Are executive function and impulsivity antipodes? A conceptual reconstruction with special reference to addiction

PubMed Central

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

2014-01-01

Rationale Although there is considerable interest in how either executive function (EF) or impulsivity relate to addiction, there is little apparent overlap between these research areas. Objectives The present paper aims to determine if components of these two constructs are conceptual antipodes—widely separated on a shared continuum. Methods EFs and impulsivities were compared and contrasted. Specifically, the definitions of the components of EF and impulsivity, the methods used to measure the various components, the populations of drug users that show deficits in these components, and the neural substrates of these components were compared and contrasted. Results Each component of impulsivity had an antipode in EF. EF, however, covered a wider range of phenomena, including compulsivity. Conclusions Impulsivity functions as an antipode of certain components of EF. Recognition of the relationship between EF and impulsivity may inform the scientific inquiry of behavioral problems such as addiction. Other theoretical implications are discussed. PMID:22441659

The relationship between addiction and religion and its possible implication for care.

PubMed

Borras, Laurence; Khazaal, Yasser; Khan, Riaz; Mohr, Sylvia; Kaufmann, Yves-Alexandre; Zullino, Daniele; Huguelet, Philippe

2010-12-01

Spirituality is a topic of increasing interest to clinicians and researchers interested in addiction because its perceived role in the promotion of meaningfulness in the recovery from addiction. Our review of the literature evaluates different domains relative to the relation between addiction, religion, and psychiatric treatment. Spirituality as a protective or precipitating factor for substance use and as a key component of recovery will be debated. Illustrations of its potential and limitations as a component of treatment will be presented. Types of investigation and integration of this dimension in an eventual therapeutic process strictly respecting the needs and specificities of each one will be discussed.

2013 Update in addiction medicine for the generalist.

PubMed

Gordon, Adam J; Bertholet, Nicolas; McNeely, Jennifer; Starrels, Joanna L; Tetrault, Jeanette M; Walley, Alexander Y

2013-11-04

Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and medical care. The authors discuss each selected articles' merits, limitations, conclusions, and implication to advancing addiction screening, assessment, and treatment of addiction in generalist physician practice environments.

Game Addiction and Academic Achievement

ERIC Educational Resources Information Center

Sahin, Mehmet; Gumus, Yusuf Yasin; Dincel, Sezen

2016-01-01

The primary aim of this study was to investigate the correlation between game addiction and academic achievement. The secondary aim was to adapt a self-report instrument to measure game addiction. Three hundred and seventy high school students participated in this study. Data were collected via an online questionnaire that included a brief…

Exploring Children's Conceptions of Smoking Addiction

ERIC Educational Resources Information Center

Wang, C.; Henley, N.; Donovan, R. J.

2004-01-01

Tobacco addiction is a major health problem for both adults and young people--between 20 and 60% of adolescents are dependent on nicotine and more than two-thirds who attempt to quit experience withdrawal symptoms. Yet, anti-smoking efforts targeted at children emphasize primary prevention and ignore addiction education, which is generally…

Internet-based attentional bias modification training as add-on to regular treatment in alcohol and cannabis dependent outpatients: a study protocol of a randomized control trial.

PubMed

Heitmann, Janika; van Hemel-Ruiter, Madelon E; Vermeulen, Karin M; Ostafin, Brian D; MacLeod, Colin; Wiers, Reinout W; DeFuentes-Merillas, Laura; Fledderus, Martine; Markus, Wiebren; de Jong, Peter J

2017-05-23

The automatic tendency to attend to and focus on substance-related cues in the environment (attentional bias), has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, contribute to treatment outcome and the reduction of relapse rates. Based on some promising research findings, we designed a study to test the clinical relevance of ABM as an add-on component of regular intervention for alcohol and cannabis patients. The current protocol describes a study which will investigate the effectiveness and cost-effectiveness of a newly developed home-delivered, multi-session, internet-based ABM (iABM) intervention as an add-on to treatment as usual (TAU). TAU consists of cognitive behavioural therapy-based treatment according to the Dutch guidelines for the treatment of addiction. Participants (N = 213) will be outpatients from specialized addiction care institutions diagnosed with alcohol or cannabis dependency who will be randomly assigned to one of three conditions: TAU + iABM; TAU + placebo condition; TAU-only. Primary outcome measures are substance use, craving, and rates of relapse. Changes in attentional bias will be measured to investigate whether changes in primary outcome measures can be attributed to the modification of attentional bias. Indices of cost-effectiveness and secondary physical and psychological complaints (depression, anxiety, and stress) are assessed as secondary outcome measures. This randomized control trial will be the first to investigate whether a home-delivered, multi-session iABM intervention is (cost-) effective in reducing relapse rates in alcohol and cannabis dependency as an add-on to TAU, compared with an active and a waiting list control group. If proven effective, this ABM intervention could be easily implemented as a home-delivered component of current TAU. Netherlands Trial Register, NTR5497 , registered on 18th September 2015.

Development, implementation, and evaluation of a multi-addiction prevention program for primary school students in Hong Kong: the B.E.S.T. Teen Program.

PubMed

Shek, Daniel T L; Yu, Lu; Leung, Hildie; Wu, Florence K Y; Law, Moon Y M

Based on the evaluation findings of the B.E.S.T. Teen Program which aimed at promoting behavioral, emotional, social, and thinking competencies in primary school students, it is argued in this paper that promotion of psychosocial competence to prevent addiction in primary school students is a promising strategy. A total of 382 Primary 5 (Grade 5) and 297 Primary 6 (Grade 6) students from five primary schools in Hong Kong participated in the program. Different evaluation strategies were adopted to evaluate the program. First, objective outcome evaluation adopting a non-equivalent group pretest-posttest experimental-control group design was conducted to examine change in the students. Second, to gauge students' perceptions of the program, subjective outcome evaluation was conducted. The evaluation findings basically converged to tentatively suggest that young adolescents benefited from participating in the program. Implications on the development, implementation, and evaluation of addiction prevention programs for teenagers are discussed.

Food Craving as a Mediator between Addictive-like Eating and Problematic Eating Outcomes

PubMed Central

Joyner, Michelle A.; Gearhardt, Ashley N.; White, Marney A.

2015-01-01

Background There is growing interest and debate about whether an addictive process contributes to problematic eating outcomes, such as obesity. Craving is a core component of addiction, but there has been little research on the relationship between addictive-like eating, craving, and eating-related concerns. In the current study, we examine the effect of both overall food craving and craving for different types of food on the relationship between addictive-like eating symptoms and elevated body mass index (BMI) and binge eating episodes. Methods In a community sample (n = 283), we conducted analyses to examine whether overall craving mediated the association between addictive-like eating and elevated BMI, as well as binge eating frequency. We also ran separate mediational models examining the indirect effect of cravings for sweets, fats, carbohydrates, and fast food fats on these same associations. Results Overall food craving was a significant partial mediator in the relationships between addictive-like eating and both elevated BMI and binge eating episodes. Cravings for sweets and other carbohydrates significantly mediated the relationship between addictive-like eating and binge eating episodes, while cravings for fats significantly mediated the relationship between addictive-like eating and elevated BMI. Conclusions Craving appears to be an important component in the pathway between addictive-like eating and problematic eating outcomes. The current results highlight the importance of further evaluating the role of an addictive process in problematic eating behaviors and potentially targeting food cravings in intervention approaches. PMID:26262570

Food craving as a mediator between addictive-like eating and problematic eating outcomes.

PubMed

Joyner, Michelle A; Gearhardt, Ashley N; White, Marney A

2015-12-01

There is growing interest and debate about whether an addictive process contributes to problematic eating outcomes, such as obesity. Craving is a core component of addiction, but there has been little research on the relationship between addictive-like eating, craving, and eating-related concerns. In the current study, we examine the effect of both overall food craving and craving for different types of food on the relationship between addictive-like eating symptoms and elevated body mass index (BMI) and binge eating episodes. In a community sample (n=283), we conducted analyses to examine whether overall craving mediated the association between addictive-like eating and elevated BMI, as well as binge eating frequency. We also ran separate mediational models examining the indirect effect of cravings for sweets, fats, carbohydrates, and fast food fats on these same associations. Overall food craving was a significant partial mediator in the relationships between addictive-like eating and both elevated BMI and binge eating episodes. Cravings for sweets and other carbohydrates significantly mediated the relationship between addictive-like eating and binge eating episodes, while cravings for fats significantly mediated the relationship between addictive-like eating and elevated BMI. Craving appears to be an important component in the pathway between addictive-like eating and problematic eating outcomes. The current results highlight the importance of further evaluating the role of an addictive process in problematic eating behaviors and potentially targeting food cravings in intervention approaches. Copyright © 2015 Elsevier Ltd. All rights reserved.

Internet Addiction of Young Greek Adults: Psychological Aspects and Information Privacy.

PubMed

Grammenos, P; Syrengela, N A; Magkos, E; Tsohou, A

2017-01-01

The main goal of this study is to examine the Internet addiction status of Greek young adults, aged from 18 to 25, using Young's Internet Addiction Test (IAT) and self-administered questionnaires. In addition this paper assesses the psychological traits of addicted persons per addiction category, using the big five factor model tool to study the user's personality and analyze the components that lead a person to become Internet addicted. Furthermore, we found an association between addicted people and the five factors from the Big Five Factor Model; i.e., extraversion, agreeableness, conscientiousness, neuroticism, openness to experience. Moreover, this paper discusses information privacy awareness issues related to Internet Addiction treatment.

The Development and Validation of the Online Shopping Addiction Scale.

PubMed

Zhao, Haiyan; Tian, Wei; Xin, Tao

2017-01-01

We report the development and validation of a scale to measure online shopping addiction. Inspired by previous theories and research on behavioral addiction, the Griffiths's widely accepted six-factor component model was referred to and an 18-item scale was constructed, with each component measured by three items. The results of exploratory factor analysis, based on Sample 1 (999 college students) and confirmatory factor analysis, based on Sample 2 (854 college students) showed the Griffiths's substantive six-factor structure underlay the online shopping addiction scale. Cronbach's alpha suggested that the resulting scale was highly reliable. Concurrent validity, based on Sample 3 (328 college students), was also satisfactory as indicated by correlations between the scale and measures of similar constructs. Finally, self-perceived online shopping addiction can be predicted to a relatively high degree. The present 18-item scale is a solid theory-based instrument to empirically measure online shopping addiction and can be used for understanding the phenomena among young adults.

The Development and Validation of the Online Shopping Addiction Scale

PubMed Central

Zhao, Haiyan; Tian, Wei; Xin, Tao

2017-01-01

We report the development and validation of a scale to measure online shopping addiction. Inspired by previous theories and research on behavioral addiction, the Griffiths's widely accepted six-factor component model was referred to and an 18-item scale was constructed, with each component measured by three items. The results of exploratory factor analysis, based on Sample 1 (999 college students) and confirmatory factor analysis, based on Sample 2 (854 college students) showed the Griffiths's substantive six-factor structure underlay the online shopping addiction scale. Cronbach's alpha suggested that the resulting scale was highly reliable. Concurrent validity, based on Sample 3 (328 college students), was also satisfactory as indicated by correlations between the scale and measures of similar constructs. Finally, self-perceived online shopping addiction can be predicted to a relatively high degree. The present 18-item scale is a solid theory-based instrument to empirically measure online shopping addiction and can be used for understanding the phenomena among young adults. PMID:28559864

Neurobiological mechanisms involved in nicotine dependence and reward: participation of the endogenous opioid system

PubMed Central

Berrendero, Fernando; Robledo, Patricia; Trigo, José Manuel; Martín-García, Elena; Maldonado, Rafael

2010-01-01

Nicotine is the primary component of tobacco that maintains the smoking habit and develops addiction. The adaptive changes of nicotinic acetylcholine receptors produced by repeated exposure to nicotine play a crucial role in the establishment of dependence. However, other neurochemical systems also participate in the addictive effects of nicotine including glutamate, cannabinoids, GABA and opioids. This review will cover the involvement of these neurotransmitters in nicotine addictive properties, with a special emphasis on the endogenous opioid system. Thus, endogenous enkephalins and beta-endorphins acting on mu-opioid receptors are involved in nicotine rewarding effects, whereas opioid peptides derived from prodynorphin participate in nicotine aversive responses. An upregulation of mu-opioid receptors has been reported after chronic nicotine treatment that could counteract the development of nicotine tolerance, whereas the downregulation induced on kappa-opioid receptors seems to facilitate nicotine tolerance. Endogenous enkephalins acting on mu-opioid receptors also play a role in the development of physical dependence to nicotine. In agreement with these actions of the endogenous opioid system, the opioid antagonist naltrexone has shown to be effective for smoking cessation in certain subpopulations of smokers. PMID:20170672

The Role of Meditation in Addiction Recovery

ERIC Educational Resources Information Center

Pruett, James M.; Nishimura, Nancy J.; Priest, Ronnie

2007-01-01

The authors examined the role of meditation as an important component in addiction recovery. Successful addiction recovery is often related to an individual's ability to develop and use a repertoire of coping behaviors, including the ability to maintain an ongoing awareness of one's vulnerability. These learned behaviors serve as reliable…

Commentary on Muscle dysmorphia as an addiction: a response to Grant (2015) and Nieuwoudt (2015).

PubMed

Griffiths, Mark D; Foster, Andrew C; Shorter, Gillian W

2015-03-01

Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction.

Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment.

PubMed

Schlam, Tanya R; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Collins, Linda M; Mermelstein, Robin; Piper, Megan E; Cook, Jessica W; Jorenby, Douglas E; Loh, Wei-Yin; Baker, Timothy B

2016-01-01

To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. A 2 × 2 × 2 × 2 × 2 randomized factorial experiment. Eleven primary care clinics in Wisconsin, USA. A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch + nicotine gum); (2) maintenance (phone) counseling versus none; (3) medication adherence counseling versus none; (4) automated (medication) adherence calls versus none; and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day. Only extended medication produced a main effect. Twenty-six versus 8 weeks of medication improved point-prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P = 0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined. Twenty-six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment. © 2015 Society for the Study of Addiction.

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…

Animal models of addiction: fat and sugar.

PubMed

Morgan, Drake; Sizemore, Glen M

2011-01-01

The concept of "food addiction" is gaining acceptance among the scientific community, and much is known about the influence of various components of food (e.g. high-fat, sugar, carbohydrate, salt) on behavior and physiology. Most of the studies to date have studied these consequences following relatively long-term diet manipulations and/or relatively free access to the food of interest. It is suggested that these types of studies are primarily tapping into the energy regulation and homeostatic processes that govern food intake and consumption. More recently, the overlap between the neurobiology of "reward-related" or hedonic effects of food ingestion and other reinforcers such as drugs of abuse has been highlighted, contributing to the notion that "food addiction" exists and that various components of food may be the substance of abuse. Based on preclinical animal models of drug addiction, a new direction for this field is using self-administration procedures and identifying an addiction-like behavioral phenotype in animals following various environmental, genetic, pharmacological, and neurobiological manipulations. Here we provide examples from this research area, with a focus on fat and sugar self-administration, and how the sophisticated animal models of drug addiction can be used to study the determinants and consequences of food addiction.

An examination of food addiction in a racially diverse sample of obese patients with binge eating disorder in primary care settings.

PubMed

Gearhardt, Ashley N; White, Marney A; Masheb, Robin M; Grilo, Carlos M

2013-07-01

The concept of food addiction in obesity and binge eating disorder (BED) continues to be a hotly debated topic yet the empirical evidence on the relationship between addictive-like eating and clinically relevant eating disorders is limited. The current study examined the association of food addiction as assessed by the Yale Food Addiction Scale (YFAS) with measures of disordered eating, dieting/weight history, and related psychopathology in a racially diverse sample of obese patients with binge eating disorder (BED). A consecutive series of 96 obese patients with BED who were seeking treatment for obesity and binge eating in primary care were given structured interviews to assess psychiatric disorders and eating disorder psychopathology and a battery of self-report measures including the YFAS to assess food addiction. Classification of food addiction was met by 41.5% (n=39) of BED patients. Patients classified as meeting YFAS food addiction criteria had significantly higher levels of negative affect, emotion dysregulation, and eating disorder psychopathology, and lower self-esteem. Higher scores on the YFAS were related to an earlier age of first being overweight and dieting onset. YFAS scores were also significant predictors of binge eating frequency above and beyond other measures. Compared to patients not classified as having food addiction, the subset of 41.5% of BED patients who met the YFAS food addiction cut-off appears to have a more severe presentation of BED and more associated pathology. Copyright © 2013 Elsevier Inc. All rights reserved.

Challenges to Practicing HIV Sex-Risk Prevention Among People in Continuing Care for Cocaine Addiction.

PubMed

Wimberly, Alexandra S; Stern, Max R; Rosenbach, Sarah B; Thomas, Tyrone; McKay, James R

2017-04-16

Intimate partnerships are discouraged during early recovery, despite research that highlights their capacity to be resources for change. This study seeks to provide descriptions of intimate partnerships and how such partnerships challenge and/or support minimizing HIV sex-risk among participants in continuing care for cocaine addiction in order to inform substance use programming. Forty-two recorded continuing care counseling sessions of 33 people who discussed HIV sex-risk behavior were transcribed and analyzed using thematic analysis. This sample was derived from a larger randomized controlled trial that looked at the impact of a continuing care intervention for people with cocaine use problems. Although participants expressed the desire for a primary intimate partnership, casual intimate partnerships that often involved HIV sex-risk behavior were more prevalent. Challenges to having a primary intimate partner included the belief that intimate partnerships do not support recovery, difficulty in developing friendships with women among heterosexual men, and the ubiquity of drug use and sex work in home environments with limited economic opportunity. Despite these challenges, some participants reported having primary intimate partners that supported their recovery through open communication. Clinicians providing substance use interventions can consider encouraging components of intimate partnerships that support recovery. In addition, the strong environmental influence on individual HIV sex-risk behavior should be considered in delivering any substance use intervention.

Nicotine and Tobacco as Substances of Abuse in Children and Adolescents.

PubMed

Siqueira, Lorena M

2017-01-01

Nicotine is the primary pharmacologic component of tobacco, and users of tobacco products seek out its effects. The highly addictive nature of nicotine is responsible for its widespread use and difficulty with quitting. This technical report focuses on nicotine and discusses the stages of use in progression to dependence on nicotine-containing products; the physiologic characteristics, neurobiology, metabolism, pharmacogenetics, and health effects of nicotine; and acute nicotine toxicity. Finally, some newer approaches to cessation are noted. Copyright © 2017 by the American Academy of Pediatrics.

Effectiveness of a mood management component as an adjunct to a telephone counselling smoking cessation intervention for smokers with a past major depression: a pragmatic randomized controlled trial.

PubMed

van der Meer, Regina M; Willemsen, Marc C; Smit, Filip; Cuijpers, Pim; Schippers, Gerard M

2010-11-01

To assess whether the addition of a mood management component to telephone counselling produces higher abstinence rates in smokers with past major depression and helps to prevent recurrence of depressive symptoms. Pragmatic randomized controlled trial with two conditions, with follow-up at 6 and 12 months. The control intervention consisted of eight sessions of proactive telephone counselling. The mood management intervention was an integration of the control intervention with a mood management component. This component consisted of a self-help mood management manual, two more preparatory proactive telephone counselling sessions and supplementary homework assignments and advice. Dutch national smoking cessation quitline. A total of 485 daily smokers with past major depression, according to the DSM-IV. The primary outcome measure was prolonged abstinence and secondary outcome measures were 7-day point prevalence abstinence and depressive symptoms. The mood management intervention resulted in significantly higher prolonged abstinence rates at 6- and 12-month follow-up (30.5% and 23.9% in experimental condition, 22.3% and 14.0% in the control condition). The odds ratios were 1.60 (95% CI 1.06-2.42) and 1.96 (95% CI 1.22-3.14) for both follow-ups. The mood management intervention did not seem to prevent recurrence of depressive symptoms. Adding a mood management component to telephone counselling for smoking cessation in smokers with a past major depression increases cessation rates without necessarily reducing depressive symptoms. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Mental health and addictions capacity building for community health centres in Ontario.

PubMed

Khenti, Akwatu; Thomas, Fiona C; Mohamoud, Sirad; Diaz, Pablo; Vaccarino, Oriana; Dunbar, Kate; Sapag, Jaime C

2017-10-01

In recent years, there has been increased recognition in Canada of the need to strengthen mental health services in primary health care (PHC). Collaborative models, including partnerships between PHC and specialized mental health care providers, have emerged as effective ways for improving access to mental health care and strengthening clinical capacity. Primary health care physicians and other health professionals are well positioned to facilitate the early detection of mental disorders and provide appropriate treatment and follow-up care, helping to tackle stigma toward mental health problems in the process. This 4-year mental health and addiction capacity-building initiative for PHC addressed competency needs at the individual, interprofessional, and organizational levels. The program included 5 key components: a needs assessment; interprofessional education; mentoring; development of organizational mental health and addiction action plans for each participating community health centre; and creation of an advanced resource manual to support holistic and culturally competent collaborative mental health care. A comprehensive evaluation framework using a mixed-methods approach was applied from the initiation of the program. A total of 184 health workers in 10 community health centres in Ontario participated in the program, including physicians, nurses, social workers, and administrative staff. Evaluation findings demonstrated high satisfaction with the training, improved competencies, and individual behavioural and organizational changes. By building capacity to integrate holistic and culturally appropriate care, this competency-based program is a promising model with strong potential to be adapted and scaled up for PHC organizations nationally and internationally. Copyright© the College of Family Physicians of Canada.

The Addiction Recovery Clinic: A Novel, Primary-Care-Based Approach to Teaching Addiction Medicine.

PubMed

Holt, Stephen R; Segar, Nora; Cavallo, Dana A; Tetrault, Jeanette M

2017-05-01

Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist. Residents spend one half-day per week for four consecutive weeks at the ARC seeing new and returning patients. Services provided include pharmacological and behavioral treatments for opioid, alcohol, and other substance use disorders, with direct referral to local addiction treatment facilities as needed. Visit numbers, a patient satisfaction survey, and an end-of-rotation resident evaluation were used to assess the ARC. From 2014 to 2015, 611 patient encounters occurred, representing 97 new patients. Sixty-one (63%) patients were seen for opioid use disorder. According to patient satisfaction surveys, 29 (of 31; 94%) patients reported that the ARC probably or definitely helped them to cope with their substance use. Twenty-eight residents completed the end-of-rotation evaluation; all rated the rotation highly. The ARC offers a unique primary-care-based approach to exposing internal medicine residents to the knowledge and skills necessary to diagnose, treat, and prevent unhealthy substance use. Future research will examine other clinical and educational outcomes.

