective on addiction treatment.

    PubMed

    El-Guebaly, Nady

    2014-01-01

    This paper presents a synopsis of addiction treatment in Canada, along with some available comparative figures with other North American countries. Within the framework of Canada's Medicare, a largely single-payer system, addiction and psychiatric disorders are insured on par with other medical disorders. Canada's strategy recognizes the four pillars of prevention, treatment, harm reduction, and enforcement. The Canadian Alcohol and Drug Use Monitoring Survey is the yearly main source of data on alcohol and illicit drug use. The main features of the Canadian addiction treatment network are identified as a "top 10" list, outlining early identification and intervention, assessment, and referral; detoxification; ambulatory care/day treatment programs; residential care; hospitals; concurrent disorders networks and regionalization; drug specific strategies; mutual help; behavioral addictions; and training, qualification, and research.

  16. The business of addiction treatment: A research agenda.

    PubMed

    Kimberly, John R; McLellan, A Thomas

    2006-10-01

    The social and economic costs of addiction are substantial and of great concern to society. Research in the past decade has led to promising therapies that appear to be highly effective but not widely diffused. This leads one to wonder if there is something about the structure, dynamics, or structure and dynamics of the addiction treatment industry that is getting in the way. However, there has been very little research in the areas of organization, finance, or management practices within the substance abuse treatment field-the kinds of issues that reduce the potential impact of addiction treatment industrywide. With this as background, this article introduces the Center for Organization and Management in Addiction Treatment (COMAT) and a special section on research in the "business of addiction treatment." Many other industries have experienced significant problems that are similar, in many respects, to those seen in substance abuse treatment, but research in leadership, innovation, investment, organization, and consolidation strategies has helped to overcome those problems. COMAT is dedicated to implementing and testing evidence-based methods from other industries to improve the outcomes performance and, ultimately, the clinical effectiveness of service providers in the addiction treatment field.

  17. Food addiction-diagnosis and treatment.

    PubMed

    Dimitrijević, Ivan; Popović, Nada; Sabljak, Vera; Škodrić-Trifunović, Vesna; Dimitrijević, Nina

    2015-03-01

    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.

  18. Food addiction-diagnosis and treatment.

    PubMed

    Dimitrijević, Ivan; Popović, Nada; Sabljak, Vera; Škodrić-Trifunović, Vesna; Dimitrijević, Nina

    2015-03-01

    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. PMID:25751444

  19. The concept of reentry in the addicted anesthesia provider.

    PubMed

    Valdes, Jorge A

    2014-04-01

    Substance abuse among healthcare providers is a serious issue affecting patient care and patient outcomes. Substance abuse among anesthesia providers is of extreme concern because of the type of drugs and easy access providers are granted. Impaired anesthesia providers jeopardize not only their own safety but also the safety of their patients. Accidental death of either the healthcare provider or the patient is often the unfortunate first sign of addiction among anesthesia providers. Most states, in the United States offer treatment programs for anesthesia providers as an option to disciplinary action, and on completion of the Substance abuse is the primary occupational program, the provider is allowed to reenter practice. Successful reentry is sometimes rare, and providers are plagued with the stigma of abuse, shame, and a high incidence of relapse. This article is an analysis of the concept of reentry into anesthesia practice, using Walker and Avant's model of concept analysis. Tenets of successful reentry are discussed. Implications for further concept analysis, practice, and research are presented. PMID:24902450

  20. Treatment Approaches for Drug Addiction

    MedlinePlus

    ... Charts Emerging Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine ... Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use ...

  1. Treating addiction with tunes: a systematic review of music therapy for the treatment of patients with addictions.

    PubMed

    Mays, Kara L; Clark, David L; Gordon, Adam J

    2008-01-01

    Music therapy is the use of musical interventions in a therapeutic setting to accomplish health-related goals. Descriptions of music therapy exist in the peer-reviewed literature and indicate potential use of music therapy in treatment of patients with addiction disorders. This systematic review describes and compares the types of music therapy demonstrated in the literature and evaluates the evidence that music therapy improves outcomes of patients with addictions. A search and critical review of all the existing published literature on music therapy for the treatment of addictions was conducted using online databases and secondary search strategies. Few studies quantitatively assess the use of music therapy in the treatment of patients with addictions. Music listening provided by music therapists is commonly studied. Music therapy sessions reported were additive, not independent, treatment modalities. In the literature, no consensus exists regarding of the efficacy of music therapy as treatment for patients with addictions. PMID:19042198

  2. Biological Contributions to Addictions in Adolescents and Adults: Prevention, Treatment and Policy Implications

    PubMed Central

    Potenza, Marc N.

    2012-01-01

    Purpose 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. Method 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. Results 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. Conclusions 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. PMID:23332567

  3. Integrating Primary Medical Care With Addiction Treatment

    PubMed Central

    Weisner, Constance; Mertens, Jennifer; Parthasarathy, Sujaya; Moore, Charles; Lu, Yun

    2010-01-01

    Context The prevalence of medical disorders is high among substance abuse patients, yet medical services are seldom provided in coordination with substance abuse treatment. Objective To examine differences in treatment outcomes and costs between integrated and independent models of medical and substance abuse care as well as the effect of integrated care in a subgroup of patients with substance abuse–related medical conditions (SAMCs). Design Randomized controlled trial conducted between April 1997 and December 1998. Setting and Patients Adult men and women (n=592) who were admitted to a large health maintenance organization chemical dependency program in Sacramento, Calif. Interventions Patients were randomly assigned to receive treatment through an integrated model, in which primary health care was included within the addiction treatment program (n=285), or an independent treatment-as-usual model, in which primary care and substance abuse treatment were provided separately (n=307). Both programs were group based and lasted 8 weeks, with 10 months of aftercare available. Main Outcome Measures Abstinence outcomes, treatment utilization, and costs 6 months after randomization. Results Both groups showed improvement on all drug and alcohol measures. Overall, there were no differences in total abstinence rates between the integrated care and independent care groups (68% vs 63%, P=.18). For patients without SAMCs, there were also no differences in abstinence rates (integrated care, 66% vs independent care, 73%; P=.23) and there was a slight but nonsignificant trend of higher costs for the integrated care group ($367.96 vs $324.09, P=.19). However, patients with SAMCs (n=341) were more likely to be abstinent in the integrated care group than the independent care group (69% vs 55%, P=.006; odds ratio [OR], 1.90; 95% confidence interval [CI], 1.22-2.97). This was true for both those with medical (OR, 3.38; 95% CI, 1.68-6.80) and psychiatric (OR, 2.10; 95% CI, 1

  4. Neuroscience of behavioral and pharmacological treatments for addictions

    PubMed Central

    Potenza, Marc N.; Sofuoglu, Mehmet; Carroll, Kathleen M.; Rounsaville, Bruce J.

    2011-01-01

    Summary Although substantial advances have been made in behavioral and pharmacological treatments for addictions, moving treatment development to the next stage may require novel ways of approaching addictions, particularly those derived from new findings regarding of the neurobiological underpinnings of addictions, while assimilating and incorporating relevant information from earlier approaches. In this review, we first briefly review theoretical and biological models of addiction and then describe existing behavioral and pharmacologic therapies for the addictions within this framework. We then propose new directions for treatment development and targets that are informed by recent evidence regarding the heterogeneity of addictions and the neurobiological contributions to these disorders. PMID:21338880

  5. Providing free heroin to addicts participating in research – ethical concerns and the question of voluntariness

    PubMed Central

    Henden, Edmund; Bærøe, Kristine

    2015-01-01

    Providing heroin to people with heroin addiction taking part in medical trials assessing the effectiveness of the drug as a treatment alternative breaches ethical research standards, some ethicists maintain. Heroin addicts, they say, are unable to consent voluntarily to taking part in these trials. Other ethicists disagree. In our view, both sides of the debate have an inadequate understanding of ‘voluntariness’. In this article we therefore offer a fuller definition of the concept, one which allows for a more flexible, case-to-case approach in which some heroin addicts are considered capable of consenting voluntarily, others not. An advantage of this approach, it is argued, is that it provides a safety net to minimise the risk of inflicting harm on trial participants. PMID:26191421

  6. Criminological profile of patients in addiction treatment.

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso; Cacho, Raúl

    2013-01-01

    This study explores the prevalence of criminal behaviour in patients addicted to drugs who are in treatment. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment at a specialized centre was assessed. Information on criminal behaviours, socio-demographic factors, consumption factors (assessed by the EuropAsi), psychopathological factors (assessed by SCL-90-R) and personality variables (assessed by MCMI-II) was collected. Patients presenting criminal behaviour were compared with those who were not associated with crime for all the variables studied. The rate of drug-addicted patients with criminal behaviour in this sample was 60.3% (n = 150), and it was mainly related to traffic offenses, followed by drug dealing offenses. Significant differences were observed between patients with and without criminal behaviour. Patients with criminal problems were mostly men and single. Moreover, they were more likely to report poly-consumption. Furthermore, significant differences were observed on several variables: EuropAsi, SCL-90-R and MCMI-II. According to these results, patients with associated criminal behaviour presented a more severe addiction problem. The implications of these findings for clinical practice and future research are discussed.

  7. Criminological profile of patients in addiction treatment.

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso; Cacho, Raúl

    2013-01-01

    This study explores the prevalence of criminal behaviour in patients addicted to drugs who are in treatment. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment at a specialized centre was assessed. Information on criminal behaviours, socio-demographic factors, consumption factors (assessed by the EuropAsi), psychopathological factors (assessed by SCL-90-R) and personality variables (assessed by MCMI-II) was collected. Patients presenting criminal behaviour were compared with those who were not associated with crime for all the variables studied. The rate of drug-addicted patients with criminal behaviour in this sample was 60.3% (n = 150), and it was mainly related to traffic offenses, followed by drug dealing offenses. Significant differences were observed between patients with and without criminal behaviour. Patients with criminal problems were mostly men and single. Moreover, they were more likely to report poly-consumption. Furthermore, significant differences were observed on several variables: EuropAsi, SCL-90-R and MCMI-II. According to these results, patients with associated criminal behaviour presented a more severe addiction problem. The implications of these findings for clinical practice and future research are discussed. PMID:23748943

  8. Pharmacotherapy in the treatment of addiction: methadone.

    PubMed

    Kreek, Mary Jeanne; Borg, Lisa; Ducat, Elizabeth; Ray, Brenda

    2010-04-01

    Methadone maintenance treatment (MMT) is the most widely available pharmacotherapy for opioid addiction and has been shown to be an effective and safe treatment over a period of 40 years. Although women comprise approximately 40% of clients currently being treated in MMT programs, comparatively little research geared specifically toward this group has been published. This article begins with an overview of neurobiological studies on opioid addiction, including a discussion of gender differences, followed by a review of the pharmacology of methadone. The authors then examine the particular needs and differences of women being treated in MMTs, including co-dependence with other substances, women's health issues, and psychosocial needs unique to this population. Research shows that women have different substance abuse treatment needs in comparison to their male counterparts. One New York City MMT program that has attempted to address these differences is highlighted.

  9. Pharmacotherapy in the Treatment of Addiction: Methadone

    PubMed Central

    Kreek, Mary Jeanne; Borg, Lisa; Ducat, Elizabeth; Ray, Brenda

    2010-01-01

    Methadone maintenance treatment is the most widely available pharmacotherapy for opioid addiction and has been shown over a period of 40 years to be an effective and safe treatment. While women comprise approximately 40% of clients currently being treated in MMT programs, comparatively little research geared specifically toward this group has been published. This article begins with an overview of neurobiological studies on opioid addiction, including a discussion of gender differences, followed by a review of the pharmacology of methadone The authors then examine the particular needs and differences of women being treated in MMTs, including co-dependence with other substances, women’s health issues and psychosocial needs unique to this population. In conclusion, research shows that women have different substance abuse treatment needs in comparison to their male counterparts. One New York City MMT program that has attempted to address these differences is highlighted. PMID:20407977

  10. Treatment Approaches for Interoceptive Dysfunctions in Drug Addiction

    PubMed Central

    Paulus, Martin P.; Stewart, Jennifer L.; Haase, Lori

    2013-01-01

    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 showing 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 insula changes that may provide a window to attenuate the increased interoceptive response to 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. PMID:24151471

  11. Scientific and conceptual flaws of coercive treatment models in addiction.

    PubMed

    Uusitalo, Susanne; van der Eijk, Yvette

    2016-01-01

    In conceptual debates on addiction, neurobiological research has been used to support the idea that addicted drug users lack control over their addiction-related actions. In some interpretations, this has led to coercive treatment models, in which, the purpose is to 'restore' control. However, neurobiological studies that go beyond what is typically presented in conceptual debates paint a different story. In particular, they indicate that though addiction has neurobiological manifestations that make the addictive behaviour difficult to control, it is possible for individuals to reverse these manifestations through their own efforts. Thus, addicted individuals should not be considered incapable of making choices voluntarily, simply on the basis that addiction has neurobiological manifestations, and coercive treatment models of addiction should be reconsidered in this respect.

  12. Gambling disorder and other behavioral addictions: recognition and treatment.

    PubMed

    Yau, Yvonne H C; Potenza, Marc N

    2015-01-01

    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.

  13. Substitution treatment for opioid addicts in Germany

    PubMed Central

    Michels, Ingo Ilja; Stöver, Heino; Gerlach, Ralf

    2007-01-01

    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 history of substitution

  14. Addiction Treatment Professionals Are Not the Gatekeepers of Recovery.

    PubMed

    Humphreys, Keith

    2015-01-01

    Addiction treatment is beneficial to many individuals who have substance use disorders. However, only a minority of individuals who recover from addiction receive it. Despite this, addiction treatment is sometimes granted the status of the "gatekeeper of recovery." The myth that treatment is necessary for recovery has no empirical support. It also undermines the confidence of individuals in their ability to change on their own and is unduly dismissive of the efforts of nonprofessional helpers.

  15. Treatment of addiction and addiction-related behavior using a composition of topiramate

    DOEpatents

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2005-06-14

    The present invention relates to the use of a composition that increases central nervous system GABA levels in a mammal, for the treatment of addiction to drugs of abuse and modification of behavior associated with addiction to drugs of abuse in said mammal.

  16. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change.

    PubMed

    Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly

    2014-04-01

    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.

  17. Socially sanctioned coercion mechanisms for addiction treatment.

    PubMed

    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

    2007-01-01

    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.

  18. Tailoring nicotine addiction treatments for chemical dependency patients.

    PubMed

    Orleans, C T; Hutchinson, D

    1993-01-01

    The growing scientific evidence for addressing nicotine addiction in chemical dependency (CD) treatment programs is reviewed. This evidence provided the impetus for a survey of smoking patterns and quitting motivation and barriers among CD patients to identify ways to tailor standard nicotine addiction treatment methods and goals to their needs. Smoking history questionnaires were administered to 118 consecutive patients in a residential CD treatment program. The 66% of patients who smoked were predominantly heavy smokers, highly addicted (mean 25 cigarettes per day, 76% smoking within 30 minutes of waking). Although 63% of patients were "precontemplators," most of the sample had a history of one or more serious quit attempts, most reported strong beliefs in smoking harms and quitting benefits, and almost half reported a strong desire to stop smoking. Major quitting barriers included the usual psychological and physical sequelae of tobacco abstinence in addition to being around other smokers. Surprisingly, very few patients expressed concerns that quitting smoking would threaten drug or alcohol sobriety. Treatment implications are discussed. In addition, a pilot 4-session group treatment program is described. This program was geared to motivating smokers in "precontemplation" and "contemplation" stages of change to move ahead into the "action" stage (i.e., taking steps to quit). PMID:8389897

  19. Romantic Love vs. Drug Addiction May Inspire a New Treatment for Addiction

    PubMed Central

    Zou, Zhiling; Song, Hongwen; Zhang, Yuting; Zhang, Xiaochu

    2016-01-01

    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

  20. The readiness of addiction treatment agencies for health care reform.

    PubMed

    Molfenter, Todd; Capoccia, Victor A; Boyle, Michael G; Sherbeck, Carol K

    2012-01-01

    The Patient Protection and Affordable Care Act (PPACA) aims to provide affordable health insurance and expanded health care coverage for some 32 million Americans. The PPACA makes provisions for using technology, evidence-based treatments, and integrated, patient-centered care to modernize the delivery of health care services. These changes are designed to ensure effectiveness, efficiency, and cost-savings within the health care system.To gauge the addiction treatment field's readiness for health reform, the authors developed a Health Reform Readiness Index (HRRI) survey for addiction treatment agencies. Addiction treatment administrators and providers from around the United States completed the survey located on the http://www.niatx.net website. Respondents self-assessed their agencies based on 13 conditions pertinent to health reform readiness, and received a confidential score and instant feedback.On a scale of "Needs to Begin," "Early Stages," "On the Way," and "Advanced," the mean scores for respondents (n = 276) ranked in the Early Stages of health reform preparation for 11 of 13 conditions. Of greater concern was that organizations with budgets of < $5 million (n = 193) were less likely than those with budgets > $5 million to have information technology (patient records, patient health technology, and administrative information technology), evidence-based treatments, quality management systems, a continuum of care, or a board of directors informed about PPACA.The findings of the HRRI indicate that the addiction field, and in particular smaller organizations, have much to do to prepare for a future environment that has greater expectations for information technology use, a credentialed workforce, accountability for patient care, and an integrated continuum of care. PMID:22551101

  1. Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: from indirect evidence to testable hypotheses.

    PubMed

    Bogenschutz, Michael P; Pommy, Jessica M

    2012-01-01

    Alcohol and drug addiction are major public health problems, and existing treatments are only moderately effective. Although there has been interest for over half a century in the therapeutic use of classic hallucinogens to treat addictions, clinical research with these drugs was halted at an early stage in the early 1970s, leaving many fundamental questions unanswered. In the past two decades, clinical research on classic hallucinogens has resumed, although addiction treatment trials are only now beginning. The purpose of this paper is to provide a targeted review of the research most relevant to the therapeutic potential of hallucinogens, and to integrate this information with current thinking about addiction and recovery. On the basis of this information, we present a heuristic model which organizes a number of hypotheses that may be tested in future research. We conclude that existing evidence provides a convincing rationale for further research on the effects of classic hallucinogens in the treatment of addiction. PMID:22761106

  2. Neuroimaging, Genetics and the Treatment of Nicotine Addiction

    PubMed Central

    Ray, Riju; Loughead, James; Wang, Ze; Detre, John; Yang, Edward; Gur, Ruben; Lerman, Caryn

    2008-01-01

    Advances in neuroimaging and genomics provide an unprecedented opportunity to accelerate medication development for nicotine dependence and other addictions. Neuroimaging studies have begun to elucidate the functional neuroanatomy and neurochemistry underlying effects of nicotine and nicotine abstinence. In parallel, genetic studies, including both candidate gene and genome-wide association approaches, are identifying key neurobiological targets and pathways important in addiction to nicotine. To date, only a few neuroimaging studies have explored effects of nicotine or abstinence on brain activity as a function of genotype. Most analyses of genotype are retrospective, resulting in small sample sizes for testing effects of the minor alleles for candidate genes. The purpose of this review is to provide an outline of the work in neuroimaging, genetics, and nicotine dependence, and to explore the potential for increased integration of these approaches to improve nicotine dependence treatment. PMID:18599130

  3. A Qualitative Analysis of Online Gaming Addicts in Treatment

    ERIC Educational Resources Information Center

    Beranuy, Marta; Carbonell, Xavier; Griffiths, Mark D.

    2013-01-01

    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…

  4. Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

    ERIC Educational Resources Information Center

    Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

    2005-01-01

    TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

  5. Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues.

    PubMed

    Weinstein, Aviv; Weinstein, Yitzhak

    2014-01-01

    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

  6. Exercise addiction- diagnosis, bio-psychological mechanisms and treatment issues.

    PubMed

    Weinstein, Aviv; Weinstein, Yitzhak

    2014-01-01

    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

  7. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-03-03

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented.

  8. Addiction treatment dropout: exploring patients' characteristics.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2012-01-01

    This study explored the characteristics associated with treatment dropout in substance dependence patients. A sample of 122 addicted patients (84 treatment completers and 38 treatment dropouts) who sought outpatient treatment was assessed to collect information on sociodemographic, consumption (assessed by EuropASI), psychopathological (assessed by SCL-90-R), and personality variables (assessed by MCMI-II). Completers and dropouts were compared on all studied variables. According to the results, dropouts scored significantly higher on the EuropASI variables measuring employment/support, alcohol consumption, and family/social problems, as well as on the schizotypal scale of MCMI-II. Because most of the significant differences were found in EuropASI variables, three clusters analyses (2, 3, and 4 groups) based on EuropASI mean scores were carried out to determine clinically relevant information predicting dropout. The most relevant results were obtained when four groups were used. Comparisons between the four groups derived from cluster analysis showed statistically significant differences in the rate of dropout, with one group exhibiting the highest dropout rate. The distinctive characteristics of the group with highest dropout rate included the presence of an increased labor problem combined with high alcohol consumption. Furthermore, this group had the highest scores on three scales of the MCMI-II: phobic, dependent, and schizotypal. The implications of these results for further research and clinical practice are discussed. 

  9. Addiction treatment dropout: exploring patients' characteristics.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2012-01-01

    This study explored the characteristics associated with treatment dropout in substance dependence patients. A sample of 122 addicted patients (84 treatment completers and 38 treatment dropouts) who sought outpatient treatment was assessed to collect information on sociodemographic, consumption (assessed by EuropASI), psychopathological (assessed by SCL-90-R), and personality variables (assessed by MCMI-II). Completers and dropouts were compared on all studied variables. According to the results, dropouts scored significantly higher on the EuropASI variables measuring employment/support, alcohol consumption, and family/social problems, as well as on the schizotypal scale of MCMI-II. Because most of the significant differences were found in EuropASI variables, three clusters analyses (2, 3, and 4 groups) based on EuropASI mean scores were carried out to determine clinically relevant information predicting dropout. The most relevant results were obtained when four groups were used. Comparisons between the four groups derived from cluster analysis showed statistically significant differences in the rate of dropout, with one group exhibiting the highest dropout rate. The distinctive characteristics of the group with highest dropout rate included the presence of an increased labor problem combined with high alcohol consumption. Furthermore, this group had the highest scores on three scales of the MCMI-II: phobic, dependent, and schizotypal. The implications of these results for further research and clinical practice are discussed.  PMID:22211350

  10. Pharmacogenetic approaches to the treatment of alcohol addiction

    PubMed Central

    Heilig, Markus; Goldman, David; Berrettini, Wade; O’Brien, Charles P.

    2012-01-01

    Addictive disorders are partly heritable, chronic, relapsing conditions that account for a tremendous disease burden. Currently available addiction pharmacotherapies are only moderately successful, continue to be viewed with considerable scepticism outside the scientific community and have not become widely adopted as treatments. More effective medical treatments are needed to transform addiction treatment and address currently unmet medical needs. Emerging evidence from alcoholism research suggests that no single advance can be expected to fundamentally change treatment outcomes. Rather, studies of opioid, corticotropin-releasing factor, GABA and serotonin systems suggest that incremental advances in treatment outcomes will result from an improved understanding of the genetic heterogeneity among patients with alcohol addiction, and the development of personalized treatments. PMID:22011682

  11. Thai men’s experiences of alcohol addiction and treatment

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    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. PMID:24845212

  12. [Addiction].

    PubMed

    Besson, J; Grivel, J; Tomei, A; Gothuey, I; Andronicos, M; Babel, H; Nunweiler, S

    2013-01-01

    What's new in addiction medicine in 2012? The news are presented according three axes: first, in the field of neuroscience, the process of extinction of addiction memories. Then in the clinical field, a reflexion is reported on how to treat addiction in psychiatric hospitals. At last, in the area of teaching, an e-learning development with a virtual patient shows a great interest in addiction psychiatry. PMID:23367696

  13. Reliability of a Personality Test for Narcotic Addicts in Treatment

    ERIC Educational Resources Information Center

    Kaestner, Elisabeth; Goldstein, Marvin

    1977-01-01

    The Sixteen Personality Factor Questionnaire (16PF) was used to determine retest reliability (7-day interval) and motivational distortion for a sample of narcotic addicts (N=141) legally committed to treatment and tested by staff for routine diagnostic purposes. (Author)

  14. Gambling Disorder and Other Behavioral Addictions: Recognition and Treatment

    PubMed Central

    Yau, Yvonne H. C.; Potenza, Marc N.

    2015-01-01

    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. PMID:25747926

  15. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    PubMed

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  16. Cognitive behavior therapy with Internet addicts: treatment outcomes and implications.

    PubMed

    Young, Kimberly S

    2007-10-01

    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.

  17. New approaches to addiction treatment based on learning and memory.

    PubMed

    Kiefer, Falk; Dinter, Christina

    2013-01-01

    Preclinical studies suggest that physiological learning processes are similar to changes observed in addicts at the molecular, neuronal, and structural levels. Based on the importance of classical and instrumental conditioning in the development and maintenance of addictive disorders, many have suggested cue-exposure-based extinction training of conditioned, drug-related responses as a potential new treatment of addiction. It may also be possible to facilitate this extinction training with pharmacological compounds that strengthen memory consolidation during cue exposure. Another potential therapeutic intervention would be based on the so-called reconsolidation theory. According to this hypothesis, already-consolidated memories return to a labile state when reactivated, allowing them to undergo another phase of consolidation-reconsolidation, which can be pharmacologically manipulated. These approaches suggest that the extinction of drug-related memories may represent a viable treatment strategy in the future treatment of addiction.

  18. New approaches to addiction treatment based on learning and memory.

    PubMed

    Kiefer, Falk; Dinter, Christina

    2013-01-01

    Preclinical studies suggest that physiological learning processes are similar to changes observed in addicts at the molecular, neuronal, and structural levels. Based on the importance of classical and instrumental conditioning in the development and maintenance of addictive disorders, many have suggested cue-exposure-based extinction training of conditioned, drug-related responses as a potential new treatment of addiction. It may also be possible to facilitate this extinction training with pharmacological compounds that strengthen memory consolidation during cue exposure. Another potential therapeutic intervention would be based on the so-called reconsolidation theory. According to this hypothesis, already-consolidated memories return to a labile state when reactivated, allowing them to undergo another phase of consolidation-reconsolidation, which can be pharmacologically manipulated. These approaches suggest that the extinction of drug-related memories may represent a viable treatment strategy in the future treatment of addiction. PMID:21735361

  19. Oral health behavior of drug addicts in withdrawal treatment

    PubMed Central

    2013-01-01

    Background Oral health behavior (OHB), one major factor contributing to proper oral health status, has been addressed insufficiently in addiction literature. The aim of our study was to investigate OHB and its determinants among drug addicts in withdrawal treatment. Methods Through a stratified cluster sampling method, we collected the data from 685 patients in withdrawal treatment in Tehran using self-administered questionnaires on OHB components and conducting interviews about patients’ characteristics and addiction history. The T-test, ANOVA, and a linear regression model served for statistical analysis. Results Of the patients, 48% reported brushing their teeth less than once a day, more than 90% used fluoride toothpaste almost or always, and 81% flossed their teeth rarely or never. Eating sugary products twice a day or more was reported by 57% of the patients and 85% of them were current smokers. Poor OHB was associated with male gender, lower education, being addicted mainly to crystalline heroin, starting drug abuse at a younger age, and having a longer history of addiction (p < .05). Conclusion Poor OHB was found among the participants in drug withdrawal treatment. Preventive strategies on oral health should be planned and be integrated into other health promotion programs for addicts along with their withdrawal treatment taking into account special groups at higher risk. PMID:23368406

  20. Exploring the Limits and Utility of Operant Conditioning in the Treatment of Drug Addiction

    ERIC Educational Resources Information Center

    Silverman, Kenneth

    2004-01-01

    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…

  1. Treatment of tobacco dependence in mental health and addictive disorders.

    PubMed

    Hitsman, Brian; Moss, Taryn G; Montoya, Ivan D; George, Tony P

    2009-06-01

    People with mental health and addictive (MHA) disorders smoke at high rates and require tobacco treatment as a part of their comprehensive psychiatric care. Psychiatric care providers often do not address tobacco use among people with mental illness, possibly owing to the belief that their patients will not be able to quit successfully or that even short-term abstinence will adversely influence psychiatric status. Progress in the development of treatments has been slow in part because smokers with current MHA disorders have been excluded from most smoking cessation trials. There are several smoking cessation treatment options, including psychological and pharmacological interventions, that should be offered to people with an MHA disorder who smoke. Building motivation and readiness to quit smoking is a major challenge, and therefore motivational interventions are essential. We review the treatment options for people with tobacco dependence and MHA disorders, offer recommendations on tobacco assessment and tailored treatment strategies, and provide suggestions for future research. Treatment efficacy could be enhanced through promoting smoking reduction as an initial treatment goal, extending duration of treatment, and delivering it within an integrated care model that also aims to reduce the availability of tobacco in MHA treatment settings and in the community.

  2. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    PubMed

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    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.

  3. Ethical concerns related to developing pharmacogenomic treatment strategies for addiction.

    PubMed

    Shields, Alexandra E

    2011-07-01

    Pharmacogenomics (PGx) research is poised to enable physicians to identify optimally effective treatments for individual substance abusers based on their genetic profiles. This paper addresses ethical issues related to PGx treatment strategies for addiction, focusing especially on the use of race variables in genomics research and ensuring equitable access to novel PGx treatments. Unless the field addresses the ethical challenges posed by these issues, PGx treatment innovations for addiction threaten to exacerbate already dramatic disparities in the burden of drug dependence for minority and other underserved populations.

  4. Current considerations regarding food addiction.

    PubMed

    Schulte, Erica M; Joyner, Michelle A; Potenza, Marc N; Grilo, Carlos M; Gearhardt, Ashley N

    2015-04-01

    "Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating.

  5. Current considerations regarding food addiction.

    PubMed

    Schulte, Erica M; Joyner, Michelle A; Potenza, Marc N; Grilo, Carlos M; Gearhardt, Ashley N

    2015-04-01

    "Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating. PMID:25749750

  6. Community-based addiction treatment staff attitudes about the usefulness of evidence-based addiction treatment and CBO organizational linkages to research institutions

    PubMed Central

    Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

    2013-01-01

    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 factors were associated with directors, and staff attitudes about the usefulness of science-based addiction treatment. For both directors and staff working in an organization that was affiliated with a research institution, working in an organization with better internet technology (measured through TCU-ORC scores) and having higher levels of education were all significantly associated with having more positive attitudes regarding science-based addiction treatment. Implications: government policy that promotes the hiring of addiction treatment clinical staff with professional degrees and encourages the development of linkages between addiction treatment researchers and treatment staff may positively impact attitudes and use of evidence-based addiction treatment practices (EBPs) in CBOs. PMID:21396714

  7. Related Addictive Disorders.

    ERIC Educational Resources Information Center

    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.…

  8. Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions.

    PubMed

    Brewer, Judson A; Elwafi, Hani M; Davis, Jake H

    2013-06-01

    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 suboptimal 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. These early models show remarkable similarity to current models of the addictive process, especially in their overlap with operant conditioning (positive and negative reinforcement). Further, they may provide explanatory power for the mechanisms of mindfulness training, including its effects on core addictive elements, such as craving, and the underlying neurobiological processes that may be active therein. In this review, using smoking as an example, we will highlight similarities between ancient and modern views of the addictive process, review studies of mindfulness training for addictions and their effects on craving and other components of this process, and discuss recent neuroimaging findings that may inform our understanding of the neural mechanisms of mindfulness training.

  9. Assessment of spirituality and its relevance to addiction treatment.

    PubMed

    Galanter, Marc; Dermatis, Helen; Bunt, Gregory; Williams, Caroline; Trujillo, Manuel; Steinke, Paul

    2007-10-01

    The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery. Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities.

  10. Re-envisioning Addiction Treatment: A Six-Point Plan.

    PubMed

    Kellogg, Scott H; Tatarsky, Andrew

    2012-01-01

    This article is focused on improving the quality of addiction treatment. Based on observations that patients are leaving treatment too early and/or are continuing to use substances during their care, the authors propose six actions that could help reorient and revitalize this kind of clinical work: (1) conceptualize and treat addictive disorders within a psychiatric/mental health framework; (2) make the creation of a strong therapeutic alliance a core part of the healing process; (3) understand patients' addictions and other problems using models based on multiple internal parts, voices, or modes; (4) make contingency management and the use of positive reinforcement systems a standard and central practice in all treatment settings; (5) envision long-term change and healing through the lens of identity theory; and (6) integrate the growing developments in recovery culture with formal treatment.

  11. Re-envisioning Addiction Treatment: A Six-Point Plan.

    PubMed

    Kellogg, Scott H; Tatarsky, Andrew

    2012-01-01

    This article is focused on improving the quality of addiction treatment. Based on observations that patients are leaving treatment too early and/or are continuing to use substances during their care, the authors propose six actions that could help reorient and revitalize this kind of clinical work: (1) conceptualize and treat addictive disorders within a psychiatric/mental health framework; (2) make the creation of a strong therapeutic alliance a core part of the healing process; (3) understand patients' addictions and other problems using models based on multiple internal parts, voices, or modes; (4) make contingency management and the use of positive reinforcement systems a standard and central practice in all treatment settings; (5) envision long-term change and healing through the lens of identity theory; and (6) integrate the growing developments in recovery culture with formal treatment. PMID:22754086

  12. Exploring the limits and utility of operant conditioning in the treatment of drug addiction.

    PubMed

    Silverman, Kenneth

    2004-01-01

    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 contingency appear to be an orderly function of familiar parameters of operant conditioning. Increasing reinforcement magnitude and duration can increase effectiveness, and sustaining the contingency can prevent relapse. Initial development of a potentially practical application of this technology suggests that it may be possible to integrate abstinence reinforcement into employment settings using salary for work to reinforce drug abstinence. This research illustrates the potential utility and current limitations of an operant approach to the treatment of drug addiction. Similar research programs are needed to explore the limits of the operant approach and to develop practical applications that can be used widely in society for the treatment of drug addiction.

  13. [Benefits of specialized centers for the treatment of addictive disorders].

    PubMed

    Soravia, Leila; Allemann, Peter

    2014-10-01

    The attendance of an in-patient therapy program is often an indispensable part in the treatment of addiction disorders. The different stages of treatment, its elements of therapy as well as advantages and disadvantages of a stationary setting are discussed. The importance of an individualized therapy matched with the stage of detoxification and withdrawal is shown on the example of the Klinik Südhang, where patients with alcohol and/or drug addiction disorders seek treatment. Advantages and disadvantages of a stationary setting are discussed. To allow a successful detoxification and/or withdrawal, an interdisciplinary assistance and aftercare is essential.

  14. Is immunotherapy an opportunity for effective treatment of drug addiction?

    PubMed

    Zalewska-Kaszubska, Jadwiga

    2015-11-27

    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. PMID:26432911

  15. Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform.

    PubMed

    Andrews, Christina; Abraham, Amanda; Grogan, Colleen M; Pollack, Harold A; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

    2015-05-01

    The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment--the state governmental organizations charged with overseeing addiction treatment programs--are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach. In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA's promise to improve access to and quality of addiction treatment. PMID:25941285

  16. Culture change in addictions treatment: a targeted training and technical assistance initiative affects tobacco-related attitudes and beliefs in addiction treatment settings.

    PubMed

    Perka, Edward J

    2011-11-01

    Targeted training and technical assistance can have a major impact on the attitudes and beliefs of addiction service providers with respect to the treatment of tobacco dependency. Major gains have been made with the general public since the mid-1960s with respect to the reduction of tobacco use behavior and tobacco-related diseases. Tobacco use continues to be a major public health problem, and tobacco control initiatives are significantly affecting public attitudes and norms regarding tobacco use. There is, however, a specific population that has not benefited from these gains and, in fact, has been encouraged to continue smoking rather than make an attempt to quit. Individuals with a substance use disorder and/or mental health disorder have a much higher percentage of tobacco use than the general population, resulting in major health disparities. The addiction treatment and recovery community has lagged behind the general public in addressing tobacco use. New York State's project, "Integrating Tobacco Use Interventions Into Chemical Dependence Services," is a model that demonstrates how innovative regulations, and training and technical assistance developed specifically for addiction service providers, can initiate culture change with respect to tobacco use within addiction treatment settings, resulting in improved treatment outcomes and longer term stable recovery.

  17. Buprenorphine Treatment for Narcotic Addiction: Not Without Risks

    PubMed Central

    Sansone, Lori A.

    2015-01-01

    While most clinicians will never prescribe buprenorphine or combined buprenorphine/naloxone, familiarity with the risks of these pharmacological approaches to the treatment of narcotic addiction remains relevant. Overall, medication-assisted treatment has clearly resulted in meaningful gains for a number of individuals who are addicted to narcotics (i.e., opiates and opioids). However, a certain level of risk is inherent with these approaches. For example, both buprenorphine and buprenorphine/naloxone may be diverted and misused (e.g., intravenously injected, intranasally administered), particularly buprenorphine. Likewise, when illicitly injected, both can cause infectious complications as well as result in death from overdose. The risk of death with buprenorphine overdose appears to be heightened with the coadministration of either benzodiazepines or sedative/hypnotics. To conclude, as with all interventions in medicine, buprenorphine treatment for narcotic addiction has a clinically fluctuating risk/benefit equation that must be continually monitored. PMID:25973324

  18. Uses of coercion in addiction treatment: clinical aspects.

    PubMed

    Sullivan, Maria A; Birkmayer, Florian; Boyarsky, Beth K; Frances, Richard J; Fromson, John A; Galanter, Marc; Levin, Frances R; Lewis, Collins; Nace, Edgar P; Suchinsky, Richard T; Tamerin, John S; Tolliver, Bryan; Westermeyer, Joseph

    2008-01-01

    Coerced or involuntary treatment comprises an integral, often positive component of treatment for addictive disorders. By the same token, coercion in health care raises numerous ethical, clinical, legal, political, cultural, and philosophical issues. In order to apply coerced care effectively, health care professionals should appreciate the indications, methods, advantages, and liabilities associated with this important clinical modality. An expert panel, consisting of the Addiction Committee of the Group for the Advancement of Psychiatry, listed the issues to be considered by clinicians in considering coerced treatment. In undertaking this task, they searched the literature using Pubmed from 1985 to 2005 using the following search terms: addiction, alcohol, coercion, compulsory, involuntary, substance, and treatment. In addition, they utilized relevant literature from published reports. In the treatment of addictions, coercive techniques can be effective and may be warranted in some circumstances. Various dimensions of coercive treatment are reviewed, including interventions to initiate treatment; contingency contracting and urine testing in the context of psychotherapy; and pharmacological methods of coercion such as disulfiram, naltrexone, and the use of a cocaine vaccine. The philosophical, historical, and societal aspects of coerced treatment are considered.

  19. Implosive Therapy Treatment of Heroin Addicts during Methadone Detoxification.

    ERIC Educational Resources Information Center

    Hirt, Michael; Greenfield, Heywood

    1979-01-01

    Examined effectiveness of implosive therapy with heroin addicts during detoxification from methadone. Treatment groups received 12 sessions of implosive therapy or eclectic counseling and were followed for a six-week period. The implosive therapy group were the only ones to significantly reduce their methadone level during treatment and follow-up.…

  20. Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform

    PubMed Central

    Andrews, Christina; Abraham, Amanda; Grogan, Colleen M.; Pollock, Harold A.; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

    2016-01-01

    The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment—the state governmental organizations charged with overseeing addiction treatment programs—are helping programs respond to new requirements under the ACA. We found that most Single State Agencies provide little assistance to addiction treatment programs. Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach. In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA’s promise to improve access to and quality of addiction treatment. PMID:25941285

  1. Transcranial magnetic stimulation (TMS) in the treatment of substance addiction

    PubMed Central

    Gorelick, David A.; Zangen, Abraham; George, Mark S.

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a non-invasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5–20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future. PMID:25069523

  2. An Examination of Addiction Treatment Completion by Gender and Ethnicity

    ERIC Educational Resources Information Center

    Matthews, Connie R.; Lorah, Peggy

    2005-01-01

    This article examines the discharge status of all clients admitted to an intensive outpatient facility over the course of 1 year, specifically exploring differences based on client gender and ethnicity. The article also argues the need for more culturally sensitive addiction treatment and addresses some alternative approaches. The purpose of the…

  3. A role for pharmacotherapy in the treatment of "internet addiction".

    PubMed

    Camardese, Giovanni; De Risio, Luisa; Di Nicola, Marco; Pizi, Giusy; Janiri, Luigi

    2012-01-01

    The advent of the Internet is among the most significant changes in recent decades and has greatly affected the entire range of human experience. However, it has, in turn, led to the emergence of psychopathological features of addiction linked to its use. Literature on the clinical management of the distress related to Internet use systematically measures up to an evolving nosography, with ambiguous definitions of the phenomenon and a diversity of diagnostic, prognostic, and therapeutic criteria. To date, case studies on "Internet addiction" treatment are rather limited, and no standard clinical treatment protocols exist. With regard to pharmacological treatment options, empirical or anecdotal assessments are mostly referred to. The aim of this article was to review current literature on Internet addiction treatment and assess the extent to which specific pharmacological interventions alleviate these patients' symptomatic burden, to propose a rationale that may guide the therapeutic approach. To this end, we also explored pharmacological interventions that target patterns of comorbidity and underlying psychopathological dimensions shared with other behavioral or substance addictions.

  4. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: From cognitive improvement to relapse prevention.

    PubMed

    Rezapour, Tara; DeVito, Elise E; Sofuoglu, Mehmet; Ekhtiari, Hamed

    2016-01-01

    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.

  5. Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

    PubMed Central

    Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

    2011-01-01

    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

  6. Surviving Hurricane Katrina: Winds of Change Transform a New Orleans Addiction Treatment Agency

    ERIC Educational Resources Information Center

    Toriello, Paul J.; Pedersen-Wasson, Else; Crisham, Erin M.; Ellis, Robert; Morse, Patricia; Morse, Edward V.

    2007-01-01

    Hurricane Katrina's impact on the operations of the largest residential, addiction treatment organization in New Orleans is described. Pre- and post-Katrina experiences are discussed and augmented with organizational performance data. Suggestions for future research are provided. (Contains 4 figures.)

  7. Adolescent psychotherapy for addiction medicine: From brain development to neurocognitive treatment mechanisms.

    PubMed

    Thayer, Rachel E; Feldstein Ewing, Sarah W

    2016-01-01

    Effectively treating addiction is a challenge among any population, and treatment for adolescents may be particularly challenging in the context of ongoing neurodevelopment, which may alter the brain's initial response to substances as well as its response to treatment. One way to improve treatment outcomes for youth is to use a translational perspective that explicitly connects cognitive and neurodevelopmental fields with the field of behavioral therapies. This integrative approach is a potential first step to inform the correspondence between the neurocognitive and behavioral fields in youth addiction. This chapter seeks to provide context for neurocognitive treatment studies by first discussing recent structural and functional neuroimaging studies showing associations with substance use or behavioral addictions. Several regions of interest are then proposed that appear to also be associated with addiction treatment across multiple studies, namely, the accumbens/striatum, precuneus, insula, anterior cingulate cortex, and dorsolateral prefrontal cortex. This research suggests that reward, self-reflective, and executive control areas might be especially relevant in youth behavioral treatment response, and preliminary evidence suggests that existing treatments may encourage neurocognitive changes in these areas. PMID:26822364

  8. Spiritual Direction in Addiction Treatment: Two Clinical Trials

    PubMed Central

    Miller, William R.; Forcehimes, Alyssa; O'Leary, Mary; LaNoue, Marnie D.

    2008-01-01

    Spirituality has long been regarded as an important component of recovery from addiction. This article reports the findings of two controlled trials of spiritual direction as an adjunct in addiction treatment. In Study 1, 60 participants were randomly assigned to receive or not receive a 12-session manual-guided spiritual guidance (SG) intervention during and after inpatient treatment, in addition to treatment as usual (TAU). In Study 2, two cohorts of 40 each received TAU without or with SG during their inpatient stay. In both trials, contrary to prediction, SG had no effect on spiritual practices or substance use outcomes at any follow-up point. At the first follow-up in Study 1 only, those randomly assigned to spiritual direction unexpectedly showed significantly less improvement on depression and anxiety, relative to TAU controls. Limitations and implications for treatment are discussed. PMID:18657945

  9. Improving public addiction treatment through performance contracting: the Delaware experiment.

    PubMed

    McLellan, A Thomas; Kemp, Jack; Brooks, Adam; Carise, Deni

    2008-09-01

    In fiscal 2002, Delaware replaced traditional cost-reimbursement contracts with performance-based contracts for all outpatient addiction treatment programs. Incentives included 90% capacity utilization and active patient participation in treatment. One of the programs failed to meet requirements. Strategies adopted by successful programs included extended hours of operation, facility enhancements, salary incentives for counselors, and two evidence-based therapies (MI and CBT). Average capacity utilization from 2001 to 2006 went from 54% to 95%; and the average proportion of patients' meeting participation requirements went from 53% to 70%--with no notable changes in the patient population. We conclude that properly designed, program-based contract incentives are feasible to apply, welcomed by programs and may help set the financial conditions necessary to implement other evidence-based clinical efforts; toward the overall goal of improving addiction treatment. PMID:18325621

  10. Improving public addiction treatment through performance contracting: The Delaware experiment☆

    PubMed Central

    McLellan, A. Thomas; Kemp, Jack; Brooks, Adam; Carise, Deni

    2009-01-01

    In fiscal 2002, Delaware replaced traditional cost-reimbursement contracts with performance-based contracts for all outpatient addiction treatment programs. Incentives included 90% capacity utilization and active patient participation in treatment. One of the programs failed to meet requirements. Strategies adopted by successful programs included extended hours of operation, facility enhancements, salary incentives for counselors, and two evidence-based therapies (MI and CBT). Average capacity utilization from 2001 to 2006 went from 54% to 95%; and the average proportion of patients’ meeting participation requirements went from 53% to 70%—with no notable changes in the patient population. We conclude that properly designed, program-based contract incentives are feasible to apply, welcomed by programs and may help set the financial conditions necessary to implement other evidence-based clinical efforts; toward the overall goal of improving addiction treatment. PMID:18325621

  11. Drug addicts seeking treatment after the Iranian Revolution: a clinic-based study.

    PubMed

    Dalvand, S; Agahi, C; Spencer, C

    1984-09-01

    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.

  12. Drug addicts seeking treatment after the Iranian Revolution: a clinic-based study.

    PubMed

    Dalvand, S; Agahi, C; Spencer, C

    1984-09-01

    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. PMID:6489156

  13. Leveraging technology to enhance addiction treatment and recovery.

    PubMed

    Marsch, Lisa A

    2012-01-01

    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.

  14. Bioethical differences between drug addiction treatment professionals inside and outside the Russian Federation

    PubMed Central

    2011-01-01

    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. PMID:21663615

  15. Training the Staff of a Drug Addiction Treatment Facility: A Case Study of Hogar De Encuentro

    ERIC Educational Resources Information Center

    Sorensen, Andrew A.; Leske, M. Cristina

    1977-01-01

    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…

  16. Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

    ERIC Educational Resources Information Center

    Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

    2011-01-01

    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…

  17. Pharmacologic treatments for women with addictions.

    PubMed

    Bogenschutz, Michael P; Geppert, Cynthia M A

    2003-09-01

    Physicians have a growing array of pharmacotherapies available for the treatment of substance use disorders. These medications are of central importance in the treatment of opioid and nicotine dependence and are of growing importance in the treatment of alcohol and stimulant dependence. Pharmacotherapy alone is rarely sufficient treatment for substance use disorder; appropriate psychosocial treatment or mutual help (eg, 12-step) participation is almost always indicated whether or not pharmacotherapy is used. Specialized facilities, licensing, and training are necessary for the use of some of the pharmacotherapies discussed in this article. The obstetrician gynecologist must determine the scope of his or her own practice in this area (ie, when to treat and when to refer) based on interest, training and experience, and available resources.

  18. Sweat testing in addicts under methadone treatment: an Italian experience.

    PubMed

    Fucci, N; De Giovanni, N; Scarlata, S

    2008-01-30

    In the last years the interest in monitoring drug exposure with human sweat as alternative biological fluid, is increasing. Sweat collection is convenient, less invasive and difficult to adulterate compared to traditional specimens. The objective of this study was to determine the excretion profile of methadone and other drugs into human sweat. Pharmscope sweat patches (Medical Europe Diagnostic, Madrid, Spain) were used on heroin abusers under methadone treatment. Sweat patches were applied to 10 heroin addicts and 3 drug free volunteers admitted into the study. Sweat patches were worn for about 1 week; urine, saliva and hair samples were collected at the time of the removal of patches. After the extraction, sweat eluates were directly analyzed by GC/MS for the presence of nicotine, cotinine, caffeine, methadone, EDDP and cocaine. The extracts were subsequently derivatized to detect benzoylecgonine, ecgonine methyl ester, morphine, codeine and 6-acetylmorphine. No false positive results were obtained on the drug free samples. All the patches showed positive results for methadone. Cocaine was detected in two cases. Mainly the parent drug was identified rather than the metabolites. The results obtained show the usefulness of sweat as complementary specimen to saliva and urine providing a longer detection window. Moreover, sweat testing offers the advantage of being a non-invasive means of obtaining information about drug exposure.

  19. Women in addictions treatment: comparing VA and community samples.

    PubMed

    Davis, Tania M; Carpenter, Kelly M; Malte, Carol A; Carney, Molly; Chambers, Sharon; Saxon, Andrew J

    2002-07-01

    Despite increasing awareness of gender issues in substance use treatment, women with substance use disorders (SUD) and gender-specific treatment remain understudied. This study examines differences, including identification of comorbid issues and patients' perceived treatment needs, between women in different SUD treatment settings: an intensive VA outpatient program (VA; N = 76) and a private residential/outpatient program (Residence XII; N = 308). In both settings the Addiction Severity Index (ASI) was administered at intake; ASI data were collected from retrospective chart review. Results support previous findings that women entering SUD treatment endorse high rates of psychiatric and medical comorbidity, and past abuse. Women in VA SUD treatment experienced more impairment on indices of medical, psychiatric, and employment issues whereas the private agency sample had higher alcohol and family/social composite scores. The differences between and similarities among the two treatment groups have implications for design of women-specific SUD treatment programs.

  20. Hidden addiction: Television

    PubMed Central

    Sussman, Steve; Moran, Meghan B.

    2013-01-01

    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

  1. A business case for quality improvement in addiction treatment: Evidence from the NIATx collaborative

    PubMed Central

    Quanbeck, Andrew R.; Madden, Lynn; Edmundson, Eldon; Ford, James H.; McConnell, K. John; McCarty, Dennis; Gustafson, David H.

    2012-01-01

    The Network for the Improvement of Addiction Treatment (NIATx) promotes treatment access and retention through a customer-focused quality improvement model. This paper explores the issue of the “business case” for quality improvement in addiction treatment from the provider’s perspective. The business case model developed in this paper is based on case examples of early NIATx participants coupled with a review of the literature. Process inefficiencies indicated by long waiting times, high no-show rates, and low continuation rates cause underutilization of capacity and prevent optimal financial performance. By adopting customer-focused practices aimed at removing barriers to treatment access and retention, providers may be able to improve financial performance, increase staff retention, and gain long-term strategic advantage. PMID:21918924

  2. Women & Addiction: Gender Issues in Abuse and Treatment.

    ERIC Educational Resources Information Center

    Gordon, Susan Merle

    This report reviews findings of research and clinical experience, which demonstrate clearly that addictive disorders differ in important ways between males and females. Addiction issues for women are highlighted including the prevalence of addiction, risk factors for women, and consequences of addiction. Also included are descriptions of womens…

  3. The National Treatment Outcomes Research Study (NTORS) and its influence on addiction treatment policy in the United Kingdom.

    PubMed

    Gossop, Michael

    2015-07-01

    This paper describes the political origins of the National Treatment Outcomes Research Study (NTORS) and the outputs and impacts of the study. NTORS was designed to meet the request of the Health Secretary and of a Government Task Force for evidence about the effectiveness of the national addiction treatment services. NTORS was a prospective cohort study which investigated outcomes over a 5-year period of drug users admitted to four major treatment modalities: in-patient treatment, residential rehabilitation, methadone reduction and methadone maintenance programmes. The study investigated treatments delivered under day-to-day operating conditions. Outcomes showed substantial reductions in illicit drug use and reduced injecting risk behaviours. These changes were accompanied by improved psychological and physical health and by reductions in criminal behaviour. However, not all outcomes were so positive. There was a continuing mortality rate in the cohort of about 1% per year, and many clients continued to drink heavily throughout the 5-year follow-up. NTORS findings informed and influenced UK addiction treatment policy both at the time and subsequently. The findings were influential in supporting an immediate increase in funding for treatment, and Government Ministers have repeatedly cited NTORS as evidence of the effectiveness of addiction treatment. One finding that received political attention was that of the cost savings provided by treatment through reductions in crime. This important finding led to an unanticipated consequence of NTORS; namely, the greater focus on crime reduction that has increasingly been promoted as a political and social priority for drug misuse treatment.

  4. Novel pharmacotherapeutic treatments for cocaine addiction

    PubMed Central

    2011-01-01

    Cocaine is a stimulant that leads to the rapid accumulation of catecholamines and serotonin in the brain due to prevention of their re-uptake into the neuron that released the neurotransmitter. Cocaine dependence is a public health concern and cause of significant morbidity and mortality worldwide. At present, there are no approved medications for the treatment of this devastating illness, and behavioral interventions have proven to be of limited use. However, there have been a number of recent trials testing promising agents including dopamine agonists, GABAergic medications and the cocaine vaccine. Here we discuss the most recent human clinical trials of potential medications for treatment of cocaine dependence, as well as pre-clinical studies for another promising agent, levo tetrahydropalmatine. Examination of these recent findings shows promise for GABAergic medications and the cocaine vaccine, as well as unique medications such as disulfiram, whose mechanism remains to be determined. Future work may also confirm specific subgroups of patients for treatment response based on clinical characteristics, biomarkers and pharmacogenetics. This review highlights the need for further, bigger studies in order to determine optimal clinical usage. PMID:22047090

  5. Internet addiction: coping styles, expectancies, and treatment implications

    PubMed Central

    Brand, Matthias; Laier, Christian; Young, Kimberly S.

    2014-01-01

    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

  6. Internet addiction: coping styles, expectancies, and treatment implications.

    PubMed

    Brand, Matthias; Laier, Christian; Young, Kimberly S

    2014-01-01

    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.

  7. Adolescent drug addiction treatment and weight gain.

    PubMed

    Hodgkins, Candace C; Cahill, Kevin S; Seraphine, Anne E; Frost-Pineda, Kimberly; Gold, Mark S

    2004-01-01

    Neurotransmitter release in the nucleus accumbens use has been linked to self-administration and learning following drug use. This endogenous reward system is also activated following food intake or sex. Therefore, rebound hyperphagia following abstinence may be a mechanism to replenish the release of neurotransmitters in this reward system, leading to increased weight gain and a rise in body mass index during recovery from substance abuse. In this report, we examined the relationship between supervised drug abstinence and increased weight gain among adolescents at a residential substance abuse treatment center. Mean weight change over time was followed by repeated analysis of weight and body mass index. Significant weight gain and body mass index increase was observed during supervised and confirmed abstinence from drug use. Furthermore, significant interactions between tobacco use and primary substance use disorder with weight gain was demonstrated by multivariate analysis of variance.

  8. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    PubMed

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    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. PMID:18082996

  9. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change

    PubMed Central

    Hilton, Thomas F.; Pilkonis, Paul A.

    2015-01-01

    Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care. PMID:26529025

  10. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change.

    PubMed

    Hilton, Thomas F; Pilkonis, Paul A

    2015-01-01

    Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care.

  11. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study

    PubMed Central

    2014-01-01

    protocol) methods, and assessment of implementation costs. Discussion If implementation is successful, the field will have a proven technology that helps Federally Qualified Health Centers and affiliated organizations provide addiction treatment and recovery support, as well as a proven strategy for implementing the technology. Seva also has the potential to improve core elements of addiction treatment, such as referral and treatment processes. A mobile technology for addiction treatment and accompanying implementation model could provide a cost-effective means to improve the lives of patients with drug and alcohol problems. Trial registration ClinicalTrials.gov (NCT01963234). PMID:24884976

  12. [Treatment approaches for synthetic drug addiction].

    PubMed

    Kobayashi, Ohji

    2015-09-01

    In Japan, synthetic drugs have emerged since late 2000s, and cases of emergency visits and fatal traffic accidents due to acute intoxication have rapidly increased. The synthetic drugs gained popularity mainly because they were cheap and thought to be "legal". The Japanese government restricted not only production and distribution, but also its possession and use in April 2014. As the synthetic drug dependent patients have better social profiles compared to methamphetamine abusers, this legal sanction may have triggered the decrease in the number of synthetic drug dependent patient visits observed at Kanagawa Psychiatric Center since July 2014. Treatment of the synthetic drug dependent patients should begin with empathic inquiry into the motives and positive psychological effects of the drug use. In the maintenance phase, training patients to trust others and express their hidden negative emotions through verbal communications is essential. The recovery is a process of understanding the relationship between psychological isolation and drug abuse, and gaining trust in others to cope with negative emotions that the patients inevitably would face in their subsequent lives. PMID:26394511

  13. Meditation Awareness Training for the Treatment of Sex Addiction: A Case Study.

    PubMed

    Van Gordon, William; Shonin, Edo; Griffiths, Mark D

    2016-06-01

    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.

  14. Meditation Awareness Training for the Treatment of Sex Addiction: A Case Study.

    PubMed

    Van Gordon, William; Shonin, Edo; Griffiths, Mark D

    2016-06-01

    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. PMID:27348560

  15. Pharmacokinetic strategies for treatment of drug overdose and addiction

    PubMed Central

    Gorelick, David A

    2012-01-01

    The pharmacokinetic treatment strategy targets the drug molecule itself, aiming to reduce drug concentration at the site of action, thereby minimizing any pharmacodynamic effect. This approach might be useful in the treatment of acute drug toxicity/overdose and in the long-term treatment of addiction. Phase IIa controlled clinical trials with anticocaine and antinicotine vaccines have shown good tolerability and some efficacy, but Phase IIb and III trials have been disappointing because of the failure to generate adequate antibody titers in most participants. Monoclonal antibodies against cocaine, methamphetamine and phencyclidine have shown promise in animal studies, as has enhancing cocaine metabolism with genetic variants of human butyrylcholinesterase, with a bacterial esterase, and with catalytic monoclonal antibodies. Pharmacokinetic treatments offer potential advantages in terms of patient adherence, absence of medication interactions and benefit for patients who cannot take standard medications. PMID:22300100

  16. Acupuncture for Detoxification in Treatment of Opioid Addiction.

    PubMed

    Wu, S Ly; Leung, A Wn; Yew, D Tw

    2016-06-01

    Opioid is a popular drug of abuse and addiction. We evaluated acupuncture as a non-pharmacological treatment with a focus on managing withdrawal symptoms. Electrical stimulation at a low frequency (2 Hz) accelerates endorphin and encephalin production. High-frequency stimulation (100 Hz) up-regulates the dynorphin level that in turn suppresses withdrawal at the spinal level. The effect of 100-Hz electroacupuncture may be associated with brain-derived neurotrophic factor activation at the ventral tegmental area, down-regulation of cAMP response element-binding protein, and enhanced dynorphin synthesis in the spinal cord, periaqueductal grey, and hypothalamus. Clinical trials of acupuncture for the management of different withdrawal symptoms were reviewed. The potential of acupuncture to allay opioid-associated depression and anxiety, and its possible use as an adjuvant treatment were evident. A lack of effect was indicated for opioid craving. Most studies were hampered by inadequate reporting details and heterogeneity, thus future well-designed studies are needed to confirm the efficacy of acupuncture in opioid addiction treatment. PMID:27377488

  17. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    PubMed Central

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsomporn, Jureerat; Östlund, Gunnel

    2016-01-01

    Background Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers. PMID:27491962

  18. Heroin Addiction: Psychosocial Characteristics and Considerations for Treatment.

    ERIC Educational Resources Information Center

    Faherty, John K.

    This paper presents a review of relevant medical and psychological literature that addresses the psychological characteristics of heroin addiction and addicts: dependence (both physical and psychological); explanations of the phenomenon of addiction (both medical and behavioral); and other psychosocial views of causation including escapism,…

  19. A web-based therapeutic workplace for the treatment of drug addiction and chronic unemployment.

    PubMed

    Silverman, Kenneth; Wong, Conrad J; Grabinski, Michael J; Hampton, Jacqueline; Sylvest, Christine E; Dillon, Erin M; Wentland, R Daniel

    2005-03-01

    This article describes a Web-based therapeutic workplace intervention designed to promote heroin and cocaine abstinence and train and employ participants as data entry operators. Patients are paid to participate in training and then to perform data entry jobs in a therapeutic workplace business. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Prior data show that a prototype of the intervention could promote drug abstinence. Preliminary data on the Web-based intervention suggest that it should be able to teach adults with histories of chronic unemployment and drug addiction to become skilled data entry operators in about 3 to 6 months. Early experience in the business provides preliminary evidence that it might become financially successful. The therapeutic workplace intervention may serve as an effective and practical long-term treatment for chronic unemployment and heroin and cocaine addiction.

  20. Addiction Treatment Experience among a Cohort of Street-Involved Youths and Young Adults

    ERIC Educational Resources Information Center

    Wong, Jellena; Marshall, Brandon D. L.; Kerr, Thomas; Lai, Calvin; Wood, Evan

    2009-01-01

    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…

  1. Addict Descriptions of Therapeutic Community, Multimodality, and Methadone Maintenance Treatment Clients and Staff.

    ERIC Educational Resources Information Center

    Stuker, Patricia B.; And Others

    1978-01-01

    Compared the Adjective Check List descriptions of addicts in treatment toward methadone maintenance, multimodality, and therapeutic community clients and program staff. Results indicate client pessimism regarding methadone maintenance. Results suggest addict opinions represent a valuable source for evaluating treatment approaches and identifying…

  2. Addiction treatment ultimatums and U.S. health reform: A case study.

    PubMed

    Weisner, Constance; Hinman, Agatha; Lu, Yun; Chi, Felicia W; Mertens, Jennifer

    2010-01-01

    AIMS: Increased access to health care, including addiction treatment, has long been a goal of health reform in the U.S. An unanswered question is whether reform will change the way people get to addiction treatment; when treatment is easily accessible, do individuals self-refer, or do they still enter treatment via ultimatums, and if so, from which sources? To begin examining this, we used a single case study of a U.S. health plan that provides access similar to that called for in health reform. METHOD: Using a case study method of data from studies conducted in a large, private non-profit, integrated managed care health plan which includes addiction services, we examined the prevalence and source of ultimatums to enter treatment, and the characteristics of those receiving them. The plan is highly representative of changes to U.S. health care and other countries due to health reform. RESULTS: Many individuals entering addiction treatment had received an ultimatum stemming from employment, legal, medical, and family sources. Having more employment problems, an occupation with public safety concerns, being older, male, and ethnicity predicted an employment ultimatum. Higher legal problem severity predicted a legal ultimatum. More men (and younger people) had family ultimatums, and more women (and older people) had medical ultimatums. Being younger, male, married, having higher employment and family problem severity, and being drug or combined drug/alcohol dependent rather than dependent on alcohol-only predicted an ultimatum from one's family. On the whole, an ultimatum from one source was not related to having one from another source. Those most likely to receive ultimatums from multiple sources were women, those separated/divorced, and those having higher psychiatric and legal problem severity. CONCLUSIONS: Even in an insured population with good access to addiction treatment, individuals often receive ultimatums to enter treatment rather than being self

  3. Treatment for Addiction: Advancing the Common Good. Recommendations from a Join Together Policy Panel on Treatment and Recovery.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Join Together convened a panel of experts to review U.S. policies for addiction treatment and recovery. Although the panel reached an agreement on six recommendations for policy changes that can make help more accessible and expand treatment to more people. These recommendations are: (1) treatment for alcoholism and other drug addiction must be…

  4. Use of therapeutic touch in treatment of drug addictions.

    PubMed

    Hagemaster, J

    2000-04-01

    The purpose of this pilot study is to examine the efficacy of Therapeutic Touch (TT) as a form of treatment intervention with persons who abuse alcohol and/or other drugs. A between-subjects design compared treatment outcomes of three groups of alcohol and other drug abusers over five months. The Addiction Severity Index (ASI), Michigan Alcoholism Screening Test (MAST), Beck Depression Inventory (BI), and Personal Experiences: Therapeutic Touch and Frequency of Alcohol/Drug Use questionnaires were administered to the group receiving TT (Group A) and both control groups (Mimic TT Group B and No Intervention Group C) at various points in the study. Preliminary findings indicate that the use of TT could be effective in prolonging periods of abstinence for alcohol and other drug abusers.

  5. Benefits of peer support groups in the treatment of addiction

    PubMed Central

    Tracy, Kathlene; Wallace, Samantha P

    2016-01-01

    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. Conclusion Peer support groups included in addiction treatment shows much promise; however, the limited data relevant to this topic diminish the ability to draw definitive conclusions. More rigorous research is needed in this area to further expand on this important line of research. PMID:27729825

  6. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

    PubMed

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

    2015-12-01

    The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain.

  7. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

    PubMed

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

    2015-12-01

    The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain. PMID:26302337

  8. Is Internet Addiction Prevalent Among Methadone Maintenance Treatment Patients? Data from Las Vegas and Tel Aviv.

    PubMed

    Peles, Einat; Linzy, Shirley; Sason, Anat; Tene, Oren; Adelson, Miriam

    2015-01-01

    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.

  9. Food addiction in overweight and obese adolescents seeking weight-loss treatment.

    PubMed

    Meule, Adrian; Hermann, Tina; Kübler, Andrea

    2015-05-01

    Some forms of overeating closely resemble addictive behaviour. The Yale Food Addiction Scale (YFAS) was developed to measure such addiction-like eating in humans and has been employed in numerous studies for examining food addiction in adults. Yet, little is known about food addiction in children and adolescents. Fifty adolescents were recruited at the beginning of treatment in a weight-loss hospital and completed the YFAS among other questionnaires. Nineteen participants (38%) received a YFAS diagnosis, who did not differ in age, body mass and gender distribution from those not receiving a diagnosis. However, those with food addiction reported more binge days, more frequent food cravings, higher eating, weight and shape concerns, more symptoms of depression and higher attentional and motor impulsivity. Eating restraint and nonplanning impulsivity did not differ between groups. Results replicate findings from studies in obese adults such that food addiction is not related to age, gender, body mass or eating restraint, but to higher eating pathology, more symptoms of depression and higher impulsivity. Furthermore, results highlight that particularly attentional impulsivity is related to 'food addiction'. Addiction-like eating appears to be a valid phenotype in a substantial subset of treatment-seeking, obese adolescents.

  10. Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation.

    PubMed

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2011-11-01

    Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field.

  11. Safe & Sound: Models for Collaboration between the Child Welfare & Addiction Treatment Systems.

    ERIC Educational Resources Information Center

    Rubenstein, Gwen

    An estimated 11 percent of American children live with at least one parent who abuses or is addicted to alcohol and/or drugs. Parental addiction is a significant factor in child abuse and neglect, with studies suggesting that 40 to 80 percent of families in the child welfare systems are affected by it. With appropriate treatment, many of these…

  12. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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...

  13. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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...

  14. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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...

  15. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  16. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  17. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  18. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  19. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

  20. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  1. Psychoanalytic Treatment of Psychological Addiction to Alcohol (Alcohol Abuse)

    PubMed Central

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments. PMID:22144975

  2. Psychoanalytic treatment of psychological addiction to alcohol (alcohol abuse).

    PubMed

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments.

  3. Impact of Medication-Assisted Treatment for Opioid Addiction on Medicaid Expenditures and Health Services Utilization Rates in Vermont.

    PubMed

    Mohlman, Mary Kate; Tanzman, Beth; Finison, Karl; Pinette, Melanie; Jones, Craig

    2016-08-01

    In the face of increasing rates of overdose deaths, escalating health care costs, and the tremendous social costs of opioid addiction, policy makers are asked to address the questions of whether and how to expand access to treatment services. In response to an upward trend in opioid abuse and adverse outcomes, Vermont is investing in statewide expansion of a medication-assisted therapy program delivered in a network of community practices and specialized treatment centers (Hub & Spoke Program). This study was conducted to test the rationale for these investments and to establish a pre-Hub & Spoke baseline for evaluating the additive impact of the program. Using a serial cross-sectional design from 2008 to 2013 to evaluate medical claims for Vermont Medicaid beneficiaries with opioid dependence or addiction (6158 in the intervention group, 2494 in the control group), this study assesses the treatment and medical service expenditures for those receiving medication-assisted treatment compared to those receiving substance abuse treatment without medication. Results suggest that medication-assisted therapy is associated with reduced general health care expenditures and utilization, such as inpatient hospital admissions and outpatient emergency department visits, for Medicaid beneficiaries with opioid addiction. For state Medicaid leaders facing similar decisions on approaches to opioid addiction, these results provide early support for expanding medication-assisted treatment services rather than relying only on psychosocial, abstinence, or detoxification interventions. PMID:27296656

  4. Treatment of internet addiction: a meta-analysis.

    PubMed

    Winkler, Alexander; Dörsing, Beate; Rief, Winfried; Shen, Yuhui; Glombiewski, Julia A

    2013-03-01

    Internet addiction (IA) has become a widespread and problematic phenomenon. Little is known about the efficacy of treatment approaches for IA. Therefore, our objective was to perform an effect size analysis of psychological and pharmacological interventions for IA. We conducted a literature search using PsycINFO, PSYNDEX, MEDLINE, EMBASE, PQDT OPEN, WorldCat, Cochrane Clinical Trials Library, and manual searches. Our meta-analysis was based on 16 studies, covered a total of 670 participants, and used a random effects model. Special emphasis was given to the inclusion of studies from "non-western" countries. Effect size estimates suggest that psychological and pharmacological interventions were highly effective for improving IA (g=1.61), time spent online (g=0.94), depression (g=0.90) and anxiety (g=1.25) from pre- to post-treatment in the overall sample. Moderator analyses revealed that studies including individual treatments, a higher number of female participants, older patients, or a North-American sample had larger effect sizes for some outcome variables. Most effect sizes were high, robust, unrelated to study quality or design, and maintained over follow-up. Due to a small number of included studies and methodological limitations the results of this meta-analysis should be regarded as preliminary.

  5. Therapeutic potential of histaminergic compounds in the treatment of addiction and drug-related cognitive disorders.

    PubMed

    Alleva, Livia; Tirelli, Ezio; Brabant, Christian

    2013-01-15

    Addiction is a behavioral disorder characterized by the compulsive seeking and taking of drugs despite serious negative consequences. In particular, the chronic use of drugs impairs memory and cognitive functions, which aggravates the loss of control over drug use and complicates treatment outcome. Therefore, cognitive enhancers targeting acetylcholine have been proposed to treat addiction. Interestingly, histamine H(3) receptor (H(3)R) antagonists/inverse agonists stimulate acetylcholine transmission in different brain areas, facilitate memory in animal models and can reverse learning deficits induced by drugs such as scopolamine, dizocilpine and alcohol. Moreover, several studies found that compounds capable of activating the histaminergic system generally decrease the reinforcing effects of drugs, namely alcohol and opioids, in preclinical models of addiction. Finally, several H(3)R antagonists/inverse agonists increase histamine in the brain and have proven to be safe in humans. However, no studies have yet investigated the therapeutic potential of cognitive enhancing H(3)R antagonists/inverse agonists in the treatment of addiction in humans. The present review first describes the impact of addictive drugs on learning processes and cognitive functions that play an important role for addicts to remain abstinent. Second, our work briefly summarizes the relevant literature describing the function of histamine in learning, memory and drug addiction. Finally, the potential therapeutic use of histaminergic agents in the treatment of addiction is discussed. Our review suggests that histaminergic compounds like H(3)R antagonists/inverse agonists may improve the treatment outcome of addiction by reversing drug-induced cognitive deficits and/or diminishing the reinforcing properties of addictive drugs, especially opioids and alcohol.

  6. Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

    ERIC Educational Resources Information Center

    Woo, Stephanie M.; Hepner, Kimberly A.; Gilbert, Elizabeth A.; Osilla, Karen Chan; Hunter, Sarah B.; Munoz, Ricardo F.; Watkins, Katherine E.

    2013-01-01

    One barrier to widespread public access to empirically supported treatments (ESTs) is the limited availability and high cost of professionals trained to deliver them. Our earlier work from 2 clinical trials demonstrated that front-line addiction counselors could be trained to deliver a manualized, group-based cognitive behavioral therapy (GCBT)…

  7. A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction

    PubMed Central

    Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

    2016-01-01

    Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction. PMID:26808307

  8. Sex Differences in Behavioral Dyscontrol: Role in Drug Addiction and Novel Treatments.

    PubMed

    Carroll, Marilyn E; Smethells, John R

    2015-01-01

    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.

  9. Sex Differences in Behavioral Dyscontrol: Role in Drug Addiction and Novel Treatments

    PubMed Central

    Carroll, Marilyn E.; Smethells, John R.

    2016-01-01

    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

  10. What works in addiction treatment and what doesn't: is the best therapy no therapy?

    PubMed

    Peele, S

    The current trend toward treating drug and alcohol (and other) addictions in disease-oriented, 12-step programs has had less success than most people believe. Treatments that teach coping skills, mobilize community forces, and instill values toward prosocial behavior have had success rates far superior to therapies that instruct individuals that they take drugs or drink excessively because they have a disease or because drugs are inherently addictive. Successful treatments instead deal with addicts' interactions with their environments and help them develop beliefs in their self-efficacy. Nonetheless, even addiction treatments which have demonstrated success face limitations in their ability to confront individual intentions and values, community standards, and environmental pressures and opportunities. At the same time, more individuals have quit addictions on their own than have been successfully treated by even the best therapies. Put simply, no therapy will ever be able in itself to make a substantial impact on our drug and alcohol or other addictive problems. In the meantime, addiction treatment is becoming more pervasive and coercive, and today holds out the possibility of corrupting our society and the self-conceptions of its members.

  11. Continuing the Epidemiological Function of the Addicts Index--Evidence from Matching the Home Office Addicts Index with the National Drug Treatment Monitoring System

    ERIC Educational Resources Information Center

    Hickman, Matthew; Griffin, Maria; Mott, Joy; Corkery, John; Madden, Peter; Sondhi, Arun; Stimson, Gerry

    2004-01-01

    Aims: We discuss the Addicts Index (AI) and examine whether the epidemiological trends of the AI can be continued by the regional drug misuse databases (DMDs, now known as National Drug Treatment Monitoring System (NDTMS). Methods: (i) Matching individuals recorded as addicted to opiates and/or cocaine in the AI with those reported to the North…

  12. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences.

    PubMed

    Sanghani, Ruchi M; Moler, Alexander K

    2015-01-01

    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. PMID:26483986

  13. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences

    PubMed Central

    Sanghani, Ruchi M.; Moler, Alexander K.

    2015-01-01

    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. PMID:26483986

  14. Applying laboratory research: drug anticipation and the treatment of drug addiction.

    PubMed

    Siegel, Shepard; Ramos, Barbara M C

    2002-08-01

    Basic research concerning drug tolerance and withdrawal may inform clinical practice, and vice versa. Three areas that integrate the work of the laboratory and the clinic are discussed: (a) drug overdose, (b) cue exposure treatment of addiction, and (c) pharmacological treatment of withdrawal symptoms. The areas are related in that they indicate the contribution of drug-paired cues to the effects of addictive drugs and the role of Pavlovian conditioning of drug effects in drug tolerance and withdrawal symptoms.