Commentary on muscle dysmorphia as an addiction: A response to Grant (2015) and Nieuwoudt (2015)

PubMed Central

FOSTER, ANDREW C.; SHORTER, GILLIAN W.

2015-01-01

Background Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Method Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. Results While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. Conclusions We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction. PMID:25786494

[A comparative study of coding and information systems for the evaluation of medical and social conditions: the case of addictive disorders].

PubMed

Bourdais-Mannone, Claire; Cherikh, Faredj; Gicquel, Nathalie; Gelsi, Eve; Jove, Frédérique; Staccini, Pascal

2011-01-01

The purpose of this study was to conduct a descriptive and comparative analysis of the tools used by healthcare professionals specializing in addictive disorders to promote a rapprochement of information systems. The evaluation guide used to assess the compensation needs of disabled persons treated in "Maisons Départementales des Personnes Handicapées" (centres for disabled people) organizes information in different areas, including a psychological component. The guide includes social and environmental information in the "Recueil Commun sur les Addictions et les Prises en charges" (Joint Report on Drug Addiction and Drug Treatment). While the program for the medicalization of information systems includes care data, the current information about social situations remains inadequate. The international classification of diseases provides synthetic diagnostic codes to describe substance use, etiologic factors and the somatic and psychological complications inherent to addictive disorders. The current system could be radically simplified and harmonized and would benefit from adopting a more individualized approach to non-substance behavioral addictions. The international classification of disabilities provides tools for evaluating the psychological component included in the recent definition of addictive disorders. Legal information should play an integral role in the structure of the information system and in international classifications. The prevalence of episodes of care and treatment of addictive and psychological disorders was assessed at Nice University Hospital in all disciplines. Except in addiction treatment units, very few patients were found to have a RECAP file.

The extent that health professionals suspect and address addiction to medicines in primary care: Findings from a survey in Northwest England.

PubMed

Bates, Geoff; Cochrane, Madeleine; Mackridge, Adam John

2017-01-01

Addiction to medicines available over the counter or via prescription is of growing international concern. The authors of the current article ran an online survey of health professionals in general medical practice and community pharmacy settings in Northwest England to explore the frequency of suspecting and responding to addiction to medicines. Health professionals reported frequently identifying addiction to medicines among patients including those with long-term pain, mental health problems, sleep disorders, and other substance use disorders, but that these addictions often go unchallenged. This adds to the evidence indicating the under-diagnosis of addiction to medicines in the United Kingdom. Strategies to improve diagnosis and treatment should recognize the diversity of individuals with addiction to medicines.

Addiction: A dysregulation of satiety and inflammatory processes.

PubMed

Harricharan, Rivona; Abboussi, Oualid; Daniels, William M U

2017-01-01

Over the years, drug addiction has proven to be a perplexing conundrum for scientists. In attempts to decipher the components of the puzzle, multiple theories of addiction have been proposed. While these theories have assisted in providing essential fundamental information, current research recommends that a new theory needs to be presented taking into consideration the results of recent developments in the fields of neuroimmunology, genetics, and neuropsychiatry. After extensively examining the published literature, we propose in this review that neuroinflammation and hypothalamic functioning strongly underpin addictive behavior. To substantiate this notion, we typed the search-string "cocaine addiction, hypothalamus, and inflammation" into PubMed and Google Scholar. 50 and 1280 results were obtained in PubMed and Google Scholar, respectively. All article abstracts were perused for relevance to this review and 177 articles were used. Recent studies have purported that both acute and chronic psychostimulant use can activate specific components of the innate immune system. Findings such as these provide the scientific evidence supporting a hypothesis that includes a role for the innate immune system and inflammation in addictive behavior. However, the pathophysiological mechanisms by which they mediate the development of addiction have not been clearly delineated. The following review particularly focuses on the lateral hypothalamus and its functioning in satiety, and how inflammatory processes in the brain may contribute to addiction. © 2017 Elsevier B.V. All rights reserved.

MRI assessment of cerebral oxygen metabolism in cocaine-addicted individuals: Hypoactivity and dose dependence

PubMed Central

Liu, Peiying; Lu, Hanzhang; Filbey, Francesca M.; Tamminga, Carol A.; Cao, Yan; Adinoff, Bryon

2014-01-01

Long-term cocaine use is known to negatively impact neural and cerebrovascular systems. However, the use of imaging markers to separately assess these parameters remains challenging. The primary reason is that most functional imaging markers such as cerebral blood flow, functional connectivity, and task-evoked functional MRI are known to reflect a complex interplay between neural and vascular components, thus the interpretation of the results is not straightforward. The goal of the present study is to examine neural-activity-specific changes in cocaine addiction, using cerebral metabolic rate of oxygen (CMRO2) as a surrogate marker of aggregated neural activity. We applied a recently developed CMRO2 technique in 13 cocaine-addicted subjects and 13 age and gender matched control subjects, and examined the impact of long-term cocaine use on CMRO2. Our results showed that CMRO2 in cocaine-addicted subjects (152±16 μmol/100g/min) is significantly lower (p=0.031) than that in controls (169±20 μmol/100g/min). Furthermore, the severity of this decreased metabolism is associated with lifetime cocaine use (p=0.05). Additionally, the CMRO2 reduction was accompanied by a trend of decrease in cerebral blood flow (p=0.058), but venous oxygenation was unaffected (p=0.96), which suggested that the CMRO2 change may be attributed to a vascular deficiency in chronic cocaine users. To our knowledge, this is the first study to measure CMRO2 in cocaine addicted individuals. Our findings suggest that CMRO2 may be a promising approach for assessing the long-term effects of cocaine use on the brain. PMID:24757009

The symbolic constitution of addiction: language, alienation, ambivalence.

PubMed

Kemp, Ryan

2012-07-01

The author offers an articulation of addiction, via existential-phenomenology and Lacanian psychoanalysis, where it is argued that the addicted subject is constituted via a symbolic structuring evolving from societal practices, laws and the effects of language. Language carries a heritage, which bears on the knowledge and practices of designated subjects and practitioners of that discourse. Addiction, as one particular form of embodied existence and knowledgeable practice, finds expression through the speech and habits of the addict. Addiction, it is argued, is symbolically saturated with ambivalence and alienation. Also the addict is described as the complete modern technocratic subject, consumed by the ideology of consumption. The clinical implications are briefly explored where it is noted that two major approaches to addiction, namely 12-step fellowships and motivational interviewing, both attend to language as a critical component of their treatment approach.

[Food addiction - substance use disorder or behavioral addiction?].

PubMed

Albayrak, Özgür; Kliewer, Josephine; Föcker, Manuel; Antel, Jochen; Hebebrand, Johannes

2015-05-01

This article looks at food addiction as a subject situated between psychiatry, neurobiology, nutritional science, internal medicine, food industry, and public health. Essentially, the question is whether or not individual nutritional components can induce physical dependence, similar to the well-known effects of drugs such as alcohol and cocaine, or whether food addiction is rather a behavioral addiction. The literature describes many overlaps as well as differences of substance-based and non-substance-based addiction in both clinical and neurobiological terms. Until recently it was argued that food addiction appears only in the realms of obesity and eating disorders (e.g., binge-eating disorder, BED). Some studies, however, described the prevalence of food addiction symptoms and diagnoses independent of overweight or that they were in subjects who do not fulfill the criteria for BED. This article sums up the controversial discussion about the phenomenological and neurobiological classification of food addiction. Implications of food addiction for children and adolescents as well as public-health-related issues are also discussed.

Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

PubMed Central

Lee, Jinhee; Kresina, Thomas F.; Campopiano, Melinda; Lubran, Robert; Clark, H. Westley

2015-01-01

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence. PMID:25629034

Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions

PubMed Central

Granero, Roser; Fernández-Aranda, Fernando; Mestre-Bach, Gemma; Steward, Trevor; Baño, Marta; del Pino-Gutiérrez, Amparo; Moragas, Laura; Mallorquí-Bagué, Núria; Aymamí, Neus; Gómez-Peña, Mónica; Tárrega, Salomé; Menchón, José M.; Jiménez-Murcia, Susana

2016-01-01

Compulsive buying behavior (CBB) has been recognized as a prevalent mental health disorder, yet its categorization into classification systems remains unsettled. The objective of this study was to assess the sociodemographic and clinic variables related to the CBB phenotype compared to other behavioral addictions. Three thousand three hundred and twenty four treatment-seeking patients were classified in five groups: CBB, sexual addiction, Internet gaming disorder, Internet addiction, and gambling disorder. CBB was characterized by a higher proportion of women, higher levels of psychopathology, and higher levels in the personality traits of novelty seeking, harm avoidance, reward dependence, persistence, and cooperativeness compared to other behavioral addictions. Results outline the heterogeneity in the clinical profiles of patients diagnosed with different behavioral addiction subtypes and shed new light on the primary mechanisms of CBB. PMID:27378999

Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions.

PubMed

Granero, Roser; Fernández-Aranda, Fernando; Mestre-Bach, Gemma; Steward, Trevor; Baño, Marta; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Mallorquí-Bagué, Núria; Aymamí, Neus; Gómez-Peña, Mónica; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

2016-01-01

Compulsive buying behavior (CBB) has been recognized as a prevalent mental health disorder, yet its categorization into classification systems remains unsettled. The objective of this study was to assess the sociodemographic and clinic variables related to the CBB phenotype compared to other behavioral addictions. Three thousand three hundred and twenty four treatment-seeking patients were classified in five groups: CBB, sexual addiction, Internet gaming disorder, Internet addiction, and gambling disorder. CBB was characterized by a higher proportion of women, higher levels of psychopathology, and higher levels in the personality traits of novelty seeking, harm avoidance, reward dependence, persistence, and cooperativeness compared to other behavioral addictions. Results outline the heterogeneity in the clinical profiles of patients diagnosed with different behavioral addiction subtypes and shed new light on the primary mechanisms of CBB.

Liking and wanting of drug and nondrug rewards in active cocaine users: the STRAP-R questionnaire

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldstein, R.Z.; Goldstein, R.Z.; Woicik, P.A..

Few studies have examined the subjective value attributed to drug rewards specifically as it compares with the value attributed to primary non-drug rewards in addicted individuals. The objective of this study is to assess liking and wanting of expected drug rewards as compared to food and sex while respondents report about three different situations (current, and hypothetical in general, and under drug influence). In all, 20 cocaine-addicted individuals (mean abstinence = 2 days) and 20 healthy control subjects were administered the STRAP-R (Sensitivity To Reinforcement of Addictive and other Primary Rewards) questionnaire after receiving an oral dose of the dopaminemore » agonist methylphenidate (20 mg) or placebo. The reinforcers relative value changed within the addicted sample when reporting about the under drug influence situation (drug > food; otherwise, drug < food). This change was highest in the addicted individuals with the youngest age of cocaine use onset. Moreover, drug wanting exceeded drug liking in the addicted subjects when reporting about this situation during methylphenidate. Thus, cocaine-addicted individuals assign the highest subjective valence to drug rewards but only when recalling cue-related situations. When recalling this situation, they also report higher drug wanting than hedonic liking, a motivational shift that was only significant during methylphenidate. Together, these valence shifts may underlie compulsive stimulant abuse upon pharmacological or behavioural cue exposure in addicted individuals. Additional studies are required to assess the reliability of the STRAP-R in larger samples and to examine its validity in measuring the subjective value attributed to experienced reinforcers or in predicting behaviour.« less

[Knowledge and life experiences of mothers facing certain addictive behaviours in youths in the region of Tunis].

PubMed

Askri, M; Belgacem, B; Zine, I; Haddad, M; Besrour, M

2008-01-01

We surveyed 415 mothers who regularly consult primary healthcare centres about their knowledge of addictive behavior in teenagers in relation to tobacco, alcohol and drugs. Most mothers considered the teenage period difficult. Apprehension of this period increased with the educational level of the mothers. Mothers did not often discuss the issue of addiction with their children, especially related to alcohol and drugs. Nevertheless, the mothers were aware of the risks of addiction. They considered information campaigns about this topic an efficient means of prevention. About half of the mothers had experience of addictive conduct involving a family member. They resolved the problems through family help or consultation with a specialist.

Comparison of risk and protective factors associated with smartphone addiction and Internet addiction.

PubMed

Choi, Sam-Wook; Kim, Dai-Jin; Choi, Jung-Seok; Ahn, Heejune; Choi, Eun-Jeung; Song, Won-Young; Kim, Seohee; Youn, Hyunchul

2015-12-01

Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction. College students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young's Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State-Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor-Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses. The risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor was courage. Discussion These differences may result from unique features of smartphones, such as high availability and primary use as a tool for interpersonal relationships. Our findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction.

A commentary on the "eating addiction" versus "food addiction" perspectives on addictive-like food consumption.

PubMed

Schulte, Erica M; Potenza, Marc N; Gearhardt, Ashley N

2017-08-01

The food addiction construct posits that vulnerable individuals may experience an addictive-like response to certain foods, such as those high in fat and refined carbohydrates. Recently, an alternative model to food addiction was proposed, suggesting that the act of eating may be a behavioral addiction that can trigger an addictive-like response in susceptible individuals. One major rationale for the eating addiction framework is that the assessment of food addiction is based on behavioral indicators, such as consuming greater quantities of food than intended and eating certain foods despite negative consequences. It is also suggested that the lack of investigation into which foods and food attributes (e.g., sugar) may have an addictive potential is evidence that food addiction does not parallel a substance-based addiction and more closely resembles a behavioral addiction. The present paper provides a commentary suggesting that the substance-based, food-addiction framework is more appropriate than the behavioral-addiction, eating-addiction perspective to conceptualize addictive-like food consumption. In order to illustrate this point, this manuscript will discuss behavioral components characteristic of all substance-use disorders, preliminary evidence to suggest that all foods are not equally associated with addictive-like eating, and key differences between the hypothesized eating addiction phenotype and the only existing behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder. Further, this paper will consider implications of applying an addiction label to food versus eating and suggest future research directions to evaluate whether food addiction is a valid and clinically useful construct. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluating Exercise as a Therapeutic Intervention for Methamphetamine Addiction-Like Behavior1

PubMed Central

Somkuwar, Sucharita S.; Staples, Miranda C.; Fannon, McKenzie J.; Ghofranian, Atoosa; Mandyam, Chitra D.

2015-01-01

Abstract The need for effective treatments for addiction and dependence to the illicit stimulant methamphetamine in primary care settings is increasing, yet no effective medications have been FDA approved to reduce dependence [1]. This is partially attributed to the complex and dynamic neurobiology underlying the various stages of addiction [2]. Therapeutic strategies to treat methamphetamine addiction, particularly the relapse stage of addiction, could revolutionize methamphetamine addiction treatment. In this context, preclinical studies demonstrate that voluntary exercise (sustained physical activity) could be used as an intervention to reduce methamphetamine addiction. Therefore, it appears that methamphetamine disrupts normal functioning in the brain and this disruption is prevented or reduced by engaging in exercise. This review discusses animal models of methamphetamine addiction and sustained physical activity and the interactions between exercise and methamphetamine behaviors. The review highlights how methamphetamine and exercise affect neuronal plasticity and neurotoxicity in the adult mammalian striatum, hippocampus, and prefrontal cortex, and presents the emerging mechanisms of exercise in attenuating intake and in preventing relapse to methamphetamine seeking in preclinical models of methamphetamine addiction. PMID:29765835

Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: a factorial screening experiment.

PubMed

Cook, Jessica W; Collins, Linda M; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Baker, Timothy B; Piper, Megan E; Schlam, Tanya R; Jorenby, Douglas; Loh, Wei-Yin; Mermelstein, Robin

2016-01-01

To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. A balanced, four-factor, randomized factorial experiment. Eleven primary care clinics in southern Wisconsin, USA. A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none; (2) nicotine gum versus none; (3) motivational interviewing (MI) versus none; and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. The primary outcome was percentage change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. There were few main effects, but a significant four-way interaction at 26 weeks post-study enrollment (P = 0.01, β = 0.12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (P = 0.04), and nicotine gum, when used without MI, increased 26-week abstinence after a subsequent aided quit attempt (P = 0.01). Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit. © 2015 Society for the Study of Addiction.

Conceptualizing primary and secondary pathological exercise using available measures of excessive exercise.

PubMed

Cunningham, Hayley E; Pearman, Silas; Brewerton, Timothy D

2016-08-01

There is disagreement about the conceptualization and measurement of pathological exercise (PE). This study seeks to elucidate the nature of this phenomenon as addictive or compulsive in its primary and secondary forms. 1,497 adults (608 men, 885 women, 4 other) completed a set of validated surveys, including the Godin Leisure-Time Exercise Questionnaire, the Exercise Dependence Scale-21, the Exercise Addiction Inventory, the Compulsive Exercise Test (CET), the Obligatory Exercise Questionnaire, the Commitment to Exercise Scale, and an exercise specific adaptation of the Dimensional Obsessive-Compulsive Scale (ESDOCS). Participants completed the Eating Disorders Examination Questionnaire, and DSM-5 eating disorder (ED) diagnoses were determined according to published guidelines. Pearson correlation coefficients, independent samples t-tests, χ(2) tests, 1-way ANOVA's, and ANCOVA's were calculated. All PE measures correlated highly with one another (P < 0.001). Participants with EDs scored higher on all measures than those without (P < 0.001), and those with bulimia nervosa had the highest scores. Participants with PE and an accompanying ED (secondary PE) scored higher than those with PE and no ED symptoms (primary ED) on the CET (P < 0.002) and ESDOCS (P < 0.003). Correlations between EDE-Q and PE scores were stronger among women than men. PE prevalence was 6.4% (1.4% primary PE, 5.0% secondary PE) in our heterogeneous sample. Secondary PE appears to be more compulsive while primary PE is more addictive in nature. Men and women are equally at risk for PE, but in men it is more often primary and addictive and in women it is more often secondary and compulsive. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:778-792). © 2016 Wiley Periodicals, Inc.

Addictive behaviors and psychological distress among adolescents and emerging adults: A mediating role of peer group identification.

PubMed

Savolainen, Iina; Kaakinen, Markus; Sirola, Anu; Oksanen, Atte

2018-06-01

Research suggests the sense of belonging to primary groups functions as an important social resource for youth well-being, but it can be compromised among those dealing with addiction. The current study examined how adolescents' and emerging adults' identification with a primary peer group consisting of friends, mediates the relationship between addictive behaviors and psychological distress. The study utilized demographically balanced survey data on 1200 Finnish participants aged 15 to 25 (mean age 21.29, 50% female). Measures were included for psychological distress, excessive drinking, excessive drug use, excessive gambling, excessive Internet use, and peer group identification. All forms of addictive behaviors had a significant direct relationship with higher psychological distress. Excessive drug use, gambling and Internet use were associated with a weaker identification with a peer group, which predicted higher psychological distress. Contrary to the above findings, excessive drinking was linked to stronger peer group identification, mediating psychological distress downwards. These findings support past research and provide a mediation model explanation onto how weaker social relations add to negative well-being consequences in different addictive behaviors, thus underlining the importance of expanding our understanding of social group outcomes among young individuals.

Brain anatomy alterations associated with Social Networking Site (SNS) addiction

PubMed Central

He, Qinghua; Turel, Ofir; Bechara, Antoine

2017-01-01

This study relies on knowledge regarding the neuroplasticity of dual-system components that govern addiction and excessive behavior and suggests that alterations in the grey matter volumes, i.e., brain morphology, of specific regions of interest are associated with technology-related addictions. Using voxel based morphometry (VBM) applied to structural Magnetic Resonance Imaging (MRI) scans of twenty social network site (SNS) users with varying degrees of SNS addiction, we show that SNS addiction is associated with a presumably more efficient impulsive brain system, manifested through reduced grey matter volumes in the amygdala bilaterally (but not with structural differences in the Nucleus Accumbens). In this regard, SNS addiction is similar in terms of brain anatomy alterations to other (substance, gambling etc.) addictions. We also show that in contrast to other addictions in which the anterior-/ mid- cingulate cortex is impaired and fails to support the needed inhibition, which manifests through reduced grey matter volumes, this region is presumed to be healthy in our sample and its grey matter volume is positively correlated with one’s level of SNS addiction. These findings portray an anatomical morphology model of SNS addiction and point to brain morphology similarities and differences between technology addictions and substance and gambling addictions. PMID:28332625

Comparison of risk and protective factors associated with smartphone addiction and Internet addiction

PubMed Central

Choi, Sam-Wook; Kim, Dai-Jin; Choi, Jung-Seok; Ahn, Heejune; Choi, Eun-Jeung; Song, Won-Young; Kim, Seohee; Youn, Hyunchul

2015-01-01

Background and Aims Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction. Methods College students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young’s Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State–Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor–Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses. Results The risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor was courage. Discussion These differences may result from unique features of smartphones, such as high availability and primary use as a tool for interpersonal relationships. Conclusions Our findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction. PMID:26690626

Prevalence and Co-Occurrence of Addictive Behaviors Among Russian and Spanish Youth.

PubMed

Tsai, Jennifer; Huh, Jimi; Idrisov, Bulat; Galimov, Artur; Espada, Jose P; Gonzálvez, María T; Sussman, Steve

2017-01-01

Recently, an addiction matrix measure was assessed among U.S. former alternative high school youth. This presentation seeks to examine the generalizability of findings using this measure among Russian and Spanish high school adolescents. Latent class analysis was used to explore addiction subgroups among adolescents in Russia (average age = 16.27; n = 715) and Spain (average age = 14.9; n = 811). Last 30-day prevalence of one or more of 11 addictions reviewed in the previous work was the primary focus (i.e., cigarettes, alcohol, hard drugs, eating, gambling, Internet, love, sex, exercise, work, and shopping) among Russian youth, and last-30 prevalence of one or more of 8 addictions among Spanish youth (the three drug use items had not been included in the questionnaire for these youths). Results confirmed a two-class model (addicted class and non-addicted class) among both Russian and Spanish adolescents. The mean number of addictions reported was 1.39 ( SD = 1.78) addictions among Russian youth and 1.56 ( SD = 1.68) addictions among Spanish youth. The prevalence of the sample that constituted the "addicted group" in Russia and Spain was 32.2% and 28.6%, respectively. The most prevalent addictions (i.e., love, Internet, exercise) were similar. These results are similar to the findings previously reported for U.S. Latent class structures for addictive behaviors are similar across international adolescent populations. Our results highlight the need to address multiple addictions in health education programming.

Training the next generation of providers in addiction medicine.