  15. Public Views on Food Addiction and Obesity: Implications for Policy and Treatment

    PubMed Central

    Lee, Natalia M.; Lucke, Jayne; Hall, Wayne D.; Meurk, Carla; Boyle, Frances M.; Carter, Adrian

    2013-01-01

    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 = 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. Conclusions 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. PMID:24086382

  16. Register data in the evaluation and program planning of addiction treatment programs: using Sweden as an example.

    PubMed

    Blom, Björn; Dukes, Kimberly A; Lundgren, Lena; Sullivan, Lisa M

    2015-04-01

    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.

  17. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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 the determination of disability. (a) If we determine that you are disabled and drug addiction...

  18. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  19. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

  20. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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 the determination of disability. (a) If we determine that you are disabled and drug addiction...

  1. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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...

  2. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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 the determination of disability. (a) If we determine that you are disabled and drug addiction...

  3. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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 the determination of disability. (a) If we determine that you are disabled and drug addiction...

  4. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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...

  5. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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...

  6. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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 the determination of disability. (a) If we determine that you are disabled and drug addiction...

  7. Existing and Future Drugs for the Treatment of the Dark Side of Addiction.

    PubMed

    Koob, George F; Mason, Barbara J

    2016-01-01

    The identification of a heuristic framework for the stages of the addiction cycle that are linked to neurocircuitry changes in pathophysiology includes the binge/intoxication stage, the withdrawal/negative affect stage, and the preoccupation/anticipation (craving) stage, which represent neuroadaptations in three neurocircuits (basal ganglia, extended amygdala, and frontal cortex, respectively). The identification of excellent and validated animal models, the development of human laboratory models, and an enormous surge in our understanding of neurocircuitry and neuropharmacological mechanisms have provided a revisionist view of addiction that emphasizes the loss of brain reward function and gain of stress function that drive negative reinforcement (the dark side of addiction) as a key to compulsive drug seeking. Reversing the dark side of addiction not only explains much of the existing successful pharmacotherapies for addiction but also points to vast new opportunities for future medications to alleviate this major source of human suffering. PMID:26514207

  8. Existing and Future Drugs for the Treatment of the Dark Side of Addiction.

    PubMed

    Koob, George F; Mason, Barbara J

    2016-01-01

    The identification of a heuristic framework for the stages of the addiction cycle that are linked to neurocircuitry changes in pathophysiology includes the binge/intoxication stage, the withdrawal/negative affect stage, and the preoccupation/anticipation (craving) stage, which represent neuroadaptations in three neurocircuits (basal ganglia, extended amygdala, and frontal cortex, respectively). The identification of excellent and validated animal models, the development of human laboratory models, and an enormous surge in our understanding of neurocircuitry and neuropharmacological mechanisms have provided a revisionist view of addiction that emphasizes the loss of brain reward function and gain of stress function that drive negative reinforcement (the dark side of addiction) as a key to compulsive drug seeking. Reversing the dark side of addiction not only explains much of the existing successful pharmacotherapies for addiction but also points to vast new opportunities for future medications to alleviate this major source of human suffering.

  9. Modulation of the endocannabinoid system: vulnerability factor and new treatment target for stimulant addiction.

    PubMed

    Olière, Stéphanie; Joliette-Riopel, Antoine; Potvin, Stéphane; Jutras-Aswad, Didier

    2013-01-01

    Cannabis is one of the most widely used illicit substance among users of stimulants such as cocaine and amphetamines. Interestingly, increasing recent 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. This article aims 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 cannabinoids 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. PMID:24069004

  10. Shifting blame: Buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America.

    PubMed

    Mendoza, Sonia; Rivera-Cabrero, Allyssa S; Hansen, Helena

    2016-08-01

    Growing nonmedical prescription opioid analgesic use among suburban and rural Whites has changed the public's perception of the nature of opioid addiction, and of appropriate interventions. Opioid addiction has been recast as a biological disorder in which patients are victims of their neurotransmitters and opioid prescribers are irresponsible purveyors of dangerous substances requiring controls. This framing has led to a different set of policy responses than the "War on Drugs" that has focused on heroin trade in poor urban communities; in response to prescription opioid addiction, prescription drug monitoring programs and tamper-resistant opioid formulations have arisen as primary interventions in place of law enforcement. Through the analysis of preliminary findings from interviews with physicians who are certified to manage opioid addiction with the opioid pharmaceutical buprenorphine, we argue that an increase in prescriber monitoring has shifted the focus from addicted people to prescribers as a threat, paradoxically driving users to illicit markets and constricting their access to pharmaceutical treatment for opioid addiction. Prescriber monitoring is also altering clinical cultures of care, as general physicians respond to heightened surveillance and the psychosocial complexities of treating addiction with either rejection of opioid dependent patients, or with resourceful attempts to create support systems for their treatment where none exists. PMID:27488225

  11. Feasibility and Efficacy of an Addiction Treatment Program in Patients With Upper Aerodigestive Tract Cancer.

    PubMed

    Perney, Pascal; Duny, Yohan; Nalpas, Bertrand; Lallemant, Benjamin; Rigole, Hélène; Cartier, César; Garrel, Renaud; Azria, The Addict-Orl Study Group David; Blanc, François; Duhamel, Olivier; Neka, Meissa; Ichou, Marc; Le Bars, Yves; Pelletier, Stéphanie; Quantin, Xavier; Stoebner, Anne

    2013-08-01

    Background: Continuing to smoke or to drink after the treatment of an upper aerodigestive tract (UADT) cancer is known to worsen the prognosis. We assessed the feasibility and efficacy of an addiction treatment program integrated into the cancer treatment. Method: In four units devoted to UADT tumors, we proposed an addiction treatment to all patients still drinking or smoking at the end of the cancer treatment; the abstinence rate was assessed 6 and 12 months later. Results: One hundred and sixteen patients were included. Among the 73 patients still drinking and/or smoking at the end of the cancer treatment, 46.6% accepted an addiction treatment. In the latter, abstinence rate was increased, 52.2% versus 31.03% ( p = .07) at M12. In patients both drinking and smoking, addiction treatment doubled the rate of abstinence of both products (31% vs. 14%). Conclusion: Offering addiction treatment to patients with UADT cancer improves abstinence rate and helps maintain long-term withdrawal.

  12. Can Decision Making Research Provide a Better Understanding of Chemical and Behavioral Addictions?

    PubMed

    Engel, Anzhelika; Cáceda, Ricardo

    2015-01-01

    We reviewed the cognitive and neurobiological commonalities between chemical and behavioral addictions. Poor impulse control, limited executive function and abnormalities in reward processing are seen in both group of entities. Brain imaging shows consistent abnormalities in frontoparietal regions and the limbic system. In drug addiction, exaggerated risk taking behavior and temporal discounting may reflect an imbalance between a hyperactive mesolimbic and hypoactive executive systems. Several cognitive distortions are found in pathological gambling that seems to harness the brain reward system that has evolved to face situations related to skill, not random chance. Abnormalities in risk assessment and impulsivity are found in variety of eating disorders, in particularly related to eating behavior. Corresponding findings in eating disorder patients include abnormalities in the limbic system, i.e. orbitofrontal cortex (OFC), striatum and insula. Similarly, internet addiction disorder is associated with risky decision making and increased choice impulsivity with corresponding discrepant activation in the dorsolateral prefrontal cortex, OFC, anterior cingulate cortex, caudate and insula. Sexual addictions are in turn associated with exaggerated impulsive choice and suggestive evidence of abnormalities in reward processing. In sum, exploration of executive function and decision making abnormalities in chemical and behavioral addictions may increase understanding in their psychopathology and yield valuable targets for therapeutic interventions.

  13. Can Decision Making Research Provide a Better Understanding of Chemical and Behavioral Addictions?

    PubMed

    Engel, Anzhelika; Cáceda, Ricardo

    2015-01-01

    We reviewed the cognitive and neurobiological commonalities between chemical and behavioral addictions. Poor impulse control, limited executive function and abnormalities in reward processing are seen in both group of entities. Brain imaging shows consistent abnormalities in frontoparietal regions and the limbic system. In drug addiction, exaggerated risk taking behavior and temporal discounting may reflect an imbalance between a hyperactive mesolimbic and hypoactive executive systems. Several cognitive distortions are found in pathological gambling that seems to harness the brain reward system that has evolved to face situations related to skill, not random chance. Abnormalities in risk assessment and impulsivity are found in variety of eating disorders, in particularly related to eating behavior. Corresponding findings in eating disorder patients include abnormalities in the limbic system, i.e. orbitofrontal cortex (OFC), striatum and insula. Similarly, internet addiction disorder is associated with risky decision making and increased choice impulsivity with corresponding discrepant activation in the dorsolateral prefrontal cortex, OFC, anterior cingulate cortex, caudate and insula. Sexual addictions are in turn associated with exaggerated impulsive choice and suggestive evidence of abnormalities in reward processing. In sum, exploration of executive function and decision making abnormalities in chemical and behavioral addictions may increase understanding in their psychopathology and yield valuable targets for therapeutic interventions. PMID:26373849

  14. Hypothesis-Driven Medication Discovery for the Treatment of Psychostimulant Addiction

    PubMed Central

    Xi, Zheng-Xiong; Gardner, Eliot L.

    2008-01-01

    Psychostimulant abuse is a serious social and health problem, for which no effective treatments currently exist. A number of review articles have described predominantly ‘clinic’-based pharmacotherapies for the treatment of psychostimulant addiction, but none have yet been shown to be definitively effective for use in humans. In the present article, we review various ‘hypothesis’- or ‘mechanism’-based pharmacological agents that have been studied at the preclinical level and evaluate their potential use in the treatment of psychostimulant addiction in humans. These compounds target brain neurotransmitter or neuromodulator systems, including dopamine (DA), γ-aminobutyric acid (GABA), endocannabinoid, glutamate, opioid and serotonin, which have been shown to be critically involved in drug reward and addiction. For drugs in each category, we first briefly review the role of each neurotransmitter system in psychostimulant actions, and then discuss the mechanistic rationale for each drug’s potential anti-addiction efficacy, major findings with each drug in animal models of psychostimulant addiction, abuse liability and potential problems, and future research directions. We conclude that hypothesis-based medication development strategies could significantly promote medication discovery for the effective treatment of psychostimulant addiction. PMID:19430578

  15. Increasing the efficacy of cue exposure treatment in preventing relapse of addictive behavior.

    PubMed

    Havermans, Remco C; Jansen, Anita T M

    2003-07-01

    Theoretically, cue exposure treatment should be able to prevent relapse by extinguishing conditioned drug responding (e.g. cue-elicited craving). According to contemporary learning theory, though, extinction does not eliminate conditioned responding. Analogous cue exposure with response prevention (CERP) as a treatment of addictive behavior might not eliminate the learned relation between drug-related cues and drug use. This does not necessarily mean that cue exposure cannot successfully prevent relapse. Various suggestions for increasing the efficacy of cue exposure treatment are being discussed from a contemporary learning theory perspective. It is suggested that cue exposure treatment incorporating retrieval cues can be a beneficial treatment in preventing relapse of addictive behavior.

  16. Psychological, physical, and sexual abuse in addicted patients who undergo treatment.

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso

    2015-05-01

    This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed.

  17. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

    PubMed

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the

  18. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.

    PubMed

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the

  19. What does addiction medicine expect from neuroscience? From genes and neurons to treatment responses.

    PubMed

    Le Foll, Bernard

    2016-01-01

    The field of neuroscience is rapidly growing as evidenced by the mapping of the human genome, the progress in brain imaging technologies, and the refinement of sophisticated molecular tools that can be combined with innovative preclinical models. With these advances, it seems that our understanding of processes underlying addiction has never been so great. In comparison, the clinical domain has evolved at a much slower pace. Nonetheless, the addiction medical field has seen some gradual improvements in clinical care with the availability of a larger range of pharmacological options. Notably, several therapeutic alternatives are now offered for the treatment of nicotine, alcohol, and opioid use disorders. Some of these developments in treatment regimens have directly emerged from basic neuroscience research and represent a success story for the bench to beside translational approach. However, the clinical and research needs in addiction medicine are huge. There are still no pharmacological interventions available for psychostimulant and cannabis use disorders. Further, major questions remain unanswered: Would a better understanding of the neurocircuitry of addiction lead to therapeutic intervention? Would a better understanding of the neurochemical signature of addiction lead to the validation of a therapeutic target? Will pharmacogenetics hold its promise as a personalized medicine treatment approach? Using recent research developments, we will illustrate the potential of neuroscience to address some of the pressing questions in Addiction Medicine. PMID:26822369

  20. rTMS in the treatment of drug addiction: an update about human studies.

    PubMed

    Bellamoli, Elisa; Manganotti, Paolo; Schwartz, Robert P; Rimondo, Claudia; Gomma, Maurizio; Serpelloni, Giovanni

    2014-01-01

    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.

  1. rTMS in the treatment of drug addiction: an update about human studies.

    PubMed

    Bellamoli, Elisa; Manganotti, Paolo; Schwartz, Robert P; Rimondo, Claudia; Gomma, Maurizio; Serpelloni, Giovanni

    2014-01-01

    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. PMID:24803733

  2. What Influences Participation in QI? A Randomized Trial of Addiction Treatment Organizations.

    PubMed

    Grazier, Kyle L; Quanbeck, Andrew R; Oruongo, John; Robinson, James; Ford, James H; McCarty, Dennis; Pulvermacher, Alice; Johnson, Roberta A; Gustafson, David H

    2015-01-01

    Healthcare providers have increased the use of quality improvement (QI) techniques, but organizational variables that affect QI uptake and implementation warrant further exploration. This study investigates organizational characteristics associated with clinics that enroll and participate over time in QI. The Network for the Improvement of Addiction Treatment (NIATx) conducted a large cluster-randomized trial of outpatient addiction treatment clinics, called NIATx 200, which randomized clinics to one of four QI implementation strategies: (1) interest circle calls, (2) coaching, (3) learning sessions, and (4) the combination of all three components. Data on organizational culture and structure were collected before, after randomization, and during the 18-month intervention. Using univariate descriptive analyses and regression techniques, the study identified two significant differences between clinics that enrolled in the QI study (n = 201) versus those that did not (n = 447). Larger programs were more likely to enroll and clinics serving more African Americans were less likely to enroll. Once enrolled, higher rates of QI participation were associated with clinics' not having a hospital affiliation, being privately owned, and having staff who perceived management support for QI. The study discusses lessons for the field and future research needs.

  3. Cognitive-behavioral approaches to outpatient treatment of internet addiction in children and adolescents.

    PubMed

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2012-11-01

    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.

  4. Exercise addiction.

    PubMed

    Landolfi, Emilio

    2013-02-01

    This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start.

  5. Treatment of addicts in Bosnia and Herzegovina--constraints and opportunities.

    PubMed

    Mehić-Basara, Nermana; Cerić, Ismet

    2012-10-01

    Chronology of important historical events in Bosnia and Herzegovina during past two centuries indirectly influenced the incidence and prevalence of different psychoactive substances use and thus the organization of services for the treatment of persons who develop addiction symptoms. The organization of health system in the last war, 1992-1995, suffered enormous damage and the reform process which inevitably followed, included the area of mental health care services and the establishment of network of centers for mental health in the community (CMHC). The centers are functioning within the primary health care almost in whole country, with specialized centers for the prevention and treatment of addicts and the therapeutic communities, which today represents the basic organizational units to help people who have drug related issues. In this paper we will present the possibility of treatment of drug addicts in Bosnia and Herzegovina, from consulting services, psycho-education and early detection of disease, detoxification and substitution programs with Methadone and Suboxone, as well as programs of rehabilitation and resocialization. Although a very complicated political and administrative structure of the country, insufficient financial support, pronounced stigmatization of addicts, insufficient staffing and number of treatment centers are objective obstacles for progress in treatment of addicts, we believe that, with existing resources, these constraints can be converted into new opportunities in terms of improvement of treatment options in the future. PMID:23114823

  6. Progress in addiction treatment: from one-size-fits-all to medications and treatment matching.

    PubMed

    Woody, George E

    2014-01-01

    This paper briefly reviews the development of treatment for substance use disorders over the last 100 years from the perspective of the author, who has participated in treatment outcome studies since the mid-1970s. It includes some personal events that contributed to the author's involvement in addiction treatment and research, and describes the gradual evolution of an approach that began with a focus on detoxification and psychosocial treatment to one that involves blending psychosocial treatments with use of Food and Drug Administration (FDA)-approved medications and adding treatments for psychiatric and medical disorders when necessary based on patient assessments. It ends with comments on the gap between what is known and the degree to which existing knowledge is applied, and how the Affordable Care Act holds promise for bridging that gap.

  7. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction.

    PubMed

    Xu, Chaoying S; Chen, Jessica S; Adelman, Ron A

    2015-09-01

    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.

  8. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction.

    PubMed

    Xu, Chaoying S; Chen, Jessica S; Adelman, Ron A

    2015-09-01

    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

  9. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction

    PubMed Central

    Xu, Chaoying S.; Chen, Jessica S.; Adelman, Ron A.

    2015-01-01

    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

  10. Multimodality Approach to Methadone Treatment of Narcotic Addicts

    ERIC Educational Resources Information Center

    Brill, Leon; Chambers, Carl D.

    1971-01-01

    This multimodality approach is geared primarily to the goal of abstinence. For addicts who cannot achieve this goal, methadone maintenance is suggested as the next step. The modalities described range from low-dose maintenance for clinic outpatients to intensive rehabilitation in a methadone maintenance residential center facility. (Author)

  11. The Network for the Improvement of Addiction Treatment (NIATx): Enhancing Access and Retention**

    PubMed Central

    McCarty, Dennis; Gustafson, David H.; Wisdom, Jennifer P.; Ford, Jay; Choi, Dongseok; Molfenter, Todd; Capoccia, Victor; Cotter, Frances

    2007-01-01

    The Network for the Improvement of Addiction Treatment (NIATx) teaches participating treatment centers to use process improvement strategies. A cross-site evaluation monitored impacts on days between first contact and first treatment and percent of patients who started treatment and completed two, three and four units of care (i.e., one outpatient session, one day of intensive outpatient care, and one week of residential treatment). The analysis included 13 agencies that began participation in August 2003, submitted 10 to 15 months of data, and attempted improvements in outpatient (n = 7), intensive outpatient (n = 4) or residential treatment services (n = 4) (two agencies provided data for two levels of care). Days to treatment declined 37% (from 19.6 to 12.4 days) across levels of care; the change was significant overall and for outpatient and intensive outpatient services. Significant overall improvement in retention in care was observed for the second unit of care (72% to 85%; 18% increase) and the third unit of care (62% to 73%; 17% increase); when level of care was assessed, a significant gain was found only for intensive outpatient services. Small incremental changes in treatment processes can lead to significant reductions in days to treatment and consistent gains in retention. PMID:17129680

  12. A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

    PubMed

    Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

    2016-09-01

    Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.

  13. A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

    PubMed

    Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

    2016-09-01

    Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions. PMID:26846506

  14. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40

    ERIC Educational Resources Information Center

    Boone, Margaret; Brown, Nancy J.; Moon, Mary A.; Schuman, Deborah J.; Thomas, Josephine; Wright, Denise L.

    2004-01-01

    This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts…

  15. Addiction Treatment Within U.S. Correctional Facilities: Bridging the Gap Between Current Practice and Evidence-Based Care.

    PubMed

    Wakeman, Sarah E; Rich, Josiah D

    2015-01-01

    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. PMID:26076211

  16. A systematic review of Internet-based therapy for the treatment of addictions.

    PubMed

    Gainsbury, Sally; Blaszczynski, Alex

    2011-04-01

    Traditional therapies for addictions are underutilized and characterized by high attrition rates suggesting they may not meet the needs of a proportion of individuals with addiction-related problems including problem drinking, smoking, substance use and problem gambling. Internet-based therapy has emerged as a new treatment modality for psychological disorders and health issues and this review is the first attempt to summarize and evaluate the evidence of the effectiveness of Internet therapy for addictions. Extensive literature searches were conducted to identify studies meeting the criteria of delivering structured Internet-based treatment programs for addictions that incorporated a component of trained therapist interaction. Only nine studies met criteria for inclusion with seven representing a randomized controlled trial. These included seven papers reporting on tobacco-cessation programs, one Internet-based therapy for pathological gambling, and one treatment program for substance abuse. A range of therapeutic models, treatment components and outcome measures was included across these studies. Positive treatment effects were reported following completion of therapy and at longer-term follow-up. The review concluded that Internet-based therapies for addictions are effective in achieving positive behavioral changes but that more research is required to determine the comparative effectiveness of various Internet-based therapies and their components.

  17. A systematic review of Internet-based therapy for the treatment of addictions.

    PubMed

    Gainsbury, Sally; Blaszczynski, Alex

    2011-04-01

    Traditional therapies for addictions are underutilized and characterized by high attrition rates suggesting they may not meet the needs of a proportion of individuals with addiction-related problems including problem drinking, smoking, substance use and problem gambling. Internet-based therapy has emerged as a new treatment modality for psychological disorders and health issues and this review is the first attempt to summarize and evaluate the evidence of the effectiveness of Internet therapy for addictions. Extensive literature searches were conducted to identify studies meeting the criteria of delivering structured Internet-based treatment programs for addictions that incorporated a component of trained therapist interaction. Only nine studies met criteria for inclusion with seven representing a randomized controlled trial. These included seven papers reporting on tobacco-cessation programs, one Internet-based therapy for pathological gambling, and one treatment program for substance abuse. A range of therapeutic models, treatment components and outcome measures was included across these studies. Positive treatment effects were reported following completion of therapy and at longer-term follow-up. The review concluded that Internet-based therapies for addictions are effective in achieving positive behavioral changes but that more research is required to determine the comparative effectiveness of various Internet-based therapies and their components. PMID:21146272

  18. Treatment of internet addiction in patient with panic disorder and obsessive compulsive disorder: a case report.

    PubMed

    Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear

    2015-01-01

    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.

  19. Enriched environment treatment counteracts enhanced addictive and depressive-like behavior induced by prenatal chronic stress.

    PubMed

    Yang, Jianli; Li, Weihui; Liu, Xiaohua; Li, Zexuan; Li, Hongying; Yang, Guifu; Xu, Lin; Li, Lingjiang

    2006-12-13

    Prenatal stress can cause many long-term behavior changes in offspring, but whether prenatal stress can alter addictive behavior in offspring and postnatal enriched environment treatment (EE) can restore these changes are unknown. We reported here that prenatal chronic stress (10 unpredictable, 1 s, 0.8 mA foot-shocks per day during gestational days 13-19) enhanced morphine-induced (10 mg/kg, s.c., per day, 6 consecutive days) place preference. Moreover, prenatal chronic stress caused higher depressive-like behavior in forced swimming test in adult offspring. However, enriched environment housing treatment on postnatal days 22-52 counteracted both the abnormal behaviors alterations. This work observed a phenomenon that might contribute to the understanding of clinically important interactions among addiction, prenatal stress and enriched environment treatment. Postnatal enriched environment treatment might be an important therapeutic intervention in preventing the prenatal stress-induced addictive disorders.

  20. Nurses' perception of the quality of care they provide to hospitalized drug addicts: testing the theory of reasoned action.

    PubMed

    Natan, Merav Ben; Beyil, Valery; Neta, Okev

    2009-12-01

    A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.

  1. Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy

    PubMed Central

    Santos, Hugo Henrique

    2016-01-01

    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 mental disorders, involving a great deal of damage in the patient’s life. Objective 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). Methods 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. Results 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) (P<.001). A significant improvement in mean Internet addiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (P<.001), indicating medium Internet use. With respect to the relationship between IA and anxiety, the correlation between scores was .724. Conclusions This study is

  2. Moving Clinical Deliberations on Administrative Discharge in Drug Addiction Treatment Beyond Moral Rhetoric to Empirical Ethics.

    PubMed

    Williams, Izaak L

    2016-01-01

    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.

  3. Modeling stress and drug craving in the laboratory: implications for addiction treatment development

    PubMed Central

    Sinha, Rajita

    2009-01-01

    Addition is a chronic relapsing illness affected by multiple social, individual and biological factors that significantly impact course and recovery of the illness. Stress interacts with these factors and increases addiction vulnerability and relapse risk, thereby playing a significant role in the course of the illness. This paper reviews our efforts in developing and validating laboratory models of stress and drug cue-related provocation to assess stress responses and stress-related adaptation in addicted individuals compared with healthy controls. Empirical findings from human laboratory and brain imaging studies are presented to show the specific stress-related dysregulation that accompanies the drug-craving state in addicted individuals. In order to adequately validate our laboratory model, we have also carefully examined relapse susceptibility in the addicted individuals and these data are reviewed. The overarching goal of these efforts is to develop a valid laboratory model to identify the stress-related pathophysiology in addiction with specific regard to persistent craving and compulsive seeking. Finally, the significant implications of these findings for the development of novel treatment interventions that target stress processes and drug craving to improve addiction relapse outcomes are discussed. PMID:18945295

  4. Diagnostic Stability of Internet Addiction in Obsessive-compulsive Disorder: Data from a Naturalistic One-year Treatment Study.

    PubMed

    Bipeta, Rajshekhar; Yerramilli, Srinivasa Srr; Karredla, Ashok Reddy; Gopinath, Srinath

    2015-01-01

    Whether internet addiction should be categorized as a primary psychiatric disorder or the result of an underlying psychiatric disorder still remains unclear. In addition, the relationship between internet addiction and obsessive-compulsive disorder remains to be explored. We hypothesized that internet addiction is a manifestation of underlying psychopathology, the treatment of which will improve internet addiction. We enrolled 34 control subjects (with or without internet addiction) and compared them to 38 patients with "pure" obsessive-compulsive disorder (with or without internet addiction). Internet addiction and obsessive-compulsive disorder were diagnosed based on Young's Diagnostic Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), respectively. Age and Internet Addiction Test scores were comparable in both the control (years: 26.87±6.57; scores: 43.65±11.56) and obsessive-compulsive disorder groups (years: 27.00±6.13 years, p=0.69; scores: 43.47±15.21, p=0.76). Eleven patients with obsessive-compulsive disorder (28.95%) were diagnosed with internet addiction as compared to three control subjects (p=0.039). In the obsessive-compulsive disorder group, no difference in the Yale-Brown Obsessive Compulsive Scale (24.07±3.73 non-internet addiction, 23.64±4.65 internet addiction; p=0.76) score was seen between the internet addiction/obsessive-compulsive disorder and non-internet addiction/obsessive-compulsive disorder groups. As expected, the Internet Addiction Test scores were higher in the internet addiction/obsessive-compulsive disorder group (64.09±9.63) than in the non-internet addiction/obsessive-compulsive disorder group (35.07±6.37; p=0.00). All enrolled patients with obsessive-compulsive disorder were subsequently treated for a period of one year. Treatment of obsessive-compulsive disorder improved Yale-Brown Obsessive Compulsive Scale and Internet Addiction Test scores over time. At 12 months, only

  5. Diagnostic Stability of Internet Addiction in Obsessive-compulsive Disorder: Data from a Naturalistic One-year Treatment Study

    PubMed Central

    Yerramilli, Srinivasa SRR; Karredla, Ashok Reddy; Gopinath, Srinath

    2015-01-01

    Whether internet addiction should be categorized as a primary psychiatric disorder or the result of an underlying psychiatric disorder still remains unclear. In addition, the relationship between internet addiction and obsessive-compulsive disorder remains to be explored. We hypothesized that internet addiction is a manifestation of underlying psychopathology, the treatment of which will improve internet addiction. We enrolled 34 control subjects (with or without internet addiction) and compared them to 38 patients with “pure” obsessive-compulsive disorder (with or without internet addiction). Internet addiction and obsessive-compulsive disorder were diagnosed based on Young’s Diagnostic Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), respectively. Age and Internet Addiction Test scores were comparable in both the control (years: 26.87±6.57; scores: 43.65±11.56) and obsessive-compulsive disorder groups (years: 27.00±6.13 years, p=0.69; scores: 43.47±15.21, p=0.76). Eleven patients with obsessive-compulsive disorder (28.95%) were diagnosed with internet addiction as compared to three control subjects (p=0.039). In the obsessive-compulsive disorder group, no difference in the Yale-Brown Obsessive Compulsive Scale (24.07±3.73 non-internet addiction, 23.64±4.65 internet addiction; p=0.76) score was seen between the internet addiction/obsessive-compulsive disorder and non-internet addiction/obsessive-compulsive disorder groups. As expected, the Internet Addiction Test scores were higher in the internet addiction/obsessive-compulsive disorder group (64.09±9.63) than in the non-internet addiction/obsessive-compulsive disorder group (35.07±6.37; p=0.00). All enrolled patients with obsessive-compulsive disorder were subsequently treated for a period of one year. Treatment of obsessive-compulsive disorder improved Yale-Brown Obsessive Compulsive Scale and Internet Addiction Test scores over time. At 12 months

  6. [Personal satisfaction of adolescent drug addicts in the family environment during treatment at a mental health institute].

    PubMed

    Velásquez Carranza, Doris Violeta; Pedrão, Luiz Jorge

    2005-01-01

    This study aimed at analyzing the level of personal satisfaction of adolescents addicted to drugs in family environment during the treatment stage at a mental health institute. Authors used the Family Satisfaction Scale with Adjectives adapted, validated and applied to a sample of 34 patients selected according to established inclusion and exclusion criteria. A significant relationship between the level of satisfaction and parents' good relationship in their marriage was found. 61% of adolescents presented an average personal satisfaction level and 41.18% of them were from families whose maintenance is provided by both parents. There are no similar studies, thus, this research aims at contributing to improve rehabilitation programs based on the nursing perspective and facilitating the relationship between the family and the addicted in treatment.

  7. Diet and Body Composition Outcomes of an Environmental and Educational Intervention among Men in Treatment for Substance Addiction

    ERIC Educational Resources Information Center

    Cowan, Jennifer A.; Devine, Carol M.

    2013-01-01

    Objective: To determine the effect of an educational and environmental intervention on diet, body mass index, and waist circumference of men in substance addiction treatment. Methods: One hundred three racially/ethnically diverse men in 6 urban substance addiction residential treatment facilities in Upstate New York participated in weekly…

  8. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Or Drug Addiction § 416.1725 Effect of your failure to comply with treatment requirements for...

  9. Obsessive-compulsive disorder, impulse control disorders and drug addiction: common features and potential treatments.

    PubMed

    Fontenelle, Leonardo F; Oostermeijer, Sanne; Harrison, Ben J; Pantelis, Christos; Yücel, Murat

    2011-05-01

    The basic concepts underlying compulsive, impulsive and addictive behaviours overlap, which may help explain why laymen use these expressions interchangeably. Although there has been a large research effort to better characterize and disentangle these behaviours, clinicians and scientists are still unable to clearly differentiate them. Accordingly, obsessive-compulsive disorder (OCD), impulse control disorders (ICD) and substance-related disorders (SUD) overlap on different levels, including phenomenology, co-morbidity, neurocircuitry, neurocognition, neurochemistry and family history. In this review we summarize these issues with particular emphasis on the role of the opioid system in the pathophysiology and treatment of OCD, ICD and SUD. We postulate that with progression and chronicity of OCD, the proportion of the OCD-related behaviours (e.g. checking, washing, ordering and hoarding, among others) that are driven by impulsive 'rash' processes increase as involvement of more ventral striatal circuits becomes prominent. In contrast, as SUD and ICD progress, the proportion of the SUD- and ICD-related behaviours that are driven by compulsive 'habitual' processes increase as involvement of more dorsal striatal circuits become prominent. We are not arguing that, with time, ICD becomes OCD or vice versa. Instead, we are proposing that these disorders may acquire qualities of the other with time. In other words, while patients with ICD/SUD may develop 'compulsive impulsions', patients with OCD may exhibit 'impulsive compulsions'. There are many potential implications of our model. Theoretically, OCD patients exhibiting impulsive or addictive features could be managed with drugs that address the quality of the underlying drives and the involvement of neural systems. For example, agents for the reduction or prevention of relapse of addiction (e.g. heavy drinking), which modulate the cortico-mesolimbic dopamine system through the opioid (e.g. buprenorphine and naltrexone

  10. [Psychosocial Treatment of Addictive Disorders--An Overview of Psychotherapeutic Options and their Efficacy].

    PubMed

    Walter, M; Dürsteler, K M; Petitjean, S A; Wiesbeck, G A; Euler, S; Sollberger, D; Lang, U E; Vogel, M

    2015-04-01

    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.

  11. Training addiction professionals in empirically-supported treatments: Perspectives from the treatment community

    PubMed Central

    Hartzler, Bryan; Rabun, Carl

    2014-01-01

    Background Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. Methods In this mixed method study, data were collected in 64 semi-structured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and two direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMM), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Results Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, ‘Seeking Safety,’ and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMM and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. Conclusions As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as

  12. Coerced addiction treatment: Client perspectives and the implications of their neglect

    PubMed Central

    2010-01-01

    Recent work has criticized the evidence base for the effectiveness of addiction treatment under social controls and coercion, suggesting that the development of sound policies and treatment practices has been hampered by numerous limitations of the research conducted to date. Implicit assumptions of the effectiveness of coerced treatment are evident in the organization and evolution of treatment, legal, and social service systems, as well as in related legislative practices. This review builds upon previous work by focusing in greater detail on the potential value of incorporating client perspectives on coercion and the implications for interpreting and applying existing research findings. Reviewing the existing empirical and theoretical literature, a case is made for greater accuracy in representing coercive experiences and events in research, so as to better align the measured concepts with actual processes of treatment entry and admission. Attention is given to studies of the effectiveness of treatment under social controls or pressures, the connections to coercion and decision-making, and theoretical perspectives on motivation and behaviour change, including Self-Determination Theory in particular. This synthesis of the available research on coerced addiction treatment suggests that it remains largely unclear to what extent many of the commonly employed methods for getting people into treatment may be detrimental to the treatment process and longer-term outcomes. The impact of coercion upon individual clients, treatment systems, and population health has not been adequately dealt with by addiction researchers to date. PMID:20565914

  13. Exercise as a Novel Treatment for Drug Addiction: A Neurobiological and Stage-Dependent Hypothesis

    PubMed Central

    Lynch, Wendy J.; Peterson, Alexis B.; Sanchez, Victoria; Abel, Jean; Smith, Mark A.

    2013-01-01

    Physical activity, and specifically exercise, has been suggested as a potential treatment for drug addiction. In this review, we discuss clinical and preclinical evidence for the efficacy of exercise at different phases of the addiction process. Potential neurobiological mechanisms are also discussed focusing on interactions with dopaminergic and glutamatergic signaling and chromatin remodeling in the reward pathway. While exercise generally produces an efficacious response, certain exercise conditions may be either ineffective or lead to detrimental effects depending on the level/type/timing of exercise exposure, the stage of addiction, the drug involved, and the subject population. During drug use initiation and withdrawal, its efficacy may be related to its ability to facilitate dopaminergic transmission, and once addiction develops, its efficacy may be related to its ability to normalize glutamatergic and dopaminergic signaling and reverse drug-induced changes in chromatin via epigenetic interactions with BDNF in the reward pathway. We conclude with future directions, including the development of exercise-based interventions alone or as an adjunct to other strategies for treating drug addiction. PMID:23806439

  14. Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

    PubMed

    Amodeo, Maryann; Storti, Susan A; Larson, Mary Jo

    2010-05-01

    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.

  15. Factors Associated with Recent Suicide Attempts in Clients Presenting for Addiction Treatment

    ERIC Educational Resources Information Center

    Penney, Alexander; Mazmanian, Dwight; Jamieson, John; Black, Nancy

    2012-01-01

    Factors associated with recent suicide attempts were examined in clients who sought treatment at an addictions facility between 2001 and 2008. Clients who reported being hospitalized for attempting suicide in the past year (n = 76) were compared to all other clients (n = 5914) on demographic, mental health, substance use, and problem gambling…

  16. Policy Issues for Integrating Parenting Interventions and Addiction Treatment for Women.

    ERIC Educational Resources Information Center

    VanBremen, Jane R.; Chasnoff, Ira J.

    1994-01-01

    This article addresses the rationale for linking addiction treatment programs and parenting education interventions in substance-abusing families. Specific components of a parenting program for women in recovery are detailed, including parenting classes and support groups, mother-child play groups, and family literacy activities. Program…

  17. When Problem Gambling Is the Primary Reason for Seeking Addiction Treatment

    ERIC Educational Resources Information Center

    Jamieson, John; Mazmanian, Dwight; Penney, Alexander; Black, Nancy; Nguyen, An

    2011-01-01

    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…

  18. Evidence-Based and Best Practice Addiction Treatment Resources: A Primer for Librarians.

    ERIC Educational Resources Information Center

    Lacroix, Sheila I.

    2002-01-01

    Introduces concepts, such as evidence-based medicine and best practices, explores these concepts in terms of addiction treatment, discusses practice guidelines, offers suggestions to find and select science-based resources, and explores the librarian's or information specialist's role in the dissemination of this information. (LRW)

  19. Methadone: The Drug and Its Therapeutic Uses In the Treatment of Addiction. Series 31, No. 1.

    ERIC Educational Resources Information Center

    Gamage, James R.; Zerkin, E. Lief

    This fact sheet from the National Clearinghouse for Drug Abuse Information discusses methadone, a therapeutic drug for the treatment of narcotic addiction. It reviews the pharmacology of the drug as well as physiological and psychological effects, patterns of use, and adverse effects (toxicity and poisoning). It examines the success rates of…

  20. [Different explanatory models for addictive behavior in Turkish and German youths in Germany: significance for prevention and treatment].

    PubMed

    Penka, S; Krieg, S; Hunner, Ch; Heinz, A

    2003-07-01

    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.

  1. Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do?

    PubMed

    Mendola, Annette; Gibson, Richard L

    2016-01-01

    Addiction is a complex phenomenon characterized by a loss of control and compulsive, habitual behavior. Since there is no single, specific cause for addiction, there is no single, standard treatment for it. A variety of approaches are used, including counseling, psychotherapy, medications, and mutual help groups (MHG). The best known and most widely available approach to addiction is 12-step (TS) programs of recovery, a variety of MHG. These have been lauded as lifesaving by some and criticized by others. We argue that TS programs are an appropriate mode of help for those seeking to quit an addiction but should not be the only approach considered.