PubMed

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

2012-06-01

Within the United States there exists a profound discrepancy between the significant public health problem of substance abuse and the access to treatment for addicted individuals. Part of the insufficient access to treatment is a function of relatively low levels or professional experts in addiction medicine. Part of the low levels of professional addiction experts is the result of inadequate addiction medicine training of medical students and residents. This article outlines deficits in addiction medicine training among medical students and residents, yet real change in the addiction medicine training process will always be subject to the complexity of producing alterations across multiple credentialing institutions as well as the keen competition between educators for “more time” for their particular subject. Other hurdles include the broad-based issue of stigma regarding alcoholism and other substance abuse that likely impact all systems that regulate physician addiction medicine training. As noted in the discussion of psychiatry residency, even psychiatry residents manifest stigma regarding substance abusing patients. Five currently active processes may allow for fundamental change to the inertia in physician addiction medicine training while also potentially impacting stigma: 1. We appear to be at the beginning of the integration of addiction into traditional medicine through the formation of a legitimized addiction medicine subspecialty. 2. The training of primary care trainees and practitioners in the use of SBIRT is accelerating, thus creating another process of addiction integration into traditional medicine. 3. The PCMH is being established as a model for primary care 4. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) became effective for group health care plan years beginning on or after July 1, 2010; thereby, substance abuse benefits and cost are to be the same as general medical or surgical 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 a diagnosis? 2. In prescribing, what constitutes legitimate follow-up of patients on antidepressants and antianxiety agents, including how to avoid additional substance abuse problems when prescribing sedative-hypnotics? 3. When and how should patients be referred to a psychiatrist? Finally, it is important to note that any of the potential changes described in this article need to influence only 10% of the approximately 17 million current heavy drinkers to seek treatment to equal the approximately 1.7 million heavy drinkers who are now in treatment, let alone any of the approximately 50 million current at-risk drinkers, virtually none of whom are in treatment. Among other social changes that will alter the future of addiction treatment, the integration of addiction into traditional medicine may go a long way in altering the current ratios of who seeks treatment and is willing to participate in treatment.

Effect of quality chronic disease management for alcohol and drug dependence on addiction outcomes.

PubMed

Kim, Theresa W; Saitz, Richard; Cheng, Debbie M; Winter, Michael R; Witas, Julie; Samet, Jeffrey H

2012-12-01

We examined the effect of the quality of primary care-based chronic disease management (CDM) for alcohol and/or other drug (AOD) dependence on addiction outcomes. We assessed quality using (1) a visit frequency based measure and (2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. The self-reported measure of care-when care was at a CDM clinic-was associated with lower drug addiction severity. The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere) was associated with lower alcohol addiction severity and abstinence. These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes. Quality measures based upon alignment with the chronic care model may better capture features of effective CDM care than a visit frequency measure. Copyright © 2012 Elsevier Inc. All rights reserved.

Relation between Video Game Addiction and Interfamily Relationships on Primary School Students

ERIC Educational Resources Information Center

Zorbaz, Selen Demirtas; Ulas, Ozlem; Kizildag, Seval

2015-01-01

This study seeks to analyze whether or not the following three variables of "Discouraging Family Relations," "Supportive Family Relations," "Total Time Spent on the Computer," and "Grade Point Average (GPA)" predict elementary school students' video game addiction rates, and whether or not there exists a…

Exploring Experiential Learning through an Abstinence Assignment within an Addictions Counseling Course

ERIC Educational Resources Information Center

Yates, Chad M.; DeLeon, Alexia; Rapp, Marisa C.

2017-01-01

Counselors-in-training may struggle in working with addictions populations for various reasons, including limited training, pre-existing stigma toward the population, and low self-efficacy treating substance use disorders. This is concerning because professional counselors have the highest proportion of clients with a primary substance abuse…

[Dysfunctionality of the primary family as a supportive factor for the development of polytoxicomany in young people].

PubMed

Nenadović, Milutin M; Šapić, Rosa; Nenadović, Nenad

2012-01-01

Dependent behaviour represents a strong homeostasis of the family of an addict. The aim of our research is to record and explore irregularities during the addicts' growth, as well as the specific type of family relations in the addicts' family. For research purposes a general questionnaire was used on growth and development, and GRADIR questionnaire on the assessment of family relationships. Our results indicate that delinquent behaviour is often found with the addicts before the occurrence of abuse. A significant dysfunctional family of addicts was detected. Families with an addict were not substantially damaged or altered in terms of emotional exchange, but in their structure that enhanced dysfunction leading to addictive behaviour. Emotional investments without control, prohibitions and penalties, contribute to a lack of consciousness that disturbs the process of socialization. Due to the apparent control and the apparent support, the addicts do not have structured organization and socialization. Emotional stimuli without obligation for polytoxicomanes to maintain a reciprocal relationship with their parents influence the parental support of egoistic style of behaviour.

Endocannabinoid system and drug addiction: new insights from mutant mice approaches.

PubMed

Maldonado, Rafael; Robledo, Patricia; Berrendero, Fernando

2013-08-01

The involvement of the endocannabinoid system in drug addiction was initially studied by the use of compounds with different affinities for each cannabinoid receptor or for the proteins involved in endocannabinoids inactivation. The generation of genetically modified mice with selective mutations in these endocannabinoid system components has now provided important advances in establishing their specific contribution to drug addiction. These genetic tools have identified the particular interest of CB1 cannabinoid receptor and endogenous anandamide as potential targets for drug addiction treatment. Novel genetic tools will allow determining if the modulation of CB2 cannabinoid receptor activity and 2-arachidonoylglycerol tone can also have an important therapeutic relevance for drug addiction. Copyright © 2013 Elsevier Ltd. All rights reserved.

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. Copyright © 2012 Elsevier Ltd. All rights reserved.

Addictive behaviors and personality traits in adolescents.

PubMed

Munno, Donato; Saroldi, Marta; Bechon, Elisa; Sterpone, Sara Chiara Maria; Zullo, Giuseppina

2016-04-01

Behavioral addictions refer to repeated dysfunctional behaviors that do not involve the ingestion of addictive substances. Studies on the association between behavioral addictions and personality traits have noted in individuals with problematic behaviors a high proclivity toward impulsivity and sensation-seeking and a low predisposition to harm avoidance. The majority of these studies have focused on adults, while far fewer have involved adolescents. The study population was 109 high school students (age range 15-18 years) in Turin, Italy. Participants completed an assessment that comprised a demographic questionnaire and 3 self-report questionnaires: the Shorter PROMIS Questionnaire (SPQ), the Internet Addiction Test (IAT), and the Multidimensional Questionnaire for Adolescents (QMA). A gender-related difference in the risk of developing an addictive behavior was observed, with a significantly higher percentage of risk seen for several addiction tendencies among the males. Statistically significant correlations emerged between some personality determinants and certain addictive behaviors. The study pinpoints epidemiological indicators for the extent of this growing problem among adolescents. The findings have implications for identifying protection factors and risk factors for addictive behaviors and related psychiatric disorders, and the development of primary prevention strategies derived from such factors.

Validation of the Thai version of Bergen Facebook addiction scale (Thai-BFAS). .

PubMed

Phanasathit, Muthita; Manwong, Mereerat; Hanprathet, Nitt; Khumsri, Jiraporn; Yingyeun, Rungmanee

2015-03-01

To determine the validity ofthe Thai version ofthe Bergen FacebookAddiction Scale (Thai-BFAS) using Facebook addiction screening in Thai high school students. The original BFAS was authorized for translation and validation in Thai. After content validity and usability were approved by three Thai psychiatrists, the Thai-BFAS was adjusted again by the authors and back translated by an English expert. Thisfinal version was investigated using the internal consistency method among 874 high schools students in Bangkok, Chiang Mai, Ubon Ratchathani and Songkhla, and confirmatoy factor analysis (CFA) was employed to prove that the six-component model could be representative of addiction behaviors. In addition, test-retest reliability was performed separately among 30 pilot high school students in Bangkok. The Thai-BFAS has six items, which are each scored on a 5-point scale with total score ranges from 0 to 24; the cutoff score for Facebook addition stands at least 12 points. The Cronbach s alpha coefficient was 0.91 (95% CI; 0.90, 0.92) and the inter-class correlation coefficient was 0.80 (95% CI; 0.49, 0.92). The CFA showed that the six items accurately represent the six-component model of addiction such as salience, mood modification, tolerance, withdrawal, relapse and conflict. The Thai-BFAS is consistent as a screening testfor Facebook addiction among high school students due to good reliability and validity. It also conforms well to the original version. The six items in the Thai-BFAS are a good representation of the addiction behaviors. Further studies should be undertaken in cases of sensitivity and specificity when compared with other similar tests of addiction as well as in various additional populations and circumstances.

Hepatitis Infection in the Treatment of Opioid Dependence and Abuse

PubMed Central

Kresina, Thomas F; Sylvestre, Diana; Seeff, Leonard; Litwin, Alain H; Hoffman, Kenneth; Lubran, Robert; Clark, H Westley

2008-01-01

Many new and existing cases of viral hepatitis infections are related to injection drug use. Transmission of these infections can result directly from the use of injection equipment that is contaminated with blood containing the hepatitis B or C virus or through sexual contact with an infected individual. In the latter case, drug use can indirectly contribute to hepatitis transmission through the dis-inhibited at-risk behavior, that is, unprotected sex with an infected partner. Individuals who inject drugs are at-risk for infection from different hepatitis viruses, hepatitis A, B, or C. Those with chronic hepatitis B virus infection also face additional risk should they become co-infected with hepatitis D virus. Protection from the transmission of hepatitis viruses A and B is best achieved by vaccination. For those with a history of or who currently inject drugs, the medical management of viral hepatitis infection comprising screening, testing, counseling and providing care and treatment is evolving. Components of the medical management of hepatitis infection, for persons considering, initiating, or receiving pharmacologic therapy for opioid addiction include: testing for hepatitis B and C infections; education and counseling regarding at-risk behavior and hepatitis transmission, acute and chronic hepatitis infection, liver disease and its care and treatment; vaccination against hepatitis A and B infection; and integrative primary care as part of the comprehensive treatment approach for recovery from opioid abuse and dependence. In addition, participation in a peer support group as part of integrated medical care enhances treatment outcomes. Liver disease is highly prevalent in patient populations seeking recovery from opioid addiction or who are currently receiving pharmacotherapy for opioid addiction. Pharmacotherapy for opioid addiction is not a contraindication to evaluation, care, or treatment of liver disease due to hepatitis virus infection. Successful pharmacotherapy for opioid addiction stabilizes patients and improves patient compliance to care and treatment regimens as well as promotes good patient outcomes. Implementation and integration of effective hepatitis prevention programs, care programs, and treatment regimens in concert with the pharmacological therapy of opioid addiction can reduce the public health burdens of hepatitis and injection drug use. PMID:25977607

Prevalence and co-occurrence of addictive behaviors among former alternative high school youth.

PubMed

Sussman, Steve; Arpawong, Thalida Em; Sun, Ping; Tsai, Jennifer; Rohrbach, Louise A; Spruijt-Metz, Donna

2014-04-01

Recent work has studied multiple addictions using a matrix measure, which taps multiple addictions through single responses for each type. The present study investigated use of a matrix measure approach among former alternative high school youth (average age = 19.8 years) at risk for addictions. Lifetime and last 30-day prevalence of one or more of 11 addictions reviewed in other work (Sussman, Lisha & Griffiths, 2011) was the primary focus (i.e., cigarettes, alcohol, other/hard drugs, eating, gambling, Internet, shopping, love, sex, exercise, and work). Also, the co-occurrence of two or more of these 11 addictive behaviors was investigated. Finally, the latent class structure of these addictions, and their associations with other measures, was examined. We found that ever and last 30-day prevalence of one or more of these addictions was 79.2% and 61.5%, respectively. Ever and last 30-day co-occurrence of two or more of these addictions was 61.5% and 37.7%, respectively. Latent Class Analysis suggested two groups: a generally Non-addicted Group (67.2% of the sample) and a "Work Hard, Play Hard"-addicted Group that was particularly invested in addiction to love, sex, exercise, the Internet, and work. Supplementary analyses suggested that the single-response type self-reports may be measuring the addictions they intend to measure. We suggest implications of these results for future studies and the development of prevention and treatment programs, though much more validation research is needed on the use of this type of measure.

Reliability and Validity of the Behavioral Addiction Measure for Video Gaming.

PubMed

Sanders, James L; Williams, Robert J

2016-01-01

Most tests of video game addiction have weak construct validity and limited ability to correctly identify people in denial. The purpose of the present research was to investigate the reliability and validity of a new test of video game addiction (Behavioral Addiction Measure-Video Gaming [BAM-VG]) that was developed in part to address these deficiencies. Regular adult video gamers (n = 506) were recruited from a Canadian online panel and completed a survey containing three measures of excessive video gaming (BAM-VG; DSM-5 criteria for Internet Gaming Disorder [IGD]; and the IGD-20), as well as questions concerning extensiveness of video game involvement and self-report of problems associated with video gaming. One month later, they were reassessed for the purposes of establishing test-retest reliability. The BAM-VG demonstrated good internal consistency as well as 1 month test-retest reliability. Criterion-related validity was demonstrated by significant correlations with the following: time spent playing, self-identification of video game problems, and scores on other instruments designed to assess video game addiction (DSM-5 IGD, IGD-20). Consistent with the theory, principal component analysis identified two components underlying the BAM-VG that roughly correspond with impaired control and significant negative consequences deriving from this impaired control. Together with its excellent construct validity and other technical features, the BAM-VG represents a reliable and valid test of video game addiction.

Examination of the Effects of an Intervention Aiming to Link Patients Receiving Addiction Treatment With Health Care: The LINKAGE Clinical Trial.

PubMed

Weisner, Constance M; Chi, Felicia W; Lu, Yun; Ross, Thekla B; Wood, Sabrina B; Hinman, Agatha; Pating, David; Satre, Derek; Sterling, Stacy A

2016-08-01

Research has shown that higher activation and engagement with health care is associated with better self-management. To our knowledge, the linkage intervention (LINKAGE) is the first to engage patients receiving addiction treatment with health care using the electronic health record and a patient activation approach. To examine the effects of an intervention aiming to link patients receiving addiction treatment with health care. A nonrandomized clinical trial evaluating the LINKAGE intervention vs usual care by applying an alternating 3-month off-and-on design over 30 months. Participants were recruited from an outpatient addiction treatment clinic in a large health system between April 7, 2011, and October 2, 2013. Six group-based, manual-guided sessions on patient engagement in health care and the use of health information technology resources in the electronic health record, as well as facilitated communication with physicians, vs usual care. Primary outcomes, measured at 6 months after enrollment, were patient activation (by interview using the Patient Activation Measure), patient engagement in health care (by interview and electronic health record), and alcohol, drug, and depression outcomes (by interview using the Addiction Severity Index for alcohol and drug outcomes and Patient Health Questionnaire (PHQ) for depression). A total of 503 patients were recruited and assigned to the LINKAGE (n = 252) or usual care (n = 251) conditions, with no differences in baseline characteristics between conditions. The mean (SD) age of the patients was 42.5 (11.8) years, 31.0% (n = 156) were female, and 455 (90.5%) completed the 6-month interview. Compared with usual care participants, LINKAGE participants showed an increase in the mean number of log-in days (incidence rate ratio, 1.53; 95% CI, 1.19-1.97; P = .001). Similar results were found across types of patient portal use (communicating by email, viewing laboratory test results and information, and obtaining medical advice). LINKAGE participants were more likely to talk with their physicians about addiction problems (odds ratio, 2.30; 95% CI, 1.52-3.49; P < .001). Although 6-month abstinence rates were high for both conditions (≥70.0% for both) and depression symptoms improved (the proportion with scores ≥15 on the 9-item PHQ dropped from 15.1% [38 of 252] to 8.0% [18 of 225] among LINKAGE participants), there were no differences between conditions. Those who received all intervention components had significantly better alcohol and other drug outcomes than those who received fewer intervention components. Findings support the feasibility and effectiveness of the LINKAGE intervention in helping patients receiving addiction treatment engage in health care and increase communication with their physicians. The intervention did not affect short-term abstinence or depression outcomes. Understanding if the LINKAGE intervention helps prevent relapse and manage long-term recovery will be important. clinicaltrials.gov Identifier: NCT01621711.

Positive Criminology and Rethinking the Response to Adolescent Addiction: Evidence on the Role of Social Support, Religiosity, and Service to Others.

PubMed

Johnson, Byron R; Lee, Matthew T; Pagano, Maria E; Post, Stephen G

2016-01-01

Adolescent addiction has emerged as a major public health problem. The greatest increase in alcohol and other drug use disorders can be found among youth. Concurrently, technological advances in policing coupled with aggressive prosecuting and sentencing practices have contributed to the growth of America's correctional system. The assertive response of policing, courts, and corrections, however, have not prevented the dramatic rise of adolescent addiction. Unfortunately, there is no national data tracking addicted youth in the criminal justice system to evaluate what works when it comes to youth with addiction. This article reviews justice system responses to adolescent offenders with addiction, and promising approaches engaging juveniles in programmatic components of Alcoholics Anonymous (AA). This study highlights the role of spirituality, service to others, and social support in maintaining sobriety, reducing arrests, and lowering recidivism for adolescents court-referred to treatment. Recommendations for improving the response to adolescent offenders with addiction are offered.

Positive Criminology and Rethinking the Response to Adolescent Addiction: Evidence on the Role of Social Support, Religiosity, and Service to Others

PubMed Central

Johnson, Byron R.; Lee, Matthew T.; Pagano, Maria E.; Post, Stephen G.

2017-01-01

Adolescent addiction has emerged as a major public health problem. The greatest increase in alcohol and other drug use disorders can be found among youth. Concurrently, technological advances in policing coupled with aggressive prosecuting and sentencing practices have contributed to the growth of America’s correctional system. The assertive response of policing, courts, and corrections, however, have not prevented the dramatic rise of adolescent addiction. Unfortunately, there is no national data tracking addicted youth in the criminal justice system to evaluate what works when it comes to youth with addiction. This article reviews justice system responses to adolescent offenders with addiction, and promising approaches engaging juveniles in programmatic components of Alcoholics Anonymous (AA). This study highlights the role of spirituality, service to others, and social support in maintaining sobriety, reducing arrests, and lowering recidivism for adolescents court-referred to treatment. Recommendations for improving the response to adolescent offenders with addiction are offered. PMID:28090237

Neural correlate of Internet use in patients undergoing psychological treatment for Internet addiction.

PubMed

Lai, Carlo; Altavilla, Daniela; Mazza, Marianna; Scappaticci, Silvia; Tambelli, Renata; Aceto, Paola; Luciani, Massimiliano; Corvino, Stefano; Martinelli, David; Alimonti, Flaminia; Tonioni, Federico

2017-06-01

The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving. The aim was to test the neural correlate in response to the Internet cue in patients with IA. Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed. sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group. These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms.

Craving to Quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions

PubMed Central

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

2012-01-01

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 sub-optimal over the past several decades. Mindfulness training, which is based on ancient Buddhist models of human suffering, has recently shown preliminary efficacy in treating addictions. Interestingly, these early models show remarkable similarity to current models of the addictive 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. PMID:22642859

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. 2013 APA, all rights reserved

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parvaz M. A.; Parvaz, M.A.; Alia-Klein, N.

In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET),more » functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.« less

Positron emission tomography molecular imaging of dopaminergic system in drug addiction.

PubMed

Hou, Haifeng; Tian, Mei; Zhang, Hong

2012-05-01

Dopamine (DA) is involved in drug reinforcement, but its role in drug addiction remains unclear. Positron emission tomography (PET) is the first technology used for the direct measurement of components of the dopaminergic system in the living human brain. In this article, we reviewed the major findings of PET imaging studies on the involvement of DA in drug addiction, especially in heroin addiction. Furthermore, we summarized PET radiotracers that have been used to study the role of DA in drug addiction. To investigate presynaptic function in drug addiction, PET tracers have been developed to measure DA synthesis and transport. For the investigation of postsynaptic function, several radioligands targeting dopamine one (D1) receptor and dopamine two (D2) receptor are extensively used in PET imaging studies. Moreover, we also summarized the PET imaging findings of heroin addiction studies, including heroin-induced DA increases and the reinforcement, role of DA in the long-term effects of heroin abuse, DA and vulnerability to heroin abuse and the treatment implications. PET imaging studies have corroborated the role of DA in drug addiction and increase our understanding the mechanism of drug addiction. Copyright © 2012 Wiley Periodicals, Inc.

Understanding the Role of Storytelling in the Transformation of Female Cocaine Addicts in Narcotics Anonymous

ERIC Educational Resources Information Center

Ventresca, Melissa Weida

2012-01-01

The purpose of this qualitative study was to understand the role of storytelling in the transformation of female cocaine addicts in Narcotics Anonymous. For this research the primary investigator utilized a theoretical orientation of transformative learning theory and storytelling. The rationale for employing transformative learning theory is that…

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…

Anger-Control Group Counseling for Women Recovering from Alcohol or Drug Addiction

ERIC Educational Resources Information Center

Gonzalez-Prendes, A. Antonio

2008-01-01

Two experimental conditions, a manualized cognitive-behavioral anger-control treatment incorporating empowerment strategies and a relapse-prevention treatment without the anger-control component, were compared to assess their impact on levels of trait anger and attributional styles of women recovering from alcohol and drug addiction. Participants…

[Involuntary admission of addict during early pregnancy].

PubMed

Hondius, Adger J K; Stikker, Tineke E; Wennink, J M B Hanneke; Honig, Adriaan

2012-01-01

A 30-year-old cocaine-dependent woman was 16 weeks pregnant. Because of possible endangerment of the fetus, an involuntary provisional admission was authorized. Of particular interest is the application of the Dutch Act on Formal Admissions to Psychiatric Hospitals for the primary diagnosis 'addiction' and the fact that the fetus was regarded as a legal 'other'. In severe cases of addiction combined with pregnancy an earlier intervention is needed and arrangement of accelerated legal custody of the newborn before birth should be considered. For the protection of the unborn, we advocate a stricter application of the United Nations Convention on the Rights of the Child. Information for addicted women with preconception counselling can help prevent a compulsory admission.

An Affective Neuroscience Framework for the Molecular Study of Internet Addiction.