  2. Social Anxiety and Peer Helping in Adolescent Addiction Treatment

    PubMed Central

    Pagano, Maria E.; Wang, Alexandra R.; Rowles, Brieana M.; Lee, Matthew T.; Johnson, Byron R.

    2015-01-01

    lifetime trauma. SAD was associated with higher service participation during treatment, which was associated with reduced risk of relapse and incarceration in the 6 months posttreatment. Findings indicate the benefits of service participation for juveniles with SAD which provides a nonjudgmental, task-focused venue for developing sober networks in the transition back into the community. PMID:25872598

  3. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use

    PubMed Central

    Kampman, Kyle; Jarvis, Margaret

    2015-01-01

    The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This “Practice Guideline” was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) – a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of

  4. Evidence-Based Practices in Addiction Treatment: Review and Recommendations for Public Policy

    PubMed Central

    Glasner-Edwards, Suzette; Rawson, Richard

    2010-01-01

    The movement in recent years towards evidence-based practice (EBP) in health care systems and policy has permeated the substance abuse treatment system, leading to a growing number of federal and statewide initiatives to mandate EBP implementation. Nevertheless, due to a lack of consensus in the addiction field regarding procedures or criteria to identify EBPs, the optimal processes for disseminating empirically based interventions into real-world clinical settings have not been identified. Although working lists of interventions considered to be evidence-based have been developed by a number of constituencies advocating for EBP dissemination in addiction treatment settings, the use of EBP lists to form policy-driven mandates has been controversial. This article examines the concept of EBP, critically reviews criteria used to evaluate the evidence basis of interventions, and highlights the manner in which such criteria have been applied in the addictions field. Controversies regarding EBP implementation policies and practices in addiction treatment are described, and suggestions are made to shift the focus of dissemination efforts from manualized psychosocial interventions to specific skill sets that are broadly applicable and easily learned by clinicians. Organizational and workforce barriers to EBP implementation are delineated, with corresponding recommendations to facilitate successful dissemination of evidence-based skills. PMID:20557970

  5. Collaborative behavioral management: integration and intensification of parole and outpatient addiction treatment services in the Step'n Out study.

    PubMed

    Friedmann, Peter D; Rhodes, Anne G; Taxman, Faye S

    2009-09-01

    Integration of community parole and addiction treatment holds promise for optimizing the participation of drug-involved parolees in re-entry services, but intensification of services might yield greater rates of technical violations. Collaborative behavioral management (CBM) integrates the roles of parole officers and treatment counselors to provide role induction counseling, contract for pro-social behavior, and to deliver contingent reinforcement of behaviors consistent with contracted objectives. Attendance at both parole and addiction treatment are specifically reinforced. The Step'n Out study of the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) randomly allocated 486 drug-involved parolees to either collaborative behavioral management or traditional parole with 3-month and 9-month follow-up. Bivariate and multivariate regression models found that, in the first 3 months, the CBM group had more parole sessions, face-to-face parole sessions, days on which parole and treatment occurred on the same day, treatment utilization and individual counseling, without an increase in parole violations. We conclude that CBM integrated parole and treatment as planned, and intensified parolees' utilization of these services, without increasing violations.

  6. Clinical presentations of substance abuse in bipolar heroin addicts at time of treatment entry

    PubMed Central

    2012-01-01

    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. PMID:22943591

  7. Drink, drugs and disruption: memory manipulation for the treatment of addiction.

    PubMed

    Milton, A L

    2013-08-01

    Addiction is a complex disorder, and one characterised by the acquisition of maladaptive instrumental (drug-seeking and drug-taking) and pavlovian (cue-drug associations) memories. These memories markedly contribute to the long-term risk of relapse, so reduction of the impact of these memories on behaviour could potentially be an important addition to current therapies for addiction. Memory reconsolidation may provide such a target for disrupting well-consolidated pavlovian cue-drug memories following an extensive drug history. Reconsolidation can be disrupted either by administering amnestic drugs in conjunction with a memory reactivation session, or by updating the memory adaptively through the induction of 'superextinction'. More work is needed before these therapies are ready for translation to the clinic, but if found clinically effective memory manipulation promises a radical new way of treating addiction.

  8. Drink, drugs and disruption: memory manipulation for the treatment of addiction.

    PubMed

    Milton, A L

    2013-08-01

    Addiction is a complex disorder, and one characterised by the acquisition of maladaptive instrumental (drug-seeking and drug-taking) and pavlovian (cue-drug associations) memories. These memories markedly contribute to the long-term risk of relapse, so reduction of the impact of these memories on behaviour could potentially be an important addition to current therapies for addiction. Memory reconsolidation may provide such a target for disrupting well-consolidated pavlovian cue-drug memories following an extensive drug history. Reconsolidation can be disrupted either by administering amnestic drugs in conjunction with a memory reactivation session, or by updating the memory adaptively through the induction of 'superextinction'. More work is needed before these therapies are ready for translation to the clinic, but if found clinically effective memory manipulation promises a radical new way of treating addiction. PMID:23265965

  9. The "new masculinity": addiction treatment as a reconstruction of gender in Puerto Rican evangelist street ministries.

    PubMed

    Hansen, Helena

    2012-06-01

    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.

  10. The "new masculinity": addiction treatment as a reconstruction of gender in Puerto Rican evangelist street ministries.

    PubMed

    Hansen, Helena

    2012-06-01

    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. PMID:21911274

  11. [The addicted patient in anaesthesia -screening, diagnosis and treatment of alcohol use disorders].

    PubMed

    Neumann, Tim

    2015-06-01

    Patients consuming > 60g/d of alcohol (e.g. 1.5l of beer), are 2-5 times more likely to suffer post-operative complications such as infectious, bleeding or cardiac complications or an alcohol withdrawal syndrome. By screening and a systematic evaluation risk patients can be identified that may benefit from interventions such as counseling, brief interventions, abstinence, tailored anesthesia, prophylactic treatment of withdrawal symptoms, stress reduction, harm reduction, psychosocial therapy, addiction therapy, multidisciplinary treatment.

  12. Internet gaming addiction: current perspectives.

    PubMed

    Kuss, Daria J

    2013-01-01

    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

  13. Internet gaming addiction: current perspectives

    PubMed Central

    Kuss, Daria J

    2013-01-01

    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

  14. [Internet addiction].

    PubMed

    Korkeila, Jyrki

    2012-01-01

    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.

  15. The Experience of Addiction as Told by the Addicted: Incorporating Biological Understandings into Self-Story

    PubMed Central

    Hammer, Rachel R; Dingel, Molly J; Ostergren, Jenny E; Nowakowski, Katherine E; Koenig, Barbara A

    2012-01-01

    How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis on the biological model. More than half of our sample articulated a biological understanding of addiction as a disease. Themes did not cluster by addictive substance used; however, biological understandings of addiction did cluster by treatment center. Biological understandings have the potential to become dominant narratives of addiction in the current era. Though the desire for a “unified theory” of addiction seems curiously seductive to scholars, it lacks utility. Conceptual “disarray” may actually reflect a more accurate representation of the illness as told by those who live with it. For practitioners in the field of addiction, we suggest the practice of narrative medicine with its ethic of negative capability as a useful approach for interpreting and relating to diverse experiences of disease and illness. PMID:23081782

  16. Relationships of Dissociative Disorders and Personality Traits in Opium Addicts on Methadone Treatment

    PubMed Central

    Ghafarinezhad, Alireza; Rajabizadeh, Ghodratollah; Shahriari, Vahid

    2013-01-01

    Background 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. Methods 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. Findings 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). Conclusion 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. PMID:24494154

  17. A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study

    PubMed Central

    Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan

    2014-01-01

    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

  18. Take Action against Hepatitis C (for People in Recovery from Mental Illness or Addiction)

    MedlinePlus

    ... For People in Recovery From Mental Illness or Addiction Attention treatment providers in behavioral health programs! This ... hepatitis C. If you have a history of addiction, you are at higher risk for hepatitis C. ...

  19. Using Experiential Activities to Prepare Counselors-in-Training to Understand the Power of Cravings when Addressing Clients with Addiction

    ERIC Educational Resources Information Center

    Harrawood, Laura K.; McClure, Cristen C.; Nelson, Jennifer

    2011-01-01

    Providing skilled treatment options for clients experiencing addiction is imperative to positive client treatment outcomes. As a prerequisite to providing efficacious addiction treatment, counselors-in-training are charged with the responsibility of understanding the affect of cravings on addiction relapse. This article presents 3 experiential,…

  20. [Assertive community treatment: promoting engagement with care of people suffering severe addiction].

    PubMed

    Morandi, Stéphane; Silva, Benedetta; Monnat, Martine; Bonsack, Charles

    2016-06-01

    Despite the increasing number of specialized addiction services and the constant deployment of health care resources, a coordinated needs-based treatment is not always available for people with severe drugs and/or alcohol problems. Too often the involved health care professionals feel helpless and overwhelmed by the complexity of the situation. In order to promote the treatment engagement of the hard-to-reach substance users, a multidisciplinary mobile team project for addiction (SIMA) was developed in Lausanne, Switzerland, in 20174. This paper describes the model of intervention, the profile of the population followed during the first year of intervention and illustrates, through two clinical cases, the advantages of this approach. PMID:27451516

  1. Subtyping patients with heroin addiction at treatment entry: factor derived from the Self-Report Symptom Inventory (SCL-90)

    PubMed Central

    2010-01-01

    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. PMID:20388223

  2. Partial MHC/neuroantigen peptide constructs: a potential neuroimmune-based treatment for methamphetamine addiction.

    PubMed

    Loftis, Jennifer M; Wilhelm, Clare J; Vandenbark, Arthur A; Huckans, Marilyn

    2013-01-01

    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.

  3. Blacks and Hispanics are less likely than whites to complete addiction treatment, largely due to socioeconomic factors.

    PubMed

    Saloner, Brendan; Lê Cook, Benjamin

    2013-01-01

    More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. Using national data, we found that blacks and Hispanics were 3.5-8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation. The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers' cultural competence. PMID:23297281

  4. A proposal to evaluate mechanistic efficacy of hallucinogens in addiction treatment.

    PubMed

    Burdick, Brittany Vasae; Adinoff, Bryon

    2013-09-01

    Current treatments for addiction are frequently ineffective. Hallucinogenic therapy has been indicated as helpful for a range of substance use disorders, yet this approach remains understudied and publicly unavailable. It is nonetheless a promising treatment, which has significant, long-term beneficial effects with single doses and a profile characterized by general safety, low toxicity, and non-addictiveness. However, pharmacological interventions, such as hallucinogens, should not be offered if the same effects (e.g. psychological insights/mystical experiences) and outcomes (e.g. decreased drug use) could be achieved absent pharmacological intervention. To date, there have been no clinical comparisons of drug-induced altered states with non-drug-induced states for addiction treatment. We propose and then outline a clinical trial to address this gap in knowledge. The proposed design would evaluate abstinence outcomes in a population of prescription opioid abusers after exposure to one of three conditions: a drug-induced altered state using psilocybin, a non-drug-induced altered state via hyperventilation (Holotropic Breathwork), and an active placebo with niacin. The outcomes of such a study would reveal important differences in therapeutic potential by discriminating hallucinogen-dependent effects from those psychological effects resulting from altered states. PMID:23968172

  5. A proposal to evaluate mechanistic efficacy of hallucinogens in addiction treatment.

    PubMed

    Burdick, Brittany Vasae; Adinoff, Bryon

    2013-09-01

    Current treatments for addiction are frequently ineffective. Hallucinogenic therapy has been indicated as helpful for a range of substance use disorders, yet this approach remains understudied and publicly unavailable. It is nonetheless a promising treatment, which has significant, long-term beneficial effects with single doses and a profile characterized by general safety, low toxicity, and non-addictiveness. However, pharmacological interventions, such as hallucinogens, should not be offered if the same effects (e.g. psychological insights/mystical experiences) and outcomes (e.g. decreased drug use) could be achieved absent pharmacological intervention. To date, there have been no clinical comparisons of drug-induced altered states with non-drug-induced states for addiction treatment. We propose and then outline a clinical trial to address this gap in knowledge. The proposed design would evaluate abstinence outcomes in a population of prescription opioid abusers after exposure to one of three conditions: a drug-induced altered state using psilocybin, a non-drug-induced altered state via hyperventilation (Holotropic Breathwork), and an active placebo with niacin. The outcomes of such a study would reveal important differences in therapeutic potential by discriminating hallucinogen-dependent effects from those psychological effects resulting from altered states.

  6. Treatment of Child/Adolescent Obesity Using the Addiction Model: A Smartphone App Pilot Study

    PubMed Central

    Stock, Carol M.; Allison, Stephen; Roeger, Leigh

    2015-01-01

    Abstract Background: The aim of this study was to test a weight loss program for young people based on an addiction treatment approach. Methods: 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. Results: 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. Conclusions: The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys. PMID:25760813

  7. The psychological and neurochemical mechanisms of drug memory reconsolidation: implications for the treatment of addiction.

    PubMed

    Milton, Amy L; Everitt, Barry J

    2010-06-01

    Memory reconsolidation is the process by which memories, destabilised at retrieval, require restabilisation to persist in the brain. It has been demonstrated that even old, well-established memories require reconsolidation following retrieval; therefore, memory reconsolidation could potentially be exploited to disrupt, or even erase, aberrant memories that underlie psychiatric disorders, thereby providing a novel therapeutic target. Drug addiction is one such disorder; it is both chronic and relapsing, and one prominent risk factor for a relapse episode is the presentation of environmental cues that have previously been associated with drugs of abuse. This 'cue-induced relapse' can be accounted for in psychological terms by reinforcing memories of the pavlovian association between the cue and the drug, which can thus influence behaviour through at least three psychologically and neurobiologically dissociable mechanisms: conditioned reinforcement, conditioned approach and conditioned motivation. As each of these psychological processes could contribute to the resumption of drug-seeking following abstinence, it is important to develop treatments that can reduce drug-seeking re-established via influences on each or all of these pavlovian processes, in order to minimise the risk of a subsequent relapse. Investigation of the memory reconsolidation mechanisms of the memories underlying conditioned reinforcement, conditioned approach and conditioned motivation indicate that they depend upon different neurochemical systems, including the glutamatergic and adrenergic systems within limbic corticostriatal circuitry. We also discuss here the subsequent translation to the clinic of this preclinical work.

  8. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    PubMed

    Goodman, Daisy

    2015-01-01

    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.

  9. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    PubMed

    Goodman, Daisy

    2015-01-01

    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. PMID:26769383

  10. Outcome studies of therapeutic community and halfway house treatment for addicts.

    PubMed

    Smart, R G

    1976-01-01

    This paper reviews the outcomes of follow-up studies of addicts in therapeutic communities. The aim is to assess the research problems in such studies and the range of recovery rates found. It was found that controlled studies are few in number and available only for correctional institutions, not for Daytop, Synanon, or Phoenix House. Most studies base outcomes on "graduates" rather than all those taken into the program. Very few graduates of traditional communities exist. Most are employed in drug or social service activities. Few return to employment outside treatment agencies for addicts. Three controlled studies, all with halfway houses, suggest that they are not more effective than probation. Further controlled studies, especially with agencies such as Daytop and Synanon, are required.

  11. Individual characteristics and response to Contingency Management treatment for cocaine addiction.

    PubMed

    García-Fernández, Gloria; Secades-Villa, Roberto; García-Rodríguez, Olaya; Alvarez-López, Heli; Sánchez-Hervás, Emilio; Fernández-Hermida, José Ramón; Fernández-Artamendi, Sergio

    2011-02-01

    Voucher-based contingency management (CM) research has demonstrated efficacy for treating cocaine addiction, but few studies have examined associations between individual baseline characteristics and response to CM treatments. The aim of this study, involving 50 cocaine outpatients receiving CM for cocaine addiction, was to assess the impact of baseline characteristics on abstinence outcomes after six months of treatment. Patients who were abstinent after six months of treatment accounted for 58% of the sample. Patients with higher scores on the Alcohol area of the EuropASI and patients that were non-abstinent during the first month of treatment were less likely to achieve abstinence. These outcome predictors have implications both for treatment research and for clinical practice. Patients who do not respond early to treatment may need a more intensive intervention, and concomitant problematic alcohol use should be detected and treated. The remaining baseline variables examined were not statistically significant predictors of abstinence. This finding is important for the generalizability of CM across the range of individual characteristics of treatment-seeking cocaine abusers.

  12. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage.

    PubMed

    Hurd, Yasmin L; Yoon, Michelle; Manini, Alex F; Hernandez, Stephanie; Olmedo, Ruben; Ostman, Maria; Jutras-Aswad, Didier

    2015-10-01

    Multiple cannabinoids derived from the marijuana plant have potential therapeutic benefits but most have not been well investigated, despite the widespread legalization of medical marijuana in the USA and other countries. Therapeutic indications will depend on determinations as to which of the multiple cannabinoids, and other biologically active chemicals that are present in the marijuana plant, can be developed to treat specific symptoms and/or diseases. Such insights are particularly critical for addiction disorders, where different phytocannabinoids appear to induce opposing actions that can confound the development of treatment interventions. Whereas Δ(9)-tetracannabinol has been well documented to be rewarding and to enhance sensitivity to other drugs, cannabidiol (CBD), in contrast, appears to have low reinforcing properties with limited abuse potential and to inhibit drug-seeking behavior. Other considerations such as CBD's anxiolytic properties and minimal adverse side effects also support its potential viability as a treatment option for a variety of symptoms associated with drug addiction. However, significant research is still needed as CBD investigations published to date primarily relate to its effects on opioid drugs, and CBD's efficacy at different phases of the abuse cycle for different classes of addictive substances remain largely understudied. Our paper provides an overview of preclinical animal and human clinical investigations, and presents preliminary clinical data that collectively sets a strong foundation in support of the further exploration of CBD as a therapeutic intervention against opioid relapse. As the legal landscape for medical marijuana unfolds, it is important to distinguish it from "medical CBD" and other specific cannabinoids, that can more appropriately be used to maximize the medicinal potential of the marijuana plant. PMID:26269227

  13. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage.

    PubMed

    Hurd, Yasmin L; Yoon, Michelle; Manini, Alex F; Hernandez, Stephanie; Olmedo, Ruben; Ostman, Maria; Jutras-Aswad, Didier

    2015-10-01

    Multiple cannabinoids derived from the marijuana plant have potential therapeutic benefits but most have not been well investigated, despite the widespread legalization of medical marijuana in the USA and other countries. Therapeutic indications will depend on determinations as to which of the multiple cannabinoids, and other biologically active chemicals that are present in the marijuana plant, can be developed to treat specific symptoms and/or diseases. Such insights are particularly critical for addiction disorders, where different phytocannabinoids appear to induce opposing actions that can confound the development of treatment interventions. Whereas Δ(9)-tetracannabinol has been well documented to be rewarding and to enhance sensitivity to other drugs, cannabidiol (CBD), in contrast, appears to have low reinforcing properties with limited abuse potential and to inhibit drug-seeking behavior. Other considerations such as CBD's anxiolytic properties and minimal adverse side effects also support its potential viability as a treatment option for a variety of symptoms associated with drug addiction. However, significant research is still needed as CBD investigations published to date primarily relate to its effects on opioid drugs, and CBD's efficacy at different phases of the abuse cycle for different classes of addictive substances remain largely understudied. Our paper provides an overview of preclinical animal and human clinical investigations, and presents preliminary clinical data that collectively sets a strong foundation in support of the further exploration of CBD as a therapeutic intervention against opioid relapse. As the legal landscape for medical marijuana unfolds, it is important to distinguish it from "medical CBD" and other specific cannabinoids, that can more appropriately be used to maximize the medicinal potential of the marijuana plant.

  14. Undergraduate and Graduate Students' Attitudes toward Addiction Treatment Manuals

    ERIC Educational Resources Information Center

    Simons, Lori; Jacobucci, Ray; Houston, Hank

    2005-01-01

    A pilot survey of 36 undergraduate (n = 10) and graduate (n = 26) students employed as counselors was used to explore students' attitudes toward empirically supported treatment (EST) manuals for chemical abuse and dependence. There were no significant differences in attitudes toward ESTs between undergraduates and graduates; however,…

  15. Facts about Naltrexone for Treatment of Opioid Addiction

    MedlinePlus

    ... SMA) 09-4443 (also in Spanish) • Introduction to Methadone (SMA) 06-4123 • Faces of Change: An Illustrated Booklet for Consumers (SMA) 08-4174 • What Is Substance Abuse Treatment? A Booklet for Families (SMA) 08-4126 (also ...

  16. Facts about Buprenorphine for Treatment of Opioid Addiction

    MedlinePlus

    ... Families and Friends (SMA) 09-4443 • Introduction to Methadone (SMA) 06-4123 • Faces of Change: An Illustrated Booklet for Consumers (SMA) 08-4174 • What Is Substance Abuse Treatment? A Booklet for Families (SMA) 08-4126 (also ...

  17. [Physical exercise and yoga in prevention and treatment of addictive diseases].

    PubMed

    Nespor, K

    2005-01-01

    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.

  18. Outcomes following treatment of veterans for substance and tobacco addiction.

    PubMed

    Vest, Bridgette Helms; Kane, Catherine; DeMarce, Josephine; Barbero, Edie; Harmon, Rebecca; Hawley, Joanne; Lehmann, Lauren

    2014-10-01

    Persons who use tobacco in addition to alcohol and other drugs have increased health risks and mortality rates. The purpose of this study was to evaluate the impact of participation in a tobacco cessation program on tobacco, alcohol, and other drug use in a population seeking treatment for substance use disorders (SUDs). Tobacco, alcohol, and other drug use were assessed by urine drug screens, breathalyzer readings, and self-report. Veterans (N=137) with a tobacco use disorder enrolled in inpatient program for the treatment of SUDs at the Salem Veterans Affairs Medical Center participated in tobacco cessation education as part of their treatment programming. Use of tobacco, drugs and/or alcohol was evaluated upon admission, 2 weeks following admission, at discharge and 1 month following graduation. The 1-month follow-up rate was 70.8%, with 97 veterans completing the follow-up assessment. Of those 97 veterans, 90.7% (n=88) reported abstinence from alcohol and 91.8% (n=89) reported abstinence from other drugs of abuse. Fourteen veterans (14.4%) reported abstinence from tobacco at the 1-month follow-up. The veterans reporting abstinence from tobacco use also reported abstinence from alcohol and other drugs at the 1-month follow-up. PMID:25439975

  19. Optogenetics: potentials for addiction research.

    PubMed

    Cao, Zhen Fang Huang; Burdakov, Denis; Sarnyai, Zoltán

    2011-10-01

    Research on the biology of addiction has advanced significantly over the last 50 years expanding our understanding of the brain mechanisms underlying reward, reinforcement and craving. Novel experimental approaches and techniques have provided an ever increasing armory of tools to dissect behavioral processes, neural networks and molecular mechanisms. The ultimate goal is to reintegrate this knowledge into a coherent, mechanistic framework of addiction to help identify new treatment. This can be greatly facilitated by using tools that allow, with great spatial and temporal specificity, to link molecular changes with altered activation of neural circuits and behavior. Such specificity can now be achieved by using optogenetic tools. Our review describes the general principles of optogenetics and its use to understand the links between neural activity and behavior. We also provide an overview of recent studies using optogenetic tools in addiction and consider some outstanding questions of addiction research that are particularly amenable for optogenetic approaches.

  20. NARCOTIC DRUG ADDICTION.

    ERIC Educational Resources Information Center

    YAHRAES, HERBERT; AND OTHERS

    MUCH HAS BEEN LEARNED IN RECENT YEARS ABOUT THE NATURE OF DRUG ADDICTION, THE FACTORS WHICH LEAD A PERSON INTO ADDICTION, AND THE EFFECTIVE TREATMENT OF PERSONS WHO HAVE BECOME ADDICTED. THIS PAMPHLET SURVEYS THE NEW FINDINGS AND IS INTENDED PRIMARILY FOR (1) THOSE WHO IN THE COURSE OF THEIR PROFESSIONAL DUTIES COME IN CONTACT WITH ADDICTED…

  1. The Soviet doctor and the treatment of drug addiction: "A difficult and most ungracious task".

    PubMed

    Latypov, Alisher B

    2011-12-30

    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].

  2. The Soviet doctor and the treatment of drug addiction: "A difficult and most ungracious task"

    PubMed Central

    2011-01-01

    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]. PMID:22208726

  3. A National Study of American Indian and Alaska Native Substance Abuse Treatment: Provider and Program Characteristics.

    PubMed

    Rieckmann, Traci; Moore, Laurie A; Croy, Calvin D; Novins, Douglas K; Aarons, Gregory

    2016-09-01

    American Indians and Alaska Natives (AIANs) experience major disparities in accessing quality care for mental health and substance use disorders. There are long-standing concerns about access to and quality of care for AIANs in rural and urban areas including the influence of staff and organizational factors, and attitudes toward evidence-based treatment for addiction. We conducted the first national survey of programs serving AIAN communities and examined workforce and programmatic differences between clinics located in urban/suburban (n=50) and rural (n=142) communities. We explored the correlates of openness toward using evidence-based treatments (EBTs). Programs located in rural areas were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff, to consult outside evaluators, to use strategic planning to improve program quality, to offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, and to participate in research or program evaluation studies. They were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes. Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services. Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness. This research provides baseline workforce and program level data that can be used to better understand changes in access and quality for AIAN over time.

  4. A National Study of American Indian and Alaska Native Substance Abuse Treatment: Provider and Program Characteristics.

    PubMed

    Rieckmann, Traci; Moore, Laurie A; Croy, Calvin D; Novins, Douglas K; Aarons, Gregory

    2016-09-01

    American Indians and Alaska Natives (AIANs) experience major disparities in accessing quality care for mental health and substance use disorders. There are long-standing concerns about access to and quality of care for AIANs in rural and urban areas including the influence of staff and organizational factors, and attitudes toward evidence-based treatment for addiction. We conducted the first national survey of programs serving AIAN communities and examined workforce and programmatic differences between clinics located in urban/suburban (n=50) and rural (n=142) communities. We explored the correlates of openness toward using evidence-based treatments (EBTs). Programs located in rural areas were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff, to consult outside evaluators, to use strategic planning to improve program quality, to offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, and to participate in research or program evaluation studies. They were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes. Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services. Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness. This research provides baseline workforce and program level data that can be used to better understand changes in access and quality for AIAN over time. PMID:27431046

  5. Addicted to the Risk, Recognition and Respect that the Graffiti Lifestyle Provides: Towards an Understanding of the Reasons for Graffiti Engagement

    ERIC Educational Resources Information Center

    Taylor, Myra Frances

    2012-01-01

    This paper, details from an educational perspective the reasons graffitists give for their involvement in graffiti. Data gathered from interviews, web-blogs and newspaper reports were analysed within the grounded theory tradition allowing the core category of, "addicted to the risk, recognition and respect that the graffiti lifestyle provides" to…

  6. Essential elements of treatment: a comparative study between European and American therapeutic communities for addiction.

    PubMed

    Goethals, Ilse; Soyez, Veerle; Melnick, Gerald; De Leon, George; Broekaert, Eric

    2011-01-01

    The purpose of this study was to investigate whether European and American therapeutic communities (TCs) for addiction, both traditional and modified, share a common perspective on what is essential in treatment using the Survey of Essential Elements Questionnaire (SEEQ). The European sample (N = 19) was gathered in 2009. For the American sample (N = 19), we used previously published research data. Despite comparable perspectives, European traditional TCs (N = 11) scored significantly higher than their American predecessors (N = 11) on four SEEQ domains. Cluster differences were more pronounced in Europe than in America. PMID:21235341

  7. Lessons From Medicaid’s Divergent Paths On Mental Health And Addiction Services

    PubMed Central

    Andrews, Christina; Grogan, Colleen M.; Brennan, Marianne; Pollack, Harold A.

    2016-01-01

    Over the past fifty years Medicaid has taken divergent paths in financing mental health and addiction treatment. In mental health, Medicaid became the dominant source of funding and had a profound impact on the organization and delivery of services. But it played a much more modest role in addiction treatment. This is poised to change, as the Affordable Care Act is expected to dramatically expand Medicaid’s role in financing addiction services. In this article we consider the different paths these two treatment systems have taken since 1965 and identify strategic lessons that the addiction treatment system might take from mental health’s experience under Medicaid. These lessons include leveraging optional coverage categories to tailor Medicaid to the unique needs of the addiction treatment system, providing incentives to addiction treatment programs to create and deliver high-quality alternatives to inpatient treatment, and using targeted Medicaid licensure standards to increase the quality of addiction services. PMID:26153307

  8. Dual diagnosis capability in mental health and addiction treatment services: an assessment of programs across multiple state systems.

    PubMed

    McGovern, Mark P; Lambert-Harris, Chantal; Gotham, Heather J; Claus, Ronald E; Xie, Haiyi

    2014-03-01

    Despite increased awareness of the benefits of integrated services for persons with co-occurring substance use and psychiatric disorders, estimates of the availability of integrated services vary widely. The present study utilized standardized measures of program capacity to address co-occurring disorders, the dual diagnosis capability in addiction treatment and dual diagnosis capability in mental health treatment indexes, and sampled 256 programs across the United States. Approximately 18 % of addiction treatment and 9 % of mental health programs met criteria for dual diagnosis capable services. This is the first report on public access to integrated services using objective measures. PMID:23183873

  9. Use of low-energy laser as adjunct treatment of alcohol addiction.

    PubMed

    Zalewska-Kaszubska, Jadwiga; Obzejta, Dominik

    2004-01-01

    Auricular acupuncture is a medical method that has been used in the treatment of alcohol addiction. In our study we decided to intensify this method by additional biostimulation of the whole organism. The aim of this study was the therapy of patients with alcohol dependence syndrome. Fifty-three alcoholics were treated with two types of laser stimulation in four sessions. Each session consisted of 20 consecutive daily helium-neon laser neck biostimulations and 10 auricular acupuncture treatments with argon laser (every 2nd day). The Beck Depression Inventory-Fast Screen (BDI-FS) was used to assess their frame of mind before the session and after 2 months of treatment. Moreover, beta-endorphin plasma concentration was estimated five times using the radioimmunoassay (RIA) method. Improvement in BDI-FS and increase in, beta-endorphin level were observed. These results suggest that laser therapy can be useful as an adjunct treatment for alcoholism. PMID:15674998

  10. AN EXPLORATORY STUDY INVESTIGATING THE EFFECTS OF A TREATMENT MANUAL FOR VIDEO GAME ADDICTION.

    PubMed

    Pallesen, Ståle; Lorvik, Ingjerd Meen; Bu, Eli Hellandsjø; Molde, Helge

    2015-10-01

    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.

  11. A Multi-Level Approach to Predicting Community Addiction Treatment Attitudes About Contingency Management

    PubMed Central

    Hartzler, Bryan; Donovan, Dennis; Tillotson, Carrie; Mongoue-Tchokote, Solange; Doyle, Suzanne; McCarty, Dennis

    2011-01-01

    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, 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. PMID:22138199

  12. The Role of Gender in Factors Associated With Addiction Treatment Satisfaction Among Long-Term Opioid Users

    PubMed Central

    Marchand, Kirsten; Palis, Heather; Peng, Defen; Fikowski, Jill; Harrison, Scott; Spittal, Patricia; Schechter, Martin T.; Oviedo-Joekes, Eugenia

    2015-01-01

    Objectives: To identify factors associated with Opioid Agonist Treatment (OAT) satisfaction and to determine whether these relationships are gender specific. Methods: This study was based on data collected in a cross-sectional study among long-term opioid-dependent individuals (n = 160; 46.3% women). Participants completed the Client Satisfaction Questionnaire in reference to OAT episodes. Sociodemographic, illicit substance use, health, and addiction treatment history data were collected. Multivariable linear regression was used to determine the relationship between these variables and treatment satisfaction. To explore the potential role of gender in these identified relationships stratified multivariable models were tested. Additional open-ended questions regarding positive and negative perceptions of treatment were collected, and a thematic analysis was conducted. Results: In the multivariable linear regression model, participants who were older, of Aboriginal ancestry, and currently receiving OAT had higher OAT satisfaction scores, whereas participants who had methadone dose preferences of 30 mg or less had lower OAT satisfaction. In stratified analyses among women, the relationship between preferred methadone dose and current OAT remained significantly associated with satisfaction. Open-ended positive and negative perceptions complemented and provided further valuable data to interpret these identified relationships. Conclusions: To our knowledge, this is the first study to explore the potential role of gender in factors associated with OAT satisfaction. These findings provide valuable information to health care providers working in OAT settings regarding how to address women and men's OAT needs and improve treatment satisfaction. PMID:26335006

  13. The application of mindfulness-based cognitive interventions in the treatment of co-occurring addictive and mood disorders.

    PubMed

    Hoppes, Kimberly

    2006-11-01

    This article reviews the theory, clinical application, and empirical findings on mindfulness-based cognitive therapy (MBCT) for mental health and addictive disorders. Expanding upon the research demonstrating the efficacy of cognitive-behavioral therapy (CBT) for addiction, this article develops and explores the rationale for combining mindfulness-based interventions with evidence-based CBTs in treating addictive disorders, with an emphasis on substance use disorders with co-occurring mood disorders. This article proposes that deficits in affect--regulation related to the behavioral and emotional effects of neurobiological changes that occur with long-term substance abuse--pose a unique set of challenges in early recovery. Prolonged use of addictive substances impairs the brain pathways that mediate certain affect regulation functions. These functions involve attention and inhibitory control, the saliency of and response to addictive versus natural reward stimuli, and the ability to detach or maintain perspective in response to strong emotional states. In treating this affective dysregulation, which can contribute to the vulnerability to relapse in the early stages of recovery, the affect-regulation-specific focus of MBCT adds a valuable element to augment CBT for addiction. Summarizing magnetic resonance imaging and positron emission tomography findings on the effects of MBCT and the neurobiology of drug addiction, this article outlines directions for further research on potential benefits of MBCT for the recovering individual. Finally, this article describes a structured protocol, developed at the Mount Sinai School of Medicine in New York City, which combines CBT with mindfulness-based intervention, for the treatment of affect-regulation issues specific to co-occurring addictive and mood disorders.

  14. Validation of the treatment identification strategy of the HEDIS addiction quality measures: concordance with medical record review

    PubMed Central

    2011-01-01

    Background Strategies to accurately identify the occurrence of specific health care events in administrative data is central to many quality improvement and research efforts. Many health care quality measures have treatment identification strategies based on diagnosis and procedure codes - an approach that is inexpensive and feasible but usually of unknown validity. In this study, we examined if the diagnosis/procedure code combinations used in the 2006 HEDIS Initiation and Engagement quality measures to identify instances of addiction treatment have high concordance with documentation of addiction treatment in clinical progress notes. Methods Four type of records were randomly sampled from VHA electronic medical data: (a) Outpatient records from a substance use disorder (SUD) specialty clinic with a HEDIS-qualified substance use disorder (SUD) diagnosis/CPT code combination (n = 700), (b) Outpatient records from a non-SUD setting with a HEDIS-qualified SUD diagnosis/CPT code combination (n = 592), (c) Specialty SUD Inpatient/residential records that included a SUD diagnosis (n = 700), and (d) Non-SUD specialty Inpatient/residential records that included a SUD diagnosis (n = 700). Clinical progress notes for the sampled records were extracted and two raters classified each as documenting or not documenting addiction treatment. Rates of concordance between the HEDIS addiction treatment identification strategy and the raters' judgments were calculated for each record type. Results Within SUD outpatient clinics and SUD inpatient specialty units, 92% and 98% of sampled records had chart evidence of addiction treatment. Of outpatient encounters with a qualifying diagnosis/procedure code combination outside of SUD clinics, 63% had chart evidence of addiction treatment. Within non-SUD specialty inpatient units, only 46% of sampled records had chart evidence of addiction treatment. Conclusions For records generated in SUD specialty settings, the HEDIS strategy of

  15. A review of lysergic acid diethylamide (LSD) in the treatment of addictions: historical perspectives and future prospects.

    PubMed

    Liester, Mitchell B

    2014-01-01

    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. PMID:25563445

  16. A review of lysergic acid diethylamide (LSD) in the treatment of addictions: historical perspectives and future prospects.

    PubMed

    Liester, Mitchell B

    2014-01-01

    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.

  17. The impact of therapists' words on the adolescent brain: In the context of addiction treatment.

    PubMed

    Feldstein Ewing, Sarah W; Houck, Jon M; Yezhuvath, Uma; Shokri-Kojori, Ehsan; Truitt, Dustin; Filbey, Francesca M

    2016-01-15

    At this time, we still do not know how therapist behaviors influence adolescent brain response and related treatment outcomes. Therefore, we examined this question with 17 binge drinking youth (mean age=16.62 years; 64.3% female; 42.9% Hispanic; 28.6% bi-/multi-racial). In this within-subjects design, all youth completed a baseline assessment, two therapy sessions, an fMRI scan, and were re-evaluated for behavior change at one-month post-treatment. During the fMRI session, youth were presented with two types of responses from their treating therapist: higher-skill statements prescribed in an empirically-supported addiction treatment (complex reflections) vs. language standard within addiction treatment more broadly (closed questions). In terms of behavior change, at the one-month follow-up, youth showed significant reductions in number of drinking days and binge drinking days. Further, we found main effects for complex reflections and closed questions across the superior middle temporal gyrus and middle temporal gyrus (FWE-corrected, p<.05). Greater brain response was observed for complex reflections versus closed questions within the bilateral anterior cingulate gyrus. Greater BOLD response in the parietal lobe during closed questions was significantly associated with less post-treatment drinking. Lower BOLD response during complex reflections and closed questions in the precuneus were associated with greater post-treatment ratings of importance of changing. This study represents a first step in understanding how therapist behaviors influence the developing adolescent brain and how that neural response may be associated with youth treatment outcomes.