PubMed

Montag, Christian; Sindermann, Cornelia; Becker, Benjamin; Panksepp, Jaak

2016-01-01

Internet addiction represents an emerging global health issue. Increasing efforts have been made to characterize risk factors for the development of Internet addiction and consequences of excessive Internet use. During the last years, classic research approaches from psychology considering personality variables as vulnerability factor, especially in conjunction with neuroscience approaches such as brain imaging, have led to coherent theoretical conceptualizations of Internet addiction. Although such conceptualizations can be valuable aid, the research field is currently lacking a comprehensive framework for determining brain-based and neurochemical markers of Internet addiction. The present work aims at providing a framework on the molecular level as a basis for future research on the neural and behavioral level, in order to facilitate a comprehensive neurobiological model of Internet addiction and its clinical symptomatology. To help establish such a molecular framework for the study of Internet addiction, we investigated in N = 680 participants associations between individual differences in tendencies toward Internet addiction measured by the Generalized Problematic Internet Use Scale-2 (GPIUS-2) and individual differences in primary emotional systems as assessed by the Affective Neuroscience Personality Scales (ANPS). Regression analysis revealed that the ANPS scales FEAR and SADNESS were the ANPS scales most robustly positively linked to several (sub)scales of the GPIUS-2. Also the scales SEEKING, CARE and PLAY explain variance in some of the GPIUS-2 subscales. As such, these scales are negatively linked to the GPIUS-2 subscales. As the ANPS has been constructed on substantial available brain data including an extensive molecular body with respect to evolutionary highly conserved emotional circuitry in the ancient mammalian brain, the present study gives first ideas on putative molecular mechanisms underlying different facets of Internet addiction as derived from associations between tendencies toward Internet addiction and individual differences in primary emotional systems. For example, as SADNESS is linked to the overall GPIUS-2 score, and the neuropeptide oxytocin is known to downregulate SADNESS, it is conceivable that the neuropeptide might play a role in Internet addition on the molecular level. Our findings provide a theoretical framework potentially illuminating the molecular underpinnings of Internet addiction. Finally, we also present data on the ANPS and smartphone addiction at the end of the paper. Similar to the reported associations between the ANPS and the GPIUS-2, these correlations might provide an initial outline for a framework guiding future studies that aim to address the molecular basis of smartphone addiction.

An Affective Neuroscience Framework for the Molecular Study of Internet Addiction

PubMed Central

Montag, Christian; Sindermann, Cornelia; Becker, Benjamin; Panksepp, Jaak

2016-01-01

Internet addiction represents an emerging global health issue. Increasing efforts have been made to characterize risk factors for the development of Internet addiction and consequences of excessive Internet use. During the last years, classic research approaches from psychology considering personality variables as vulnerability factor, especially in conjunction with neuroscience approaches such as brain imaging, have led to coherent theoretical conceptualizations of Internet addiction. Although such conceptualizations can be valuable aid, the research field is currently lacking a comprehensive framework for determining brain-based and neurochemical markers of Internet addiction. The present work aims at providing a framework on the molecular level as a basis for future research on the neural and behavioral level, in order to facilitate a comprehensive neurobiological model of Internet addiction and its clinical symptomatology. To help establish such a molecular framework for the study of Internet addiction, we investigated in N = 680 participants associations between individual differences in tendencies toward Internet addiction measured by the Generalized Problematic Internet Use Scale-2 (GPIUS-2) and individual differences in primary emotional systems as assessed by the Affective Neuroscience Personality Scales (ANPS). Regression analysis revealed that the ANPS scales FEAR and SADNESS were the ANPS scales most robustly positively linked to several (sub)scales of the GPIUS-2. Also the scales SEEKING, CARE and PLAY explain variance in some of the GPIUS-2 subscales. As such, these scales are negatively linked to the GPIUS-2 subscales. As the ANPS has been constructed on substantial available brain data including an extensive molecular body with respect to evolutionary highly conserved emotional circuitry in the ancient mammalian brain, the present study gives first ideas on putative molecular mechanisms underlying different facets of Internet addiction as derived from associations between tendencies toward Internet addiction and individual differences in primary emotional systems. For example, as SADNESS is linked to the overall GPIUS-2 score, and the neuropeptide oxytocin is known to downregulate SADNESS, it is conceivable that the neuropeptide might play a role in Internet addition on the molecular level. Our findings provide a theoretical framework potentially illuminating the molecular underpinnings of Internet addiction. Finally, we also present data on the ANPS and smartphone addiction at the end of the paper. Similar to the reported associations between the ANPS and the GPIUS-2, these correlations might provide an initial outline for a framework guiding future studies that aim to address the molecular basis of smartphone addiction. PMID:28018255

Prevalence and co-occurrence of addictive behaviors among former alternative high school youth: A longitudinal follow-up study.

PubMed

Sussman, Steve; Pokhrel, Pallav; Sun, Ping; Rohrbach, Louise A; Spruijt-Metz, Donna

2015-09-01

Recent work has studied addictions using a matrix measure, which taps multiple addictions through single responses for each type. This is the first longitudinal study using a matrix measure. We investigated the use of this approach among former alternative high school youth (average age = 19.8 years at baseline; longitudinal n = 538) at risk for addictions. Lifetime and last 30-day prevalence of one or more of 11 addictions reviewed in other work was the primary focus (i.e., cigarettes, alcohol, hard drugs, shopping, gambling, Internet, love, sex, eating, work, and exercise). These were examined at two time-points one year apart. Latent class and latent transition analyses (LCA and LTA) were conducted in Mplus. Prevalence rates were stable across the two time-points. As in the cross-sectional baseline analysis, the 2-class model (addiction class, non-addiction class) fit the data better at follow-up than models with more classes. Item-response or conditional probabilities for each addiction type did not differ between time-points. As a result, the LTA model utilized constrained the conditional probabilities to be equal across the two time-points. In the addiction class, larger conditional probabilities (i.e., 0.40-0.49) were found for love, sex, exercise, and work addictions; medium conditional probabilities (i.e., 0.17-0.27) were found for cigarette, alcohol, other drugs, eating, Internet and shopping addiction; and a small conditional probability (0.06) was found for gambling. Persons in an addiction class tend to remain in this addiction class over a one-year period.

Prevalence and co-occurrence of addictive behaviors among former alternative high school youth

PubMed Central

Sussman, Steve; Arpawong, Thalida Em; Sun, Ping; Tsai, Jennifer; Rohrbach, Louise A.; Spruijt-Metz, Donna

2014-01-01

Background and Aims: Recent work has studied multiple addictions using a matrix measure, which taps multiple addictions through single responses for each type. Methods: The present study investigated use of a matrix measure approach among former alternative high school youth (average age = 19.8 years) at risk for addictions. Lifetime and last 30-day prevalence of one or more of 11 addictions reviewed in other work (Sussman, Lisha & Griffiths, 2011) was the primary focus (i.e., cigarettes, alcohol, other/hard drugs, eating, gambling, Internet, shopping, love, sex, exercise, and work). Also, the co-occurrence of two or more of these 11 addictive behaviors was investigated. Finally, the latent class structure of these addictions, and their associations with other measures, was examined. Results: We found that ever and last 30-day prevalence of one or more of these addictions was 79.2% and 61.5%, respectively. Ever and last 30-day co-occurrence of two or more of these addictions was 61.5% and 37.7%, respectively. Latent Class Analysis suggested two groups: a generally Non-addicted Group (67.2% of the sample) and a “Work Hard, Play Hard”-addicted Group that was particularly invested in addiction to love, sex, exercise, the Internet, and work. Supplementary analyses suggested that the single-response type self-reports may be measuring the addictions they intend to measure. Discussion and Conclusions: We suggest implications of these results for future studies and the development of prevention and treatment programs, though much more validation research is needed on the use of this type of measure. PMID:24701344

Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia.

PubMed

Swarna Nantha, Yogarabindranath

2014-10-01

The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research. "Food addiction" could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory-based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete. Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country. Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities. © The Author(s) 2014.

The prescription of addiction medications after implementation of chronic care management for substance dependence in primary care

PubMed Central

Park, Tae Woo; Samet, Jeffrey H.; Cheng, Debbie M.; Winter, Michael R.; Kim, Theresa W.; Fitzgerald, Anna; Saitz, Richard

2014-01-01

People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction (n=282), we examined factors associated with the prescription of addiction medications. Among participants with alcohol dependence, 17% (95%CI 12.0–22.1%) were prescribed alcohol dependence medications. Among those with drug dependence, 9% (95%CI 5.5–12.6%) were prescribed drug dependence medications. Among those with opioids as a substance of choice, 15% (95%CI 9.3–20.9%) were prescribed opioid agonist therapy. In contrast, psychiatric medications were prescribed to 64% (95%CI 58.2–69.4%). Absence of co-morbid drug dependence was associated with prescription of alcohol dependence medications. Lower alcohol addiction severity and recent opioid use were associated with prescription of drug dependence medications. Better understanding of infrequent prescription of addiction medications, despite a supportive clinical setting, might inform optimal approaches to delivering addiction medications. PMID:25524751

Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: relationships to resting-state functional connectivity

PubMed Central

Moeller, Scott J.; London, Edythe D.; Northoff, Georg

2015-01-01

Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications. PMID:26657968

Identifying effective intervention components for smoking cessation: a factorial screening experiment.

PubMed

Piper, Megan E; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Collins, Linda M; Mermelstein, Robin; Schlam, Tanya R; Cook, Jessica W; Jorenby, Douglas E; Loh, Wei-Yin; Baker, Timothy B

2016-01-01

To identify promising intervention components intended to help smokers to attain and maintain abstinence in their quit smoking attempts. A fully crossed, six-factor randomized fractional factorial experiment. Eleven primary care clinics in southern Wisconsin, USA. A total of 637 adult smokers (55% women, 88% white) motivated to quit smoking who visited primary care clinics. Six intervention components designed to prepare smokers to quit, and achieve and maintain abstinence (i.e. for the preparation, cessation and maintenance phases of smoking treatment): (1) preparation nicotine patch versus none; (2) preparation nicotine gum versus none; (3) preparation counseling versus none; (4) intensive cessation in-person counseling versus minimal; (5) intensive cessation telephone counseling versus minimal; and (6) 16 versus 8 weeks of combination nicotine replacement therapy (nicotine patch  +  nicotine gum). Seven-day self-reported point-prevalence abstinence at 16 weeks. Preparation counseling significantly improved week 16 abstinence rates (P = .04), while both forms of preparation nicotine replacement therapy interacted synergistically with intensive cessation in-person counseling (P < 0.05). Conversely, intensive cessation phone counseling and intensive cessation in-person counseling interacted antagonistically (P < 0.05)-these components produced higher abstinence rates by themselves than in combination. Preparation counseling and the combination of intensive cessation in-person counseling with preparation nicotine gum or patch are promising intervention components for smoking and should be evaluated as an integrated treatment package. © 2015 Society for the Study of Addiction.

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…

Relationship between Psychological Well-Being and Smartphone Addiction of University Students

ERIC Educational Resources Information Center

Kumcagiz, Hatice; Gündüz, Yüksel

2016-01-01

This study was carried out to examine the relationship between university students' levels of psychological well-being and smartphone addiction. The study group consists of a total of 408 students (303 female and 105 male) selected by random sampling method and studying at the departments of Primary Education, Science Teaching, Art and Crafts…

A Step Forward in Teaching Addiction Counselors How to Supervise Motivational Interviewing Using a Clinical Trials Training Approach

ERIC Educational Resources Information Center

Martino, Steve; Gallon, Steve; Ball, Samuel A.; Carroll, Kathleen M.

2007-01-01

A clinical trials training approach to supervision is a promising and empirically supported method for preparing addiction counselors to implement evidence-based behavioral treatments in community treatment programs. This supervision approach has three main components: (1) direct observation of treatment sessions; (2) structured performance…

Street "Doctory" among a Group of Heroin Addicts in India: Naturalistic Peer Learning

ERIC Educational Resources Information Center

Dhand, Amar

2009-01-01

Street "doctory" is a form of peer-based medical care performed in street settings among a group of heroin addicts in Yamuna Bazaar, New Delhi. Using participant observation and semi-structured interviews, this study describes three components of the practice, and suggests that each contained peer learning processes. First, participants…

[Chemicals added to cigarettes and their effects on tobacco dependence].

PubMed

Gonseth, S; Cornuz, J

2009-07-01

This paper summarizes data on the factors involved in addiction and dependence to cigarettes. Nicotine has been intensively studied by the tobacco industry, for instance for its addictive effect at the lowest possible rates. The addition of diammonium phosphate and urea produces an alcalinization of the pH of cigarette smoke, and promotes the absorption and the trans-membrane passage of nicotine. The taste, the smell of smoke, and the visual aspect of the pack of cigarettes are also sensory components that promote addiction. Finally, menthol, sugar, cocoa and liquorice added to cigarettes also play a role in dependence and addiction to cigarettes by, for instance, making an anesthetic effect on the airways.

Gene network analysis shows immune-signaling and ERK1/2 as novel genetic markers for multiple addiction phenotypes: alcohol, smoking and opioid addiction.

PubMed

Reyes-Gibby, Cielito C; Yuan, Christine; Wang, Jian; Yeung, Sai-Ching J; Shete, Sanjay

2015-06-05

Addictions to alcohol and tobacco, known risk factors for cancer, are complex heritable disorders. Addictive behaviors have a bidirectional relationship with pain. We hypothesize that the associations between alcohol, smoking, and opioid addiction observed in cancer patients have a genetic basis. Therefore, using bioinformatics tools, we explored the underlying genetic basis and identified new candidate genes and common biological pathways for smoking, alcohol, and opioid addiction. Literature search showed 56 genes associated with alcohol, smoking and opioid addiction. Using Core Analysis function in Ingenuity Pathway Analysis software, we found that ERK1/2 was strongly interconnected across all three addiction networks. Genes involved in immune signaling pathways were shown across all three networks. Connect function from IPA My Pathway toolbox showed that DRD2 is the gene common to both the list of genetic variations associated with all three addiction phenotypes and the components of the brain neuronal signaling network involved in substance addiction. The top canonical pathways associated with the 56 genes were: 1) calcium signaling, 2) GPCR signaling, 3) cAMP-mediated signaling, 4) GABA receptor signaling, and 5) G-alpha i signaling. Cancer patients are often prescribed opioids for cancer pain thus increasing their risk for opioid abuse and addiction. Our findings provide candidate genes and biological pathways underlying addiction phenotypes, which may be future targets for treatment of addiction. Further study of the variations of the candidate genes could allow physicians to make more informed decisions when treating cancer pain with opioid analgesics.

The endogenous opioid system: a common substrate in drug addiction.

PubMed

Trigo, José Manuel; Martin-García, Elena; Berrendero, Fernando; Robledo, Patricia; Maldonado, Rafael

2010-05-01

Drug addiction is a chronic brain disorder leading to complex adaptive changes within the brain reward circuits that involve several neurotransmitters. One of the neurochemical systems that plays a pivotal role in different aspects of addiction is the endogenous opioid system (EOS). Opioid receptors and endogenous opioid peptides are largely distributed in the mesolimbic system and modulate dopaminergic activity within these reward circuits. Chronic exposure to the different prototypical drugs of abuse, including opioids, alcohol, nicotine, psychostimulants and cannabinoids has been reported to produce significant alterations within the EOS, which seem to play an important role in the development of the addictive process. In this review, we will describe the adaptive changes produced by different drugs of abuse on the EOS, and the current knowledge about the contribution of each component of this neurobiological system to their addictive properties.

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, only two of the 11 patients with obsessive-compulsive disorder (18.18%) fulfilled the Young’s Diagnostic Questionnaire criteria for internet addiction. In conclusion, treatment of the underlying disorder improved internet addiction. PMID:26000201

A place for the hippocampus in the cocaine addiction circuit: Potential roles for adult hippocampal neurogenesis.

PubMed

Castilla-Ortega, Estela; Serrano, Antonia; Blanco, Eduardo; Araos, Pedro; Suárez, Juan; Pavón, Francisco J; Rodríguez de Fonseca, Fernando; Santín, Luis J

2016-07-01

Cocaine addiction is a chronic brain disease in which the drug seeking habits and profound cognitive, emotional and motivational alterations emerge from drug-induced neuroadaptations on a vulnerable brain. Therefore, a 'cocaine addiction brain circuit' has been described to explain this disorder. Studies in both cocaine patients and rodents reveal the hippocampus as a main node in the cocaine addiction circuit. The contribution of the hippocampus to cocaine craving and the associated memories is essential to understand the chronic relapsing nature of addiction, which is the main obstacle for the recovery. Interestingly, the hippocampus holds a particular form of plasticity that is rare in the adult brain: the ability to generate new functional neurons. There is an active scientific debate on the contributions of these new neurons to the addicted brain. This review focuses on the potential role(s) of adult hippocampal neurogenesis (AHN) in cocaine addiction. Although the current evidence primarily originates from animal research, these preclinical studies support AHN as a relevant component for the hippocampal effects of cocaine. Copyright © 2016 Elsevier Ltd. All rights reserved.

Glutamatergic synaptic plasticity in the mesocorticolimbic system in addiction

PubMed Central

van Huijstee, Aile N.; Mansvelder, Huibert D.

2015-01-01

Addictive drugs remodel the brain’s reward circuitry, the mesocorticolimbic dopamine (DA) system, by inducing widespread adaptations of glutamatergic synapses. This drug-induced synaptic plasticity is thought to contribute to both the development and the persistence of addiction. This review highlights the synaptic modifications that are induced by in vivo exposure to addictive drugs and describes how these drug-induced synaptic changes may contribute to the different components of addictive behavior, such as compulsive drug use despite negative consequences and relapse. Initially, exposure to an addictive drug induces synaptic changes in the ventral tegmental area (VTA). This drug-induced synaptic potentiation in the VTA subsequently triggers synaptic changes in downstream areas of the mesocorticolimbic system, such as the nucleus accumbens (NAc) and the prefrontal cortex (PFC), with further drug exposure. These glutamatergic synaptic alterations are then thought to mediate many of the behavioral symptoms that characterize addiction. The later stages of glutamatergic synaptic plasticity in the NAc and in particular in the PFC play a role in maintaining addiction and drive relapse to drug-taking induced by drug-associated cues. Remodeling of PFC glutamatergic circuits can persist into adulthood, causing a lasting vulnerability to relapse. We will discuss how these neurobiological changes produced by drugs of abuse may provide novel targets for potential treatment strategies for addiction. PMID:25653591

An integrated treatment model for dual diagnosis of psychosis and addiction.

PubMed

Minkoff, K

1989-10-01

A model that integrates the treatment of patients with a dual diagnosis of psychosis and addiction has been developed on a general hospital psychiatric unit. The model emphasizes the parallels between the standard biopsychosocial illness-and-rehabilitation model for treatment of serious psychiatric disorders and the 12-step disease-and-recovery model of Alcoholics Anonymous for treatment of addiction. Dual-diagnosis patients are viewed as having two primary, chronic, biologic mental illnesses, each requiring specific treatment to stabilize acute symptoms and engage the patient in a recovery process. An integrated treatment program is described, as are the steps taken to alleviate psychiatric clinicians' concerns about patient involvement in AA and addiction clinicians' discomfort with patients' use of medication.

The Addicted-Self Model of addictive behavior cessation: does it predict recovery for gender, ethnic, age and drug preference populations?

PubMed

Fiorentine, Robert; Hillhouse, Maureen P

2004-01-01

Although previous research provided empirical support for the main assumptions of the Addicted-Self (A-S) Model of recovery, it is not known whether the model predicts recovery for various gender, ethnic, age, and drug preference populations. It may be that the model predicts recovery only for some groups of addicts and should not be viewed as a general theory of the recovery process. Addressing this concern using data from the Los Angeles Target Cities Drug Treatment Enhancement Project, it was determined that only trivial population differences exist in the primary variables associated with the A-S Model. The A-S Model predicts abstinence with about the same degree of accuracy and parsimony for all populations. The findings indicate that the A-S Model is a general theory of drug and alcohol addictive behavior cessation.

Neuropeptide modulation of addiction: focus on galanin.

PubMed

Genders, Shannyn G; Scheller, Karlene J; Djouma, Elvan

2018-06-24

Addiction is a chronic, relapsing disorder characterised by the use of a substance or act to the point of compulsion. There are a number of medical treatments available for the intervention of these disorders, however, the effectiveness of current therapeutics is far from adequate. Neuropeptides are known to modulate addictive behaviours and may provide new therapeutic targets for the treatment of substance abuse. Accumulating evidence has suggested galanin as a potential important neuromodulator of addiction. Both human genetic studies and animal models have highlighted a role for this neuropeptide in affective disorders, as well as alcohol, nicotine, and opiate dependence. This review highlights the role of galanin and other primary neuropeptides implicated in modulating addiction to different drugs of abuse. Orexin, relaxin-3, corticotrophin-releasing factor, dynorphin and enkephalin, are also discussed given their involvement in mediating reward-seeking behaviour. Copyright © 2018. Published by Elsevier Ltd.

Application of the principles of evidence-based practice in decision making among senior management in Nova Scotia's addiction services agencies.

PubMed

Murphy, Matthew; MacCarthy, M Jayne; McAllister, Lynda; Gilbert, Robert

2014-12-05

Competency profiles for occupational clusters within Canada's substance abuse workforce (SAW) define the need for skill and knowledge in evidence-based practice (EBP) across all its members. Members of the Senior Management occupational cluster hold ultimate responsibility for decisions made within addiction services agencies and therefore must possess the highest level of proficiency in EBP. The objective of this study was to assess the knowledge of the principles of EBP, and use of the components of the evidence-based decision making (EBDM) process in members of this occupational cluster from selected addiction services agencies in Nova Scotia. A convenience sampling method was used to recruit participants from addiction services agencies. Semi-structured qualitative interviews were conducted with eighteen Senior Management. The interviews were audio-recorded, transcribed verbatim and checked by the participants. Interview transcripts were coded and analyzed for themes using content analysis and assisted by qualitative data analysis software (NVivo 9.0). Data analysis revealed four main themes: 1) Senior Management believe that addictions services agencies are evidence-based; 2) Consensus-based decision making is the norm; 3) Senior Management understand the principles of EBP and; 4) Senior Management do not themselves use all components of the EBDM process when making decisions, oftentimes delegating components of this process to decision support staff. Senior Management possess an understanding of the principles of EBP, however, when making decisions they often delegate components of the EBDM process to decision support staff. Decision support staff are not defined as an occupational cluster in Canada's SAW and have not been ascribed a competency profile. As such, there is no guarantee that this group possesses competency in EBDM. There is a need to advocate for the development of a defined occupational cluster and associated competency profile for this critical group.