  18. Healthcare Providers' Treatment of College Smokers

    ERIC Educational Resources Information Center

    Koontz, Jennifer Scott; Harris, Kari Jo; Okuyemi, Kolawole S.; Mosier, Michael C.; Grobe, James; Nazir, Niaman; Ahluwalia, Jasjit S.

    2004-01-01

    About 28% of college students smoke tobacco, and many will continue smoking into adulthood. Although little is known about how to help college students quit smoking. I promising strategy is healthcare providers' advice. To estimate their lifetime receipt of brief advice and to identify characteristics that predict who may receive that advice, 348…

  19. Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction.

    PubMed

    Garcia-Romeu, Albert; Griffiths, Roland R; Johnson, Matthew W

    2014-01-01

    Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment. PMID:25563443

  20. Psilocybin-occasioned Mystical Experiences in the Treatment of Tobacco Addiction

    PubMed Central

    Garcia-Romeu, Albert; Griffiths, Roland R.; Johnson, Matthew W.

    2014-01-01

    Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for “complete” mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment. PMID:25563443

  1. Ethical issues in the conduct of longitudinal studies of addiction treatment.

    PubMed

    Scott, Christy K; White, William L

    2005-01-01

    Many complex ethical issues arise in the day-to-day conduct of longitudinal studies of addiction treatment. These issues are rooted, in part, in the sustained and potentially ambiguous relationship between research staff and study participants, the frequently changing clinical and legal status of study participants, the assertive methods required to generate high follow-up rates, and the numerous systems of care and control in which participants are involved. To identify common ethical issues that arise in such studies, the authors conducted individual and group interviews with seasoned members (case trackers, field trackers, interviewers, and supervisors) of the research team. The ethical dilemmas identified through these interviews fell into seven broad arenas: (1) informed consent for research participation, (2) confidentiality and information disclosure, (3) relationship boundaries between study participants and research staff, (4) duty to warn/report responsibilities, (5) questions of autonomy and privacy, (6) issues related to compensation for research participation, and (7) data integrity. Case studies that illustrate common ethical dilemmas within each of these seven areas are presented and discussed. Ethical dilemmas in the study of addiction treatment can be effectively managed via ethically informed research protocols, staff training in ethical decision-making, monitoring and supervision, and collective debriefing of critical events.

  2. Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction.

    PubMed

    Garcia-Romeu, Albert; Griffiths, Roland R; Johnson, Matthew W

    2014-01-01

    Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.

  3. Differential profile and treatment development of drug-addicted patients depending on violent behaviours and/or criminal acts.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso; Cacho, Raúl

    2015-01-01

    This study explored the prevalence of violent and/or criminal behaviors in drug-addicted patients. A sample of 252 drug-addicted patients who sought treatment was assessed. Information was collected on violent behaviors, criminal acts, socio-demographic factors, consumption factors, psychopathological factors, and personality variables. The sample was divided into 4 groups according to the presence of violence and/or criminal behaviors. There were significant differences between the groups on some variables. In general, patients associated with both violence and criminal behaviors showed a greater severity in drug consumption and maladjustment variables, as well as a higher rate of treatment dropout and re-entry.

  4. Differential profile and treatment development of drug-addicted patients depending on violent behaviours and/or criminal acts.

    PubMed

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso; Cacho, Raúl

    2015-01-01

    This study explored the prevalence of violent and/or criminal behaviors in drug-addicted patients. A sample of 252 drug-addicted patients who sought treatment was assessed. Information was collected on violent behaviors, criminal acts, socio-demographic factors, consumption factors, psychopathological factors, and personality variables. The sample was divided into 4 groups according to the presence of violence and/or criminal behaviors. There were significant differences between the groups on some variables. In general, patients associated with both violence and criminal behaviors showed a greater severity in drug consumption and maladjustment variables, as well as a higher rate of treatment dropout and re-entry. PMID:25774971

  5. A review of computer-based interventions used in the assessment, treatment, and research of drug addiction.

    PubMed

    Bickel, Warren K; Christensen, Darren R; Marsch, Lisa A

    2011-01-01

    Computer-based interventions are cost-efficient methods that may result in greater access to drug addiction treatment. We review recent findings from our laboratory where computer-based interventions have produced outcomes that are comparable to therapist-delivered interventions. We also examine how computer-based interventions targeting substance abuse disorders relate to cognitive functioning. This review will suggest that not only are computer-based interventions cost-efficient and accessible but that they are also effective methods for the motivation, engagement, and treatment of drug-dependent individuals. Moreover, computer-based interventions are compatible with a recently proposed biological mechanism implicated as the basis for drug addiction.

  6. What's in the 'treatment gap'? Ethnographic perspectives on addiction and global mental health from China, Russia, and the United States.

    PubMed

    Bartlett, Nicholas; Garriott, William; Raikhel, Eugene

    2014-01-01

    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.

  7. Opioid addiction and abuse in primary care practice: a comparison of methadone and buprenorphine as treatment options.

    PubMed

    Bonhomme, Jean; Shim, Ruth S; Gooden, Richard; Tyus, Dawn; Rust, George

    2012-01-01

    Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, side-effects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care. PMID:23092049

  8. Providing treatment to persons with mental illness.

    PubMed

    Shore, M F; Cohen, M D

    1994-01-01

    The RWJF Program on Chronic Mental illness created centralized mental health authorities in nine cities as a demonstration project. Evaluation teams, selected after the project began, and a national program office, established to provide technical assistance and to communicate progress and results, worked in tandem with the program staff. The project was evaluated as "logic model" to determine the feasibility of centralized authorities and to estimate their effect on various outcomes. One finding was that service reorganization does not cancel out the need to supply funds or mental health care. The problems of delay in the publication of results and of public officials' reluctance to act without "definitive" research data are described, as are the remedies for these difficulties.

  9. Integrating Shamanic Methodology into the Spirituality of Addictions Recovery Work

    ERIC Educational Resources Information Center

    Rich, Marcia L.

    2012-01-01

    Responding to an increased recognition of the importance of spirituality in the aetiology and treatment of addictions, this article provides an overview of the potential contributions of both transpersonal psychology and shamanic methodology for the addictions field. A case study is provided to illustrate the integration of conventional,…

  10. Effect of subcutaneous thymopentin treatment in drug addicts with persistent generalized lymphadenopathy

    PubMed Central

    Barcellini, Wilma; Meroni, P. L.; Frasca, Daniela; Sguotti, Chiara; Borghi, Maria Orietta; Uberti-Foppa, Caterina; Buzzetti, P.; Lazzarin, A.; Doria, G.; Moroni, M.; Zanussi, C.

    1987-01-01

    The effect of thymopentin treatment on the immune defects in drug addicts with persistent generalized lymphadenopathy and HTLV-III infection was investigated. Thymopentin was administered subcutaneously at two different dose schedules: 50 mg three times a week for 3 weeks (first cycle) and 50 mg/week for 3 months (second cycle). After the first cycle an increased number of OKT4+ lymphocytes and an improvement of PWM-induced blastogenesis and IgG synthesis in vitro was observed. The second cycle was unable to modify the same immune parameters in vitro. The treatment had no effect on the PHA responsiveness and on PHA-induced interleukin 2 production. The significance and the prognostic value of these findings are discussed in terms of the clinical evolution of the syndrome. PMID:3301099

  11. A review of addiction.

    PubMed

    Clay, Steven W; Allen, Jason; Parran, Theorore

    2008-07-01

    Addiction to drugs and alcohol is often undiagnosed and untreated. Physicians are often unaware or have negative attitudes regarding these patients, such as the perception that treatment is ineffective. Addiction--psychological dependence with or without tolerance and withdrawal--is essentially compulsive uncontrolled substance use despite physical, psychological, or social consequences. We now have an understanding of the 2 major neurological pathways involved in addiction. First, the mesolimbic dopamine reward pathway, which is essential for survival, can be physically altered by drug abuse to result in uncontrolled cravings. Second, the decision-making prefrontal cortex, which suppresses inappropriate reward response, can also be altered by drug abuse. Thus, accelerated "go" signals and impaired "stop" signals result in uncontrolled use despite severe consequences. Further, addicts can be predisposed to addiction by genetic defects in reward pathway neurotransmission and stress-related developmental brain abnormalities. Relapse to drug use can occur because of stress or cue-related reward pathway stimulation or even by a single drug dose. Individualized treatment of addiction, including pharmacological and cognitive-behavioral interventions, can be as successful as treatment of other chronic diseases. Several pharmaceuticals are available or under study for these disorders. Waiting for the addict to "be ready" for treatment can be dangerous and detoxification alone is often ineffective. The physician's role in treating addiction includes prevention, diagnosis, brief intervention, motivational interviewing, referral, and follow-up care. An understanding of the biological reality of addiction allows physicians to understand addicts as having a brain disease. Further, the reality of effective pharmacological and cognitive-behavioral treatments for addiction allows physicians to be more optimistic in treating addicts. The challenge to the physician is to embrace the

  12. The Neurobiology of "Food Addiction" and Its Implications for Obesity Treatment and Policy.

    PubMed

    Carter, Adrian; Hendrikse, Joshua; Lee, Natalia; Yücel, Murat; Verdejo-Garcia, Antonio; Andrews, Zane; Hall, Wayne

    2016-07-17

    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. PMID:27296500

  13. Diagnostic instruments for behavioural addiction: an overview

    PubMed Central

    Albrecht, Ulrike; Kirschner, Nina Ellen; Grüsser, Sabine M.

    2007-01-01

    In non-substance-related addiction, the so-called behavioural addiction, no external psychotropic substances are consumed. The psychotropic effect consists of the body’s own biochemical processes induced only by excessive activities. Until recently, knowledge was limited with respect to clinically relevant excessive reward-seeking behaviour, such as pathological gambling, excessive shopping and working which meet diagnostic criteria of dependent behaviour. To date, there is no consistent concept for diagnosis and treatment of excessive reward-seeking behaviour, and its classification is uncertain. Therefore, a clear conceptualization of the so-called behavioural addictions is of great importance. The use of adequate diagnostic instruments is necessary for successful therapeutical implications. This article provides an overview of the current popular diagnostic instruments assessing the different forms of behavioural addiction. Especially in certain areas there are only few valid and reliable instruments available to assess excessive rewarding behaviours that fulfill the criteria of addiction. PMID:19742294

  14. Sex differences in addictive disorders.

    PubMed

    Fattore, Liana; Melis, Miriam; Fadda, Paola; Fratta, Walter

    2014-08-01

    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.

  15. Sex differences in addictive disorders.

    PubMed

    Fattore, Liana; Melis, Miriam; Fadda, Paola; Fratta, Walter

    2014-08-01

    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. PMID:24769267

  16. Critical thoughts on current rodent models for evaluating potential treatments of alcohol addiction and withdrawal

    PubMed Central

    Ripley, Tamzin L; Stephens, David N

    2011-01-01

    Despite years of neurobiological research that have helped to identify potential therapeutic targets, we do not have a reliable pharmacological treatment for alcoholism. There are a range of possible explanations for this failure, including arguments that alcoholism is a spectrum disorder and that different population subtypes may respond to different treatments. This view is supported by categorisations such as early- and late-onset alcoholism, whilst multifactorial genetic factors may also alter responsivity to pharmacological agents. Furthermore, experience of alcohol withdrawal may play a role in future drinking in a way that may distinguish alcoholism from other forms of addiction. Additionally, our neurobiological models, based largely upon results from rodent studies, may not mimic specific aspects of the human condition and may reflect different underlying phenomena and biological processes from the clinical pattern. As a result, potential treatments may be targeting inappropriate aspects of alcohol-related behaviours. Instead, we suggest a more profitable approach is (a) to identify well-defined intermediate behavioural phenotypes in human experimental models that reflect defined aspects of the human clinical disorder and (b) to develop animal models that are homologous with those phenotypes in terms of psychological processes and underlying neurobiological mechanisms. This review describes an array of animal models currently used in the addiction field and what they tell us about alcoholism. We will then examine how established pharmacological agents have been developed using only a limited number of these models, before describing some alternative novel approaches to achieving homology between animal and human experimental measures. LINKED ARTICLES This article is part of a themed issue on Translational Neuropharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.164.issue-4 PMID:21470204

  17. Neural and psychological mechanisms underlying compulsive drug seeking habits and drug memories – indications for novel treatments of addiction*

    PubMed Central

    Everitt, Barry J

    2014-01-01

    This review discusses the evidence for the hypothesis that the development of drug addiction can be understood in terms of interactions between Pavlovian and instrumental learning and memory mechanisms in the brain that underlie the seeking and taking of drugs. It is argued that these behaviours initially are goal-directed, but increasingly become elicited as stimulus–response habits by drug-associated conditioned stimuli that are established by Pavlovian conditioning. It is further argued that compulsive drug use emerges as the result of a loss of prefrontal cortical inhibitory control over drug seeking habits. Data are reviewed that indicate these transitions from use to abuse to addiction depend upon shifts from ventral to dorsal striatal control over behaviour, mediated in part by serial connectivity between the striatum and midbrain dopamine systems. Only some individuals lose control over their drug use, and the importance of behavioural impulsivity as a vulnerability trait predicting stimulant abuse and addiction in animals and humans, together with consideration of an emerging neuroendophenotype for addiction are discussed. Finally, the potential for developing treatments for addiction is considered in light of the neuropsychological advances that are reviewed, including the possibility of targeting drug memory reconsolidation and extinction to reduce Pavlovian influences on drug seeking as a means of promoting abstinence and preventing relapse. PMID:24935353

  18. Proceedings of a Symposium on the Use of Group Procedures in the Prevention and Treatment of Drug and Alcohol Addiction.

    ERIC Educational Resources Information Center

    Gazda, George M., Ed.

    The theme of the fifth annual Symposium on Group Procedures was "The Use of Group Procedures in the Prevention and Treatment of Drug and Alcohol Addiction." Symposium participants included professionals in counseling; clinical, school, and educational psychology, psychiatry, and social work. In addition, invitations were sent to members of…

  19. Preparing Addiction Specialists to Include Case Management and Vocational Rehabilitation Services in the Treatment Model for Problem Gamblers

    ERIC Educational Resources Information Center

    Glenn, Margaret K.; Diaz, Sebastian R.; Hawley, Carolyn

    2009-01-01

    Professionals in the field of addictions view problems associated with recovery management across multiple domains. This exploratory study utilized concept mapping and pattern matching methodology to conceptualize the resulting 7 domains of concern for treatment and aftercare of problem and pathological gamblers. The information can be used by…

  20. Carvedilol and spirulina may provide important health protection to smokers and other nicotine addicts: a call for pertinent research.

    PubMed

    McCarty, Mark F; O'Keefe, James H; DiNicolantonio, James J

    2015-01-01

    Nicotine and soluble semi-stable aldehydes and ketones in cigarette smoke are key mediators of the elevated risks for vascular disease, cancer, and chronic obstructive pulmonary disease observed in smokers. Nicotine, via sympathetic stimulation, increases risk for both vascular disease and cancer. Comprehensive suppression of sympathetic activity with the well-tolerated drug carvedilol, which inhibits betal 1, beta2 and alphal adrenergic receptors, may be protective to smokers and other nicotine addicts. The soluble aldehydes and ketones in tobacco smoke appear to exert their adverse effects through activation of NADPH oxidase complexes in vascular tissues and in the lungs. The phytochemical phycocyanobilin (PhyCB), richly supplied by the edible cyanobacterium spirulina, in studies on rodents and in human cell cultures has shown the ability to safely mimic intracellular bilirubin's physiological role as an inhibitor ofNADPH oxidase activity. It therefore may have potential for mitigating the pro-oxidative effects of tobacco smoke aldehydes and ketones. Joint administration of carvedilol and spirulina merits exploration as a strategy for moderating the pathogenic impact of smoking in chronic tobacco users who either fail to quit or refuse to try cessation of tobacco. Carvedilol may be appropriate for those who manage a nicotine addiction in other ways (smokeless tobacco, e-cigarettes, nicotine gum). Further clinical studies to evaluate the impact of carvedilol on cardiovascular risk factors in nicotine addicts, and rodent studies to assess markers of lung inflammation in smoke- exposed rodents fed PhyCB, are recommended. PMID:25812281

  1. Midkine and Pleiotrophin in the Treatment of Neurodegenerative Diseases and Drug Addiction.

    PubMed

    Alguacil, Luis F; Herradón, Gonzalo

    2015-01-01

    Pleiotrophin (PTN) and Midkine (MK) are neurotrophines with documented protective actions in experimental models of neurodegenerative diseases and beneficial effects on toxicity and addictive behaviours related to drug abuse. Concerning the latter, both PTN and MK prevent the neurotoxic effects of amphetamine on nigrostriatal pathways and endogenous PTN also limits amphetamine reward. Moreover, endogenous PTN overexpression in the prefontral cortex abolishes alcohol- induced conditioned place preference. This review summarizes the existing patents for using PTN and MK in the treatment and diagnosis of neuropsychiatric disorders with a focus on neurotoxicity, neurodegeneration and substance use disorders. We have also reviewed the mechanism of action of PTN and MK and summarized existing patents on downstream modulators in their signaling pathways for the same indications. PMID:25808239

  2. [Risk behaviour in association with addictive drugs - data and insights on treatment].

    PubMed

    Böning, J

    2004-02-01

    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.

  3. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction.

    PubMed

    Johnson, Matthew W; Garcia-Romeu, Albert; Cosimano, Mary P; Griffiths, Roland R

    2014-11-01

    Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction. PMID:25213996

  4. Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction.

    PubMed

    Johnson, Matthew W; Garcia-Romeu, Albert; Cosimano, Mary P; Griffiths, Roland R

    2014-11-01

    Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow-up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20 mg/70 kg) and high (30 mg/70 kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of six previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction.

  5. Pilot Study of the 5-HT2AR Agonist Psilocybin in the Treatment of Tobacco Addiction

    PubMed Central

    Johnson, Matthew W.; Garcia-Romeu, Albert; Cosimano, Mary P.; Griffiths, Roland R.

    2014-01-01

    Despite suggestive early findings on the therapeutic use of hallucinogens in the treatment of substance use disorders, rigorous follow up has not been conducted. To determine the safety and feasibility of psilocybin as an adjunct to tobacco smoking cessation treatment we conducted an open-label pilot study administering moderate (20mg/70kg) and high (30mg/70kg) doses of psilocybin within a structured 15-week smoking cessation treatment protocol. Participants were 15 psychiatrically healthy nicotine-dependent smokers (10 males; mean age of 51 years), with a mean of 6 previous lifetime quit attempts, and smoking a mean of 19 cigarettes per day for a mean of 31 years at intake. Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically <35%). Although the open-label design does not allow for definitive conclusions regarding the efficacy of psilocybin, these findings suggest psilocybin may be a potentially efficacious adjunct to current smoking cessation treatment models. The present study illustrates a framework for future research on the efficacy and mechanisms of hallucinogen-facilitated treatment of addiction. PMID:25213996

  6. Effects of biperiden on the treatment of cocaine/crack addiction: a randomised, double-blind, placebo-controlled trial.

    PubMed

    Dieckmann, Luiz Henrique Junqueira; Ramos, Anna Carolina; Silva, Eroy Aparecida; Justo, Luis Pereira; Sabioni, Pamela; Frade, Iracema Francisco; de Souza, Altay Lino; Galduróz, José Carlos Fernandes

    2014-08-01

    Cocaine use affects approximately 13.4 million people, or 0.3% of the world's population between 15 and 64 years of age. Several authors have described drug addiction as a disease of the brain reward system. Given that the cholinergic system impacts reward mechanisms and drug self-administration, acetylcholine (ACh) might play an important role in the cocaine addiction process. We evaluated the efficacy of biperiden (a cholinergic antagonist) in reducing craving and the amount used, and in increasing compliance with treatment for cocaine/crack addiction. It was a study double-blind, randomised, placebo-controlled, 8-week trial of 111 cocaine or crack addicted male patients between 18 and 50 years old. Two groups were compared: placebo (n=55) or biperiden (n=56) combined with weekly sessions of brief group cognitive-behavioural therapy. The efficacy of treatment was evaluated according to the patients' compliance and several instruments: the Minnesota Cocaine Craving Scale, the Beck Depression and Anxiety Scales and a questionnaire assessing the amount of drug used. All of the patients attended weekly sessions for two months. We analysed the data considering the patients' intention to treat based on our last observation. Of the 56 patients in the biperiden group, 24 completed the treatment (42.8%) compared with only 11 patients in the placebo group (20%), which was a significant difference (p=0.009). Compliance with treatment was 118% higher in the biperiden group, which was also the group that presented a statistically significant reduction in the amount of cocaine/crack use (p<0.001). There was statistically significant difference between the craving score in the biperiden group. Pharmacological blockade of the cholinergic system with biperiden is a promising alternative to treat cocaine/crack addiction, helping patients to reduce the amount used and improving compliance with psychotherapy treatment.

  7. Narcotic Addiction

    PubMed Central

    Fern, B. J.

    1976-01-01

    This article presents the major features of narcotic addictions, focusing on the role of methadone as a means of controlling or removing the addiction. It concludes with some observations on society's attitude towards addicts, addictions and programs for control of addiction. PMID:21308103

  8. Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review.

    PubMed

    Ashe, Melinda L; Newman, Michelle G; Wilson, Stephen J

    2015-01-01

    In recent decades, researchers have integrated measurements of delay discounting, how the subjective valuation of a reward changes as a function of time, into their study of addiction. Research has begun to explore the idea that delay discounting may serve as both a marker for the effectiveness of existing treatments for addiction and a potential target for novel intervention strategies. As this work is in its infancy, many potentially significant connections between the construct of delay discounting and the treatment of addiction have yet to be explored. Here, we present a conceptual review highlighting novel points of intersection between delay discounting and two approaches to treating addiction that have become increasingly popular in recent years: those that focus on the development of mindfulness skills and those that emphasize the use of distraction techniques. Viewing these two techniques through the lens of delay discounting is particularly intriguing because of the very different way that they address the experience of drug cravings in the present moment (nonjudgmentally attending to vs. shifting attention away from subjective cravings, respectively). We propose that these opposing strategies for dealing with cravings may interact with delay discounting in ways that have important implications for treatment effectiveness. PMID:25545725

  9. Socio-spatial stigmatization and the contested space of addiction treatment: Remapping strategies of opposition to the disorder of drugs

    PubMed Central

    Smith, Christopher B.R.

    2011-01-01

    In recent years, the Not-In-My-Back-Yard (NIMBY) phenomenon has become increasingly prevalent with regard to harm reduction sites, addiction treatment facilities and their clients. Drawing from a case study of community conflict generated by the relocation of a methadone clinic into a rapidly gentrifying neighbourhood in downtown Toronto, Canada, this article offers a unique analysis of oppositional strategies regarding the perceived (socio-spatial) ‘disorder of drugs’. Based on interviews with local residents and business owners this article suggests the existence of three interrelated oppositional strategies, shifting from a recourse to urban planning policy, to a critique of methadone maintenance treatment (MMT) practice, to explicit forms of socio-spatial stigmatization that posited the body of the (methadone) ‘addict’ as abject agent of infection and the clinic as a site of contagion. Exploring the dialectical, socio-spatial interplay between the body of the addict and the social body of the city, this article demonstrates the unique aspects of opposition to the physically, ideologically and discursively contested space of addiction treatment. Representations of the methadone clinic, its clients and the larger space of the neighbourhood, this paper suggests, served to situate addiction as a ‘pathology (out) of place’ and recast the city itself as a site of safe/supervised consumption. PMID:19944509

  10. Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review.

    PubMed

    Ashe, Melinda L; Newman, Michelle G; Wilson, Stephen J

    2015-01-01

    In recent decades, researchers have integrated measurements of delay discounting, how the subjective valuation of a reward changes as a function of time, into their study of addiction. Research has begun to explore the idea that delay discounting may serve as both a marker for the effectiveness of existing treatments for addiction and a potential target for novel intervention strategies. As this work is in its infancy, many potentially significant connections between the construct of delay discounting and the treatment of addiction have yet to be explored. Here, we present a conceptual review highlighting novel points of intersection between delay discounting and two approaches to treating addiction that have become increasingly popular in recent years: those that focus on the development of mindfulness skills and those that emphasize the use of distraction techniques. Viewing these two techniques through the lens of delay discounting is particularly intriguing because of the very different way that they address the experience of drug cravings in the present moment (nonjudgmentally attending to vs. shifting attention away from subjective cravings, respectively). We propose that these opposing strategies for dealing with cravings may interact with delay discounting in ways that have important implications for treatment effectiveness.

  11. Delay Discounting and the use of Mindful Attention versus Distraction in the Treatment of Drug Addiction: A Conceptual Review

    PubMed Central

    Ashe, Melinda L.; Newman, Michelle G.; Wilson, Stephen J.

    2015-01-01

    In recent decades, researchers have integrated measurements of delay discounting, how the subjective valuation of a reward changes as a function of time, into their study of addiction. Research has begun to explore the idea that delay discounting may serve as both a marker for the effectiveness of existing treatments for addiction and a potential target for novel intervention strategies. As this work is in its infancy, many potentially significant connections between the construct of delay discounting and the treatment of addiction have yet to be explored. Here, we present a conceptual review highlighting novel points of intersection between delay discounting and two approaches to treating addiction that have become increasingly popular in recent years: those that focus on the development of mindfulness skills and those that emphasize the use of distraction techniques. Viewing these two techniques through the lens of delay discounting is particularly intriguing because of the very different way that they address the experience of drug cravings in the present moment (nonjudgmentally attending to versus shifting attention away from subjective cravings, respectively). We propose that these opposing strategies for dealing with cravings may interact with delay discounting in ways that have important implications for treatment effectiveness. PMID:25545725

  12. Navigating the poverty of heroin addiction treatment and recovery opportunity in Kenya: access work, self-care and rationed expectations.

    PubMed

    Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia

    2015-01-01

    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. PMID:26089184

  13. Navigating the poverty of heroin addiction treatment and recovery opportunity in Kenya: access work, self-care and rationed expectations.

    PubMed

    Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia

    2015-01-01

    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.

  14. Internet Addiction: A Logotherapeutic Approach

    ERIC Educational Resources Information Center

    Didelot, Mary J.; Hollingsworth, Lisa; Buckenmeyer, Janet A.

    2012-01-01

    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…

  15. Attitudes of Former Drug Addicts

    ERIC Educational Resources Information Center

    Boudouris, James

    1977-01-01

    Characteristics of addicts (N=222) and their own appraisal of which treatment modality they found most successful based upon their own experiences are of primary importance in prescribing a treatment for the addict. For the long-term addict continually in and out of prisons, perhaps methadone maintenance is the solution. (Author)

  16. Follow-up study of heroin-addicted persons admitted for treatment in Barcelona.

    PubMed

    Guardia Serecigni, J; Masip Vidal, J; Viladrich Segues, M C

    1988-01-01

    A follow-up study of 73 heroin-addicted persons three years after their first visit for treatment in 1981 to the Department of the Prevention of Drug Dependence and Guidance and Treatment of Drug Dependent Persons at Barcelona, Spain, was compared to a study of the same persons carried out after one year. The comparison showed that after one year 37 per cent of the cases had a favourable and 36 per cent an unfavourable outcome; for 27 per cent of the cases, information was lacking. After three years, 56 per cent showed a favourable and 30.3 per cent an unfavourable outcome; for 13.7 per cent information was lacking. Certain factors, such as a longer duration of treatment, a change in residence from an urban to a rural environment and treatment in a therapeutic community, were found to have enhanced the likelihood of achieving favourable results. Detoxification when not supplemented with supportive measures aimed at rehabilitation had a poor outcome.

  17. Addictions and Personality Traits: Impulsivity and Related Constructs

    PubMed Central

    Mitchell, Marci R.; Potenza, Marc N.

    2014-01-01

    Behavioral tendencies that might be captured through self-report measures may provide insight into personality features that are associated with substance addictions. Recently, impulsivity and related constructs, such as sensation-seeking, have been examined to help better understand their relationships with addictions. Here, we review recent findings that show links over developmental epochs between addictive behaviors and impulsivity, sensation-seeking, and other constructs that are theoretically linked. These findings have significant implications for generating improved treatments and interventions aimed at preventing the development of addictive disorders. PMID:24772382

  18. Addiction therapy. Refining deep brain stimulation to emulate optogenetic treatment of synaptic pathology.

    PubMed

    Creed, Meaghan; Pascoli, Vincent Jean; Lüscher, Christian

    2015-02-01

    Circuit remodeling driven by pathological forms of synaptic plasticity underlies several psychiatric diseases, including addiction. Deep brain stimulation (DBS) has been applied to treat a number of neurological and psychiatric conditions, although its effects are transient and mediated by largely unknown mechanisms. Recently, optogenetic protocols that restore normal transmission at identified synapses in mice have provided proof of the idea that cocaine-adaptive behavior can be reversed in vivo. The most efficient protocol relies on the activation of metabotropic glutamate receptors, mGluRs, which depotentiates excitatory synaptic inputs onto dopamine D1 receptor medium-sized spiny neurons and normalizes drug-adaptive behavior. We discovered that acute low-frequency DBS, refined by selective blockade of dopamine D1 receptors, mimics optogenetic mGluR-dependent normalization of synaptic transmission. Consequently, there was a long-lasting abolishment of behavioral sensitization.

  19. [Therapy in heroin addiction].

    PubMed

    Hosztafi, Sáandor; Fürst, Zsuzsanna

    2014-09-01

    Heroin addiction is one of the most devastating and expensive of public health problems. The most effective treatment is opioid replacement therapy. Replacement of heroin, a short-acting euphoriant with methadone or other opioids that have significantly longer duration of action provides a number of therapeutic benefits. Opioid detoxification has a role in both preventing acute withdrawal and maintaining long-term abstinence. Opioid-based detoxification is based on the principle of cross-tolerance, in which one opioid is replaced with another one that is slowly tapered. For the treatment of heroin addicts a wide range of psychosocial and pharmacotherapeutic treatments are available; of these, methadone maintenance therapy has the most evidence of benefit. Methadone maintenance reduces and/or eliminates the use of heroin, reduces the death rate and criminality associated with heroin use, and allows patients to improve their health and social productivity. In addition, enrollment in methadone maintenance has the potential to reduce the transmission of infectious diseases associated with heroin injection, such as hepatitis and HIV. The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with heroin. There is growing interest in expanding treatment into primary care, allowing opioid addiction to be managed like other chronic illnesses. Buprenorphine which is a long-acting partial agonist was also approved as pharmacotherapy for opioid dependence. Opioid antagonists can reduce heroin self-administration and opioid craving in detoxified addicts. Naltrexone, which is a long-acting competitive antagonist at the opioid receptors, blocks the subjective and objective responses produced by intravenous opioids. Naltrexone is employed to accelerate opioid detoxification by displacing heroin and as a maintenance agent for detoxified formerly heroin-dependent patients who want to

  20. The “New Masculinity”: Addiction Treatment as a Reconstruction of Gender In Puerto Rican Evangelist Street Ministries

    PubMed Central

    Hansen, Helena

    2011-01-01

    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. PMID:21911274

  1. Inpatient Hospitalization in Addiction Treatment for Patients with a History of Suicide Attempt: A Case of Support for Treatment Performance Measures†

    PubMed Central

    Glass, Joseph E.; Ilgen, Mark A.; Winters, Jamie J.; Murray, Regan L.; Perron, Brian E.; Chermack, Stephen T.

    2010-01-01

    This study attempts to validate substance use disorder (SUD) treatment performance measures (PM) in a naturalistic treatment setting. Despite its significance in healthcare systems and in SUD populations, suicidality is one patient characteristic that remains unexplored in the context of SUD PMs. The current study focused on the extent to which the care processes encouraged by SUD PMs were associated with improved outcomes in patients with a prior suicide attempt as compared to those without. We abstracted Addiction Severity Index and health services data from the VA medical record for 381 veterans who initiated outpatient SUD treatment and completed baseline intake measures at a Midwestern VA hospital. Cox proportional hazard regressions examined how baseline characteristics, prior suicide attempts, and PM status predicted the time until hospitalization for psychiatric or substance use problems. Prior suicide attempts significantly interacted with treatment engagement, and hospitalization risk was significantly higher among individuals with a prior suicide attempt who did not meet PMs. This study provides initial observational evidence that past suicide attempts may be a factor that should be considered when defining performance standards that influence the processes of SUD treatment. Future research on PMs should take into account the differences on indicators of high risk and poor treatment outcomes. PMID:21053754

  2. Using Relational-Cultural Theory to Conceptualize Couple Interventions in the Treatment of Sex Addiction

    ERIC Educational Resources Information Center

    Vogel, Joanne E.

    2007-01-01

    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…

  3. Heroin Addiction and Methadone Treatment in America: Using Our Heads in the Search for Solutions

    ERIC Educational Resources Information Center

    Basham, Richard

    1977-01-01

    An examination of America's attempts to cope with the problem of heroin (and other drug) addiction must proceed through an analysis of the basic responses to the problem--penal, behavioral and medical--from two quite different, and frequently conflicting, vantage points: that of the individual addict and that of the society as a whole. (Author/NQ)

  4. Application of Neurolinguistic Programming for Treatment and Relapse Prevention of Addictive Behaviors.

    ERIC Educational Resources Information Center

    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…

  5. Involvement in a Drug Subculture and Abstinence Following Treatment Among Puerto Rican Narcotic Addicts.

    ERIC Educational Resources Information Center

    Snarr, Richard W.; Ball, John C.

    The study investigated the life career of a sample of native Puerto Rican narcotic addicts who were treated at the Lexington, Kentucky Public Health Service Hospital. Specifically, it deals with the relationship between the addicts' involvement in a drug subculture and their subsequent drug use and abstinence. The hypothesis presented states that…

  6. Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

    PubMed Central

    Ghitza, Udi E.; Epstein, David H.; Preston, Kenzie L.

    2008-01-01

    The relationship between pretreatment illicit benzodiazepine use (days of use in the last 30) assessed on the Addiction Severity Index (ASI) and treatment outcome was investigated by retrospective analysis of data from two controlled clinical trials in 361 methadone maintained cocaine/opiate users randomly assigned to 12-week voucher- or prize-based contingency management (CM) or control interventions. Based on screening ASI, participants were identified as nonusers (BZD-N; 0 days of use) or users (BZD-U; >0 days of use). Outcome measures were: urine drug screens (thrice weekly); quality of life and self-reported HIV-risk behaviors (every 2 weeks); and current DSM-IV diagnosis of cocaine and heroin dependence (study exit). In the CM group, BZD-U had significantly worse outcomes on in-treatment cocaine use, quality-of-life scores, needle-sharing behaviors, and current heroin dependence diagnoses at study exit compared to BZD-N. In the control group, BZD-U had significantly higher in-treatment cocaine use but did not differ from BZD-N on psychosocial measures. Thus, in a sample of non-dependent BZD users, self-reported illicit BZD use on the ASI, even at low levels, predicted worse outcome on cocaine use and blunted response to CM. PMID:18499354

  7. Epigenetics and memory: causes, consequences and treatments for post-traumatic stress disorder and addiction.

    PubMed

    Pizzimenti, C L; Lattal, K M

    2015-01-01

    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.

  8. Therapeutic advances in the treatment of nicotine addiction: present and future.

    PubMed

    Casella, Giuseppina; Caponnetto, Pasquale; Polosa, Riccardo

    2010-05-01

    While the proportion of the adult population that smokes has declined steadily in several westernized societies, the rate of successful quit attempts is still low. This is because smokers develop nicotine dependence, a powerful addiction that may require multiple attempts and long-term treatment to achieve enduring abstinence. Currently available first-line agents for smoking cessation therapy include nicotine replacement therapy (available in several formulations, including transdermal patch, gum, nasal spray, inhaler, and lozenge), bupropion (an atypical antidepressant), and varenicline (a partial agonist of the α4β2 nicotinic acetylcholine receptor that was recently developed and approved specifically for smoking cessation therapy). Second-line agents are nortriptyline (a tricyclic antidepressant agent) and the antihypertensive agent clonidine. With the exception of varenicline, which has been shown to offer significant improvement in abstinence rates over bupropion, all of the available treatments appear similarly effective. The adverse event profiles of nortriptyline and clonidine make them more appropriate for second-line therapy, when first-line treatments have failed or are not tolerated. However, the currently marketed smoking cessation drugs reportedly lack high levels of efficacy, particularly in real-life settings. New medications and vaccines with significant clinical advantage are now in the advanced stage of development and offer promise. These include nicotine vaccines and monoamine type B inhibitors. In this review article we discuss current and emerging pharmacotherapies for tobacco dependence focusing on their mechanisms of action, efficacy and adverse event profiles. PMID:23251732

  9. Epigenetics and memory: causes, consequences and treatments for post-traumatic stress disorder and addiction

    PubMed Central

    Pizzimenti, C. L.; Lattal, K. M.

    2015-01-01

    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. PMID:25560936

  10. Collaboration among sex offender treatment providers and probation and parole officers: the beliefs and behaviors of treatment providers.

    PubMed

    McGrath, Robert J; Cumming, Georgia; Holt, John

    2002-01-01

    New and emerging collaborative responses to sex offender management are challenging traditional notions about how treatment providers and probation and parole officers (POs) deliver services to this difficult population. Typically, sex offender treatment professionals provide community-based services to offenders who are supervised by POs. Yet, no comprehensive survey has investigated how treatment providers and POs collaborate and view their relationships with each other. This national random survey examined the beliefs and behaviors of community-based adult sex-offender treatment providers concerning various types of provider and PO interactions and collaborative models. Overall, treatment providers reported that they value frequent and substantive communication with POs concerning mutual clients. There was, however, considerable diversity in practice and opinion among providers with regard to POs leading, coleading, and observing sex offender treatment groups. Treatment providers' opinions about various clinical, ethical, and legal issues evident in these collaborative approaches are examined.

  11. An Online Health Prevention Intervention for Youth with Addicted or Mentally Ill Parents: Experiences and Perspectives of Participants and Providers from a Randomized Controlled Trial

    PubMed Central

    Bindels, Jill APM; Evers, Silvia MAA; Paulus, Aggie TG; van Asselt, Antoinette DI; van Schayck, Onno CP

    2015-01-01

    Background Mental illnesses affect many people around the world, either directly or indirectly. Families of persons suffering from mental illness or addiction suffer too, especially their children. In the Netherlands, 864,000 parents meet the diagnostic criteria for a mental illness or addiction. Evidence shows that offspring of mentally ill or addicted parents are at risk for developing mental disorders or illnesses themselves. The Kopstoring course is an online 8-week group course with supervision by 2 trained psychologists or social workers, aimed to prevent behavioral and psychological problems for children (aged 16 to 25 years) of parents with mental health problems or addictions. The course addresses themes such as roles in the family and mastery skills. An online randomized controlled trial (RCT) was conducted to assess the effectiveness of the Kopstoring course. Objective The aim was to gain knowledge about expectations, experiences, and perspectives of participants and providers of the online Kopstoring course. Methods A process evaluation was performed to evaluate the online delivery of Kopstoring and the experiences and perspectives of participants and providers of Kopstoring. Interviews were performed with members from both groups. Participants were drawn from a sample from the Kopstoring RCT. Results Thirteen participants and 4 providers were interviewed. Five main themes emerged from these interviews: background, the requirements for the intervention, experience with the intervention, technical aspects, and research aspects. Overall, participants and providers found the intervention to be valuable because it was online; therefore, protecting their anonymity was considered a key component. Most barriers existed in the technical sphere. Additional barriers existed with conducting the RCT, namely gathering informed consent and gathering parental consent in the case of minors. Conclusions This study provides valuable insight into participants’ and

  12. "What do you mean by spirituality? Please draw me a picture!" Complementary faith-based addiction treatment in Switzerland from the client's perspective.

    PubMed

    Klingemann, Harald; Schläfli, Katrin; Steiner, Martin

    2013-09-01

    This article reviews: (1) the relative importance of spirituality and religion in Switzerland and the United States, (2) the rationale for faith-based addiction intervention programs and the drawbacks of measurement approaches, and (3) results from a pilot study exploring the meaning of spirituality and religiosity from the consumer's perspective. Twenty-three patients entering the Swiss Südhang clinic in-patient alcohol user treatment program during the first five months in 2012 participated upon their admission in a video-taped drawing task, designed to provide their personal visualized definitions of the terms "spirituality" and "religiosity." Nine dimensions emerged pointing to a high complexity of the concepts.

  13. A Systematic Review of Pediatric Obesity and Family Communication Through the Lens of Addiction Literature

    PubMed Central

    Mogul, Ashley; Irby, Megan B.

    2014-01-01

    Abstract Background: Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. Methods: A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. Results: Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. Conclusions: Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity. PMID:24809221

  14. Neurobiology of Adolescent Substance Use and Addictive Behaviors: Prevention and Treatment Implications

    PubMed Central

    Hammond, Christopher J.; Mayes, Linda C.; Potenza, Marc N.

    2015-01-01

    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

  15. Addiction and will

    PubMed Central

    Johnson, Brian

    2013-01-01

    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

  16. Analysis of Gap in Service Quality in Drug Addiction Treatment Centers of Kerman, Iran, Using SERVQUAL Model

    PubMed Central

    Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar

    2014-01-01

    Background 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. Methods 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. Findings 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 < 0.001). Considering the 5 dimensions of the SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). Conclusion 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. PMID:25984274

  17. Evaluation of an Internet addiction treatment program for Chinese adolescents in Hong Kong.

    PubMed

    Shek, Daniel T L; Tang, Vera M Y; Lo, C Y

    2009-01-01

    This paper described an indigenous multi-level counseling program designed for young people with Internet addiction problems based on the responses of 59 clients. Regarding objective outcome evaluation, pretest and posttest data generally showed that the Internet addiction problems of the participants decreased after joining the program and there were some slight positive changes in the parenting attributes. For the subjective outcome evaluation findings, participants generally perceived that the program was helpful. Findings based on these two evaluation strategies suggest this multi-level indigenous counseling program has promise for helping young people with Internet addiction problems.

  18. "Eating addiction", rather than "food addiction", better captures addictive-like eating behavior.

    PubMed

    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

    2014-11-01

    "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.

  19. Provider knowledge, attitudes and treatment preferences for early pregnancy failure

    PubMed Central

    Dalton, Vanessa K.; Harris, Lisa H.; Gold, Katherine J.; Kane-Low, Lisa; Schulkin, Jay; Guire, Ken; Fendrick, A. Mark

    2010-01-01

    Objective To describe health care provider knowledge, attitudes and treatment preferences for early pregnancy failure (EPF). Study Design We surveyed 976 obstetrician/gynecologists, midwives and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices. Results Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments. Conclusions Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment. PMID:20227674

  20. The Dreams of Heroin Addicts

    ERIC Educational Resources Information Center

    Looney, Maryanne

    1972-01-01

    Few heroin addicts get high'' in their dreams. An exploration of the reasons for this failure provides some clues to the conflicts and other problems that retard an addict's progress in therapy. (Author)

  1. Continuity of care in addictions treatment: the role of advocacy and coordination in case management.

    PubMed

    Graham, K; Timney, C B; Bois, C; Wedgerfield, K

    1995-11-01

    Although advocacy and coordination are recognized as important aspects of the addictions treatment process, little research has been done in these areas. The present study examined advocacy and coordination at two programs where the mandate was assessment, referral, and case management. Both programs spent a similar proportion of client-related effort on advocacy and/or coordination (about 25% of contact time, accounting for about half of contacts made regarding clients). The majority of advocacy and coordination contacts were with other agencies about clients (the remainder with family and friends of clients). A framework for advocacy and coordination was developed that allowed contacts to be categorized into mutually exclusive advocacy or coordination activities. Advocacy was defined as any activity undertaken to obtain something for clients; coordination involved the giving or receiving of information regarding specific clients. Sources of variability in the provision of advocacy and coordination were found between the programs that could be attributed to differences between the systems within which the programs operated, as well as differences in program clientele. In terms of client characteristics, it was found that females were more likely than males to receive advocacy; those over 65 years were most likely to receive both advocacy and coordination; those who were referred by school or employer or by corrections were most likely to receive coordination; those with no prior treatment were most likely to receive advocacy; and self-referrals and those who had had prior treatment were most likely to receive neither advocacy nor coordination. Receiving advocacy or coordination was not found to reduce the need by clients for other case management services, such as supportive counseling. The findings are discussed in terms of the need for knowledge regarding highly variable aspects of treatment such as advocacy and coordination. New research approaches (as taken in

  2. Differentiation of personality types among opiate addicts.

    PubMed

    Blatt, S J; Berman, W H

    1990-01-01

    A wide range of studies indicate that although sociopathic characteristics are predominant in opiate addiction, depressive and psychotic features are also frequently observed. To test the hypothesis that there are really three types of individuals who become addicted to opiates (rather than a single, predominant personality style), fifty-three opiate addicts were given the Loevinger Sentence Completion Test, the Bellak Ego Functions Interview, and the Rorschach. Variables derived from these three procedures were submitted to cluster and discriminant function analyses. Three groups of addicts were identified--those primarily with impaired interpersonal relationships and affective lability (42%), those primarily characterized by thought disorder and impaired ego functioning (30%), and a group with diminished ideational and verbal activity (28%). Comparison of the assessment of these three groups with independently defined normal, neurotic, and schizophrenic samples provided support for three opiate-addicted personality types, each respectively characterized as character disordered, borderline psychotic, and depressed. Although there seems to be a predominance of character-disordered individuals who become addicted to opiates, the data indicate several additional types of opiate addicts with different types of psychopathology who may require different approaches to management and treatment.

  3. The impact of managed care on substance abuse treatment: a report of the American Society of Addiction Medicine.

    PubMed

    Galanter, M; Keller, D S; Dermatis, H; Egelko, S

    2000-01-01

    This report examines the impact of managed care (MC) and related developments on substance abuse treatment, and evaluates how it has been associated with a decline in the availability of proper treatment for many addicted patients. A trend toward carve-out and for-profit MC organizations is associated with lower financial incentives for intensive treatment than in earlier staff-model and not-for-profit MC organizations. The value of substance abuse insurance coverage has declined by 75% between 1988 and 1998 for employees of mid-to large-size companies, compared with only an 11.5% decline for general health insurance. The shift towards MC has also been associated with a drastic reduction in frequency and duration of inpatient hospitalization, and there is no clear evidence that this reduction has been offset by a corresponding increase in outpatient support. In a survey of physicians treating addiction, the majority felt that MC had a negative impact on detoxification and rehabilitation, and on their ethical practice of addiction medicine. PMID:11076117

  4. Anti-addiction vaccines

    PubMed Central

    Shen, Xiaoyun; Orson, Frank M.

    2011-01-01

    Despite intensive efforts to eradicate it, addiction to both legal and illicit drugs continues to be a major worldwide medical and social problem. Anti-addiction vaccines can produce the antibodies to block the effects of these drugs on the brain, and have great potential to ameliorate the morbidity and mortality associated with illicit drug intoxications. This review provides a current overview of anti-addiction vaccines that are under clinical trial and pre-clinical research evaluation. It also outlines the development challenges, ethical concerns, and likely future intervention for anti-addiction vaccines. PMID:22003367

  5. Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men

    PubMed Central

    Wolff, Nancy; Huening, Jessica; Shi, Jing; Frueh, B. Christopher; Hoover, Donald R.; McHugo, Gregory

    2015-01-01

    A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n = 230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n = 142) or by preference (n = 88) to receive SS or M-TREM, with a waitlist group of (n = 93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co

  6. The role of the TCI-R (Temperament Character Inventory) in individualized treatment plannning in a population of addicted professionals.

    PubMed

    Angres, Daniel H; Nielsen, Ailsa K

    2007-01-01

    This article discusses a multi-faceted treatment paradigm used to service professionals with addictive disorders. Individualized treatment plans are developed based on a multitude of factors including administration of the TCI-R (Temperament Character Inventory), MCMI-III (Millon Clinical Multiaxial Inventory) and the WASI (Wechsler Abbreviated Scale of Intelligence). Treatment goals include specific therapeutic interventions and patient and therapist-directed tasks related to enhanced development of the character dimensions of Self-Directedness, Cooperativeness and Self-Transcendence, as measured on Cloninger's TCI-R inventory.

  7. Preference for brand-name buprenorphine is related to severity of addiction among outpatients in opioid maintenance treatment.

    PubMed

    Binder, Philippe; Messaadi, Nassir; Perault-Pochat, Marie-Christine; Gagey, Stéphanie; Brabant, Yann; Ingrand, Pierre

    2016-01-01

    As a form of opioid maintenance treatment, high-dose buprenorphine is increasingly being used in the United States. On the French market since 1996, it is the most commonly prescribed and frequently employed opioid maintenance treatment. For unknown reasons, the brand-name form is used far more often than the generic form (76-24%). The objective was to show that the patients' levels of addiction were differentiated according to the form of buprenorphine currently being used and to their previous experience of a different form. An observational study in 9 sites throughout France used self-assessment questionnaires filled out in retail pharmacies by all patients to whom their prescribed buprenorphine treatment was being delivered. The 151 canvassed pharmacies solicited 879 patients, of whom 724 completed the questionnaires. Participants were statistically similar to non-participants. The patients using the brand-name form subsequent to experience with the generic form exhibited a more elevated addiction severity index and a higher dosage than brand-name form users with no experience of a different form. Compared to generic users, their doses were higher, their was addiction more severe, and their alcohol consumption was more excessive; they were also more likely to make daily use of psychotropic substances. However, the level of misuse or illicit consumption was similar between these groups. Preferring the brand-name buprenorphine form to the generic form is associated with a higher level of severe addiction, a more frequent need for daily psychotropics, and excessive drinking; but the study was unable to show a causal link.

  8. An Evaluation of the Italian Version of the Yale Food Addiction Scale in Obese Adult Inpatients Engaged in a 1-Month-Weight-Loss Treatment.

    PubMed

    Ceccarini, Martina; Manzoni, Gian Mauro; Castelnuovo, Gianluca; Molinari, Enrico

    2015-11-01

    Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance, and psychophysiological symptoms. Excessive food consumption is similar to that of substance addiction. Some individuals who have trouble losing weight display addictive eating symptoms. To investigate food addiction in a sample of obese adults referred to hospital for a 1-month-weight-loss treatment. The Italian version of the Yale Food Addiction Scale (YFAS-16) was used as a screening tool in 88 obese inpatients. The construct validity of the YFAS-16 was assessed by testing its correlations with measures of binge eating (Binge Eating Scale), impulsiveness (Barratt Impulsiveness Scale), and emotional dysregulation (Difficulties in Emotion Regulation Scale). 34.1% of our sample was diagnosed with YFAS food addiction. Such diagnosis was also supported by strong associations between FA and psychological and behavioral features, typically descriptive of classic addiction. Patients who endorsed the YFAS-16 criteria for food addiction (FA) had significantly higher binge eating levels, greater emotional dysregulation, and nonacceptance of negative feelings; they lacked goal-oriented behavior, had little impulse control, had difficulty in emotion recognition, and attentional impulsivity; and they were unable to concentrate and lacked inhibitory control behavior, unlike participants who did not meet the FA criteria. Further research is needed to support the reliability of the YFAS-16. This measure has the potential to be applied in epidemiological research, estimating the prevalence of FA within the Italian population and to assess new treatments' efficacy for obese patients with food addiction symptoms seeking weight-loss treatments.

  9. An Evaluation of the Italian Version of the Yale Food Addiction Scale in Obese Adult Inpatients Engaged in a 1-Month-Weight-Loss Treatment.

    PubMed

    Ceccarini, Martina; Manzoni, Gian Mauro; Castelnuovo, Gianluca; Molinari, Enrico

    2015-11-01

    Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance, and psychophysiological symptoms. Excessive food consumption is similar to that of substance addiction. Some individuals who have trouble losing weight display addictive eating symptoms. To investigate food addiction in a sample of obese adults referred to hospital for a 1-month-weight-loss treatment. The Italian version of the Yale Food Addiction Scale (YFAS-16) was used as a screening tool in 88 obese inpatients. The construct validity of the YFAS-16 was assessed by testing its correlations with measures of binge eating (Binge Eating Scale), impulsiveness (Barratt Impulsiveness Scale), and emotional dysregulation (Difficulties in Emotion Regulation Scale). 34.1% of our sample was diagnosed with YFAS food addiction. Such diagnosis was also supported by strong associations between FA and psychological and behavioral features, typically descriptive of classic addiction. Patients who endorsed the YFAS-16 criteria for food addiction (FA) had significantly higher binge eating levels, greater emotional dysregulation, and nonacceptance of negative feelings; they lacked goal-oriented behavior, had little impulse control, had difficulty in emotion recognition, and attentional impulsivity; and they were unable to concentrate and lacked inhibitory control behavior, unlike participants who did not meet the FA criteria. Further research is needed to support the reliability of the YFAS-16. This measure has the potential to be applied in epidemiological research, estimating the prevalence of FA within the Italian population and to assess new treatments' efficacy for obese patients with food addiction symptoms seeking weight-loss treatments. PMID:26267366

  10. The genetics of the opioid system and specific drug addictions.

    PubMed

    Levran, Orna; Yuferov, Vadim; Kreek, Mary Jeanne

    2012-06-01

    Addiction to drugs is a chronic, relapsing brain disease that has major medical, social, and economic complications. It has been established that genetic factors contribute to the vulnerability to develop drug addiction and to the effectiveness of its treatment. Identification of these factors may increase our understanding of the disorders, help in the development of new treatments and advance personalized medicine. In this review, we will describe the genetics of the major genes of the opioid system (opioid receptors and their endogenous ligands) in connection to addiction to opioids, cocaine, alcohol and methamphetamines. Particular emphasis is given to association and functional studies of specific variants. We will provide information on the sample populations and the size of each study, as well as a list of the variants implicated in association with addiction-related phenotypes, and with the effectiveness of pharmacotherapy for addiction.

  11. Addiction treatment intervention: an uncontrolled prospective pilot study of Spiritual Self-Schema therapy with Latina women.

    PubMed

    Amaro, Hortensia; Magno-Gatmaytan, Cielo; Meléndez, Michael; Cortés, Dharma E; Arevalo, Sandra; Margolin, Arthur

    2010-04-01

    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.

  12. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model

    PubMed Central

    George, Sanju; Bowden-Jones, Henrietta

    2016-01-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  13. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model.

    PubMed

    George, Sanju; Bowden-Jones, Henrietta

    2016-06-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  14. Molecular and Genetic Substrates Linking Stress and Addiction

    PubMed Central

    Briand, Lisa A.; Blendy, Julie A.

    2009-01-01

    Drug addiction is one of the top three health concerns in the United States in terms of economic and health care costs. Despite this, there are very few effective treatment options available. Therefore, understanding the causes and molecular mechanisms underlying the transition from casual drug use to compulsive drug addiction could aid in the development of treatment options. Studies in humans and animal models indicate that stress can lead to both vulnerability to develop addiction, as well as increase drug taking and relapse in addicted individuals. Exposure to stress or drugs of abuse results in long-term adaptations in the brain that are likely to involve persistent alterations in gene expression or activation of transcription factors, such as the cAMP Response Element Binding protein, CREB. The signaling pathways controlled by CREB have been strongly implicated in drug addiction and stress. Many potential CREB target genes have been identified based on the presence of a CRE element in promoter DNA sequences. These include, but are not limited to CRF, BDNF, and dynorphin. These genes have been associated with initiation or reinstatement of drug reward and are altered in one direction or the other following stress. While many reviews have examined the interactions between stress and addiction, the goal of this review is to focus on specific molecules that play key roles in both stress and addiction and are therefore posed to mediate the interaction between the two. Focus on these molecules could provide us with new targets for pharmacological treatments for addiction. PMID:19900417

  15. Food addiction and neuroimaging.

    PubMed

    Zhang, Yi; von Deneen, Karen M; Tian, Jie; Gold, Mark S; Liu, Yijun

    2011-01-01

    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).

  16. Lighting the darkness of addiction: can phototherapy enhance contingency-management-based treatment of substance-related and addictive disorders?

    PubMed

    Siporin, Sheldon

    2014-01-01

    Maladaptive patterns of substance use are serious social problems. Both pharmacological and nonpharmacological treatments are available, but nondrug options may be preferable because they avoid the expense and adverse side effects of psychotropic medication. Contingency management (CM) and nondrug social and recreational activities (NDSRAs) are based on operant conditioning principles and seek to decrease substance use by means of nondrug rewards. However, their efficacy may be hindered where brain reward circuitry is dysfunctional. Research shows that substance abuse biases neural reward systems in favor of drug-induced highs, while disrupting circadian-based rhythms. Circadian systems also have been found to influence human reward pathways. Possibly, a bidirectional relationship exists between circadian disturbance and substance abuse effects. If so, repair of abnormal circadian rhythms might help normalize reward response in substance abusers, with positive effects on CM or NDSRA treatment outcomes. Phototherapy has been effective in repairing circadian rhythms in persons with seasonal affective disorder and other chronobiological conditions. This article proposes that it similarly may repair circadian response in substance abusers, thereby normalizing brain reward systems. By doing so, it would enhance the efficacy of CM and NDSRA therapies and may also help prevent relapse. Given its low cost and ease of administration, phototherapy seems a promising avenue to pursue.

  17. Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

    ERIC Educational Resources Information Center

    van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing a…

  18. [Cocaine - Characteristics and addiction].

    PubMed

    Girczys-Połedniok, Katarzyna; Pudlo, Robert; Jarząb, Magdalena; Szymlak, Agnieszka

    2016-01-01

    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. PMID:27623834

  19. [Cocaine - Characteristics and addiction].

    PubMed

    Girczys-Połedniok, Katarzyna; Pudlo, Robert; Jarząb, Magdalena; Szymlak, Agnieszka

    2016-01-01

    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.

  20. Prairie Voles as a Model to Screen Medications for the Treatment of Alcoholism and Addictions.

    PubMed

    Ryabinin, A E; Hostetler, C M

    2016-01-01

    Most preclinical studies of medications to treat addictions are performed in mice and rats. These two rodent species belong to one phylogenetic subfamily, which narrows the likelihood of identifying potential mechanisms regulating addictions in other species, ie, humans. Expanding the genetic diversity of organisms modeling alcohol and drug abuse enhances our ability to screen for medications to treat addiction. Recently, research laboratories adapted the prairie vole model to study mechanisms of alcohol and drugs of abuse. This development not only expanded the diversity of genotypes used to screen medications, but also enhanced capabilities of such screens. Prairie voles belong to 3-5% of mammalian species exhibiting social monogamy. This unusual trait is reflected in their ability to form lasting long-term affiliations between adult individuals. The prairie vole animal model has high predictive validity for mechanisms regulating human social behaviors. In addition, these animals exhibit high alcohol intake and preference. In laboratory settings, prairie voles are used to model social influences on drug reward and alcohol consumption as well as effects of addictive substances on social bonding. As a result, this species can be adapted to screen medications whose effectiveness could be (a) resistant to social influences promoting excessive drug taking, (b) dependent on the presence of social support, and (c) medications affecting harmful social consequences of alcohol and drug abuse. This report reviews the literature on studies of alcohol and psychostimulants in prairie voles and discusses capabilities of this animal model as a screen for novel medications to treat alcoholism and addictions.

  1. [Functional neuroimaging of addiction].

    PubMed

    Takahashi, Hidehiko

    2015-09-01

    Positron emission tomography studies investigating dopamine release by drug or reward demonstrated blunted dopamine release in relation to addiction to psychostimulants such as cocaine and amphetamine. However, recent studies reported that nicotine and gambling addiction showed opposite results. Several factors such as illness stage or neurotoxicity of substances could be considered for this discrepancy. Behavioral addiction such as gambling disorder is a good target of neuroimaging because it is free from overt neurotoxicity. However, even in gambling disorder, the results of fMRI studies investigating neural response to reward are mixed. Neuroimaging together with taking the various backgrounds of patients into account should contribute not only to a better understanding of the neurobiology of addiction but also to the development of more effective and individually tailored treatment strategies for addiction. PMID:26394506

  2. Trace amine-associated receptor 1: a promising target for the treatment of psychostimulant addiction

    PubMed Central

    Jing, Li; Li, Jun-Xu

    2015-01-01

    Abuse of and addiction to psychostimulants remains a challenging clinical issue, yet no effective pharmacotherapy is available. Trace amine associated receptor 1 (TAAR 1) is increasingly recognized as a novel drug target that participates in the modulation of drug abuse. This review analyzed existing preclinical evidence from electrophysiological, biochemical to behavioral aspects regarding the functional interactions between TAAR 1 and dopaminergic system. TAAR 1 knockout mice demonstrate increased sensitivity to dopaminergic activation while TAAR 1 agonists reduce the neurochemical effects of cocaine and amphetamines, attenuate abuse- and addiction-related behavioral effects of cocaine and methamphetamine. It is concluded that TAAR 1 activation functionally modulate the dopaminergic activity and TAAR 1 agonists appear to be promising pharmacotherapies against psychostimulant addiction. PMID:26092759

  3. Trace amine-associated receptor 1: A promising target for the treatment of psychostimulant addiction.

    PubMed

    Jing, Li; Li, Jun-Xu

    2015-08-15

    Abuse of and addiction to psychostimulants remains a challenging clinical issue; yet no effective pharmacotherapy is available. Trace amine associated receptor 1 (TAAR 1) is increasingly recognized as a novel drug target that participates in the modulation of drug abuse. This review analyzed existing preclinical evidence from electrophysiological, biochemical to behavioral aspects regarding the functional interactions between TAAR 1 and dopaminergic system. TAAR 1 knockout mice demonstrate increased sensitivity to dopaminergic activation while TAAR 1 agonists reduce the neurochemical effects of cocaine and amphetamines, attenuate abuse- and addiction-related behavioral effects of cocaine and methamphetamine. It is concluded that TAAR 1 activation functionally modulates the dopaminergic activity and TAAR 1 agonists appear to be promising pharmacotherapies against psychostimulant addiction.

  4. The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction.

    PubMed

    Bickel, Warren K; Jarmolowicz, David P; Mueller, E Terry; Gatchalian, Kirstin M

    2011-10-01

    The current paper presents a novel approach to understanding and treating addiction. Drawing from work in behavioral economics and developments in the new field of neuroeconomics, we describe addiction as pathological patterns of responding resulting from the persistently high valuation of a reinforcer and/or an excessive preference for the immediate consumption of that reinforcer. We further suggest that, as indicated by the competing neurobehavioral decision systems theory, these patterns of pathological choice and consumption result from an imbalance between two distinct neurobehavioral systems. Specifically, pathological patterns of responding result from hyperactivity in the evolutionarily older impulsive system (which values immediate and low-cost reinforcers) and/or hypoactivity in the more recently evolved executive system (which is involved in the valuation of delayed reinforcers). This approach is then used to explain five phenomena that we believe any adequate theory of addiction must address. PMID:21732213

  5. The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction.

    PubMed

    Bickel, Warren K; Jarmolowicz, David P; Mueller, E Terry; Gatchalian, Kirstin M

    2011-10-01

    The current paper presents a novel approach to understanding and treating addiction. Drawing from work in behavioral economics and developments in the new field of neuroeconomics, we describe addiction as pathological patterns of responding resulting from the persistently high valuation of a reinforcer and/or an excessive preference for the immediate consumption of that reinforcer. We further suggest that, as indicated by the competing neurobehavioral decision systems theory, these patterns of pathological choice and consumption result from an imbalance between two distinct neurobehavioral systems. Specifically, pathological patterns of responding result from hyperactivity in the evolutionarily older impulsive system (which values immediate and low-cost reinforcers) and/or hypoactivity in the more recently evolved executive system (which is involved in the valuation of delayed reinforcers). This approach is then used to explain five phenomena that we believe any adequate theory of addiction must address.

  6. [How much treatment does a person need? Addiction, spontaneous remission and "family" as biographical as leitmotiv].

    PubMed

    Klingemann, K H; Efionayi-Mäder, D

    1994-08-23

    Referring to theoretical and empirical examples taken from psychiatry, psychology and sociology, this paper first clarifies the dimensions and application of concepts such as 'natural recovery' and 'spontaneous remission'. In order to illustrate the general development of research in the area of therapy free drug remission from a purely quantitative approach to a qualitative, ethnographic one, two studies are referred to: the classic Vietnam veteran study done by Robins and a longitudinal analysis of a network of cocaine users. This is also supplemented by the latest results from Germany. Next, the empirical results of the ongoing spontaneous remitter follow-up study from the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA) are presented. The analysis of the gender specific processes involved in the long-term stabilization of heroin autoremission, taking the support of social surroundings into consideration, shows the following: independent of gender, a high stability of autoremission was determined four years after the initial survey. In only three out of thirty cases has there been a relapse since the first interview. This result confirms the general significance of social support during the autoremission phase for both gender groups. Measured against dominant role expectations, it can be said that most of the men have successfully reintegrated into society. Women, on the other hand, seem to deviate more strongly from traditional professional and family roles. This might be due to particularly longlasting social sanctions during their former addiction. Finally, some practical consequences for the drug treatment system drawn from autoremission research are discussed as well as some drug and social policy conditions favorable to autoremission.

  7. High Risk Situations Predicting Relapse in Self-Referred Addicts to Bushehr Province Substance Abuse Treatment Centers

    PubMed Central

    Shafiei, Ebrahim; Hoseini, Agha Fatemeh; Bibak, Alireza; Azmal, Mohammad

    2014-01-01

    Background: Relapse prevention is a medical intervention designed for educating cognitive and behavioral skills to avoid continued drug abuse and relapse. Objectives: This study examined high risk situations for relapse for self-referred addicts are related in Bushehr province substance abuse treatment centers. Patients and Methods: The present study is descriptive cross-sectional. The sample size consisted of 609 self-referred addicts to Bushehr province substance abuse centers. IDTS Marlatt questionnaire was used. Analytical and descriptive statistics were used to analyze the data. Results: The findings showed that 73.1% of addicts have used substance during the past 12 months, and 72% have experienced a full relapse. Unpleasant emotions and physical discomfort was the most important reason for relapse and testing personal control and pleasure emotions the least important reason. Interpersonal factors have also a great role in this regard. Conclusions: Considering the high rates of relapse, more attention should be paid to reasons for relapse. It seems necessary that both clinical and psychological approaches would be undertaken simultaneously. PMID:25032159

  8. Deleuze and the theory of addiction.

    PubMed

    Oksanen, Atte

    2013-01-01

    This theoretical article presents and applies the theories of the French philosopher Gilles Deleuze. The article takes as its starting point the observation that current biomedical, social and psychological research does not provide a coherent view of the nature of addiction and there is a great deal of controversy in the field. The material philosophy of Deleuze provides the opportunity to introduce new ideas and bridge the gaps between different theories and approaches. Deleuze's philosophy is especially useful since neurological research on addiction has developed rapidly. Deleuzian concepts have implications not only for the general theory of addiction, but also for different theories on treatment and recovery. A Deleuzian theory, developed in this article, analyzes addictions as situational and interactional processes. Alcohol and drugs are used because they are connected with situations and interactions that enable the production of desire. They change and alter the body. Addiction alters the production of desire and life itself begins to be reduced to alcohol, drugs or a specific mode of behavior. Recovery from addictions is connected with the changes in life that offer subjects an open future. A recovering body must increase its capacity to be affected and be capable of creating new biopsychosocial connections of desire.

  9. Internet Addiction and Other Behavioral Addictions.

    PubMed

    Jorgenson, Alicia Grattan; Hsiao, Ray Chih-Jui; Yen, Cheng-Fang

    2016-07-01

    The Internet is increasingly influential in the lives of adolescents. Although there are many positives, there are also risks related to excessive use and addiction. It is important to recognize clinical signs and symptoms of Internet addiction (compulsive use, withdrawal, tolerance, and adverse consequences), treat comorbid conditions (other substance use disorders, attention deficit hyperactivity disorder, anxiety, depression, and hostility), and initiate psychosocial interventions. More research on this topic will help to provide consensus on diagnostic criteria and further clarify optimal management. PMID:27338971

  10. Gambling Addiction

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Gambling Addiction KidsHealth > For Teens > Gambling Addiction Print A ... So what's the story with gambling? What Is Gambling? Gambling means taking part in any activity or ...

  11. The God-Shaped Hole: Addictive Disorders and the Search for Perfection

    ERIC Educational Resources Information Center

    Hagedorn, W. Bryce; Moorhead, Holly J. Hartwig

    2010-01-01

    Clients with addictive disorders who have an internalized need for perfection benefit from an integration of spirituality into counseling treatment. This article provides a review of the literature, offers a spiritual approach for working with clients who struggle with addiction and perfectionism, and provides a case study to demonstrate the…

  12. Health-related quality of life among veterans in addictions treatment: identifying behavioral targets for future intervention

    PubMed Central

    Oppezzo, Marily A.; Michalek, Anne K.; Delucchi, Kevin; Baiocchi, Michael T. M.; Barnett, Paul G.

    2016-01-01

    Background US veterans report lower health-related quality of life (HRQoL) relative to the general population. Identifying behavioral factors related to HRQoL that are malleable to change may inform interventions to improve well-being in this vulnerable group. Purpose The current study sought to characterize HRQoL in a largely male sample of veterans in addictions treatment, both in relation to US norms and in association with five recommended health behavior practices: regularly exercising, managing stress, having good sleep hygiene, consuming fruits and vegetables, and being tobacco free. Methods We assessed HRQoL with 250 veterans in addictions treatment (96 % male, mean age 53, range 24–77) using scales from four validated measures. Data reduction methods identified two principal components reflecting physical and mental HRQoL. Model testing of HRQoL associations with health behaviors adjusted for relevant demographic and treatment-related covariates. Results Compared to US norms, the sample had lower HRQoL scores. Better psychological HRQoL was associated with higher subjective social standing, absence of pain or trauma, lower alcohol severity, and monotonically with the sum of health behaviors (all p < 0.05). Specifically, psychological HRQoL was associated with regular exercise, stress management, and sleep hygiene. Regular exercise also related to better physical HRQoL. The models explained >40 % of the variance in HRQoL. Conclusions Exercise, sleep hygiene, and stress management are strongly associated with HRQoL among veterans in addictions treatment. Future research is needed to test the effect of interventions for improving well-being in this high-risk group. PMID:26886926

  13. Issues In-Depth: Advancing Understanding of Drug Addiction and Treatment

    ERIC Educational Resources Information Center

    Miller, Roxanne Greitz

    2009-01-01

    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…

  14. NIDA-Drug Addiction Treatment Outcome Study (DATOS) Relapse as a Function of Spirituality/Religiosity

    PubMed Central

    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.

    2015-01-01

    Background 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. Methods 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. Results 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 (x2 = 15.18, p = 0.028; logistic regression = 10.65, p = 0.006); frequency of attending religious services (x2 = 40.78, p < 0.0005; logistic regression = 30.45, p < 0.0005); frequency of reading religious books (x2 = 27.190, p < 0.0005; logistic regression = 17.31, p < 0.0005); frequency of watching religious programs (x2 = 19.02, p = 0.002; logistic regression = ns); and frequency of meditation/prayer (x2 = 11.33, p = 0.045; logistic regression = 9.650, p = 0.002). Across the five measures of spirituality, the spiritual participants reported between 7% and 21% less alcohol, cocaine, heroin, and marijuana use than the non-spiritual subjects. However, the crack users who reported that religion was not important reported significantly less crack use than the spiritual participants. The strongest association between remission and spirituality

  15. Sex Differences in Spiritual Coping, Forgiveness, and Gratitude Before and After a Basic Alcohol Addiction Treatment Program.

    PubMed

    Charzyńska, Edyta

    2015-10-01

    The aim of the study was to examine the sex differences in the initial level of spiritual coping, forgiveness, and gratitude and changes occurring in these areas during a basic alcohol addiction treatment program. The study involved 112 persons, including 56 women and 56 men, who started and completed a basic alcohol addiction treatment program at day care units of 11 treatment centers. Two measurements were taken: one in the first week of the treatment, and one in the last week (5th-7th week after baseline). The Spiritual Coping Questionnaire, the Forgiveness Scale, and Gratitude Questionnaire were used. When starting the therapy, women had a higher level of negative spiritual coping (p = .024) and a lower level of forgiveness of others (p = .041) than men. During the therapy, positive changes in spiritual coping occurred in both sex groups, although in the case of women they involved improvements in more domains and they were stronger. The increase in the level of moral values (except for self-forgiveness) was noted solely in women. The study reveals the need to take sex differences into consideration when introducing spiritual elements into the therapy.

  16. Addiction: Choice or Compulsion?

    PubMed Central

    Henden, Edmund; Melberg, Hans Olav; Røgeberg, Ole Jørgen

    2013-01-01

    Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behavior under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behavior. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. PMID:23966955

  17. Prairie Voles as a Model to Screen Medications for the Treatment of Alcoholism and Addictions.

    PubMed

    Ryabinin, A E; Hostetler, C M

    2016-01-01

    Most preclinical studies of medications to treat addictions are performed in mice and rats. These two rodent species belong to one phylogenetic subfamily, which narrows the likelihood of identifying potential mechanisms regulating addictions in other species, ie, humans. Expanding the genetic diversity of organisms modeling alcohol and drug abuse enhances our ability to screen for medications to treat addiction. Recently, research laboratories adapted the prairie vole model to study mechanisms of alcohol and drugs of abuse. This development not only expanded the diversity of genotypes used to screen medications, but also enhanced capabilities of such screens. Prairie voles belong to 3-5% of mammalian species exhibiting social monogamy. This unusual trait is reflected in their ability to form lasting long-term affiliations between adult individuals. The prairie vole animal model has high predictive validity for mechanisms regulating human social behaviors. In addition, these animals exhibit high alcohol intake and preference. In laboratory settings, prairie voles are used to model social influences on drug reward and alcohol consumption as well as effects of addictive substances on social bonding. As a result, this species can be adapted to screen medications whose effectiveness could be (a) resistant to social influences promoting excessive drug taking, (b) dependent on the presence of social support, and (c) medications affecting harmful social consequences of alcohol and drug abuse. This report reviews the literature on studies of alcohol and psychostimulants in prairie voles and discusses capabilities of this animal model as a screen for novel medications to treat alcoholism and addictions. PMID:27055620

  18. Characteristics and treatment response of self-identified problematic Internet users in a behavioral addiction outpatient clinic

    PubMed Central

    Thorens, Gabriel; Achab, Sophia; Billieux, Joël; Khazaal, Yasser; Khan, Riaz; Pivin, Edward; Gupta, Vishal; Zullino, Daniel

    2014-01-01

    Aims: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:25215217

  19. Coexisting addiction and pain in people receiving methadone for addiction.

    PubMed

    St Marie, Barbara

    2014-04-01

    The aim of this qualitative study was to examine the narratives of people who experience chronic pain (lasting 6 months or more) and were receiving methadone for the treatment of their opiate addiction through a major methadone clinic. This paper featured the pathway of how the participants developed chronic pain and addiction, and their beliefs of how prescription opioids would impact their addiction in the future. Thirty-four participants who experienced chronic pain and received methadone for treatment of opiate addiction were willing to tell the story of their experiences. The findings in three areas are presented: (a) whether participants experienced addiction first or pain first and how their exposures to addictive substances influenced their experiences, (b) the significance of recreational drug use and patterns of abuse behaviors leading to chronic pain, and (c) participants' experiences and beliefs about the potential for abuse of prescription opioid used for treatment of pain.

  20. [Food addiction].

    PubMed

    Locatelli, L; Correia, J C; Golay, A

    2015-03-25

    Food addiction is a common term used in everyday language by obese patients. Although the neurobiological evidence points to some similarities between addictive mechanisms and the consumption of certain foods, this diagnosis is not yet officially recognized. After a brief history of food addiction compared to other eating disorders, we review the neurobiological processes underlying this concept. A food addiction assessment tool is presented and discussed with the current literature and new classifications of the DSM-5. The concept of food addiction needs to be rethought and requires further research.

  1. Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center.