Prevalence and co-occurrence of addictive behaviors among former alternative high school youth: A longitudinal follow-up study

PubMed Central

Sussman, Steve; Pokhrel, Pallav; Sun, Ping; Rohrbach, Louise A.; Spruijt-Metz, Donna

2015-01-01

Background and Aims Recent work has studied addictions using a matrix measure, which taps multiple addictions through single responses for each type. This is the first longitudinal study using a matrix measure. Methods We investigated the use of this approach among former alternative high school youth (average age = 19.8 years at baseline; longitudinal n = 538) at risk for addictions. Lifetime and last 30-day prevalence of one or more of 11 addictions reviewed in other work was the primary focus (i.e., cigarettes, alcohol, hard drugs, shopping, gambling, Internet, love, sex, eating, work, and exercise). These were examined at two time-points one year apart. Latent class and latent transition analyses (LCA and LTA) were conducted in Mplus. Results Prevalence rates were stable across the two time-points. As in the cross-sectional baseline analysis, the 2-class model (addiction class, non-addiction class) fit the data better at follow-up than models with more classes. Item-response or conditional probabilities for each addiction type did not differ between time-points. As a result, the LTA model utilized constrained the conditional probabilities to be equal across the two time-points. In the addiction class, larger conditional probabilities (i.e., 0.40−0.49) were found for love, sex, exercise, and work addictions; medium conditional probabilities (i.e., 0.17−0.27) were found for cigarette, alcohol, other drugs, eating, Internet and shopping addiction; and a small conditional probability (0.06) was found for gambling. Discussion and Conclusions Persons in an addiction class tend to remain in this addiction class over a one-year period. PMID:26551909

Validity of the Malay version of the Internet Addiction Test: a study on a group of medical students in Malaysia.

PubMed

Guan, Ng Chong; Isa, Saramah Mohammed; Hashim, Aili Hanim; Pillai, Subash Kumar; Harbajan Singh, Manveen Kaur

2015-03-01

The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students. © 2012 APJPH.

A Systematic Analysis of Candidate Genes Associated with Nicotine Addiction

PubMed Central

Liu, Meng; Li, Xia; Fan, Rui; Liu, Xinhua; Wang, Ju

2015-01-01

Nicotine, as the major psychoactive component of tobacco, has broad physiological effects within the central nervous system, but our understanding of the molecular mechanism underlying its neuronal effects remains incomplete. In this study, we performed a systematic analysis on a set of nicotine addiction-related genes to explore their characteristics at network levels. We found that NAGenes tended to have a more moderate degree and weaker clustering coefficient and to be less central in the network compared to alcohol addiction-related genes or cancer genes. Further, clustering of these genes resulted in six clusters with themes in synaptic transmission, signal transduction, metabolic process, and apoptosis, which provided an intuitional view on the major molecular functions of the genes. Moreover, functional enrichment analysis revealed that neurodevelopment, neurotransmission activity, and metabolism related biological processes were involved in nicotine addiction. In summary, by analyzing the overall characteristics of the nicotine addiction related genes, this study provided valuable information for understanding the molecular mechanisms underlying nicotine addiction. PMID:26097843

Identifying the features of an exercise addiction: A Delphi study

PubMed Central

Macfarlane, Lucy; Owens, Glynn; Cruz, Borja del Pozo

2016-01-01

Objectives There remains limited consensus regarding the definition and conceptual basis of exercise addiction. An understanding of the factors motivating maintenance of addictive exercise behavior is important for appropriately targeting intervention. The aims of this study were twofold: first, to establish consensus on features of an exercise addiction using Delphi methodology and second, to identify whether these features are congruous with a conceptual model of exercise addiction adapted from the Work Craving Model. Methods A three-round Delphi process explored the views of participants regarding the features of an exercise addiction. The participants were selected from sport and exercise relevant domains, including physicians, physiotherapists, coaches, trainers, and athletes. Suggestions meeting consensus were considered with regard to the proposed conceptual model. Results and discussion Sixty-three items reached consensus. There was concordance of opinion that exercising excessively is an addiction, and therefore it was appropriate to consider the suggestions in light of the addiction-based conceptual model. Statements reaching consensus were consistent with all three components of the model: learned (negative perfectionism), behavioral (obsessive–compulsive drive), and hedonic (self-worth compensation and reduction of negative affect and withdrawal). Conclusions Delphi methodology allowed consensus to be reached regarding the features of an exercise addiction, and these features were consistent with our hypothesized conceptual model of exercise addiction. This study is the first to have applied Delphi methodology to the exercise addiction field, and therefore introduces a novel approach to exercise addiction research that can be used as a template to stimulate future examination using this technique. PMID:27554504

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

PubMed Central

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

2016-01-01

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

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. © The Author(s) 2016.

Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence.

PubMed

Staiger, Petra K; Richardson, Ben; Long, Caroline M; Carr, Victoria; Marlatt, G Alan

2013-07-01

Despite recognition of the harms related to alcohol misuse and its potential to interfere substantially with sustained recovery from drug dependency, research evaluating drug treatment outcomes has not addressed the issue comprehensively. It has been overlooked possibly because treatment research has been framed according to the primary drug of choice, rather than investigating the interactions between different combinations of drugs and/or alcohol use. This paper reports on a systematic review investigating whether concurrent alcohol use could impede recovery from illicit drug use in two potential ways: first, alcohol could become a substitute addiction and/or secondly, alcohol misuse post-treatment may place an individual at risk for relapse to their primary drug problem. A systematic search of four relevant databases was undertaken to identify peer-reviewed, quantitative drug treatment outcome studies that reported alcohol use pre-, post-treatment and follow-up. The search revealed 567 papers, of which 13 were assessed as fulfilling the key inclusion criteria.The review indicated inconsistent and therefore inconclusive support for the substitution hypothesis. However, the data revealed consistent support for the hypothesis that alcohol use increases relapse to drug use. (i) The potential negative impact of alcohol misuse on drug treatment outcomes remains under-researched and overlooked; (ii) alcohol consumption post-drug treatment may increase the likelihood that an individual will relapse to their primary drug; (ii) existing evidence regarding the substitution hypothesis is inconclusive, although there was an indication that a subgroup of participants will be vulnerable to alcohol becoming the primary addiction instead of drugs. We argue that future drug treatment outcome studies need to include detailed analysis of the influence of alcohol use pre- and post-drug treatment. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents.

PubMed

Elias, Jesse; Hendlin, Yogi Hale; Ling, Pamela M

2018-05-01

Tobacco addiction is a complex, multicomponent phenomenon stemming from nicotine's pharmacology and the user's biology, psychology, sociology, and environment. After decades of public denial, the tobacco industry now agrees with public health authorities that nicotine is addictive. In 2000, Philip Morris became the first major tobacco company to admit nicotine's addictiveness. Evolving definitions of addiction have historically affected subsequent policymaking. This article examines how Philip Morris internally conceptualized addiction immediately before and after this announcement. We analyzed previously secret, internal Philip Morris documents made available as a result of litigation against the tobacco industry. We compared these documents to public company statements and found that Philip Morris's move from public denial to public affirmation of nicotine's addictiveness coincided with pressure on the industry from poor public approval ratings, the Master Settlement Agreement (MSA), the United States government's filing of the Racketeer Influenced and Corrupt Organizations (RICO) suit, and the Institute of Medicine's (IoM's) endorsement of potentially reduced risk products. Philip Morris continued to research the causes of addiction through the 2000s in order to create successful potentially reduced exposure products (PREPs). While Philip Morris's public statements reinforce the idea that nicotine's pharmacology principally drives smoking addiction, company scientists framed addiction as the result of interconnected biological, social, psychological, and environmental determinants, with nicotine as but one component. Due to the fragmentary nature of the industry document database, we may have missed relevant information that could have affected our analysis. Philip Morris's research suggests that tobacco industry activity influences addiction treatment outcomes. Beyond nicotine's pharmacology, the industry's continued aggressive advertising, lobbying, and litigation against effective tobacco control policies promotes various nonpharmacological determinants of addiction. To help tobacco users quit, policy makers should increase attention on the social and environmental dimensions of addiction alongside traditional cessation efforts.

Neuroimaging markers of glutamatergic and GABAergic systems in drug addiction: Relationships to resting-state functional connectivity.

PubMed

Moeller, Scott J; London, Edythe D; Northoff, Georg

2016-02-01

Drug addiction is characterized by widespread abnormalities in brain function and neurochemistry, including drug-associated effects on concentrations of the excitatory and inhibitory neurotransmitters glutamate and gamma-aminobutyric acid (GABA), respectively. In healthy individuals, these neurotransmitters drive the resting state, a default condition of brain function also disrupted in addiction. Here, our primary goal was to review in vivo magnetic resonance spectroscopy and positron emission tomography studies that examined markers of glutamate and GABA abnormalities in human drug addiction. Addicted individuals tended to show decreases in these markers compared with healthy controls, but findings also varied by individual characteristics (e.g., abstinence length). Interestingly, select corticolimbic brain regions showing glutamatergic and/or GABAergic abnormalities have been similarly implicated in resting-state functional connectivity deficits in drug addiction. Thus, our secondary goals were to provide a brief review of this resting-state literature, and an initial rationale for the hypothesis that abnormalities in glutamatergic and/or GABAergic neurotransmission may underlie resting-state functional deficits in drug addiction. In doing so, we suggest future research directions and possible treatment implications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Addiction and substance abuse in anesthesiology.

PubMed

Bryson, Ethan O; Silverstein, Jeffrey H

2008-11-01

Despite substantial advances in our understanding of addiction and the technology and therapeutic approaches used to fight this disease, addiction still remains a major issue in the anesthesia workplace, and outcomes have not appreciably changed. Although alcoholism and other forms of impairment, such as addiction to other substances and mental illness, impact anesthesiologists at rates similar to those in other professions, as recently as 2005, the drug of choice for anesthesiologists entering treatment was still an opioid. There exists a considerable association between chemical dependence and other psychopathology, and successful treatment for addiction is less likely when comorbid psychopathology is not treated. Individuals under evaluation or treatment for substance abuse should have an evaluation with subsequent management of comorbid psychiatric conditions. Participation in self-help groups is still considered a vital component in the therapy of the impaired physician, along with regular monitoring if the anesthesiologist wishes to attempt reentry into clinical practice.

Addictive Behavior Interventions Among College Students.

PubMed

Jeffries, Emily R; Lemke, Austin W; Shah, Sonia M; Dean, Kimberlye E; Richter, Ashley A; Buckner, Julia D

2016-12-01

Addictive behaviors among college students are a significant public health concern. This manuscript reviews the past two years of literature on prevention and treatment approaches for college students who engage in addictive behaviors. In-person skills-based interventions and motivational interventions that incorporate personalized feedback are effective in the short-term but little support was found for long-term effects. Although web-based interventions reduced certain addictive behaviors (e.g., alcohol, problematic gambling), in-person interventions that include motivational interviewing components and personalized feedback appear to be more efficacious. Research has largely focused on alcohol and little is known about the utility of interventions for students who use tobacco or illicit substances or who engage in problematic gambling. Research on interventions for these high-risk behaviors is recommended.

Glutamatergic substrates of drug addiction and alcoholism1

PubMed Central

Gass, Justin T.; Foster Olive, M.

2008-01-01

The past two decades have witnessed a dramatic accumulation of evidence indicating that the excitatory amino acid glutamate plays an important role in drug addiction and alcoholism. The purpose of this review is to summarize findings on glutamatergic substrates of addiction, surveying data from both human and animal studies. The effects of various drugs of abuse on glutamatergic neurotransmission are discussed, as are the effects of pharmacological or genetic manipulation of various components of glutamate transmission on drug reinforcement, conditioned reward, extinction, and relapse-like behavior. In addition, glutamatergic agents that are currently in use or are undergoing testing in clinical trials for the treatment of addiction are discussed, including acamprosate, N-acetylcysteine, modafinil, topiramate, lamotrigine, gabapentin and mematine. All drugs of abuse appear to modulate glutamatergic transmission, albeit by different mechanisms, and this modulation of glutamate transmission is believed to result in long-lasting neuroplastic changes in the brain that may contribute to the perseveration of drug-seeking behavior and drug-associated memories. In general, attenuation of glutamatergic transmission reduces drug reward, reinforcement, and relapse-like behavior. On the other hand, potentiation of glutamatergic transmission appears to facilitate the extinction of drug-seeking behavior. However, attempts at identifying genetic polymorphisms in components of glutamate transmission in humans have yielded only a limited number of candidate genes that may serve as risk factors for the development of addiction. Nonetheless, manipulation of glutamatergic neurotransmission appears to be a promising avenue of research in developing improved therapeutic agents for the treatment of drug addiction and alcoholism. PMID:17706608

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

PubMed Central

2014-01-01

Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Methods/Design Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers’s diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods — pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance — with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of 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

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

PubMed

Quanbeck, Andrew R; Gustafson, David H; Marsch, Lisa A; McTavish, Fiona; Brown, Randall T; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E; Atwood, Amy K; McDowell, Helene

2014-05-29

Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods - pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance - with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of implementation costs. 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. ClinicalTrials.gov (NCT01963234).

Addiction and brain reward and antireward pathways.

PubMed

Gardner, Eliot L

2011-01-01

Addictive drugs have in common that they are voluntarily self-administered by laboratory animals (usually avidly), and that they enhance the functioning of the reward circuitry of the brain (producing the 'high' that the drug user seeks). The core reward circuitry consists of an 'in-series' circuit linking the ventral tegmental area, nucleus accumbens and ventral pallidum via the medial forebrain bundle. Although originally believed to simply encode the set point of hedonic tone, these circuits are now believed to be functionally far more complex, also encoding attention, expectancy of reward, disconfirmation of reward expectancy, and incentive motivation. 'Hedonic dysregulation' within these circuits may lead to addiction. The 'second-stage' dopaminergic component in this reward circuitry is the crucial addictive-drug-sensitive component. All addictive drugs have in common that they enhance (directly or indirectly or even transsynaptically) dop-aminergic reward synaptic function in the nucleus accumbens. Drug self-administration is regulated by nucleus accumbens dopamine levels, and is done to keep nucleus accumbens dopamine within a specific elevated range (to maintain a desired hedonic level). For some classes of addictive drugs (e.g. opiates), tolerance to the euphoric effects develops with chronic use. Postuse dysphoria then comes to dominate reward circuit hedonic tone, and addicts no longer use drugs to get high, but simply to get back to normal ('get straight'). The brain circuits mediating the pleasurable effects of addictive drugs are anatomically, neurophysiologically and neurochemically different from those mediating physical dependence, and from those mediating craving and relapse. There are important genetic variations in vulnerability to drug addiction, yet environmental factors such as stress and social defeat also alter brain-reward mechanisms in such a manner as to impart vulnerability to addiction. In short, the 'bio-psycho-social' model of etiology holds very well for addiction. Addiction appears to correlate with a hypodopaminergic dysfunctional state within the reward circuitry of the brain. Neuroimaging studies in humans add credence to this hypothesis. Credible evidence also implicates serotonergic, opioid, endocannabinoid, GABAergic and glutamatergic mechanisms in addiction. Critically, drug addiction progresses from occasional recreational use to impulsive use to habitual compulsive use. This correlates with a progression from reward-driven to habit-driven drug-seeking behavior. This behavioral progression correlates with a neuroanatomical progression from ventral striatal (nucleus accumbens) to dorsal striatal control over drug-seeking behavior. The three classical sets of craving and relapse triggers are (a) reexposure to addictive drugs, (b) stress, and (c) reexposure to environmental cues (people, places, things) previously associated with drug-taking behavior. Drug-triggered relapse involves the nucleus accumbens and the neurotransmitter dopamine. Stress-triggered relapse involves (a) the central nucleus of the amygdala, the bed nucleus of the stria terminalis, and the neurotransmitter corticotrophin-releasing factor, and (b) the lateral tegmental noradrenergic nuclei of the brain stem and the neurotransmitter norepinephrine. Cue-triggered relapse involves the basolateral nucleus of the amygdala, the hippocampus and the neurotransmitter glutamate. Knowledge of the neuroanatomy, neurophysiology, neurochemistry and neuropharmacology of addictive drug action in the brain is currently producing a variety of strategies for pharmacotherapeutic treatment of drug addiction, some of which appear promising. Copyright © 2011 S. Karger AG, Basel.

A Research Agenda to Advance the Coordination of Care for General Medical and Substance Use Disorders.

PubMed

Quinn, Amity E; Rubinsky, Anna D; Fernandez, Anne C; Hahm, Hyeouk Chris; Samet, Jeffrey H

2017-04-01

The separation of addiction care from the general medical care system has a negative impact on patients' receipt of high-quality medical care. Clinical and policy-level strategies to improve the coordination of addiction care and general medical care include identifying and engaging patients with unhealthy substance use in general medical settings, providing effective chronic disease management of substance use disorders in primary care, including patient and family perspectives in care coordination, and implementing pragmatic models to pay for the coordination of addiction and general medical care. This Open Forum discusses practice and research recommendations to advance the coordination of general medical and addiction care. The discussion is based on the proceedings of a national meeting of experts in 2014.

Primary Care Clinic Re-Design for Prescription Opioid Management.

PubMed

Parchman, Michael L; Von Korff, Michael; Baldwin, Laura-Mae; Stephens, Mark; Ike, Brooke; Cromp, DeAnn; Hsu, Clarissa; Wagner, Ed H

The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations. Site visits included interviews with leadership, clinic tours, observations of clinic processes and team meetings, and interviews with staff and clinicians. Data were reviewed to identify common attributes of clinic system changes around chronic opioid therapy (COT) management. These concepts were reviewed to develop narrative descriptions of key components of changes made to improve COT use. Twenty of the thirty sites had addressed improvements in COT prescribing. Across these sites a common set of 6 Building Blocks were identified: 1) providing leadership support; 2) revising and aligning clinic policies, patient agreements (contracts) and workflows; 3) implementing a registry tracking system; 4) conducting planned, patient-centered visits; 5) identifying resources for complex patients; and 6) measuring progress toward achieving clinic objectives. Common components of clinic policies, patient agreements and data tracked in registries to assess progress are described. In response to prescription opioid overuse and the resulting epidemic of overdose and addiction, primary care clinics are making improvements driven by a common set of best practices that address complex challenges of managing COT patients in primary care settings. © Copyright 2017 by the American Board of Family Medicine.

Review of interventions to reduce ultraviolet tanning: Need for treatments targeting excessive tanning, an emerging addictive behavior.

PubMed

Stapleton, Jerod L; Hillhouse, Joel; Levonyan-Radloff, Kristine; Manne, Sharon L

2017-12-01

Millions of Americans engage in tanning each year, defined as intentional ultraviolet radiation (UVR) exposure in the form of sunbathing or the use of indoor tanning beds. An emerging body of research suggests that UVR has addictive properties and some tanners engage in excessive tanning. This article provides an overview of the evidence of tanning addiction and a systematic review of existing tanning interventions with the goal of evaluating their potential to impact addicted tanners. Our search identified 24 intervention studies that were summarized and discussed according to 3 primary themes. First, there is a dearth of tanning interventions that target excessive tanning or are designed as treatments for tanning addiction. Second, tanning interventions are primarily educational interventions designed to increase knowledge of the risks of tanning. Third, there are notable aspects of existing tanning interventions that are relevant to addiction science, including the use of brief motivational and cognitive-behavioral-based interventions. Future directions are considered including recommendations for utilizing the existing evidence base to formulate interventions targeting excessive tanners. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Deficient plasticity in the hippocampus and the spiral of addiction: focus on adult neurogenesis.

PubMed

Canales, Juan J

2013-01-01

Addiction is a complex neuropsychiatric disorder which causes disruption at multiple levels, including cognitive, emotional, and behavioral domains. Traditional biological theories of addiction have focused on the mesolimbic dopamine pathway and the nucleus accumbens as anatomical substrates mediating addictive-like behaviors. More recently, we have begun to recognize the engagement and dynamic influence of a much broader circuitry which encompasses the frontal cortex, the amygdala, and the hippocampus. In particular, neurogenesis in the adult hippocampus has become a major focus of attention due to its ability to influence memory, motivation, and affect, all of which are disrupted in addiction. First, I summarize toxicological data that reveal strongly suppressive effects of drug exposure on adult hippocampal neurogenesis. Then, I discuss the impact of deficient neurogenesis on learning and memory function, stress responsiveness and affective behavior, as they relate to addiction. Finally, I examine recent behavioral observations that implicate neurogenesis in the adult hippocampus in the emergence and maintenance of addictive behavior. The evidence reviewed here suggests that deficient neurogenesis is associated with several components of the downward spiraling loop that characterizes addiction, including elevated sensitivity to drug-induced reward and reinforcement, enhanced neurohormonal responsiveness, emergence of a negative affective state, memory impairment, and inflexible behavior.

Inhibitory Control and Emotional Stress Regulation: Neuroimaging Evidence for Frontal-Limbic Dysfunction in Psycho-stimulant Addiction

PubMed Central

Ray Li, Chiang-shan; Sinha, Rajita

2008-01-01

This review focuses on neuroimaging studies that examined stress processing and regulation and cognitive inhibitory control in patients with psycho-stimulant addiction. We provide an overview of these studies, summarizing converging evidence and discrepancies as they occur in the literature. We also adopt an analytic perspective and dissect these psychological processes into their sub-components, to identify the neural pathways specific to each component process and those that are more specifically involved in psycho-stimulant addiction. To this aim we refer frequently to studies conducted in healthy individuals. Despite the separate treatment of stress/affect regulation, stress-related craving or compulsive drug seeking, and inhibitory control, neural underpinnings of these processes overlap significantly. In particular, the ventromedial prefrontal regions including the anterior cingulate cortex, amygdala and the striatum are implicated in psychostimulant dependence. Our overarching thesis is that prefrontal activity ensures intact emotional stress regulation and inhibitory control. Altered prefrontal activity along with heightened striatal responses to addicted drug and drug-related salient stimuli perpetuates habitual drug seeking. Further studies that examine the functional relationships of these neural systems will likely provide the key to understanding the mechanisms underlying compulsive drug use behaviors in psycho-stimulant dependence. PMID:18164058

Neuroclinical Framework for the Role of Stress in Addiction

PubMed Central

Kwako, Laura E.; Koob, George F.

2017-01-01

Addiction has been conceptualized as a three-stage cycle—binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation—that worsens over time and involves allostatic changes in hedonic function via changes in the brain reward and stress systems. Using the withdrawal/negative affect stage and negative reinforcement as an important source of motivation for compulsive drug seeking, we outline the neurobiology of the stress component of the withdrawal/negative affect stage and relate it to a derivative of the Research Domain Criteria research construct for the study of psychiatric disease, known as the Addictions Neuroclinical Assessment. Using the Addictions Neuroclinical Assessment, we outline five subdomains of negative emotional states that can be operationally measured in human laboratory settings and paralleled by animal models. We hypothesize that a focus on negative emotionality and stress is closely related to the acute neurobiological alterations that are experienced in addiction and may serve as a bridge to a reformulation of the addiction nosology to better capture individual differences in patients for whom the withdrawal/negative affect stage drives compulsive drug taking. PMID:28653044

Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake

PubMed Central

Avena, Nicole M.; Rada, Pedro; Hoebel, Bartley G.