    PubMed

    Witkiewitz, Katie; Warner, Kaitlin; Sully, Betsy; Barricks, Adria; Stauffer, Connie; Thompson, Brian L; Luoma, Jason B

    2014-04-01

    Reincarceration rates are high among substance-involved criminal offenders. This study (conducted during 2010-2011 in an urban area and funded by a Washington State University-Vancouver mini-grant) used a randomized design to examine the effectiveness of mindfulness-based relapse prevention (MBRP) as compared to relapse prevention (RP), as part of a residential addictions treatment program for women referred by the criminal-justice system (N = 105). At 15-week follow up, regression analyses found women in MBRP, compared to RP, reported significantly fewer drug use days and fewer legal and medical problems. Study limitations and future research directions for studying the efficacy of MBRP are discussed.

  2. Adult heavy and low users of dental services: treatment provided.

    PubMed

    Nihtilä, Annamari; Widström, Eeva; Elonheimo, Outi

    2016-01-01

    The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults.

  3. Adult heavy and low users of dental services: treatment provided.

    PubMed

    Nihtilä, Annamari; Widström, Eeva; Elonheimo, Outi

    2016-01-01

    The aim of this study was to compare treatment provided to adult heavy and low users of dental services in the Finnish Public Dental Service (PDS) and to analyse changes in patients' oral health status. We assigned all adults who attended the PDS in Espoo in 2004 to a group of heavy users (n = 3,173) if they had made six or more dental visits and to a comparison group of low users (n = 22,820), if they had made three or fewer dental visits. Data were obtained from the patient register of the PDS. A sample of 320 patients was randomly selected from each group. Baseline information (year 2004) on age, sex, number and types of visits, oral health status and treatment provided was collected from treatment records. Both groups were followed-up for five years. Restorative treatment measures dominated the heavy and low users'treatments; 88.8% of heavy users and 79.6% low users had received restorations during the five-year period. Fixed prosthetic treatments were provided to just 2% of the heavy users and 0.8% of the low users. Emergency visits were more common for heavy users (74.8%) than for low users (21.6%) (p < 0.001). Fewer than half of the heavy (46.1%) or low (46.5%) users were examined twice. Typical for heavy use of oral health services was a cycle of repetitive repair or replacement of restorations, often as emergency treatment, a lack of proper examinations and preventive care; crown therapy was seldom used. Immediately after the major dental care reform in Finland, the PDS in Espoo had problems providing good quality dental care for the new adult patients. Older patients with lower social class background were not accustomed to regular dental care and the PDS did not actively propose proper comprehensive regular care for adults. PMID:27464379

  4. The genetic basis of addictive disorders.

    PubMed

    Ducci, Francesca; Goldman, David

    2012-06-01

    Addictions are common, chronic, and relapsing diseases that develop through a multistep process. The impact of addictions on morbidity and mortality is high worldwide. Twin studies have shown that the heritability of addictions ranges from 0.39 (hallucinogens) to 0.72 (cocaine). Twin studies indicate that genes influence each stage from initiation to addiction, although the genetic determinants may differ. Addictions are by definition the result of gene × environment interaction. These disorders, which are in part volitional, in part inborn, and in part determined by environmental experience, pose the full range of medical, genetic, policy, and moral challenges. Gene discovery is being facilitated by a variety of powerful approaches, but is in its infancy. It is not surprising that the genes discovered so far act in a variety of ways: via altered metabolism of drug (the alcohol and nicotine metabolic gene variants), via altered function of a drug receptor (the nicotinic receptor, which may alter affinity for nicotine but as discussed may also alter circuitry of reward), and via general mechanisms of addiction (genes such as monoamine oxidase A and the serotonin transporter that modulate stress response, emotion, and behavioral control). Addiction medicine today benefits from genetic studies that buttress the case for a neurobiologic origin of addictive behavior, and some general information on familially transmitted propensity that can be used to guide prevention. A few well-validated, specific predictors such as OPRM1, ADH1B, ALDH2, CHRNA5, and CYP26 have been identified and can provide some specific guidance, for example, to understand alcohol-related flushing and upper GI cancer risk (ADH1B and AKLDH2), variation in nicotine metabolism (CYP26), and, potentially, naltrexone treatment response (OPRM1). However, the genetic predictors available are few in number and account for only a small portion of the genetic variance in liability, and have not been integrated

  5. Addiction surplus: the add-on margin that makes addictive consumptions difficult to contain.

    PubMed

    Adams, Peter J; Livingstone, Charles

    2015-01-01

    Addictive consumptions generate financial surpluses over-and-above non-addictive consumptions because of the excessive consumption of addicted consumers. This add-on margin or 'addiction surplus' provides a powerful incentive for beneficiaries to protect their income by ensuring addicted consumers keep consuming. Not only that, addiction surplus provides the financial base that enables producers to sponsor activities which aim to prevent public health initiatives from reducing consumption. This paper examines the potency of addiction surplus to engage industry, governments and communities in an on-going reliance on addiction surplus. It then explores how neo-liberal constructions of a rational consumer disguise the ethical and exploitative dynamics of addiction surplus by examining ways in which addictive consumptions fail to conform to notions of autonomy and rationality. Four measures are identified to contain the distorting effects of addiction surplus.

  6. A behavioral intervention for improving verbal behaviors of heroin addicts in a treatment clinic.

    PubMed

    Petry, N M; Bickel, W K; Tzanis, E; Taylor, R; Kubik, E; Foster, M; Hughes, M E

    1998-01-01

    Positively reinforcing appropriate behaviors improved verbal behaviors of opioid-dependent patients in a buprenorphine treatment clinic. During B phases of an ABAB design, clients received stickers for engaging in appropriate verbal or nonverbal behaviors. Each sticker provided a chance of winning $25. No reinforcement was provided during the A phases. Appropriate verbal behaviors increased during reinforcement periods, and inappropriate verbal behaviors decreased.

  7. Stress, habits, and drug addiction: a psychoneuroendocrinological perspective.

    PubMed

    Schwabe, Lars; Dickinson, Anthony; Wolf, Oliver T

    2011-02-01

    It is well known that stress is a significant risk factor for the development of drug addiction and addiction relapse. Remarkably, the cognitive processes involved in the effects of stress on addictive behavior remain poorly understood. Here it is proposed that stress-induced changes in the neural circuits controlling instrumental action provide a potential mechanism by which stress affects the development of addiction and relapse vulnerability. Instrumental action can be controlled by two anatomically distinct systems: a goal-directed system that involves learning of action-outcome associations, and a habit system that learns stimulus-response associations. The transition from initial voluntary drug use to subsequent involuntary, compulsive drug use represents a switch from goal-directed to habitual control of action. Recent evidence indicates that this switch from goal-directed to habit action can be prompted by stress and stress hormones. We argue (i) that acute stressors reinstate habitual responding to drug-related cues and thus trigger relapse to addictive behavior, and (ii) that prolonged or repeated stress may accelerate the transition from voluntary to involuntary drug use and thus promote the development of addiction. The suggested mechanism encompasses cognitive processes that may contribute to the effects of stress on addictive behavior and could have important implications for the treatment of addiction and the prevention of relapse.

  8. Programma Conoscenza: Psycho-Educational, Integrated and Evolved Treatment for Cocaine Addiction

    ERIC Educational Resources Information Center

    Leonardi, Andrea; Fioravanti, Paolo; Scavelli, Sonia; Velicogna, Francesco

    2009-01-01

    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 for the…

  9. Challenges to Implementing Opioid Substitution Therapy in Ukrainian Prisons: Personnel Attitudes Toward Addiction, Treatment, and People With HIV/AIDS

    PubMed Central

    Polonsky, Maxim; Azbel, Lyuba; Wickersham, Jeffrey A.; Taxman, Faye S.; Grishaev, Evgeny; Dvoryak, Sergey; Altice, Frederick L.

    2015-01-01

    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

  10. The media and behavioral genetics: Alternatives coexisting with addiction genetics

    PubMed Central

    Dingel, Molly J.; Ostergren, Jenny; McCormick, Jennifer B.; Hammer, Rachel; Koenig, Barbara A.

    2015-01-01

    To understand public discourse in the U.S. on genetic causation of behavioral disorders, we analyzed media representations of genetic research on addiction published between 1990 and 2010. We conclude first that the media simplistically represent biological bases of addiction and willpower as being mutually exclusive: behaviors are either genetically determined, or they are a choice. Second, most articles provide only cursory or no treatment of the environmental contribution. A media focus on genetics directs attention away from environmental factors. Rhetorically, media neglect the complexity underlying of the etiology of addiction and direct focus back toward individual causation and responsibility. PMID:26392644

  11. The obligation to provide antiretroviral treatment in HIV prevention trials.

    PubMed

    Lo, Bernard; Padian, Nancy; Barnes, Mark

    2007-06-19

    Providing antiretroviral therapy (ART) to participants who seroconvert during HIV prevention trials in developing countries is an ethical expectation. Promising treatment to the few seroconverters widens disparities within a resource-poor country and would be unjust. Such an assurance should be done in a way that also improves access to ART for others in the country. US funds for ART in poor countries from the PEPFAR should be available to all countries that host HIV prevention and clinical trials. PMID:17545698

  12. Reducing the addictiveness of cigarettes

    PubMed Central

    Henningfield, J.; Benowitz, N.; Slade, J.; Houston, T.; Davis, R.; Deitchman, S.

    1998-01-01

    OBJECTIVE—To assess the feasibility of reducing tobacco-caused disease by gradually removing nicotine from cigarettes until they would not be effective causes of nicotine addiction.
DATA SOURCES—Issues posed by such an approach, and potential solutions, were identified from analysis of literature published by the US Food and Drug Administration (FDA) in its 1996 Tobacco Rule, comments of the tobacco industry and other institutions and individuals on the rule, review of the reference lists of relevant journal articles, other government publications, and presentations made at scientific conferences.
DATA SYNTHESIS—The role of nicotine in causing and sustaining tobacco use was evaluated to project the impact of a nicotine reduction strategy on initiation and maintenance of, and relapse to, tobacco use. A range of potential concerns and barriers was addressed, including the technical feasibility of reducing cigarette nicotine content to non-addictive levels, the possibility that compensatory smoking would reduce potential health benefits, and whether such an approach would foster illicit ("black market") tobacco sales. Education, treatment, and research needs to enable a nicotine reduction strategy were also addressed. The Council on Scientific Affairs came to the following conclusions: (a) gradually eliminating nicotine from cigarettes is technically feasible; (b) a nicotine reduction strategy holds great promise in preventing adolescent tobacco addiction and assisting the millions of current cigarette smokers in their efforts to quit using tobacco products; (c) potential problems such as compensatory over-smoking of denicotinised cigarettes and black market sales could be minimised by providing alternate forms of nicotine delivery with less or little risk to health, as part of expanded access to treatment; and (d) such a strategy would need to be accompanied by relevant research and increased efforts to educate consumers and health professionals about

  13. A behavioral intervention for improving verbal behaviors of heroin addicts in a treatment clinic.

    PubMed Central

    Petry, N M; Bickel, W K; Tzanis, E; Taylor, R; Kubik, E; Foster, M; Hughes, M E

    1998-01-01

    Positively reinforcing appropriate behaviors improved verbal behaviors of opioid-dependent patients in a buprenorphine treatment clinic. During B phases of an ABAB design, clients received stickers for engaging in appropriate verbal or nonverbal behaviors. Each sticker provided a chance of winning $25. No reinforcement was provided during the A phases. Appropriate verbal behaviors increased during reinforcement periods, and inappropriate verbal behaviors decreased. PMID:9652105

  14. The "PSOST": Providers' Signout for Scope of Treatment.

    PubMed

    Newport, Kristina Braine; Patel, Shejal; Lyckholm, Laurie; Bobb, Barton; Coyne, Patrick; Smith, Thomas J

    2010-09-01

    Palliative care provides open and honest communication, medically appropriate goal setting, and meticulous attention to symptom assessment and control. The Physicians Orders for Life Sustaining Treatment (POLST) is a growing movement to allow health care providers to indicate, with their patients, what they want done in specific situations, such as feeding tubes, mechanical ventilation, or transfer to an intensive care unit. We have developed an internal signout tool used by palliative medicine fellows in our institution to specify similar interventions-or not-with seriously ill palliative care patients, the Providers Signout for Scope of Treatment (PSOST). We have found that this situation-specific tool enables smooth transitions of care on nights and weekends, especially when the patient is near death, and may help prevent both overescalation of care and underuse of life saving treatments such as resuscitation. The PSOST differs from other signout tools in that it gives clear direction regarding the patient's medical goals and desire for escalation of care, or not. We present it here for open access and use anywhere. This tool has also assisted in building team communication with the nursing shifts, especially nights and weekends, as all team members are able to deliver a consistent message, while meeting the goals of care for patients and families. We believe this tool could be useful with a broader patient population, outside of Palliative Medicine, to provide clearer direction for hospitalized or nursing home patients whose care is often directed by multiple providers. It could also be used as a template for signouts on other inpatient services, as care goals are important for all patients.

  15. The Need for National Credentialing Standards for Addiction Counselors

    ERIC Educational Resources Information Center

    Miller, Geri; Scarborough, Jim; Clark, Catherine; Leonard, Justin C.; Keziah, Tyler B.

    2010-01-01

    The authors review the current state of credentialing for addiction counselors in the United States and provide recommendations to the addiction counseling field regarding national standards for credentialing.

  16. Behavioral addictions.

    PubMed

    Robbins, T W; Clark, L

    2015-02-01

    Behavioral addictions are slowly becoming recognized as a valid category of psychiatric disorder as shown by the recent allocation of pathological gambling to this category in DSM-5. However, several other types of psychiatric disorder proposed to be examples of behavioral addictions have yet to be accorded this formal acknowledgment and are dispersed across other sections of the DSM-5. This brief review marks this important point in the evolution of this concept and looks to future investigation of behavioral addictions with the theoretical frameworks currently being used successfully to investigate substance addiction and obsessive-compulsive disorder, in a potentially new spectrum of impulsive-compulsive disorders.

  17. Symposium overview--Food addiction: fact or fiction?

    PubMed

    Corwin, Rebecca L; Grigson, Patricia S

    2009-03-01

    Food addiction is a pervasive, yet controversial, topic that has gained recent attention in both lay media and the scientific literature. The goal of this series of articles is to use a combination of preclinical and clinical data to determine whether foods, like drugs of abuse, can be addictive, the conditions under which the addiction develops, and the underlying neurophysiological substrates. Operational definitions of addiction that have been used in the treatment of human disorders and to guide research in both humans and animals are presented, and an overview of the symposium articles is provided. We propose that specific foods, especially those that are rich in fat and/or sugar, are capable of promoting "addiction"-like behavior and neuronal change under certain conditions. That is, these foods, although highly palatable, are not addictive per se but become so following a restriction/binge pattern of consumption. Such consummatory patterns have been associated with increased risk for comorbid conditions such as obesity, early weight gain, depression, anxiety, and substance abuse as well as with relapse and treatment challenges. The topic of food addiction bears study, therefore, to develop fresh approaches to clinical intervention and to advance our understanding of basic mechanisms involved in loss of control.

  18. Experiences of Power and Violence in Mexican Men Attending Mutual-Aid Residential Centers for Addiction Treatment.

    PubMed

    Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio

    2016-05-01

    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.

  19. Promoting new practices to increase access to and retention in addiction treatment: an analysis of five communication channels.

    PubMed

    Johnson, Kimberly A; Ford, James H; McCluskey, Matthew

    2012-11-01

    Addiction treatment programs adopt evidence-based practices slowly, in part because adopting a new practice is a process, not an event. Using different communication channels may have a different effect at different points in the process. This paper reports the effectiveness of five communication channels in getting substance abuse treatment programs to adopt new business practices. In this study, national trade media coverage produced the greatest interest among programs and the greatest number of decisions to adopt. Conference presentations produced fewer decisions to adopt than national media, but were the most effective channel when compared to the number of programs they reached. Peers were the greatest influence in moving clinic staff from the decision to adopt to implementation. These findings give preliminary evidence for using different communication channels at different times during an effort to promote the adoption of best practices. PMID:22771023

  20. Association between caries location and restorative material treatment provided

    PubMed Central

    Lubisich, Erinne B.; Hilton, Thomas J.; Ferracane, Jack L.; Pashova, Hristina I.; Burton, Bruce

    2013-01-01

    Objectives This cross-sectional study by the Northwest PRECEDENT practitioners correlated the location of caries diagnosed in the past 12 months with treatment provided. Methods An oral health survey was conducted on up to 20 patients per practice for 101 practices in the Northwest PRECEDENT network. A total of 1943 eligible patients were randomly assessed for the location of and treatment provided for caries lesions diagnosed within the past 12 months. Regression analysis using Generalized Estimating Equations (GEE) was performed to assess association of treatment to tooth location and surface characterization, adjusting for age, practice location (urban/rural), dentist gender, and experience level. The analysis accounts for clustering by practice using robust variance estimates. Results Overall, 55.4% of patients exhibited recent caries and 42.8% received treatment for at least one permanent tooth. 18% of treated teeth were treated with amalgam, and 72% were treated with composite. This percentage varied as a function of tooth surface characteristics, patient characteristics, and dentist characteristics. The results suggest that restoration selection does depend on tooth type and which surfaces are being restored. The odds of a molar receiving an amalgam restoration are 2.44 (95% CI=1.81–3.30) times higher as compared to a bicuspid, adjusting for all other covariates. When the restoration includes the occlusal surface of a tooth the odds are 0.42 (95% CI=0.20–0.89) times as great that amalgam will be placed. When the restoration includes the mesial or distal surface of the tooth the odds for amalgam restoration are 2.49 (95% CI=1.25–4.95) times higher compared to when it does not include these surfaces. Conclusion Restorative material choice varied based on caries location and practitioner gender. PMID:21256915

  1. Engagement and Substance Dependence in a Primary Care-Based Addiction Treatment Program for People Infected with HIV and People at High-Risk for HIV Infection.

    PubMed

    Walley, Alexander Y; Palmisano, Joseph; Sorensen-Alawad, Amy; Chaisson, Christine; Raj, Anita; Samet, Jeffrey H; Drainoni, Mari-Lynn

    2015-12-01

    To improve outcomes for people with substance dependence and HIV infection or at risk for HIV infection, patients were enrolled in a primary care-based addiction treatment program from 2008-2012 that included a comprehensive substance use assessment, individual and group counseling, addiction pharmacotherapy and case management. We examined whether predisposing characteristics (depression, housing status, polysubstance use) and an enabling resource (buprenorphine treatment) were associated with engagement in the program and persistent substance dependence at 6 months. At program enrollment 61% were HIV-infected, 53% reported heroin use, 46% reported alcohol use, 37% reported cocaine use, and 28% reported marijuana use in the past 30 days, 72% reported depression, 19% were homeless, and 53% had polysubstance use. Within 6-months 60% had been treated with buprenorphine. Engagement (defined as 2 visits in first 14 days and 2 additional visits in next 30 days) occurred in 64%; 49% had substance dependence at 6-months. Receipt of buprenorphine treatment was associated with engagement (Adjusted Odds Ratio (AOR) 8.32 95% CI: 4.13-16.77). Self-reported depression at baseline was associated with substance dependence at 6-months (AOR 3.30 95% CI: 1.65-6.61). Neither housing status nor polysubstance use was associated with engagement or substance dependence. The FAST PATH program successfully engaged and treated patients in a primary care-based addiction treatment program. Buprenorphine, a partial opioid agonist, was a major driver of addiction treatment engagement. Given depression's association with adverse outcomes in this clinical population, including mental health treatment as part of integrated care holds potential to improve addiction treatment outcomes. PMID:26298399

  2. Pharmacogenetic aspects of addictive behaviors.

    PubMed

    Hejazi, Nadia S

    2007-01-01

    Addictions are illnesses of complex causation, including inheritance and a role for gene/environment interactions. Functional alleles influencing pharmacodynamic (tissue response) and pharmacokinetic (absorption, distribution, and metabolism) play a role, but these interact with diverse environmental factors including early life stress, underage drug exposure, availability of addictive agents, and response to clinical interventions including pharmacotherapies. Identification of genetic factors in addiction thus plays an important role in the understanding of processes of addiction and origins of differential vulnerabilities and treatment responses. PMID:18286803

  3. Stress and addiction.

    PubMed

    Hildebrandt, Tom; Greif, Rebecca

    2013-09-01

    Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction.

  4. Stress and addiction.

    PubMed

    Hildebrandt, Tom; Greif, Rebecca

    2013-09-01

    Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction. PMID:23849597

  5. Provider and patient correlates of provider decisions to recommend HCV treatment to HIV co-infected patients.

    PubMed

    Wagner, Glenn; Osilla, Karen Chan; Garnett, Jeffrey; Ghosh-Dastidar, Bonnie; Bhatti, Laveeza; Witt, Mallory; Goetz, Matthew Bidwell

    2012-01-01

    Despite low uptake of hepatitis C virus (HCV) treatment among HIV co-infected patients, few studies have examined the factors that contribute to provider decisions to recommend treatment. Surveys of 173 co-infected patients and their primary care providers, as well as patient chart data, were collected at 3 HIV clinics in Los Angeles; 73% of the patients had any history of being recommended HCV treatment. Multivariate predictors of being offered treatment included being Caucasian, greater HCV knowledge, receiving depression treatment if depressed, and one's provider having a lower weekly patient load and more years working at the study site. These findings suggest that provider decisions to recommend HCV treatment are influenced by patient factors including race and psychosocial treatment readiness, as well as characteristics of their own practice and treatment philosophy. With changes to HCV treatment soon to emerge, further evaluation of factors influencing treatment decisions is needed to improve HCV treatment uptake. PMID:22564797

  6. [Internet addiction].

    PubMed

    Nakayama, Hideki; Higuchi, Susumu

    2015-09-01

    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.

  7. [Neurobiology of addictive behavior].

    PubMed

    Ivlieva, N Iu

    2011-01-01

    Addictive behavior developes after repeated substance use and it typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to the drug use than to other activities. Relapse, the resumption of drug taking after periods of abstinence, remains the major problem for the treatment of addiction. The process of drug addiction shares striking commonalities with neural plasticity associated with natural reward learning and memory and is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems that attribute incentive salience to reward-associated stimuli. The switch from controlled to compulsive drug seeking represents a transition at the neural level from prefrontal cortical to striatal control. Current neurophysiologic evidence suggests that the development of addiction is to some extent due to neurochemical stimulation of the midbrain dopaminergic system that is traditionally considered as a 'common neural currency' for rewards of most kinds. Addictions are a result of the interplay of multiple genetic and environmental factors. They are characterized by phenotypic and genetic heterogeneity as well as polygenicity. Environmental factors are crucial in addiction vulnerability and resistese too.

  8. Treatment outcomes in patients with internet addiction: a clinical pilot study on the effects of a cognitive-behavioral therapy program.

    PubMed

    Wölfling, K; Beutel, M E; Dreier, M; Müller, K W

    2014-01-01

    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.

  9. RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS

    PubMed Central

    Heidari, Mohammad; Ghodusi, Mansureh

    2016-01-01

    Objective: 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. Methods: 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. Results: According to the results, in the 12th 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. Conclusion: 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. PMID:27698598

  10. RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS

    PubMed Central

    Heidari, Mohammad; Ghodusi, Mansureh

    2016-01-01

    Objective: 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. Methods: 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. Results: According to the results, in the 12th 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. Conclusion: 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.

  11. Treatment Outcomes in Patients with Internet Addiction: A Clinical Pilot Study on the Effects of a Cognitive-Behavioral Therapy Program

    PubMed Central

    Wölfling, K.; Beutel, M. E.; Dreier, M.; Müller, K. W.

    2014-01-01

    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. PMID:25097858

  12. The evidence doesn't justify steps by state Medicaid programs to restrict opioid addiction treatment with buprenorphine.

    PubMed

    Clark, Robin E; Samnaliev, Mihail; Baxter, Jeffrey D; Leung, Gary Y

    2011-08-01

    Many state Medicaid programs restrict access to buprenorphine, a prescription medication that relieves withdrawal symptoms for people addicted to heroin or other opiates. The reason is that officials fear that the drug is costlier or less safe than other therapies such as methadone. To find out if this is true, we compared spending, the use of services related to drug-use relapses, and mortality for 33,923 Massachusetts Medicaid beneficiaries receiving either buprenorphine, methadone, drug-free treatment, or no treatment during the period 2003-07. Buprenorphine appears to have significantly expanded access to treatment because the drug can be prescribed by a physician and taken at home compared with methadone, which by law must be administered at an approved clinic. Buprenorphine was associated with more relapse-related services but $1,330 lower mean annual spending than methadone when used for maintenance treatment. Mortality rates were similar for buprenorphine and methadone. By contrast, mortality rates were 75 percent higher among those receiving drug-free treatment, and more than twice as high among those receiving no treatment, compared to those receiving buprenorphine. The evidence does not support rationing buprenorphine to save money or ensure safety. PMID:21821560

  13. Inhibition of FAAH and activation of PPAR: New approaches to the treatment of cognitive dysfunction and drug addiction

    PubMed Central

    Panlilio, Leigh V.; Justinova, Zuzana; Goldberg, Steven R.

    2013-01-01

    Enhancing the effects of endogenously-released cannabinoid ligands in the brain might provide therapeutic effects more safely and effectively than administering drugs that act directly at the cannabinoid receptor. Inhibitors of fatty acid amide hydrolase (FAAH) prevent the breakdown of endogenous ligands for cannabinoid receptors and peroxisome proliferator-activated receptors (PPAR), prolonging and enhancing the effects of these ligands when they are naturally released. This review considers recent research on the effects of FAAH inhibitors and PPAR activators in animal models of addiction and cognition (specifically learning and memory). These studies show that FAAH inhibitors can produce potentially therapeutic effects, some through cannabinoid receptors and some through PPAR. These effects include enhancing certain forms of learning, counteracting the rewarding effects of nicotine and alcohol, relieving symptoms of withdrawal from cannabis and other drugs, and protecting against relapse-like reinstatement of drug self-administration. Since FAAH inhibition might have a wide range of therapeutic actions but might also share some of the adverse effects of cannabis, it is noteworthy that at least one FAAH-inhibiting drug (URB597) has been found to have potentially beneficial effects but no indication of liability for abuse or dependence. Although these areas of research are new, the preliminary evidence indicates that they might lead to improved therapeutic interventions and a better understanding of the brain mechanisms underlying addiction and memory. PMID:23333350

  14. Food addiction and bulimia nervosa.

    PubMed

    Meule, Adrian; von Rezori, Vittoria; Blechert, Jens

    2014-09-01

    In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

  15. Neuroscience research on the addictions: a prospectus for future ethical and policy analysis.

    PubMed

    Hall, Wayne; Carter, Lucy; Morley, Katherine I

    2004-09-01

    The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify "addicts" or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work

  16. Neuroscience research on the addictions: a prospectus for future ethical and policy analysis.

    PubMed

    Hall, Wayne; Carter, Lucy; Morley, Katherine I

    2004-09-01

    The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify "addicts" or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work

  17. Internet and Gaming Addiction: A Systematic Literature Review of Neuroimaging Studies

    PubMed Central

    Kuss, Daria J.; Griffiths, Mark D.

    2012-01-01

    In the past decade, research has accumulated suggesting that excessive Internet use can lead to the development of a behavioral addiction. Internet addiction has been considered as a serious threat to mental health and the excessive use of the Internet has been linked to a variety of negative psychosocial consequences. The aim of this review is to identify all empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective. Neuroimaging studies offer an advantage over traditional survey and behavioral research because with this method, it is possible to distinguish particular brain areas that are involved in the development and maintenance of addiction. A systematic literature search was conducted, identifying 18 studies. These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related addictions and Internet and gaming addiction, on a variety of levels. On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction led to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction. On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains. The paper shows that understanding the neuronal correlates associated with the development of Internet and gaming addiction will promote future research and will pave the way for the development of addiction treatment approaches. PMID:24961198

  18. Internet and gaming addiction: a systematic literature review of neuroimaging studies.

    PubMed

    Kuss, Daria J; Griffiths, Mark D

    2012-01-01

    In the past decade, research has accumulated suggesting that excessive Internet use can lead to the development of a behavioral addiction. Internet addiction has been considered as a serious threat to mental health and the excessive use of the Internet has been linked to a variety of negative psychosocial consequences. The aim of this review is to identify all empirical studies to date that used neuroimaging techniques to shed light upon the emerging mental health problem of Internet and gaming addiction from a neuroscientific perspective. Neuroimaging studies offer an advantage over traditional survey and behavioral research because with this method, it is possible to distinguish particular brain areas that are involved in the development and maintenance of addiction. A systematic literature search was conducted, identifying 18 studies. These studies provide compelling evidence for the similarities between different types of addictions, notably substance-related addictions and Internet and gaming addiction, on a variety of levels. On the molecular level, Internet addiction is characterized by an overall reward deficiency that entails decreased dopaminergic activity. On the level of neural circuitry, Internet and gaming addiction led to neuroadaptation and structural changes that occur as a consequence of prolonged increased activity in brain areas associated with addiction. On a behavioral level, Internet and gaming addicts appear to be constricted with regards to their cognitive functioning in various domains. The paper shows that understanding the neuronal correlates associated with the development of Internet and gaming addiction will promote future research and will pave the way for the development of addiction treatment approaches. PMID:24961198

  19. Time Trends of Cannabis Use Among Treatment-seeking Individuals at Government De-addiction Centers Across India Over a Period of 7 Years

    PubMed Central

    Balhara, Yatan Pal Singh; Mishra, Ashwani; Sethi, Hem; Singh, Shalini; Khandelwal, Sudhir Kumar

    2016-01-01

    Background: Cannabis continues to be the most commonly used illicit psychoactive substance globally. The National Survey in India conducted in the year 2004 also reported it to be the most commonly used illicit substance in the country. Furthermore, it was reported to be the second most commonly used psychoactive substance by the treatment seekers at de-addiction centers in the country. Objectives: To assess time trends of cannabis use among treatment-seeking individuals at government de-addiction centers across India over a period of 7 years. Materials and Methods: The study utilized data collected through Drug Abuse Monitoring System across India. The data of treatment seekers from de-addiction centers established under the Drug De-addiction Program, Ministry of Health and Family Welfare, Government of India and supported by the Ministry of Social Justice and Empowerment, Government of India (122 in number) across the country were analyzed. Results: A total of 107,469 individuals sought treatment from government de-addiction centers over the 7 years (2007–2013) period. With the exception of an aberration for the year 2012, there has been a steady decline in the proportion of treatment seekers who are not current cannabis users. A significantly greater proportion (Chi-square: 586.30, df: 1, P < 0.001) of individuals with current cannabis use alone or along with tobacco (20.4%) tend to have a co-morbid psychiatric disorder as compared to treatment seekers with current use of substances other than cannabis (6.1%). Conclusions: It is important to focus on cannabis in clinical service delivery and research in the country. PMID:27570345

  20. Is fast food addictive?

    PubMed

    Garber, Andrea K; Lustig, Robert H

    2011-09-01

    Studies of food addiction have focused on highly palatable foods. While fast food falls squarely into that category, it has several other attributes that may increase its salience. This review examines whether the nutrients present in fast food, the characteristics of fast food consumers or the presentation and packaging of fast food may encourage substance dependence, as defined by the American Psychiatric Association. The majority of fast food meals are accompanied by a soda, which increases the sugar content 10-fold. Sugar addiction, including tolerance and withdrawal, has been demonstrated in rodents but not humans. Caffeine is a "model" substance of dependence; coffee drinks are driving the recent increase in fast food sales. Limited evidence suggests that the high fat and salt content of fast food may increase addictive potential. Fast food restaurants cluster in poorer neighborhoods and obese adults eat more fast food than those who are normal weight. Obesity is characterized by resistance to insulin, leptin and other hormonal signals that would normally control appetite and limit reward. Neuroimaging studies in obese subjects provide evidence of altered reward and tolerance. Once obese, many individuals meet criteria for psychological dependence. Stress and dieting may sensitize an individual to reward. Finally, fast food advertisements, restaurants and menus all provide environmental cues that may trigger addictive overeating. While the concept of fast food addiction remains to be proven, these findings support the role of fast food as a potentially addictive substance that is most likely to create dependence in vulnerable populations.

  1. Is fast food addictive?

    PubMed

    Garber, Andrea K; Lustig, Robert H

    2011-09-01

    Studies of food addiction have focused on highly palatable foods. While fast food falls squarely into that category, it has several other attributes that may increase its salience. This review examines whether the nutrients present in fast food, the characteristics of fast food consumers or the presentation and packaging of fast food may encourage substance dependence, as defined by the American Psychiatric Association. The majority of fast food meals are accompanied by a soda, which increases the sugar content 10-fold. Sugar addiction, including tolerance and withdrawal, has been demonstrated in rodents but not humans. Caffeine is a "model" substance of dependence; coffee drinks are driving the recent increase in fast food sales. Limited evidence suggests that the high fat and salt content of fast food may increase addictive potential. Fast food restaurants cluster in poorer neighborhoods and obese adults eat more fast food than those who are normal weight. Obesity is characterized by resistance to insulin, leptin and other hormonal signals that would normally control appetite and limit reward. Neuroimaging studies in obese subjects provide evidence of altered reward and tolerance. Once obese, many individuals meet criteria for psychological dependence. Stress and dieting may sensitize an individual to reward. Finally, fast food advertisements, restaurants and menus all provide environmental cues that may trigger addictive overeating. While the concept of fast food addiction remains to be proven, these findings support the role of fast food as a potentially addictive substance that is most likely to create dependence in vulnerable populations. PMID:21999689

  2. Exploring needs and expectations of spouses of addicted men in Iran: a qualitative study.

    PubMed

    Joolaee, Soodabeh; Fereidooni, Zhila; Seyed Fatemi, Naeemeh; Meshkibaf, Mohammad Hassan; Mirlashari, Jila

    2014-09-01

    Addiction is one of the major 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

  3. Exploring Needs and Expectations of Spouses of Addicted Men in Iran: A Qualitative Study

    PubMed Central

    Joolaee, Soodabeh; Fereidooni, Zhila; Fatemi, Naeemeh Seyed; Meshkibaf, Mohammad Hassan; Mirlashri, Jila

    2014-01-01

    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

  4. Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center.

    PubMed

    Witkiewitz, Katie; Warner, Kaitlin; Sully, Betsy; Barricks, Adria; Stauffer, Connie; Thompson, Brian L; Luoma, Jason B

    2014-04-01

    Reincarceration rates are high among substance-involved criminal offenders. This study (conducted during 2010-2011 in an urban area and funded by a Washington State University-Vancouver mini-grant) used a randomized design to examine the effectiveness of mindfulness-based relapse prevention (MBRP) as compared to relapse prevention (RP), as part of a residential addictions treatment program for women referred by the criminal-justice system (N = 105). At 15-week follow up, regression analyses found women in MBRP, compared to RP, reported significantly fewer drug use days and fewer legal and medical problems. Study limitations and future research directions for studying the efficacy of MBRP are discussed. PMID:24611849

  5. Research to practice in addiction treatment: key terms and a field-driven model of technology transfer.

    PubMed

    2011-09-01

    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.

  6. The Dynamics of a Heroin Addiction Epidemic

    ERIC Educational Resources Information Center

    DuPont, Robert L.; Greene, Mark H.

    1973-01-01

    Discusses recent trends in heroin addiction in Washington, D.C. In 1969 a comprehensive, multimodal treatment program for addicts was introduced and a major law enforcement commitment was made to reduce the heroin supply. These factors, together with changing community attitudes, may be responsible for a remarkable decline in heroin addiction. (JR)

  7. A Meaning-Centered Therapy for Addictions

    ERIC Educational Resources Information Center

    Thompson, Geoff

    2012-01-01

    This article describes a treatment for addictions, based on the idea that addiction is a response to living a life that has little personal meaning. First, it presents the theory of Meaning-Centered Therapy (MCT) as developed by Paul Wong, particularly the need to understand intoxication from the addict's perspective. Next, it presents the…

  8. Stent-Graft Placement with Early Debridement and Antibiotic Treatment for Femoral Pseudoaneurysms in Intravenous Drug Addicts

    SciTech Connect

    Fu, Qining Meng, Xiyun Li, Fenghe Wang, Xuehu Cheng, Jun Huang, Wen Ren, Wei Zhao, Yu

    2015-06-15

    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.

  9. Hair treatment process providing dispersed colors by light diffraction

    SciTech Connect

    Sutton, Richard Matthew Charles; Lamartine, Bruce Carvell; Orler, E. Bruce; Song, Shuangqi

    2015-12-22

    A hair treatment process for providing dispersed colors by light diffraction including (a) coating the hair with a material comprising a polymer, (b) pressing the hair with a pressing device including one or more surfaces, and (c) forming a secondary nanostructured surface pattern on the hair that is complementary to the primary nanostructured surface pattern on the one or more surfaces of the pressing device. The secondary nanostructured surface pattern diffracts light into dispersed colors that are visible on the hair. The section of the hair is pressed with the pressing device for from about 1 to 55 seconds. The polymer has a glass transition temperature from about 55.degree. C. to about 90.degree. C. The one or more surfaces include a primary nanostructured surface pattern.

  10. Disordered gambling: a behavioral addiction.

    PubMed

    Clark, Luke; Limbrick-Oldfield, Eve H

    2013-08-01

    Developments in psychiatry have ratified the existence of behavioral addictions, that certain activities such as gambling or video-game play may be considered addictive in the absence of exogenous (i.e. drug-induced) stimulation of brain reinforcement circuitry. This article describes recent advances in understanding the neurobiological basis of behavioral addiction, with a focus on pathological gambling as the prototypical disorder. We describe positron emission tomography (PET) studies characterizing dopaminergic transmission, and functional imaging studies of reward processing and gambling-related cognitive distortions. The current evidence not only indicates changes in pathological gamblers in core circuitry implicated in drug addiction, but also highlights some subtle differences. Behavioral addictions can also provide experimental traction on distinguishing vulnerability markers for addictions from the active detrimental effects of chronic drug use.

  11. Safety and efficacy of oral slow release morphine for maintenance treatment in heroin addicts: a 6-month open noncomparative study.