2008-01-01

The experimental question is whether or not sugar can be a substance of abuse and lead to a natural form of addiction. “Food addiction” seems plausible because brain pathways that evolved to respond to natural rewards are also activated by addictive drugs. Sugar is noteworthy as a substance that releases opioids and dopamine and thus might be expected to have addictive potential. This review summarizes evidence of sugar dependence in an animal model. Four components of addiction are analyzed. “Bingeing”, “withdrawal”, “craving” and cross-sensitization are each given operational definitions and demonstrated behaviorally with sugar bingeing as the reinforcer. These behaviors are then related to neurochemical changes in the brain that also occur with addictive drugs. Neural adaptations include changes in dopamine and opioid receptor binding, enkephalin mRNA expression and dopamine and acetylcholine release in the nucleus accumbens. The evidence supports the hypothesis that under certain circumstances rats can become sugar dependent. This may translate to some human conditions as suggested by the literature on eating disorders and obesity. PMID:17617461

The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review.

PubMed

Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles

2015-01-01

Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

Steep delay discounting and addictive behavior: a meta-analysis of continuous associations.

PubMed

Amlung, Michael; Vedelago, Lana; Acker, John; Balodis, Iris; MacKillop, James

2017-01-01

To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates and gambling) were identified via PubMed, MEDLINE and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random-effects meta-analysis was conducted using Pearson's r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger's tests, meta-regression of publication year and effect size and imputation of missing studies. The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, P < 10 -14 ). Significantly larger effect sizes were observed for studies examining severity compared with QF (P = 0.01), but not between the type of addictive behavior (P = 0.30) or DRD assessment (P = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Delayed reward discounting is associated robustly with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. © 2016 Society for the Study of Addiction.

The prevalence of computer and Internet addiction among pupils.

PubMed

Zboralski, Krzysztof; Orzechowska, Agata; Talarowska, Monika; Darmosz, Anna; Janiak, Aneta; Janiak, Marcin; Florkowski, Antoni; Gałecki, Piotr

2009-02-02

Media have an influence on the human psyche similar to the addictive actions of psychoactive substances or gambling. Computer overuse is claimed to be a cause of psychiatric disturbances such as computer and Internet addiction. It has not yet been recognized as a disease, but it evokes increasing controversy and results in mental disorders commonly defined as computer and Internet addiction. This study was based on a diagnostic survey in which 120 subjects participated. The participants were pupils of three kinds of schools: primary, middle, and secondary school (high school). Information for this study was obtained from a questionnaire prepared by the authors as well as the State-Trait Anxiety Inventory (STAI) and the Psychological Inventory of Aggression Syndrome (IPSA-II). he results confirmed that every fourth pupil was addicted to the Internet. Internet addiction was very common among the youngest users of computers and the Internet, especially those who had no brothers and sisters or came from families with some kind of problems. Moreover, more frequent use of the computer and the Internet was connected with higher levels of aggression and anxiety. Because computer and Internet addiction already constitute a real danger, it is worth considering preventive activities to treat this phenomenon. It is also necessary to make the youth and their parents aware of the dangers of uncontrolled Internet use and pay attention to behavior connected with Internet addiction.

Implication of Genes for the N-Methyl-D-Aspartate (NMDA) Receptor in Substance Addictions.

PubMed

Chen, Jiali; Ma, Yunlong; Fan, Rongli; Yang, Zhongli; Li, Ming D

2018-02-10

Drug dependence is a chronic brain disease with harmful consequences for both individual users and society. Glutamate is a primary excitatory neurotransmitter in the brain, and both in vivo and in vitro experiments have implicated N-methyl-D-aspartate (NMDA) receptor, a glutamate receptor, as an element in various types of addiction. Recent findings from genetics-based approaches such as genome-wide linkage, candidate gene association, genome-wide association (GWA), and next-generation sequencing have demonstrated the significant association of NMDA receptor subunit genes such as GluN3A, GluN2B, and GluN2A with various addiction-related phenotypes. Of these genes, GluN3A has been the most studied, and it has been revealed to play crucial roles in the etiology of addictions. In this communication, we provide an updated view of the genetic effects of NMDA receptor subunit genes and their functions in the etiology of addictions based on the findings from investigation of both common and rare variants as well as SNP-SNP interactions. To better understand the molecular mechanisms underlying addiction-related behaviors and to promote the development of specific medicines for the prevention and treatment of addictions, current efforts aim not only to identify more causal variants in NMDA receptor subunits by using large independent samples but also to reveal the molecular functions of these variants in addictions.

Investigating the differential effects of social networking site addiction and Internet gaming disorder on psychological health.

PubMed

Pontes, Halley M

2017-12-01

Background and aims Previous studies focused on examining the interrelationships between social networking site (SNS) addiction and Internet gaming disorder (IGD) in isolation. Moreover, little is known about the potential simultaneous differential effects of SNS addiction and IGD on psychological health. This study investigated the interplay between these two technological addictions and ascertained how they can uniquely and distinctively contribute to increasing psychiatric distress when accounting for potential effects stemming from sociodemographic and technology-related variables. Methods A sample of 509 adolescents (53.5% males) aged 10-18 years (mean = 13.02, SD = 1.64) were recruited. Results It was found that key demographic variables can play a distinct role in explaining SNS addiction and IGD. Furthermore, it was found that SNS addiction and IGD can augment the symptoms of each other, and simultaneously contribute to deterioration of overall psychological health in a similar fashion, further highlighting potentially common etiological and clinical course between these two phenomena. Finally, the detrimental effects of IGD on psychological health were found to be slightly more pronounced than those produced by SNS addiction, a finding that warrants additional scientific scrutiny. Discussion and conclusion The implications of these results are further discussed in light of the existing evidence and debates regarding the status of technological addictions as primary and secondary disorders.

24 CFR 8.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... a primary recipient as a condition of eligibility for Federal financial assistance. An application... a primary purpose. Historic properties means those properties that are listed or are eligible for... retardation, emotional illness, drug addiction and alcoholism. (b) Major life activities means functions such...

24 CFR 8.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... a primary recipient as a condition of eligibility for Federal financial assistance. An application... a primary purpose. Historic properties means those properties that are listed or are eligible for... retardation, emotional illness, drug addiction and alcoholism. (b) Major life activities means functions such...

Children and video games: addiction, engagement, and scholastic achievement.

PubMed

Skoric, Marko M; Teo, Linda Lay Ching; Neo, Rachel Lijie

2009-10-01

The aim of this study is to assess the relationship between video gaming habits and elementary school students' academic performance. More specifically, we seek to examine the usefulness of a distinction between addiction and high engagement and assess the predictive validity of these concepts in the context of scholastic achievement. Three hundred thirty-three children ages 8 to 12 years from two primary schools in Singapore were selected to participate in this study. A survey utilizing Danforth's Engagement-Addiction (II) scale and questions from DSM-IV was used to collect information from the schoolchildren, while their grades were obtained directly from their teachers. The findings indicate that addiction tendencies are consistently negatively related to scholastic performance, while no such relationship is found for either time spent playing games or for video game engagement. The implications of these findings are discussed.

EFFECT OF QUALITY CHRONIC DISEASE MANAGEMENT FOR ALCOHOL AND DRUG DEPENDENCE ON ADDICTION OUTCOMES

PubMed Central

Kim, Theresa W.; Saitz, Richard; Cheng, Debbie M.; Winter, Michael R; Witas, Julie; Samet, Jeffrey H.

2012-01-01

We examinedthe effect ofthe quality of primary care-basedchronic disease management (CDM)for alcohol and/or other drug (AOD) dependenceonaddiction outcomes.We assessed qualityusing 1)avisit frequencybased measure and 2) a self-reported assessment measuring alignment with the chronic care model. The visit frequency based measure had no significant association with addiction outcomes. Theself-reported measure of care - when care was at a CDM clinic - was associated with lower drug addiction severity.The self-reported assessment of care from any healthcare source (CDM clinic or elsewhere)was associated with lower alcoholaddiction severity and abstinence.These findings suggest that high quality CDM for AOD dependence may improve addiction outcomes.Quality measuresbased upon alignment with the chronic care model may better capture features of effective CDM care than a visitfrequency measure. PMID:22840687

Introduction: Addiction and Brain Reward and Anti-Reward Pathways

PubMed Central

Gardner, Eliot L.

2013-01-01

Addictive drugs have in common that they are voluntarily self-administered by laboratory animals (usually avidly) and that they enhance the functioning of the reward circuitry of the brain (producing the “high” that the drug-user seeks). The core reward circuitry consists of an “in series” circuit linking the ventral tegmental area, nucleus accumbens, and ventral pallidum - via the medial forebrain bundle. Although originally believed to encode simply the set-point of hedonic tone, these circuits are now believed to be functionally far more complex - also encoding attention, expectancy of reward, disconfirmation of reward expectancy, and incentive motivation. “Hedonic dysregulation” within these circuits may lead to addiction. The “second-stage” dopaminergic component in this reward circuitry is the crucial addictive-drug-sensitive component. All addictive drugs have in common that they enhance (directly or indirectly or even transsynaptically) dopaminergic reward synaptic function in the nucleus accumbens. Drug self-administration is regulated by nucleus accumbens dopamine levels, and is done to keep nucleus accumbens dopamine within a specific elevated range (to maintain a desired hedonic level). For some classes of addictive drugs (e.g., opiates), tolerance to the euphoric effects develops with chronic use. Post-use dysphoria then comes to dominate reward circuit hedonic tone, and addicts no longer use drugs to get “high,” but simply to get back to normal (“get straight”). The brain circuits mediating the pleasurable effects of addictive drugs are anatomically, neurophysiologically, and neurochemically different from those mediating physical dependence, and from those mediating craving and relapse. There are important genetic variations in vulnerability to drug addiction, yet environmental factors such as stress and social defeat also alter brain-reward mechanisms in such a manner as to impart vulnerability to addiction. In short, the “bio-psycho-social” model of etiology holds very well for addiction. Addiction appears to correlate with a hypo-dopaminergic dysfunctional state within the reward circuitry of the brain. Neuroimaging studies in humans add credence to this hypothesis. Credible evidence also implicates serotonergic, opioid, endocannabinoid, GABAergic, and glutamatergic mechanisms in addiction. Critically, drug addiction progresses from occasional recreational use to impulsive use to habitual compulsive use. This correlates with a progression from reward-driven to habit-driven drug-seeking behavior. This behavioral progression correlates with a neuroanatomical progression from ventral striatal (nucleus accumbens) to dorsal striatal control over drug-seeking behavior. The three classical sets of craving and relapse triggers are a) re-exposure to addictive drugs, b) stress, and c) re-exposure to environmental cues (“people, places, things”) previously associated with drug-taking behavior. Drug-triggered relapse involves the nucleus accumbens and the neurotransmitter dopamine. Stress-triggered relapse involves a) the central nucleus of the amygdala, the bed nucleus of the stria terminalis, and the neurotransmitter CRF; and b) the lateral tegmental noradrenergic nuclei of the brain stem and the neurotransmitter norepinephrine. Cue-triggered relapse involves the basolateral nucleus of the amygdala, the hippocampus, and the neurotransmitter glutamate. Knowledge of the neuroanatomy, neurophysiology, neurochemistry, and neuropharmacology of addictive drug action in the brain is currently producing a variety of strategies for pharmacotherapeutic treatment of drug addiction, some of which appear promising. PMID:21508625

Steep Delay Discounting and Addictive Behavior: A Meta-Analysis of Continuous Associations

PubMed Central

Amlung, Michael; Vedelago, Lana; Acker, John; Balodis, Iris; MacKillop, James

2016-01-01

Aims To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Methods Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates, and gambling) were identified via PubMed, MEDLINE, and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random effects meta-analysis was conducted using Pearson’s r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger’s tests, meta-regression of publication year and effect size, and imputation of missing studies. Results The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, p < 10−14). Significantly larger effect sizes were observed for studies examining severity compared with QF (p = 0.01), but not between the type of addictive behavior (p = 0.30) or DRD assessment (p = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Conclusions Delayed reward discounting is robustly associated with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. PMID:27450931

Staff regard towards working with substance users: a European multi-centre study.

PubMed

Gilchrist, Gail; Moskalewicz, Jacek; Slezakova, Silvia; Okruhlica, Lubomir; Torrens, Marta; Vajd, Rajko; Baldacchino, Alex

2011-06-01

To compare regard for working with different patient groups (including substance users) among different professional groups in different health-care settings in eight European countries. A multi-centre, cross-sectional comparative study. Primary care, general psychiatry and specialist addiction services in Bulgaria, Greece, Italy, Poland, Scotland, Slovakia, Slovenia and Spain. A multi-disciplinary convenience sample of 866 professionals (physicians, psychiatrists, psychologists, nurses and social workers) from 253 services. The Medical Condition Regard Scale measured regard for working with different patient groups. Multi-factor between-subjects analysis of variance determined the factors associated with regard for each condition by country and all countries. Regard for working with alcohol (mean score alcohol: 45.35, 95% CI 44.76, 45.95) and drug users (mean score drugs: 43.67, 95% CI 42.98, 44.36) was consistently lower than for other patient groups (mean score diabetes: 50.19, 95% CI 49.71, 50.66; mean score depression: 51.34, 95% CI 50.89, 51.79) across all countries participating in the study, particularly among staff from primary care compared to general psychiatry or specialist addiction services (P<0.001). After controlling for sex of staff, profession and duration of time working in profession, treatment entry point and country remained the only statistically significant variables associated with regard for working with alcohol and drug users. Health professionals appear to ascribe lower status to working with substance users than helping other patient groups, particularly in primary care; the effect is larger in some countries than others. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Implications of genome wide association studies for addiction: are our a priori assumptions all wrong?

PubMed

Hall, F Scott; Drgonova, Jana; Jain, Siddharth; Uhl, George R

2013-12-01

Substantial genetic contributions to addiction vulnerability are supported by data from twin studies, linkage studies, candidate gene association studies and, more recently, Genome Wide Association Studies (GWAS). Parallel to this work, animal studies have attempted to identify the genes that may contribute to responses to addictive drugs and addiction liability, initially focusing upon genes for the targets of the major drugs of abuse. These studies identified genes/proteins that affect responses to drugs of abuse; however, this does not necessarily mean that variation in these genes contributes to the genetic component of addiction liability. One of the major problems with initial linkage and candidate gene studies was an a priori focus on the genes thought to be involved in addiction based upon the known contributions of those proteins to drug actions, making the identification of novel genes unlikely. The GWAS approach is systematic and agnostic to such a priori assumptions. From the numerous GWAS now completed several conclusions may be drawn: (1) addiction is highly polygenic; each allelic variant contributing in a small, additive fashion to addiction vulnerability; (2) unexpected, compared to our a priori assumptions, classes of genes are most important in explaining addiction vulnerability; (3) although substantial genetic heterogeneity exists, there is substantial convergence of GWAS signals on particular genes. This review traces the history of this research; from initial transgenic mouse models based upon candidate gene and linkage studies, through the progression of GWAS for addiction and nicotine cessation, to the current human and transgenic mouse studies post-GWAS. © 2013.

Discovery of a novel site of opioid action at the innate immune pattern-recognition receptor TLR4 and its role in addiction.

PubMed

Jacobsen, Jonathan Henry W; Watkins, Linda R; Hutchinson, Mark R

2014-01-01

Opioids have historically, and continue to be, an integral component of pain management. However, despite pharmacokinetic and dynamic optimization over the past 100 years, opioids continue to produce many undesirable side effects such as tolerance, reward, and dependence. As such, opioids are liable for addiction. Traditionally, opioid addiction was viewed as a solely neuronal process, and while substantial headway has been made into understanding the molecular and cellular mechanisms mediating this process, research has however, been relatively ambivalent to how the rest of the central nervous system (CNS) responds to opioids. Evidence over the past 20 years has clearly demonstrated the importance of the immunocompetent cells of the CNS (glia) in many aspects of opioid pharmacology. Particular focus has been placed on microglia and astrocytes, who in response to opioids, become activated and release inflammatory mediators. Importantly, the mechanism underlying immune activation is beginning to be elucidated. Evidence suggests an innate immune pattern-recognition receptor (toll-like receptor 4) as an integral component underlying opioid-induced glial activation. The subsequent proinflammatory response may be viewed akin to neurotransmission creating a process termed central immune signaling. Translationally, we are beginning to appreciate the importance of central immune signaling as it contributes to many behavioral actions of addiction including reward, withdrawal, and craving. As such, the aim of this chapter is to review and integrate the neuronal and central immune signaling perspective of addiction. © 2014 Elsevier Inc. All rights reserved.

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. © 2016 Elsevier B.V. All rights reserved.

Public versus internal conceptions of addiction: An analysis of internal Philip Morris documents

PubMed Central

2018-01-01

Background Tobacco addiction is a complex, multicomponent phenomenon stemming from nicotine’s pharmacology and the user’s biology, psychology, sociology, and environment. After decades of public denial, the tobacco industry now agrees with public health authorities that nicotine is addictive. In 2000, Philip Morris became the first major tobacco company to admit nicotine’s addictiveness. Evolving definitions of addiction have historically affected subsequent policymaking. This article examines how Philip Morris internally conceptualized addiction immediately before and after this announcement. Methods and findings We analyzed previously secret, internal Philip Morris documents made available as a result of litigation against the tobacco industry. We compared these documents to public company statements and found that Philip Morris’s move from public denial to public affirmation of nicotine’s addictiveness coincided with pressure on the industry from poor public approval ratings, the Master Settlement Agreement (MSA), the United States government’s filing of the Racketeer Influenced and Corrupt Organizations (RICO) suit, and the Institute of Medicine’s (IoM’s) endorsement of potentially reduced risk products. Philip Morris continued to research the causes of addiction through the 2000s in order to create successful potentially reduced exposure products (PREPs). While Philip Morris’s public statements reinforce the idea that nicotine’s pharmacology principally drives smoking addiction, company scientists framed addiction as the result of interconnected biological, social, psychological, and environmental determinants, with nicotine as but one component. Due to the fragmentary nature of the industry document database, we may have missed relevant information that could have affected our analysis. Conclusions Philip Morris’s research suggests that tobacco industry activity influences addiction treatment outcomes. Beyond nicotine’s pharmacology, the industry’s continued aggressive advertising, lobbying, and litigation against effective tobacco control policies promotes various nonpharmacological determinants of addiction. To help tobacco users quit, policy makers should increase attention on the social and environmental dimensions of addiction alongside traditional cessation efforts. PMID:29715300

Effectiveness of school- and family-based interventions to prevent gaming addiction among grades 4–5 students in Bangkok, Thailand

PubMed Central

Apisitwasana, Nipaporn; Perngparn, Usaneya; Cottler, Linda B

2018-01-01

Purpose This study aimed to assess the effectiveness of Participatory Learning School and Family Based Intervention Program for Preventing Game Addiction by Developing Self-Regulation of gaming addiction among students of grades 4 and 5 in Bangkok. Methods A quasi-experimental study was implemented among students of grades 4 and 5 at primary schools in Bangkok selected through multistage random sampling. Two comparable schools were randomly assigned to either the intervention or control group. Then, 310 students in the randomly selected classrooms were allocated to each group. The intervention group received the self-regulation program with school and family involvement to prevent gaming addiction. Master teachers attended in-house training on prevention of gaming addiction in children. Parents of these children received a gaming addiction prevention manual and guidelines. The program lasted 8 weeks. The control group received no intervention. Knowledge and Attitude About Gaming Questionnaire, Game Addiction Screening Test (GAST), and Game Addiction Protection Scale were utilized to assess subjects at baseline, immediately after, and 3 months post-intervention. Descriptive statistics, chi-square, and independent t-test were used to describe characteristics of the participants, and repeated measures ANOVA was analyzed to test the effectiveness of the intervention. Results The findings revealed that there were significant differences in knowledge, attitude, self-regulation, and gaming addiction behaviors (p < 0.05) immediately and 3 months post-intervention. Positive effects of the intervention included increase in knowledge, attitude, and self-regulation, whereas the GAST score was significantly decreased (p < 0.05) immediately and 3 months after the program. Conclusion The program based on self-regulation and school and family participation is effective for preventing gaming addiction in students of grades 4 and 5 in Bangkok, Thailand. PMID:29695939

Effectiveness of school- and family-based interventions to prevent gaming addiction among grades 4-5 students in Bangkok, Thailand.

PubMed

Apisitwasana, Nipaporn; Perngparn, Usaneya; Cottler, Linda B

2018-01-01

This study aimed to assess the effectiveness of Participatory Learning School and Family Based Intervention Program for Preventing Game Addiction by Developing Self-Regulation of gaming addiction among students of grades 4 and 5 in Bangkok. A quasi-experimental study was implemented among students of grades 4 and 5 at primary schools in Bangkok selected through multistage random sampling. Two comparable schools were randomly assigned to either the intervention or control group. Then, 310 students in the randomly selected classrooms were allocated to each group. The intervention group received the self-regulation program with school and family involvement to prevent gaming addiction. Master teachers attended in-house training on prevention of gaming addiction in children. Parents of these children received a gaming addiction prevention manual and guidelines. The program lasted 8 weeks. The control group received no intervention. Knowledge and Attitude About Gaming Questionnaire, Game Addiction Screening Test (GAST), and Game Addiction Protection Scale were utilized to assess subjects at baseline, immediately after, and 3 months post-intervention. Descriptive statistics, chi-square, and independent t -test were used to describe characteristics of the participants, and repeated measures ANOVA was analyzed to test the effectiveness of the intervention. The findings revealed that there were significant differences in knowledge, attitude, self-regulation, and gaming addiction behaviors ( p < 0.05) immediately and 3 months post-intervention. Positive effects of the intervention included increase in knowledge, attitude, and self-regulation, whereas the GAST score was significantly decreased ( p < 0.05) immediately and 3 months after the program. The program based on self-regulation and school and family participation is effective for preventing gaming addiction in students of grades 4 and 5 in Bangkok, Thailand.

Muscle dysmorphia: could it be classified as an addiction to body image?

PubMed

Foster, Andrew C; Shorter, Gillian W; Griffiths, Mark D

2015-03-01

Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular.MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. METHOD AND AIM: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD--the ‘Addiction to Body Image’ (ABI) model--using Griffiths (2005)addiction components model as the framework in which to define MD as an addiction. It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise,eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements,and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.