    PubMed

    Vasilev, Georgi N; Alexieva, Daniela Z; Pavlova, Rositsa Z

    2006-01-01

    This open-label, noncomparative, single-center trial evaluated the safety and efficacy of once-daily treatment with slow release oral morphine (SROM) capsules for the maintenance treatment of 20 outpatients with heroin dependency over 6 months at the National Institute for Addictions in Sofia, Bulgaria. Doses were individually titrated up to a mean daily maintenance dose of 760 mg (range 440-1,200 mg). SROM was effective in significantly reducing the signs and symptoms of opioid withdrawal and craving for heroin, with stabilization generally evident within two weeks. Nineteen patients completed 6 months of treatment and illicit opioid use was virtually eliminated. One patient withdrew voluntarily at 22 weeks. Validated questionnaires and tests indicated improvements in patients' well-being from baseline assessments. These included significant improvements with regard to suicidal depression (85%), anxiety and dysphoria (66%), general illness (58%), social dysfunction (54%), sense of hopelessness (34%), attention (25%), and self-reported typical depressive (27%) and disease-related (11%) symptoms. No deaths, serious adverse events, or withdrawals due to adverse events occurred. Five episodes of constipation and one episode of sweating (all nonserious and of mild or moderate severity) were reported. Vital signs were unaffected by SROM and no weight change was evident over the study period. The observations made in this study indicate a promising role for once-daily treatment with SROM in the clinical management of heroin dependency.

  12. Group and individual change in the treatment of drug addictions: a follow-up study in therapeutic communities.

    PubMed

    López-Goñi, José Javier; Fernández-Montalvo, Javier; Menéndez, Juan Carlos; Yudego, Fausto; García, Angel Rico; Esarte, Sonia

    2010-11-01

    The pre-post treatment change of 112 patients in two therapeutics Spanish communities is described. The Addiction Severity Index (ASI) was used at intake and at the end of the treatment program. Results of the treatment program were evaluated by applying composite scores (CS) of the ASI, and the evolution of each patient was evaluated using the Reliable Change Index (RCI). 69.7% of the sample completed treatment, and 30.3% dropped out prematurely. At intake, the percentage of people who could improve in the different areas of the ASI ranged between 35.1% for alcohol consumption and 95.3% for family relationships. At the follow-up, the percentage of subjects who showed significant statistical improvements in the different areas varied between 7.9% in family relations and 66.7% in alcohol consumption. The percentage of patients who deteriorated was less than 10% for all variables. Implications for further research and clinical practice are commented upon.

  13. Group and individual change in the treatment of drug addictions: a follow-up study in therapeutic communities.

    PubMed

    López-Goñi, José Javier; Fernández-Montalvo, Javier; Menéndez, Juan Carlos; Yudego, Fausto; García, Angel Rico; Esarte, Sonia

    2010-11-01

    The pre-post treatment change of 112 patients in two therapeutics Spanish communities is described. The Addiction Severity Index (ASI) was used at intake and at the end of the treatment program. Results of the treatment program were evaluated by applying composite scores (CS) of the ASI, and the evolution of each patient was evaluated using the Reliable Change Index (RCI). 69.7% of the sample completed treatment, and 30.3% dropped out prematurely. At intake, the percentage of people who could improve in the different areas of the ASI ranged between 35.1% for alcohol consumption and 95.3% for family relationships. At the follow-up, the percentage of subjects who showed significant statistical improvements in the different areas varied between 7.9% in family relations and 66.7% in alcohol consumption. The percentage of patients who deteriorated was less than 10% for all variables. Implications for further research and clinical practice are commented upon. PMID:20977038

  14. Buprenorphine for opioid addiction

    PubMed Central

    Ling, Walter; Mooney, Larissa; Torrington, Matthew

    2014-01-01

    SUMMARY Buprenorphine is a partial opioid agonist of the µ-receptor, and is used as a daily dose sublingual tablet or filmstrip for managing opioid addiction. In the USA, the Drug Addiction Treatment Act of 2000 made buprenorphine the only opioid medication for opioid addiction that can be prescribed in an office-based setting. Owing to its high affinity for the µ-receptor, buprenorphine inhibits the reinforcing effect of exogenous opioids. The ceiling effect of buprenorphine's µ-agonist activity reduces the potential for drug overdose and confers low toxicity even at high doses. Buprenorphine pharmacotherapy has proven to be a treatment approach that supports recovery from addiction while reducing or curtailing the use of opioids. This article examines buprenorphine pharmacotherapy for opioid addiction, focusing on the situation in the USA, and is based on a review of pertinent literature, and the authors’ research and clinical experience. The references in this paper were chosen according to the authors’ judgment of quality and relevance, and with respect to their familiarity and involvement in related research. PMID:24654720

  15. Internet addiction in young people.

    PubMed

    Ong, Say How; Tan, Yi Ren

    2014-07-01

    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.

  16. Cannabis use, addiction risk and functional impairment in youth seeking treatment for primary mood or anxiety concerns.

    PubMed

    Osuch, Elizabeth; Vingilis, Evelyn; Ross, Erin; Forster, Christeen; Summerhurst, Carolyn

    2013-01-01

    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. PMID:23839811

  17. Clinical potential of methylphenidate in the treatment of cocaine addiction: a review of the current evidence

    PubMed Central

    Dürsteler, Kenneth M; Berger, Eva-Maria; Strasser, Johannes; Caflisch, Carlo; Mutschler, Jochen; Herdener, Marcus; Vogel, Marc

    2015-01-01

    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 open-label studies, the results of randomized controlled trials have been disappointing so far and do not corroborate the use of MPH as a substitute for cocaine dependence in patients without attention deficit hyperactivity disorder. Conclusion Clinical studies evaluating MPH substitution for cocaine dependence have provided inconsistent findings. However, the negative findings may be explained by

  18. Association between morningness/eveningness, addiction severity and psychiatric disorders among individuals with addictions.

    PubMed

    Kervran, Charlotte; Fatséas, Mélina; Serre, Fuschia; Taillard, Jacques; Beltran, Virginie; Leboucher, Juliette; Debrabant, Romain; Alexandre, Jean-Marc; Daulouède, Jean-Pierre; Philip, Pierre; Auriacombe, Marc

    2015-10-30

    Studies have shown that Evening-Type (ET) subjects used more stimulating and sedative substances, and presented more psychiatric disorders than Morning-Type (MT) subject. However, there is a lack of data on the chronotype of patients with addiction. The aim of our study was to describe chronotype and associated factors in a sample of outpatients beginning treatment for addiction. Subjects were assessed with the Morningness-Eveningness questionnaire of Hörne & Ostberg, the Addiction Severity Index and the Mini International Neuropsychiatric Interview. In the 333 subjects with an addiction, 20% were MT and 32% were ET. When comparing ET to MT, multivariate analysis showed that ET was significantly associated with poly-problematic addiction, non-substance addictions, cannabis addiction, and mood disorders, but not with severity of addiction. MT was associated with antisocial personality disorder. Results suggested that chronotype was associated with specific addiction pattern and psychiatric disorders.

  19. Heroin Addiction

    MedlinePlus

    ... the sharing of contaminated injection equipment. TODAY Our knowledge of the opioid system has led to new medications for treating pain—and for treating opioid addiction. The discovery of opiate receptors by NIH-supported researchers, along ...

  20. 76 FR 81899 - TRICARE; Removal of the Prohibition to Use Addictive Drugs in the Maintenance Treatment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... potential for a drug of addiction (e.g. the ] substitution of methadone for heroin). The current regulation... the public is to make these submissions available for public viewing on the Internet at http://www... drug of addiction. However, medicine is constantly evolving including in the area of drug...

  1. Can persons with a history of multiple addiction treatment episodes benefit from technology delivered behavior therapy? A moderating role of treatment history at baseline.

    PubMed

    Kim, Sunny Jung; Marsch, Lisa A; Acosta, Michelle C; Guarino, Honoria; Aponte-Melendez, Yesenia

    2016-03-01

    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, ps<.01. The standard+TES condition enhanced cocaine abstinence compared to standard treatment among people 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, ps<.01. We found that including technology-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.

  2. Prescription drug abuse & addiction: past, present and future: the paradigm for an epidemic.

    PubMed

    Hall, P Bradley; Hawkinberry, Denzil; Moyers-Scott, Pam

    2010-01-01

    Prescription drug abuse has reached epidemic proportions in the United States and West Virginia is not immune. It is estimated that in 2009, the number of adolescents and adults with a substance abuse and/or dependence problem has reached 23.2 million in the US. There has been an alarming rate of increased sales of methadone, hydrocodone and oxycodone. This article addresses the scope of the problem of prescription drug abuse in West Virginia and the impact by and on the addicted individual. Addiction is a chronic relapsing neuropsychiatric illness manifested by compulsive drug seeking and use. It has created a substantive socioeconomic burden on our state. Prescription drug abuse and addiction increase medical expenses, drug related crime and unemployment. There are misconceptions regarding the etiology and treatment of addiction based on past clinical experience. The view of addiction as volitional misconduct alone has been disproven scientifically. A more current understanding of neurobiological alterations caused by this disease, current treatment strategies and future directions will be presented. This article provides an understanding of prescription drug abuse and addiction's contribution and impact on society's health and social policy. Addressing the problem of prescription drug abuse requires an understanding of the disease of addiction, thus enhancing the effectiveness in diminishing the associated health and social costs. It is the article's intent to illuminate the mutually symbiotic relationship of prescription drug abuse and the disease of addiction and subsequently provide recommendations toward the resolution of this most important issue.

  3. Social Identities as Pathways into and out of Addiction.

    PubMed

    Dingle, Genevieve A; Cruwys, Tegan; Frings, Daniel

    2015-01-01

    There exists a predominant identity loss and "redemption" narrative in the addiction literature describing how individuals move from a "substance user" identity to a "recovery" identity. However, other identity related pathways influencing onset, treatment seeking and recovery may exist, and the process through which social identities unrelated to substance use change over time is not well understood. This study was designed to provide a richer understanding of such social identities processes. Semi-structured interviews were conducted with 21 adults residing in a drug and alcohol therapeutic community (TC) and thematic analysis revealed two distinct identity-related pathways leading into and out of addiction. Some individuals experienced a loss of valued identities during addiction onset that were later renewed during recovery (consistent with the existing redemption narrative). However, a distinct identity gain pathway emerged for socially isolated individuals, who described the onset of their addiction in terms of a new valued social identity. Almost all participants described their TC experience in terms of belonging to a recovery community. Participants on the identity loss pathway aimed to renew their pre-addiction identities after treatment while those on the identity gain pathway aimed to build aspirational new identities involving study, work, or family roles. These findings help to explain how social factors are implicated in the course of addiction, and may act as either motivations for or barriers to recovery. The qualitative analysis yielded a testable model for future research in other samples and settings. PMID:26648882

  4. Social Identities as Pathways into and out of Addiction.

    PubMed

    Dingle, Genevieve A; Cruwys, Tegan; Frings, Daniel

    2015-01-01

    There exists a predominant identity loss and "redemption" narrative in the addiction literature describing how individuals move from a "substance user" identity to a "recovery" identity. However, other identity related pathways influencing onset, treatment seeking and recovery may exist, and the process through which social identities unrelated to substance use change over time is not well understood. This study was designed to provide a richer understanding of such social identities processes. Semi-structured interviews were conducted with 21 adults residing in a drug and alcohol therapeutic community (TC) and thematic analysis revealed two distinct identity-related pathways leading into and out of addiction. Some individuals experienced a loss of valued identities during addiction onset that were later renewed during recovery (consistent with the existing redemption narrative). However, a distinct identity gain pathway emerged for socially isolated individuals, who described the onset of their addiction in terms of a new valued social identity. Almost all participants described their TC experience in terms of belonging to a recovery community. Participants on the identity loss pathway aimed to renew their pre-addiction identities after treatment while those on the identity gain pathway aimed to build aspirational new identities involving study, work, or family roles. These findings help to explain how social factors are implicated in the course of addiction, and may act as either motivations for or barriers to recovery. The qualitative analysis yielded a testable model for future research in other samples and settings.

  5. Social Identities as Pathways into and out of Addiction

    PubMed Central

    Dingle, Genevieve A.; Cruwys, Tegan; Frings, Daniel

    2015-01-01

    There exists a predominant identity loss and “redemption” narrative in the addiction literature describing how individuals move from a “substance user” identity to a “recovery” identity. However, other identity related pathways influencing onset, treatment seeking and recovery may exist, and the process through which social identities unrelated to substance use change over time is not well understood. This study was designed to provide a richer understanding of such social identities processes. Semi-structured interviews were conducted with 21 adults residing in a drug and alcohol therapeutic community (TC) and thematic analysis revealed two distinct identity-related pathways leading into and out of addiction. Some individuals experienced a loss of valued identities during addiction onset that were later renewed during recovery (consistent with the existing redemption narrative). However, a distinct identity gain pathway emerged for socially isolated individuals, who described the onset of their addiction in terms of a new valued social identity. Almost all participants described their TC experience in terms of belonging to a recovery community. Participants on the identity loss pathway aimed to renew their pre-addiction identities after treatment while those on the identity gain pathway aimed to build aspirational new identities involving study, work, or family roles. These findings help to explain how social factors are implicated in the course of addiction, and may act as either motivations for or barriers to recovery. The qualitative analysis yielded a testable model for future research in other samples and settings. PMID:26648882

  6. Exercise rehabilitation for smartphone addiction.

    PubMed

    Kim, Hyunna

    2013-12-31

    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.

  7. Exercise rehabilitation for smartphone addiction.

    PubMed

    Kim, Hyunna

    2013-01-01

    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. PMID:24409425

  8. Exercise rehabilitation for smartphone addiction

    PubMed Central

    Kim, Hyunna

    2013-01-01

    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. PMID:24409425

  9. Addictive sexual behavior.

    PubMed

    Myers, W A

    1994-01-01

    Case material is presented from two patients suffering from addictive sexual behavior. The term addiction is used because of the intense, driven quality of the behavior and because of its mood-elevating effects. Psychodynamically, the patients' sexual acts helped to undo feelings of rejection at the hands of their mothers and to enhance feelings of lovability and of self-esteem. The behavior also helped to neutralize powerful feelings of rage toward the mother. In one patient, the acts also helped to ease inner turmoil related to an underlying attention deficit disorder. I speculate that some adults with addictive sexual behavior may have underlying attention deficit disorders. In both my patients, the sexual behaviors served the self-regulatory function of alleviating inner feelings of anhedonia and depression. When they decreased their sexual activities during the course of the treatment, they required adjunctive antidepressant medication. The underlying meaning of the medication and countertransference attitudes toward such patients are explored.

  10. Animal Studies of Addictive Behavior

    PubMed Central

    Ahmed, Serge H.

    2013-01-01

    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. PMID:23249442

  11. Animal studies of addictive behavior.

    PubMed

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    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. PMID:23249442

  12. Animal studies of addictive behavior.

    PubMed

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    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.

  13. What virtual reality research in addictions can tell us about the future of obesity assessment and treatment.

    PubMed

    Bordnick, Patrick S; Carter, Brian L; Traylor, Amy C

    2011-03-01

    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

  14. [Treatment with tianeptine of depressive disorders in drug addicts under withdrawal. Assessment of efficacy and study of dependence].

    PubMed

    Lôo, H; Hantzberg, P; Defrance, R; Kamoun, A; Deniker, P

    1987-01-01

    The study concerns the use of a new antidepressant, tianeptine, as a treatment of depressive and/or amotival syndrome, in 30 drug addicts, detoxified from opiates. From a thymoanaleptic point of view, 85% of the patients exhibit a positive result after 28 days of treatment with 37.5 mg/day. These good results are confirmed by the evolution of the Hamilton Depression Rating Scale global score, which significantly decreases from D0 to D14 and from D14 to D28. The acceptability of the antidepressant is good. Anticholinergic side-effects are very uncommon. Tianeptine appears devoid of any obvious psychostimulant or sedative effect. The drug compliance, estimated by counting the tablets, is very satisfying: there is no tendency to a spontaneous increase of dosing. The follow-up of the patients after drug cessation has not shown any symptoms suggesting psychological or physical dependence towards the drug. During this study in subjects particularly predisposed to the abuse of psychoactive drugs, tianeptine has not induced anything suggesting the possibility of drug abuse or tolerance.

  15. Behavioral addictions: a novel challenge for psychopharmacology.

    PubMed

    Marazziti, Donatella; Presta, Silvio; Baroni, Stefano; Silvestri, Stefano; Dell'Osso, Liliana

    2014-12-01

    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.

  16. Research on the effects of integrated resorts in Korea on gambling addiction.

    PubMed

    Jin, Chan-Ho

    2015-08-01

    This research discusses the effects of the integrated resorts centered around casinos being implemented in Korea. It particularly focuses on the symptoms and most recent definitions of gambling addiction such as physiological or psychological dependence from excessive gambling. This paper suggests that there is a high prevalence rate of pathological gambling in Korea. It provides an argument for prevention, early detection, and lastly, active and voluntary treatment. Furthermore, the study addresses the physiological pathway of gambling addiction and the physiological factors of gambling addicts to suggest exercise rehabilitation that are currently limited to psychological treatments. PMID:26331132

  17. Research on the effects of integrated resorts in Korea on gambling addiction

    PubMed Central

    Jin, Chan-Ho

    2015-01-01

    This research discusses the effects of the integrated resorts centered around casinos being implemented in Korea. It particularly focuses on the symptoms and most recent definitions of gambling addiction such as physiological or psychological dependence from excessive gambling. This paper suggests that there is a high prevalence rate of pathological gambling in Korea. It provides an argument for prevention, early detection, and lastly, active and voluntary treatment. Furthermore, the study addresses the physiological pathway of gambling addiction and the physiological factors of gambling addicts to suggest exercise rehabilitation that are currently limited to psychological treatments. PMID:26331132

  18. Behavioral addictions: an overview.

    PubMed

    Karim, Reef; Chaudhri, Priya

    2012-01-01

    The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase "impulse control disorders" described these conditions but many researchers and clinicians also use the term "behavioral addictions," "process addictions" or "impulsive-compulsive behaviors" to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment.

  19. Behavioral addictions: an overview.

    PubMed

    Karim, Reef; Chaudhri, Priya

    2012-01-01

    The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase "impulse control disorders" described these conditions but many researchers and clinicians also use the term "behavioral addictions," "process addictions" or "impulsive-compulsive behaviors" to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment. PMID:22641961

  20. Obesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?

    PubMed Central

    Barry, Danielle; Clarke, Megan; Petry, Nancy M.

    2010-01-01

    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

  1. Obesity and its relationship to addictions: is overeating a form of addictive behavior?

    PubMed

    Barry, Danielle; Clarke, Megan; Petry, Nancy M

    2009-01-01

    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.

  2. Sever's injury: treatment with insoles provides effective pain relief.

    PubMed

    Perhamre, S; Janson, S; Norlin, R; Klässbo, M

    2011-12-01

    Sever's injury (apophysitis calcanei) is considered to be the dominant cause of heel pain among children between 8 and 15 years. The traditional advice is to reduce and modify the level of physical activity. Recommended treatment in general is the same as for adults with Achilles tendon pain. The purpose of the study was to find out if insoles, of two different types, were effective in relieving heel pain in a group of boys (n=38) attending a Sports Medicine Clinic for heel pain diagnosed as Sever's injury. The type of insole was randomized, and self-assessed pain during physical activity in the treatment phase with insoles was compared with pain in the corresponding pre- and post-treatment phases without insoles. There were no other treatments added and the recommendations were to stay on the same activity level. All patients maintained their high level of physical activity throughout the study period. Significant pain reduction during physical activity when using insoles was found. Application of two different types of insoles without any immobilization, other treatment, or modification of sport activities results in significant pain relief in boys with Sever's injury.

  3. Comparing epidemiologically estimated treatment need with treatment provided in two dental schemes in Ireland

    PubMed Central

    2012-01-01

    Background Valid estimation of dental treatment needed at population level is important for service planning. In many instances, planning is informed by survey data, which provide epidemiologically estimated need from the dental fieldworkers’ perspective. The aim of this paper is to determine the validity of this type of information for planning. A comparison of normative (epidemiologically estimated) need for selected treatments, as measured on a randomly-selected representative sample, is compared with treatment actually provided in the population from which the sample was drawn. Methods This paper compares dental treatment need-estimates, from a national survey, with treatment provided within two choice-of-dentist schemes: Scheme 1, a co-payment scheme for employed adults, and Scheme 2, a ‘free’ service for less-well-off adults. Epidemiologically estimated need for extractions, restorations, advanced restorations and denture treatments was recorded for a nationally representative sample in 2000/02. Treatments provided to employed and less-well-off adults were retrieved from the claims databases for both schemes. We used the chi-square test to compare proportions, and the student’s t-test to compare means between the survey and claims databases. Results Among employed adults, the proportion of 35-44-year-olds whose teeth had restorations was greater than estimated as needed in the survey (55.7% vs. 36.7%;p <0.0001). Mean number of teeth extracted was less than estimated as needed among 35-44 and 65+ year-olds. Among less-well-off adults, the proportion of 16-24-year-olds who had teeth extracted was greater than estimated as needed in the survey (27.4% vs. 7.9%;p <0.0001). Mean number of restorations provided was greater than estimated as needed in the survey for 16-24-year-olds (3.0 vs. 0.9; p <0.0001) and 35-44-year-olds (2.7 vs. 1.4;p <0.01). Conclusions Significant differences were found between epidemiologically estimated need and treatment provided

  4. Safety and tolerability of the switch from buprenorphine to buprenorphine/naloxone in an Italian addiction treatment centre.

    PubMed

    Stimolo, Clementina; Favero, Valentina Del; Zecchinato, Giancarlo; Buson, Roberto; Cusin, Davide; Pellachin, Patrizia; Simonetto, Pamela

    2010-01-01

    Abuse and misuse of pharmacological therapies represent major challenges in the healthcare system, particularly in patients receiving long-acting opioid drugs for the treatment of heroin or opioid addiction. The partial mu-opioid receptor agonist buprenorphine is used to treat opioid dependence, but diversion and misuse may occur. The sublingual combination formulation of buprenorphine and the opioid receptor antagonist naloxone (buprenorphine/naxolone) is associated with a reduced abuse potential, and has been shown to have promising efficacy for the treatment of opioid dependence. This observational study assessed the safety and efficacy of sublingual buprenorphine/naloxone combination therapy in patients with opioid dependence after therapeutic switch from buprenorphine monotherapy. A total of 94 patients being treated with buprenorphine monotherapy (average dose 8 mg/day; mean duration of therapy 840 days) were switched to buprenorphine/naloxone combination therapy. Patients were asked to rate their level of satisfaction with buprenorphine/naloxone combination treatment with respect to the management of withdrawal symptoms, and urinary toxicology tests were carried out before and 14 days after switching to combination therapy. Within 3 months, 75/94 patients (80%) previously treated with buprenorphine monotherapy had switched to sublingual buprenorphine/naloxone combination treatment (average dose buprenorphine 8 mg). Among patients receiving combination treatment for >3 months, 83% were receiving medication either weekly or fortnightly, based on the results of toxicological testing. A reduction in positive urinary toxicology tests was observed in patients within two weeks after being switched to combination treatment (before switch: 28, 9 and 2 positive tests for heroin, cocaine and heroin + cocaine, respectively vs 11, 3 and 1 after switch) and a total of 64 patients of the 75 who switched to combination therapy (85%) were satisfied with the management of

  5. Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction.

    PubMed

    Han, Doug Hyun; Hwang, Jun Won; Renshaw, Perry F

    2010-08-01

    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 (<3 days/week and <1 hr/day). At baseline and at the end of 6 weeks of bupropion SR treatment, brain activity in response to StarCraft cue presentation was assessed using 1.5 Tesla functional MRI. In addition, symptoms of depression, craving for playing the game, and the severity of 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.

  6. Effectively addressing addiction requires changing the language of addiction.

    PubMed

    Richter, Linda; Foster, Susan E

    2014-02-01

    Public knowledge and attitudes about addiction are largely inconsistent with scientific evidence. The gap between the facts and public and professional perceptions is due in part to the language used to describe the disease and those who have it. A key step in modifying public attitudes and improving how health professionals and policymakers address addiction is to better align the language of addiction with the scientific evidence. Unless we clarify the language, those with the disease will continue to experience the stigma associated with it and attempts to deliver comprehensive and effective evidence-based prevention, treatment, and disease management will be profoundly compromised. PMID:24226552

  7. Association of genetic variation in pharmacodynamic factors with methadone dose required for effective treatment of opioid addiction

    PubMed Central

    Levran, Orna; Peles, Einat; Randesi, Matthew; Shu, Xu; Ott, Jurg; Shen, Pei-Hong; Adelson, Miriam; Kreek, Mary Jeanne

    2013-01-01

    Aim The interindividual variability in the dose required for effective methadone maintenance treatment (MMT) for opioid addiction may be influenced in part by genetic variations in genes encoding pharmacodynamic factors of methadone. This study was conducted to identify some of these variants. Materials & methods This study focused on 11 genes encoding components of the opioidergic (OPRM1, POMC and ARRB2), the dopaminergic (ANKK1 and DRD2) and the glutamatergic pathways (GRIN1 and GRIN2A), as well as the neurotrophin system (NGFB, BDNF, NTRK1 and NTRK2). The study includes 227 Israeli patients undergoing stable MMT. Results Out of the 110 variants analyzed, 12 SNPs (in BDNF, NTRK2, OPRM1, DRD2 and ANKK1) were associated with methadone dose (nominal p < 0.05). Of these SNPs, ANKK1 rs7118900 and DRD2 rs2283265 are known to affect gene expression. Logistic regression of five representative SNPs discriminated between individuals requiring a methadone dose of >120 mg/day and <120 mg/day (p = 0.019), and showed moderate sensitivity and specificity (AUC of 0.63 in receiver operating characteristic analysis). Conclusion This data should stimulate further research on the potential influence and clinical significance of these variants on MMT. PMID:23651024

  8. Revised sampling campaigns to provide sludge for treatment process testing

    SciTech Connect

    PETERSEN, C.A.

    1999-02-18

    The purpose of this document is to review the impact to the sludge sampling campaigns planned for FY 1999 given the recent decision to delete any further sludge sampling in the K West Basin. Requirements for Sludge sample material for Sludge treatment process testing are reviewed. Options are discussed for obtaining the volume sample material required and an optimized plan for obtaining this sludge is summarized.

  9. Possible association between human blood types and opioid addiction.

    PubMed

    Aflatoonian, Mohammad Reza; Meymandi, Manzumeh Shamsi; Divsalar, Kouros; Mahmoudi, Minoo; Heravi, Gioia

    2011-01-01

    Drug addiction is a complex disorder that has been shown to have a genetic component like several other diseases. Finding any factor that is associated with higher risk of addiction tendency may influence the strategies of prevention and treatment of drug abuse and also provide an avenue of further research in genetics, immunology, and other related fields. This case-control study aimed at finding the frequency rate of ABO blood groups and Rhesus (Rh) factor among opioid dependents. Therefore, 249 opioid dependents referred to the Drug Quit center at Bam, Iran (case group) were compared with 360 blood donors referred to the Blood Transfusion Center (control group) in regard to the frequency of blood groups and Rh factor. The two groups were matched for demographic features. The odds ratio for AB blood group in addicts was 3.98 compared to non-addicts (p < .001) and the odds ratio of negative Rh in addicts compared to non-addicts was 4.27 (p < .001). According to the findings, in this population the frequency of negative Rh and AB blood group were significantly less than the predictive values. The relationship between opioid use and blood group type requires a cohort study eliminating all extraneous factors in order to be proved.

  10. NrCAM regulating neural systems and addiction related behaviors

    PubMed Central

    Ishiguro, Hiroki; Hall, Frank S.; Horiuchi, Yasue; Sakurai, Takeshi; Hishimoto, Akitoyo; Grumet, Martin; Uhl, George R.; Onaivi, Emmanuel S.; Arinami, Tadao

    2012-01-01

    We have previously shown that a haplotype associated with decreased NrCAM expression in brain is protective against addiction vulnerability for polysubstance abuse in humans and that Nrcam knockout mice do not develop conditioned place preferences for morphine, cocaine, or amphetamine. In order to gain insight into NrCAM involvement in addiction vulnerability, which may involve specific neural circuits underlying behavioral characteristics relevant to addiction, we evaluated several behavioral phenotypes in Nrcam knockout mice. Consistent with a potential general reduction in motivational function, Nrcam knockout mice demonstrated less curiosity for novel objects and for an unfamiliar conspecific, showed also less anxiety in the zero maze. Nrcam heterozygote knockout mice reduced alcohol preference and buried fewer marbles in home cage. These observations provide further support for a role of NrCAM in substance abuse including alcoholism vulnerability, possibly through its effects on behavioral traits that may affect addiction vulnerability, including novelty seeking, obsessive compulsion and responses to aversive or anxiety-provoking stimuli. Additionally, in order to prove glutamate homeostasis hypothesis of addiction, we analyzed glutamatergic molecules regulated by NRCAM. Glutaminase appears to be involved in NrCAM-related molecular pathway in two different tissues from human and mouse. An inhibitor of the enzyme, PLG, treatment produced, at least, some of the phenotypes of mice shown in alcohol preference and in anxiety-like behavior. Thus, NrCAM could affect addiction-related behaviors via at least partial modulation of some glutamatargic pathways and neural function in brain. PMID:22780223

  11. The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

    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.…

  12. METODO, a prospective observational study to assess the efficacy and tolerability of methadone in heroin-addicted patients undergoing a methadone maintenance treatment: preliminary results at baseline evaluation.

    PubMed

    D'Egidio, Pietro Fausto; Bignamini, Emanuele; De Vivo, Enrico; Leonardi, Claudio; Pieri, Maria Chiara; González-Saiz, Francisco; Lucchini, Alfio

    2013-12-01

    METODO (methadone efficacy therapy optimization dosage on-going) is a prospective observational study to assess the efficacy and tolerability of methadone in 500 heroin-addicted patients taking a methadone maintenance treatment, enrolled through 2010 to 2011 in five Italian sites, observed over 2 years. The Opiate Dosage Adequacy Scale has been used for the evaluation of the "adequacy" of the methadone dosage and to stratify patients in adequate and not adequate groups. The treatment efficacy has been evaluated in correlation to the dosage adequacy during the visits. Moreover, patients have been evaluated according to the retention rate and duration of retention in treatment and a series of questionnaires.

  13. Opiate versus psychostimulant addiction: the differences do matter.

    PubMed

    Badiani, Aldo; Belin, David; Epstein, David; Calu, Donna; Shaham, Yavin

    2011-10-05

    The publication of the psychomotor stimulant theory of addiction in 1987 and the finding that addictive drugs increase dopamine concentrations in the rat mesolimbic system in 1988 have led to a predominance of psychobiological theories that consider addiction to opiates and addiction to psychostimulants as essentially identical phenomena. Indeed, current theories of addiction - hedonic allostasis, incentive sensitization, aberrant learning and frontostriatal dysfunction - all argue for a unitary account of drug addiction. This view is challenged by behavioural, cognitive and neurobiological findings in laboratory animals and humans. Here, we argue that opiate addiction and psychostimulant addiction are behaviourally and neurobiologically distinct and that the differences have important implications for addiction treatment, addiction theories and future research.

  14. Opiate versus psychostimulant addiction: the differences do matter

    PubMed Central

    Badiani, Aldo; Belin, David; Epstein, David; Calu, Donna; Shaham, Yavin

    2013-01-01

    The publication of the psychomotor stimulant theory of addiction in 1987 and the finding that addictive drugs increase dopamine concentrations in the rat mesolimbic system in 1988 have led to a predominance of psychobiological theories that consider addiction to opiates and addiction to psychostimulants as essentially identical phenomena. Indeed, current theories of addiction — hedonic allostasis, incentive sensitization, aberrant learning and frontostriatal dysfunction — all argue for a unitary account of drug addiction. This view is challenged by behavioural, cognitive and neurobiological findings in laboratory animals and humans. Here, we argue that opiate addiction and psychostimulant addiction are behaviourally and neurobiologically distinct and that the differences have important implications for addiction treatment, addiction theories and future research. PMID:21971065

  15. A critical review of accounting and economic methods for estimating the costs of addiction treatment.

    PubMed

    Cartwright, William S

    2008-04-01

    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.

  16. [Exercise addiction].

    PubMed

    Petit, A; Lejoyeux, M

    2013-01-01

    Socially valorised, sport like other forms of behaviour, can take on an addictive aspect. A review of the English and French literatures from 1979 to 2012 was conducted, using PubMed, Google Scholar, EMBASE, and PsycInfo, using the following key words alone or combined :sport, dependence, exercise, addiction. Exercise dependence is defined as a craving for physical activity that leads to extreme exercise intensity and generates physiological and psychological symptoms. Measurement scales have been proposed to make the diagnosis. No epidemiological studies have examined the prevalence of exercise dependence in the general population, although some studies suggest a frequency ranging from 10 to 80%. Disorders begin with a search for pleasure in physical effort, which then gives way to an obsession for sport resulting in a need to practice a sport more and more frequently and intensely. This addiction is more common among alcohol and illicit drug addicts than among the general population, while the rate of eating disorders can reach 40%. Personality traits most often associated are perfectionism, extraversion, and sensation seeking, while possible links between sporting activity and intensive doping will be discussed.

  17. [Heroin addiction].

    PubMed

    Hosztafi, Sándor

    2011-01-01

    Heroin is an illicit, highly addictive drug. It is either the most abused or the most rapidly acting member of opioids. Abusers describe a feeling of a surge of pleasurable sensation, named as "rush" or "high". Repeated administration of high doses of heroin results in the induction of physical dependence. Physical dependence refers to an altered physiological state produced by chronic administration of heroin which necessitates the continued administration of the drug to prevent the appearance of a characteristic syndrome, the opioid withdrawal or abstinence syndrome. Withdrawal symptoms may occur within a few hours after the last administration of heroin. Symptoms of the withdrawal include restlessness, insomnia, drug craving, diarrhea, muscle and bone pain, cold flashes with goose bumps, and leg movements. Major withdrawal symptoms peak between 48 and 72 hours after the last dose of heroin and subside after about a week. At this time, weakness and depression are pronounced and nausea and vomiting are common. Nevertheless, some chronic addicts have shown persistent withdrawal signs for many months or even years. Heroin addiction is considered as a behavioural state of compulsive drug use and a high tendency to relapse after periods of abstinence. It is generally accepted that compulsive use and relapse are typically associated with the status of heroin craving or heroin hunger that are difficult to define but appear to be powerful motivational significance in the addiction process. The route of administering heroin varies largely and may indicate the degree of seriousness of the individual's addiction. Intravenous administration seems to be the predominant method of heroin use, but recently a shift in heroin use pattern has been found, i.e. from injection to sniffing and smoking. Frequent injections coupled with widespread sharing of syringes increase the risk of contracting HIV, hepatitis B, C and other blood-borne infectious diseases. Long-term use of heroin

  18. Prevalence of HCV Infections and Co-Infection With HBV and HIV and Associated Risk Factors Among Addicts in Drug Treatment Centers, Lorestan Province, Iran

    PubMed Central

    Norouzian, Hossein; Gholami, Mohammadreza; Shakib, Pegah; Goudarzi, Gholamreza; Ghobadian Diali, Hamze; Rezvani, Azam

    2016-01-01

    Background: Hepatitis C is an infectious disease caused by blood-borne pathogen, hepatitis C virus (HCV). Objectives: The purpose of this study was to investigate the prevalence of HCV infection and associated risk factors among addicts in drug treatment centers in Lorestan Province, Iran. Patients and Methods: A cross-sectional sero-behavioral survey was given to drug addicts in the drug treatment centers of Khorramabad, Lorestan Province, Iran during June 2012 - March 2013. Drug addicts were interviewed using a standard questionnaire including demographic, imprisonment history, and HCV-related risk behavior items. Thereafter, the sera drawn from the participants were tested for anti-HCV antibody (Ab), anti-human immunodeficiency virus (HIV) Ab, and hepatitis B surface antigen (HBsAg). Results: The mean age of the cohorts was 31.7. Up to 60.2% of drug users had educational levels less than high school, 67.5% were self-employed, and 32.5% were office workers. The mean duration of drug injection was 6.8 years. Statistical analyses indicated that the prevalence of HCV among drug addicts was positively associated with age, past incarceration, drug injection history, the duration of drug use, and tattooing. In addition, 16.23% of volunteers were HCV-positive. Of those infected with HCV, 1.10% was co-infected with HBV, 2.95% were positive for HIV, and 0.36% of HCV-positive cases were infected with all three viruses. Conclusions: The high prevalence of HCV infection among this group implies a high rate of transmission and exposure to the risk of serious diseases. It is important that the high prevalence of HCV infection be taken into consideration to control further transmission of this infection. PMID:27162762

  19. Biofeedback combined with cue-exposure as a treatment for heroin addicts.

    PubMed

    Du, Jiang; Fan, Chenglu; Jiang, Haifeng; Sun, Haiming; Li, Xu; Zhao, Min

    2014-05-10

    The aim of this study was to test if cue-exposure therapy (CET) combined with biofeedback therapy (BT) could decrease craving and physiological reactivity to drug-related cues in heroin dependents. Forty-five participants were randomly assigned to usual rehabilitation with or without CET combined with BT. Craving was assessed by a 100-point visual analog scale (VAS). Skin conductance (SC) and muscle electromyography (MEG) were recorded using a biofeedback device. After 2 months of treatment, both the pre-cue exposure craving and the post-cue exposure craving, SC, and MEG were lower in the experimental group than in the control group. Compared to the control group, the experimental group had a greater decrease in craving, SC, and MEG from baseline after the treatment. The results suggest that CET combined with BT treatment is effective in reducing craving and physiology reactivity in heroin dependents and could be used as a component of heroin-dependence rehabilitation. PMID:24631304

  20. Innovation attributes and adoption decisions: perspectives from leaders of a national sample of addiction treatment organizations.

    PubMed

    Knudsen, Hannah K; Roman, Paul M

    2015-02-01

    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