Exercise addiction in men is associated with lower fat-adjusted leptin levels.

PubMed

Lichtenstein, Mia B; Andries, Alin; Hansen, Stinus; Frystyk, Jan; Støving, René K

2015-03-01

To test a hypothesized association between resting leptin levels (adjusted for body fat percentage) and symptoms of primary exercise addiction. Cross-sectional design. Habitual amateur exercisers participating in running, fitness, weight training, and biking. Twenty men with exercise addiction as defined by the Exercise Addiction Inventory (EAI scores 24-30) and 20 men in an exercise control group (EAI scores 6-16) matched on body mass index. Plasma leptin and sex hormones were measured in blood samples collected under fasting and resting conditions. Body composition was assessed by dual-energy x-ray absorptiometry. Eating disorder symptoms were identified by the Eating Disorder Inventory 2. The exercise addiction group had significantly (P < 0.001) lower leptin levels (1.1 μg/L, SD = 1.3) than controls (4.3 μg/L, SD = 2.9). Even when adjusted for body fat percentage, the addiction group had significantly (P < 0.001) lower leptin levels (0.1 μg/L, SD = 0.1) than the controls (0.2 μg/L, SD = 0.1). Body fat-adjusted leptin correlated with free bioavailable testosterone, but it was only significant in nonaddictive exercisers. None of the exercisers seemed to suffer from an eating disorder. This is the first study showing that excessive training in exercise addiction is associated with low levels of body fat-adjusted leptin levels. Hypoleptinemia could be involved in the pathogenesis of exercise addiction. However, further studies are needed to explore the potential causal relationship.

Neurocognitive Characterizations of Russian Heroin Addicts without a Significant History of Other Drug Use

PubMed Central

Fishbein, Diana H.; Krupitsky, Evgeny; Flannery, Barbara A.; Langevin, Doris J.; Bobashev, Georgiy; Verbitskaya, Elena; Augustine, Cynthia B.; Bolla, Karen I.; Zvartau, Edwin; Schech, Barry; Egorova, Valentina; Bushara, Natali; Tsoy, Marina

2007-01-01

Research on the neurocognitive characteristics of heroin addiction is sparse and studies that do exist include polydrug abusers; thus, they are unable to distinguish neurocognitive effects of heroin from those of other drugs. To identify neurocognitive correlates specific to heroin addiction, the present study was conducted in St. Petersburg, Russia where individuals typically abuse and/or become addicted to only one substance, generally alcohol or heroin. Heroin addicts were recruited from an inpatient treatment facility in St. Petersburg. Three comparison groups included alcoholics, addicts who used both alcohol and heroin, and non-abusers. Psychiatric, background, and drug history evaluations were administered after detoxification to screen for exclusion criteria and characterize the sample. Executive Cognitive Functions (ECF) that largely activate areas of the prefrontal cortex and its circuitry measured include complex visual pattern recognition (Paired Associates Learning), working memory (Delayed Matching to Sample), problem solving (Stockings of Cambridge), executive decision making (Cambridge Decision Making Task), cognitive flexibility (Stroop Color-Word Task) and response shifting (Stop Change Task). In many respects, the heroin addicts were similar to alcohol and alcohol\\heroin dependent groups in neurocognitive deficits relative to controls. The primary finding was that heroin addicts exhibited significantly more disadvantageous decision making and longer deliberation times while making risky decisions than the other groups. Because the nature and degree of recovery from drug abuse are likely a function of the type or pattern of neurocognitive impairment, differential drug effects must be considered. PMID:17382488

The meaning of suffering in drug addiction and recovery from the perspective of existentialism, Buddhism and the 12-Step program.

PubMed

Chen, Gila

2010-09-01

The aim of the current article was to examine the meaning of suffering in drug addiction and in the recovery process. Negative emotions may cause primary suffering that can drive an individual toward substance abuse. At the same time, drugs only provide temporary relief, and over time, the pathological effects of the addiction worsen causing secondary suffering, which is a motivation for treatment. The 12-Step program offers a practical way to cope with suffering through a process of surrender. The act of surrender sets in motion a conversion experience, which involves a self-change including reorganization of one's identity and meaning in life. This article is another step toward understanding one of the several factors that contribute to the addict's motivation for treatment. This knowledge may be helpful for tailoring treatment that addresses suffering as a factor that initiates treatment motivation and, in turn, treatment success.

Reliability and Validity of the Korean Version of the Internet Addiction Test among College Students

PubMed Central

Lee, Kounseok; Lee, Hye-Kyung; Gyeong, Hyunsu; Yu, Byeongkwan; Song, Yul-Mai

2013-01-01

We developed a Korean translation of the Internet Addiction Test (KIAT), widely used self-report for internet addiction and tested its reliability and validity in a sample of college students. Two hundred seventy-nine college students at a national university completed the KIAT. Internal consistency and two week test-retest reliability were calculated from the data, and principal component factor analysis was conducted. Participants also completed the Internet Addiction Diagnostic Questionnaire (IADQ), the Korea Internet addiction scale (K-scale), and the Patient Health Questionnaire-9 for the criterion validity. Cronbach's alpha of the whole scale was 0.91, and test-retest reliability was also good (r = 0.73). The IADQ, the K-scale, and depressive symptoms were significantly correlated with the KIAT scores, demonstrating concurrent and convergent validity. The factor analysis extracted four factors (Excessive use, Dependence, Withdrawal, and Avoidance of reality) that accounted for 59% of total variance. The KIAT has outstanding internal consistency and high test-retest reliability. Also, the factor structure and validity data show that the KIAT is comparable to the original version. Thus, the KIAT is a psychometrically sound tool for assessing internet addiction in the Korean-speaking population. PMID:23678270

Exercise addiction in CrossFit: Prevalence and psychometric properties of the Exercise Addiction Inventory.

PubMed

Lichtenstein, Mia Beck; Jensen, Tanja Tang

2016-06-01

CrossFit is a mix of aerobic and anaerobic exercise regimes with the stated goal of improving fitness and physical performance. It is growing in popularity and has a strong community known to motivate and push the participants to maximal performance. The negative consequences of these extreme exercise patterns have rarely been described. The prevalence of injuries in CrossFit is high but exercise addiction and harmful exercise attitudes have not yet been assessed. The aim of this study was to measure the prevalence of exercise addiction in CrossFit and to evaluate the reliability and validity of the Exercise Addiction Inventory (EAI) in a CrossFit population. We invited crossfitters to participate in an online survey using Facebook groups. A total of 603 regular crossfitters completed the EAI and additional questions concerning exercise amounts and negative exercise attitudes and beliefs. We used principal component analyses and structural equation models to test the psychometric properties of the EAI and to describe the characteristics of the addicted crossfitters. We found that 5% of the crossfitters were addicted to exercise and that young males had a higher risk. The EAI had good internal reliability (0.73) and construct validity. Thus we found significant positive associations between exercise addiction and the tendency to exercise in spite of injury, feelings of guilt when unable to exercise, passion turning into obsession and taking medication to be able to exercise. Exercise addiction is prevalent in CrossFit and needs further exploration. The EAI is recommended for research in CrossFit communities and applied settings.

Cancer pain in the opioid-addicted patient: can we treat it right?

PubMed

Modesto-Lowe, Vania; Girard, Lisa; Chaplin, Margaret

2012-01-01

Although cancer elicits an array of physical and emotional symptoms, pain is often identified as the most distressing. Cancer pain may result from the primary tumor, metastasis, surgery, radiation, chemotherapy, or medical comorbidities. Although treatment with opioid analgesics is accepted as appropriate therapy for cancer-related pain, under treatment may persist among certain patients. Opioid-addicted individuals represent a challenging and heterogeneous population to treat. Addiction is linked to psychopathology and antisocial behaviors (eg, lying) which often complicate evaluation. Chronic exposure to opioids may lead to physiologic dependence and its correlates, tolerance and hyperalgesia. Given the variability and subjectivity of the cancer pain experience, there are no objective measures which capture the adequacy of pain control. Thus, when faced with complaints of uncontrolled pain, clinicians must consider a differential diagnosis of tolerance, disease progression, addiction, pseudoaddiction, chemical coping, or even criminal behavior. This article explores the cognitive, behavioral, and physiological correlates of opioid addiction that may impact cancer pain management. It also discusses risk reduction strategies for opioid misuse and research directions that may lead to improved clinical outcomes in these patients.

Treating opioid dependence. Growing implications for primary care.

PubMed

Krantz, Mori J; Mehler, Philip S

2004-02-09

Almost 3 million Americans have abused heroin. The most effective treatment for this concerning epidemic is opioid replacement therapy. Although, from a historical perspective, acceptance of this therapy has been slow, growing evidence supports its efficacy. There are 3 approved medications for opioid maintenance therapy: methadone hydrochloride, levomethadyl acetate, and buprenorphine hydrochloride. Each has unique characteristics that determine its suitability for an individual patient. Cardiac arrhythmias have been reported with methadone and levomethadyl, but not with buprenorphine. Due to concerns about cardiac risk, levomethadyl use has declined and the product may ultimately be discontinued. These recent safety concerns, specifics about opioid detoxification and maintenance, and new federal initiatives were studied. Opioid detoxification has a role in both preventing acute withdrawal and maintaining long-term abstinence. Although only a minority of eligible patients are engaged in treatment, opioid maintenance therapy appears to offer the greatest public health benefits. There is growing interest in expanding treatment into primary care, allowing opioid addiction to be managed like other chronic illnesses. This model has gained wide acceptance in Europe and is now being implemented in the United States. The recent Drug Addiction Treatment Act enables qualified physicians to treat opioid-dependent patients with buprenorphine in an office-based setting. Mainstreaming opioid addiction treatment has many advantages; its success will depend on resolution of ethical and delivery system issues as well as improved and expanded training of physicians in addiction medicine.

The neurobiology of tobacco dependence: a preclinical perspective on the role of the dopamine projections to the nucleus accumbens [corrected].

PubMed

Balfour, David J K

2004-12-01

It is now widely accepted that nicotine is the primary addictive component of tobacco smoke and that a majority of habitual smokers find it difficult to quit smoking because of their dependence upon this component of the smoke. However, although nicotine replacement therapy elicits a clinically valuable and significant improvement in the number of quit attempts that are ultimately successful, its efficacy remains disappointingly low. This review considers some of the reasons for this problem. It focuses on the hypothesis that stimulation of the dopamine (DA) projections to the medial shell and the core of the nucleus accumbens play complementary roles in the development of nicotine dependence. The hypothesis proposes that increased extra-synaptic DA in the medial shell of the accumbens confers hedonic properties on behaviors, such as smoking, which deliver nicotine, and thereby increase the probability that the response is learned. It also summarizes the evidence that the primary role of the increased DA overflow, observed in the accumbal core of nicotine-pretreated individuals, challenged with nicotine, is the attribution of incentive salience to cues associated with delivery of the drug and the transition to Pavlovian responding to these conditioned stimuli. The review argues that sensitization of the DA projections to the accumbal core, and the behaviors that depend upon this process, play a pivotal role in the maintenance of the tobacco smoking habit and that it is this component of the dependence that is inadequately addressed by nicotine replacement therapy.

Muscle dysmorphia: Could it be classified as an addiction to body image?

PubMed Central

FOSTER, ANDREW C.; SHORTER, GILLIAN W.

2015-01-01

Background Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. Method and aim Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD – the ‘Addiction to Body Image’ (ABI) model – using Griffiths (2005) addiction components model as the framework in which to define MD as an addiction. Results It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Conclusions Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm. PMID:25592218

Episodic Memories and Their Relevance for Psychoactive Drug Use and Addiction

PubMed Central

Müller, Christian P.

2013-01-01

The majority of adult people in western societies regularly consume psychoactive drugs. While this consumption is integrated in everyday life activities and controlled in most consumers, it may escalate and result in drug addiction. Non-addicted drug use requires the systematic establishment of highly organized behaviors, such as drug-seeking and -taking. While a significant role for classical and instrumental learning processes is well established in drug use and abuse, declarative drug memories have largely been neglected in research. Episodic memories are an important part of the declarative memories. Here a role of episodic drug memories in the establishment of non-addicted drug use and its transition to addiction is suggested. In relation to psychoactive drug consumption, episodic drug memories are formed when a person prepares for consumption, when the drug is consumed and, most important, when acute effects, withdrawal, craving, and relapse are experienced. Episodic drug memories are one-trial memories with emotional components that can be much stronger than “normal” episodic memories. Their establishment coincides with drug-induced neuronal activation and plasticity. These memories may be highly extinction resistant and influence psychoactive drug consumption, in particular during initial establishment and at the transition to “drug instrumentalization.” In that, understanding how addictive drugs interact with episodic memory circuits in the brain may provide crucial information for how drug use and addiction are established. PMID:23734106

Episodic memories and their relevance for psychoactive drug use and addiction.

PubMed

Müller, Christian P

2013-01-01

The majority of adult people in western societies regularly consume psychoactive drugs. While this consumption is integrated in everyday life activities and controlled in most consumers, it may escalate and result in drug addiction. Non-addicted drug use requires the systematic establishment of highly organized behaviors, such as drug-seeking and -taking. While a significant role for classical and instrumental learning processes is well established in drug use and abuse, declarative drug memories have largely been neglected in research. Episodic memories are an important part of the declarative memories. Here a role of episodic drug memories in the establishment of non-addicted drug use and its transition to addiction is suggested. In relation to psychoactive drug consumption, episodic drug memories are formed when a person prepares for consumption, when the drug is consumed and, most important, when acute effects, withdrawal, craving, and relapse are experienced. Episodic drug memories are one-trial memories with emotional components that can be much stronger than "normal" episodic memories. Their establishment coincides with drug-induced neuronal activation and plasticity. These memories may be highly extinction resistant and influence psychoactive drug consumption, in particular during initial establishment and at the transition to "drug instrumentalization." In that, understanding how addictive drugs interact with episodic memory circuits in the brain may provide crucial information for how drug use and addiction are established.

Molecular Genetic Testing in Reward Deficiency Syndrome (RDS): Facts and Fiction.

PubMed

Blum, Kenneth; Badgaiyan, Rajendra D; Agan, Gozde; Fratantonio, James; Simpatico, Thomas; Febo, Marcelo; Haberstick, Brett C; Smolen, Andrew; Gold, Mark S

The Brain Reward Cascade (BRC) is an interaction of neurotransmitters and their respective genes to control the amount of dopamine released within the brain. Any variations within this pathway, whether genetic or environmental (epigenetic), may result in addictive behaviors or RDS, which was coined to define addictive behaviors and their genetic components. To carry out this review we searched a number of important databases including: Filtered: Cochrane Systematic reviews; DARE; Pubmed Central Clinical Quaries; National Guideline Clearinghouse and unfiltered resources: PsychINFO; ACP PIER; PsychSage; Pubmed/Medline. The major search terms included: dopamine agonist therapy for Addiction; dopamine agonist therapy for Reward dependence; dopamine antagonistic therapy for addiction; dopamine antagonistic therapy for reward dependence and neurogenetics of RDS. While there are many studies claiming a genetic association with RDS behavior, not all are scientifically accurate. Albeit our bias, this Clinical Pearl discusses the facts and fictions behind molecular genetic testing in RDS and the significance behind the development of the Genetic Addiction Risk Score (GARS PREDX ™), the first test to accurately predict one's genetic risk for RDS.

Internet addiction: a systematic review of epidemiological research for the last decade.

PubMed

Kuss, D J; Griffiths, M D; Karila, L; Billieux, J

2014-01-01

In the last decade, Internet usage has grown tremendously on a global scale. The increasing popularity and frequency of Internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse. Over the last decade, research into Internet addiction has proliferated. This paper reviews the existing 68 epidemiological studies of Internet addiction that (i) contain quantitative empirical data, (ii) have been published after 2000, (iii) include an analysis relating to Internet addiction, (iv) include a minimum of 1000 participants, and (v) provide a full-text article published in English using the database Web of Science. Assessment tools and conceptualisations, prevalence, and associated factors in adolescents and adults are scrutinised. The results reveal the following. First, no gold standard of Internet addiction classification exists as 21 different assessment instruments have been identified. They adopt official criteria for substance use disorders or pathological gambling, no or few criteria relevant for an addiction diagnosis, time spent online, or resulting problems. Second, reported prevalence rates differ as a consequence of different assessment tools and cut-offs, ranging from 0.8% in Italy to 26.7% in Hong Kong. Third, Internet addiction is associated with a number of sociodemographic, Internet use, and psychosocial factors, as well as comorbid symptoms and disorder in adolescents and adults. The results indicate that a number of core symptoms (i.e., compulsive use, negative outcomes and salience) appear relevant for diagnosis, which assimilates Internet addiction and other addictive disorders and also differentiates them, implying a conceptualisation as syndrome with similar etiology and components, but different expressions of addictions. Limitations include the exclusion of studies with smaller sample sizes and studies focusing on specific online behaviours. Conclusively, there is a need for nosological precision so that ultimately those in need can be helped by translating the scientific evidence established in the context of Internet addiction into actual clinical practice.

Decision rules for GHB (γ-hydroxybutyric acid) detoxification: a vignette study.

PubMed

Kamal, Rama M; van Iwaarden, Sjacco; Dijkstra, Boukje A G; de Jong, Cornelis A J

2014-02-01

GHB dependent patients can suffer from a severe and sometimes life-threatening withdrawal syndrome. Therefore, most of the patients are treated within inpatient settings. However, some prefers an outpatient approach to treatment. The aim of this study was to develop decision rules for addiction physicians to determine whether an outpatient or inpatient setting should be chosen for a safe GHB detoxification. A prospective vignette study was performed. Forty addiction medicine specialists from various treatment settings and residents of the Addiction Medicine postgraduate Master training were asked to contribute vignettes of GHB dependent patients. A focus group of 15 psychiatrists and addiction medicine specialists was asked to recommend an outpatient or inpatient setting for GHB detoxification treatment per vignette. Finally, five addiction medicine specialists, experts in GHB dependence treatment in the Netherlands, assessed the bio-psychosocial reasons for the choices of the focus group and formulated the recommended criteria. Based on the bio-psychosocial state of twenty vignette patients, addiction physicians and psychiatrists established the criteria and conditions recommended for the indication of an outpatient GHB detoxification. Intensity of addiction (GHB dose ≤32 g/d and frequency of abuse ≤2 h) was stated as the primary criterion in determining the setting as well as the complexity of the psychiatric comorbid disorders. The importance of a stable support system was emphasised. The vignette study resulted in a set of criteria with which addiction medicine specialists can make a weighted decision as to an outpatient or inpatient setting for GHB detoxification. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Preliminary validation of the Malay Yale Food Addiction Scale: Factor structure and item analysis in an obese population.

PubMed

Swarna Nantha, Yogarabindranath; Abd Patah, Norafidza Ashiquin; Ponnusamy Pillai, Mahalakshmi

2016-12-01

Researchers suggest that the rise in obesity rates may be explained by the addictive properties of certain types of food. In view of the growing obesity epidemic in South-East Asia, there is a need for a psychometric tool to assess the concept of food addiction amongst high-risk populations. The objective of this study is to translate the Yale Food Addiction Scale (YFAS) into the Malay language and subsequently validate its use in an obese population. Between the year 2014 and 2015, a total of 250 obese adults were assessed for food addiction utilizing the Malay version of the YFAS at a primary care clinic. An assessment of the psychometric properties of the scale was performed to determine the factor structure, item statistics and internal consistency of the scale. A one factorial structure of YFAS was confirmed in this study through factor analysis. All items except 4 (items 19, 22, 24 and 25) had factor loadings >0.42. The internal reliability (KR-20) coefficient of the one-factor solution was α = 0.76. The mean YFAS symptom count was M = 2.74 (SD = 1.57) with 10.4% (N = 26) of the participants received the diagnosis of food addiction. The determination of construct validity and the identification of other latent variables in the Malay food addiction model is necessary prior to the formal utilization of the scale as a tool to detect addictive eating patterns in the community. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Similarity and Difference in Drug Addiction Process Between Heroin- and Methamphetamine-Dependent Users.

PubMed

Wang, Ziyun; Li, Wei-Xiu; Zhi-Min, Liu

2017-03-21

This study aimed to compare the drug addiction process between Chinese heroin- and methamphetamine (MA)-dependent users via a modified 4-stage addiction model (experimentation, occasional use, regular use, and compulsive use). A descriptive study was conducted among 683 eligible participants. In the statistical analysis, we selected 340 heroin- and 295 MA-dependent users without illicit drug use prior to onset of heroin or MA use. The addiction process of heroin-dependent users was shorter than that of MA-dependent users, with shorter transitions from the onset of drug-use to the first drug craving (19.5 vs. 50.0 days), regular use (30.0 vs. 60.0 days), and compulsive use (50.0 vs. 85.0 days). However, no significant differences in the addiction process were observed in frequency of drug administration, except that heroin users reported more administrations of the drug (20.0 vs. 15.0) before progressing to the stage of compulsive drug use. A larger proportion of regular heroin users progressed to use illicit drugs recklessly than did MA users. Most heroin and MA users reported psychological dependence as their primary motivation for compulsive drug use, but more heroin users selected uncomfortable symptoms upon ceasing drug use as further reason to continue. Our results suggest that typical heroin and MA users may experience a similar four-stage addiction process, but MA users might undergo a longer addiction process (in days). More research is necessary to further explore factors influencing the drug addiction process.

A home for body and soul: Substance using women in recovery

PubMed Central

2013-01-01

Background We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Method Data were gathered about women’s experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Results Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long-term multi-phase recovery, and variety and choice of programming. Conclusion A key barrier to the addiction recovery of women is the present framework of addiction treatment, as well as current drug laws, policies and service delivery systems. The expectation of women is that harm reduction-based recovery services will facilitate safe, supportive transitioning from the point of the decision to access services, through independent living with community integration. PMID:24359089

A home for body and soul: substance using women in recovery.

PubMed

Kruk, Edward; Sandberg, Kathryn

2013-12-20

We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Data were gathered about women's experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long-term multi-phase recovery, and variety and choice of programming. A key barrier to the addiction recovery of women is the present framework of addiction treatment, as well as current drug laws, policies and service delivery systems. The expectation of women is that harm reduction-based recovery services will facilitate safe, supportive transitioning from the point of the decision to access services, through independent living with community integration.

Cigarette smoking and brain regulation of energy homeostasis.

PubMed

Chen, Hui; Saad, Sonia; Sandow, Shaun L; Bertrand, Paul P

2012-01-01

Cigarette smoking is an addictive behavior, and is the primary cause of cardiovascular and pulmonary disease, and cancer (among other diseases). Cigarette smoke contains thousands of components that may affect caloric intake and energy expenditure, although nicotine is the major addictive substance present, and has the best described actions. Nicotine exposure from cigarette smoke can change brain feeding regulation to reduce appetite via both energy homeostatic and reward mechanisms, causing a negative energy state which is characterized by reduced energy intake and increased energy expenditure that are linked to low body weight. These findings have led to the public perception that smoking is associated with weight loss. However, its effects at reducing abdominal fat mass (a predisposing factor for glucose intolerance and insulin resistance) are marginal, and its promotion of lean body mass loss in animal studies suggests a limited potential for treatment in obesity. Smoking during pregnancy puts pressure on the mother's metabolic system and is a significant contributor to adverse pregnancy outcomes. Smoking is a predictor of future risk for respiratory dysfunction, social behavioral problems, cardiovascular disease, obesity, and type-2 diabetes. Catch-up growth is normally observed in children exposed to intrauterine smoke, which has been linked to subsequent childhood obesity. Nicotine can have a profound impact on the developing fetal brain, via its ability to rapidly and fully pass the placenta. In animal studies this has been linked with abnormal hypothalamic gene expression of appetite regulators such as downregulation of NPY and POMC in the arcuate nucleus of the hypothalamus. Maternal smoking or nicotine replacement leads to unhealthy eating habits (such as junk food addiction) and other behavioral disorders in the offspring.

Systematic services audit of consecutive suicides in New Brunswick: the case for coordinating specialist mental health and addiction services.

PubMed

Lesage, Alain; Séguin, Monique; Guy, Andrée; Daigle, France; Bayle, Marie-Noëlle; Chawky, Nadia; Tremblay, Nancy; Turecki, Gustavo

2008-10-01

To weight the potential of promotion, prevention, and treatment programs to help establish priorities in multipronged suicide prevention strategies. Psychological autopsy methods served to collect information on consecutive suicides over 14 months in New Brunswick (n = 102). A panel of researchers, clinicians, provincial planners, and consumers reviewed the cases and applied a systematic needs assessment procedure to establish interventions and services received, unmet needs at the individual level, and programmatic and systemic shortcomings. More than two-thirds of the individuals suffered from a depressive disorder and a similar proportion from substance (essentially alcohol) abuse or dependence; one-half also presented a personality disorder. In the last year, more than one-half had been in contact with a mental health services specialist, but less than 5% had contact with addiction services, though one-third had previous contact in their lifetime. In one-third of the cases, service gaps called for greater coordination and integration of mental health specialists and addiction services within the health care system. In one-half of the cases, system needs were found to be unmet for public awareness efforts aimed at encouraging individuals to consult health and social services professionals, and in terms of training efforts geared to improving detection, treatment, and referral for mental illness, substance-related problems, and suicidal behaviour by primary medical, social, and specialist services. This study supports multipronged suicide prevention strategies that should include integrated public promotion, professional development campaigns, and better program coordination. Authorities in New Brunswick have opted to favour the latter strategy component, whose development and application must be evaluated to determine its impact on suicide rates.

Internet-delivered treatment for substance abuse: a multisite randomized controlled trial.

PubMed

Campbell, Aimee N C; Nunes, Edward V; Matthews, Abigail G; Stitzer, Maxine; Miele, Gloria M; Polsky, Daniel; Turrigiano, Eva; Walters, Scott; McClure, Erin A; Kyle, Tiffany L; Wahle, Aimee; Van Veldhuisen, Paul; Goldman, Bruce; Babcock, Dean; Stabile, Patricia Quinn; Winhusen, Theresa; Ghitza, Udi E

2014-06-01

Computer-delivered interventions have the potential to improve access to quality addiction treatment care. The objective of this study was to evaluate the effectiveness of the Therapeutic Education System (TES), an Internet-delivered behavioral intervention that includes motivational incentives, as a clinician-extender in the treatment of substance use disorders. Adult men and women (N=507) entering 10 outpatient addiction treatment programs were randomly assigned to receive 12 weeks of either treatment as usual (N=252) or treatment as usual plus TES, with the intervention substituting for about 2 hours of standard care per week (N=255). TES consists of 62 computerized interactive modules covering skills for achieving and maintaining abstinence, plus prize-based motivational incentives contingent on abstinence and treatment adherence. Treatment as usual consisted of individual and group counseling at the participating programs. The primary outcome measures were abstinence from drugs and heavy drinking (measured by twice-weekly urine drug screens and self-report) and time to dropout from treatment. Compared with patients in the treatment-as-usual group, those in the TES group had a lower dropout rate (hazard ratio=0.72, 95% CI=0.57, 0.92) and a greater abstinence rate (odds ratio=1.62, 95% CI=1.12, 2.35). This effect was more pronounced among patients who had a positive urine drug or breath alcohol screen at study entry (N=228) (odds ratio=2.18, 95% CI=1.30, 3.68). Internet-delivered interventions such as TES have the potential to expand access and improve addiction treatment outcomes. Additional research is needed to assess effectiveness in non-specialty clinical settings and to differentiate the effects of the community reinforcement approach and contingency management components of TES.

Drugging the Cancers Addicted to DNA Repair.

PubMed

Nickoloff, Jac A; Jones, Dennie; Lee, Suk-Hee; Williamson, Elizabeth A; Hromas, Robert

2017-11-01

Defects in DNA repair can result in oncogenic genomic instability. Cancers occurring from DNA repair defects were once thought to be limited to rare inherited mutations (such as BRCA1 or 2). It now appears that a clinically significant fraction of cancers have acquired DNA repair defects. DNA repair pathways operate in related networks, and cancers arising from loss of one DNA repair component typically become addicted to other repair pathways to survive and proliferate. Drug inhibition of the rescue repair pathway prevents the repair-deficient cancer cell from replicating, causing apoptosis (termed synthetic lethality). However, the selective pressure of inhibiting the rescue repair pathway can generate further mutations that confer resistance to the synthetic lethal drugs. Many such drugs currently in clinical use inhibit PARP1, a repair component to which cancers arising from inherited BRCA1 or 2 mutations become addicted. It is now clear that drugs inducing synthetic lethality may also be therapeutic in cancers with acquired DNA repair defects, which would markedly broaden their applicability beyond treatment of cancers with inherited DNA repair defects. Here we review how each DNA repair pathway can be attacked therapeutically and evaluate DNA repair components as potential drug targets to induce synthetic lethality. Clinical use of drugs targeting DNA repair will markedly increase when functional and genetic loss of repair components are consistently identified. In addition, future therapies will exploit artificial synthetic lethality, where complementary DNA repair pathways are targeted simultaneously in cancers without DNA repair defects. © The Author 2017. Published by Oxford University Press.

PubMed Central

Lehmann, François; Lauzon, Pierre

1989-01-01

The authors, both family physicians, report on a profile of fifty-eight (58) Montreal narcotic addicts admitted to a methadone treatment program in 1986. Their characteristic are similar to those published for addicts being treated in the United States. In particular, there is a high rate of involvement with crime, multiple drug abuse and family histories of violence. Certain characteristics are very helpful in the planning of future resources for the Montreal area and suggest possible avenues to primary prevention. The question is asked about which factors, if any, have prognostic significance. PMID:21248864

The Bergen Shopping Addiction Scale: reliability and validity of a brief screening test.

PubMed

Andreassen, Cecilie S; Griffiths, Mark D; Pallesen, Ståle; Bilder, Robert M; Torsheim, Torbjørn; Aboujaoude, Elias

2015-01-01

Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms 'shopping,' 'buying,' and 'spending' interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (M age = 35.8 years, SD age = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA = 0.064, CFI = 0.983, TLI = 0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed.

The Bergen Shopping Addiction Scale: reliability and validity of a brief screening test

PubMed Central

Andreassen, Cecilie S.; Griffiths, Mark D.; Pallesen, Ståle; Bilder, Robert M.; Torsheim, Torbjørn; Aboujaoude, Elias

2015-01-01

Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms ‘shopping,’ ‘buying,’ and ‘spending’ interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (Mage = 35.8 years, SDage = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA = 0.064, CFI = 0.983, TLI = 0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed. PMID:26441749

The science of tobacco addiction and cessation.

PubMed

2014-01-01

Over the past decade, researchers have found genetic variations that affect how nicotine, the main addictive component of tobacco, interacts with cells in the brain and how fast the body metabolizes it. Carrying a high-risk variant predicts a person's ability to snuff out their cigarettes for good. Genetic testing could help predict which smokers might benefit from nicotine replacement therapy or other prescription medications, much like sequencing of malignant tumors can point to the most effective cancer treatment.

Reward loss and addiction: Opportunities for cross-pollination.

PubMed

Ortega, Leonardo A; Solano, José L; Torres, Carmen; Papini, Mauricio R

2017-03-01

Paradigms used to study the response to and consequences of exposure to reward loss have been underutilized in approaches to the psychobiology of substance use disorders. We propose here that bringing these two areas into contact will help expanding our understanding of both reward loss and addictive behavior, hence opening up opportunities for cross-pollination. This review focuses on two lines of research that point to parallels. First, several neurochemical systems involved in addiction are also involved in the modulation of the behavioral effects of reward loss, including opioid, GABA, and dopamine receptors. Second, there are extensive overlaps in the brain circuitry underlying both reward loss and addiction. Common components of this system include, at least, the amygdala, ventral and dorsal striatum, and various prefrontal cortex regions. Four emerging avenues of research that benefit from emphasis on the common ground between reward loss and addiction are reviewed, namely, the neural circuitry involved in reward devaluation, the influence of genetic and reward history on the behavioral vulnerability and resilience, the role of competing natural rewards, and emotional self-medication. An understanding of the role of reward loss in addiction will point to a deeper understanding of the initiation and maintenance of substance use disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

Dynorphin and the Pathophysiology of Drug Addiction

PubMed Central

Shippenberg, T.S.; Zapata, A.; Chefer, V.I.

2009-01-01

Drug addiction is a chronic relapsing disease in which drug administration becomes the primary stimulus that drives behavior regardless of the adverse consequence that may ensue. As drug use becomes more compulsive, motivation for natural rewards that normally drive behavior decreases. The discontinuation of drug use is associated with somatic signs of withdrawal, dysphoria, anxiety and anhedonia. These consequences of drug use are thought to contribute to the maintenance of drug use and to the reinstatement of compulsive drug use that occurs during the early phase of abstinence. Even, however, after prolonged periods of abstinence, 80-90% of human addicts relapse to addiction suggesting that repeated drug use produces enduring changes in brain circuits that subserve incentive motivation and stimulus-response (habit) learning. A major goal of addiction research is the identification of the neural mechanisms by which drugs of abuse produce these effects. This article will review data showing that the dynorphin/κ-opioid receptor system serves an essential function in opposing alterations in behavior and brain neurochemistry that occur as a consequence of repeated drug use and that aberrant activity of this system may not only contribute to the dysregulation of behavior that characterizes addiction but to individual differences in vulnerability to the pharmacological actions of cocaine and alcohol. We will provide evidence that the repeated administration of cocaine and alcohol up-regulates the dynorphin/κ-opioid receptor system and that pharmacological treatments that target this system may prove effective in the treatment of drug addiction. PMID:17868902

Effects of chronic mild stress on the development of drug dependence in rats.

PubMed

Papp, Mariusz; Gruca, Piotr; Lason-Tyburkiewicz, Magdalena; Litwa, Ewa; Willner, Paul

2014-09-01

There is high comorbidity between depression and addiction. Features of addiction relevant to depression have been studied extensively, but less is known about features of depression relevant to addiction. Here, we have studied the effects of chronic mild stress (CMS), a valid animal model of depression, on measures of physical and psychological dependence resulting from subchronic treatment of rats with three drugs of abuse that act through disparate neurobiological mechanisms: morphine, nicotine and diazepam. In animals not treated subchronically with drugs of abuse, CMS increased the withdrawal-like effects of the opiate antagonist naloxone, but not those of the nicotinic antagonist mecamylamine or the benzodiazepine antagonist flumazenil. In animals treated subchronically with drugs of abuse, CMS exacerbated, precipitated and conditioned withdrawal effects associated with all three antagonists. CMS also potentiated withdrawal-induced and cue-induced place aversions associated with all three antagonists. All of the effects of CMS were reversed by chronic treatment with the specific serotonin reuptake inhibitor citalopram. These results suggest that treatment of comorbid depression, although not a primary treatment for addiction, may facilitate other treatments for addiction, by decreasing the severity of withdrawal symptoms and the likelihood of relapse.

Cystine addiction of triple-negative breast cancer associated with EMT augmented death signaling.

PubMed

Tang, X; Ding, C-K; Wu, J; Sjol, J; Wardell, S; Spasojevic, I; George, D; McDonnell, D P; Hsu, D S; Chang, J T; Chi, J-T

2017-07-27

Despite the advances in the diagnosis and treatment of breast cancer, breast cancers still cause significant mortality. For some patients, especially those with triple-negative breast cancer, current treatments continue to be limited and ineffective. Therefore, there remains an unmet need for a novel therapeutic approach. One potential strategy is to target the altered metabolic state that is rewired by oncogenic transformation. Specifically, this rewiring may render certain outside nutrients indispensable. To identify such a nutrient, we performed a nutrigenetic screen by removing individual amino acids to identify possible addictions across a panel of breast cancer cells. This screen revealed that cystine deprivation triggered rapid programmed necrosis, but not apoptosis, in the basal-type breast cancer cells mostly seen in TNBC tumors. In contrast, luminal-type breast cancer cells are cystine-independent and exhibit little death during cystine deprivation. The cystine addiction phenotype is associated with a higher level of cystine-deprivation signatures noted in the basal type breast cancer cells and tumors. We found that the cystine-addicted breast cancer cells and tumors have strong activation of TNFα and MEKK4-p38-Noxa pathways that render them susceptible to cystine deprivation-induced necrosis. Consistent with this model, silencing of TNFα and MEKK4 dramatically reduces cystine-deprived death. In addition, the cystine addiction phenotype can be abrogated in the cystine-addictive cells by miR-200c, which converts the mesenchymal-like cells to adopt epithelial features. Conversely, the introduction of inducers of epithelial-mesenchymal transition (EMT) in cystine-independent breast cancer cells conferred the cystine-addiction phenotype by modulating the signaling components of cystine addiction. Together, our data reveal that cystine-addiction is associated with EMT in breast cancer during tumor progression. These findings provide the genetic and mechanistic basis to explain how cystine deprivation triggers necrosis by activating pre-existing oncogenic pathways in cystine-addicted TNBC with prominent mesenchymal features.

[Functional connectivity of temporal parietal junction in online game addicts:a resting-state functional magnetic resonance imaging study].

PubMed

Yuan, Ji; Qian, Ruobing; Lin, Bin; Fu, Xianming; Wei, Xiangpin; Weng, Chuanbo; Niu, Chaoshi; Wang, Yehan

2014-02-11

To explore the functions of temporal parietal junction (TPJ) as parts of attention networks in the pathogenesis of online game addiction using resting-state functional magnetic resonance imaging (fMRI). A total of 17 online game addicts (OGA) were recruited as OGA group and 17 healthy controls during the same period were recruited as CON group. The neuropsychological tests were performed for all of them to compare the inter-group differences in the results of Internet Addiction Test (IAT) and attention functions. All fMRI data were preprocessed after resting-state fMRI scanning. Then left and right TPJ were selected as regions of interest (ROIs) to calculate the linear correlation between TPJ and entire brain to compare the inter-group differences. Obvious differences existed between OGA group (71 ± 5 scores) and CON group (19 ± 7 scores) in the IAT results and attention function (P < 0.05). Compared with the controls, right TPJ in online game addicts showed decreased functional connectivity with bilateral ventromedial prefrontal cortex (VMPFC), bilateral hippocampal gyrus and bilateral amygdaloid nucleus, but increased functional connectivity with right cuneus.However, left TPJ demonstrated decreased functional connectivity with bilateral superior frontal gyrus and bilateral middle frontal gyrus, but increased functional connectivity with bilateral cuneus (P < 0.05). Altered functional connectivity of TPJ reflected its dysfunction in online game addicts.It suggests that TPJ is an important component of attention networks participating in the generation of online game addiction.

Prescription opioid abuse, chronic pain, and primary care: a Co-occurring Disorders Clinic in the chronic disease model.

PubMed

Pade, Patricia A; Cardon, Karen E; Hoffman, Richard M; Geppert, Cynthia M A

2012-12-01

Abuse of opioids has become a public health crisis. The historic separation between the addiction and pain communities and a lack of training in medical education have made treatment difficult to provide, especially in primary care. The Co-occurring Disorders Clinic (COD) was established to treat patients with co-morbid chronic pain and addiction. This retrospective chart review reports results of a quality improvement project using buprenorphine/naloxone to treat co-occurring chronic non-cancer pain (CNCP) and opioid dependence in a primary care setting. Data were collected for 143 patients who were induced with buprenorphine/naloxone (BUP/NLX) between June 2009 and November 2011. Ninety-three patients (65%) continued to be maintained on the medication and seven completed treatment and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population. Published by Elsevier Inc.

Development and validation study of the Smartphone Overuse Screening Questionnaire.

PubMed

Lee, Han-Kyeong; Kim, Ji-Hae; Fava, Maurizio; Mischoulon, David; Park, Jae-Hyun; Shim, Eun-Jung; Lee, Eun-Ho; Lee, Ji Hyeon; Jeon, Hong Jin

2017-11-01

The aim of this study was to develop a screening questionnaire that could distinguish individuals at high risk of smartphone overuse from casual users. The reliability, validity, and diagnostic ability of the Smartphone Overuse Screening Questionnaire (SOS-Q) were evaluated. Preliminary items were assessed by 50 addiction experts on-line, and 28 questions were selected. A total of 158 subjects recruited from six community centers for internet addiction participated in this study. The SOS-Q, Young's internet addiction scale, Korean scale for internet addiction, and Smartphone Scale for Smartphone Addiction (S-Scale) were used to assess the concurrent validity. Construct validity was supported by a six-factor model using an exploratory factor analysis. The internal consistency and the item-total correlations were favorable (α = 0.95, r = 0.35-0.81). The test-retest reliability was moderate (r = 0.70). The SOS-Q showed superior concurrent validity with the highest correlation between the S-Scale (r = 0.76). Receiver operating characteristic curve analysis revealed an area under the curve of 0.877. A cut-off point of 49 effectively categorized addiction high-risk group with a sensitivity of 0.81 and specificity of 0.86. Overall, the current study supports the use of SOS-Q as both a primary and supplementary measurement tool in a variety of settings. Copyright © 2017 Elsevier B.V. All rights reserved.

Is there addiction to loud music? Findings in a group of non-professional pop/rock musicians.

PubMed

Schmuziger, Nicolas; Patscheke, Jochen; Stieglitz, Rolf; Probst, Rudolf

2012-01-09

Listening to loud music may be connected to addictive behavior possibly leading to damaging effects on the cochlea. We hypothesized that members of non-professional pop/rock bands with regular exposure to loud music are more likely to show an addictive-like behavior for loud music than matched control subjects. Fifty non-professional musicians and 50 matched control subjects were asked to complete the Northeastern Music Listening Survey (NEMLS) with two basic components. The first comprises an adaptation of the validated Michigan Alcohol Screening Test (MAST) to study the addictive-like behavior towards loud music. The second comprises the criteria outlined by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Society for the diagnosis of substance dependence. The NEMLS was scored using the same point system as used in the MAST. The DSM-IV criteria for substance dependence were met by nine of the musician group and by one control subject. Seven of these nine musicians also had a positive NEMLS score. Traits of addictive-like behavior to loud music were detected more often in members of nonprofessional pop/rock bands than in control subjects.

Addiction, Adolescence, and Innate Immune Gene Induction

PubMed Central

Crews, Fulton T.; Vetreno, Ryan Peter

2011-01-01

Repeated drug use/abuse amplifies psychopathology, progressively reducing frontal lobe behavioral control, and cognitive flexibility while simultaneously increasing limbic temporal lobe negative emotionality. The period of adolescence is a neurodevelopmental stage characterized by poor behavioral control as well as strong limbic reward and thrill seeking. Repeated drug abuse and/or stress during this stage increase the risk of addiction and elevate activator innate immune signaling in the brain. Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) is a key glial transcription factor that regulates proinflammatory chemokines, cytokines, oxidases, proteases, and other innate immune genes. Induction of innate brain immune gene expression (e.g., NF-κB) facilitates negative affect, depression-like behaviors, and inhibits hippocampal neurogenesis. In addition, innate immune gene induction alters cortical neurotransmission consistent with loss of behavioral control. Studies with anti-oxidant, anti-inflammatory, and anti-depressant drugs as well as opiate antagonists link persistent innate immune gene expression to key behavioral components of addiction, e.g., negative affect-anxiety and loss of frontal–cortical behavioral control. This review suggests that persistent and progressive changes in innate immune gene expression contribute to the development of addiction. Innate immune genes may represent a novel new target for addiction therapy. PMID:21629837

Is there addiction to loud music? Findings in a group of non-professional pop/rock musicians

PubMed Central

Schmuziger, Nicolas; Patscheke, Jochen; Stieglitz, Rolf; Probst, Rudolf

2012-01-01

Listening to loud music may be connected to addictive behavior possibly leading to damaging effects on the cochlea. We hypothesized that members of non-professional pop/rock bands with regular exposure to loud music are more likely to show an addictive-like behavior for loud music than matched control subjects. Fifty non-professional musicians and 50 matched control subjects were asked to complete the Northeastern Music Listening Survey (NEMLS) with two basic components. The first comprises an adaptation of the validated Michigan Alcohol Screening Test (MAST) to study the addictive-like behavior towards loud music. The second comprises the criteria outlined by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Society for the diagnosis of substance dependence. The NEMLS was scored using the same point system as used in the MAST. The DSM-IV criteria for substance dependence were met by nine of the musician group and by one control subject. Seven of these nine musicians also had a positive NEMLS score. Traits of addictive-like behavior to loud music were detected more often in members of nonprofessional pop/rock bands than in control subjects. PMID:26557326

Moderate alcohol exposure during early brain development increases stimulus-response habits in adulthood.

PubMed

Parker, Matthew O; Evans, Alexandra M-D; Brock, Alistair J; Combe, Fraser J; Teh, Muy-Teck; Brennan, Caroline H

2016-01-01

Exposure to alcohol during early central nervous system development has been shown variously to affect aspects of physiological and behavioural development. In extreme cases, this can extend to craniofacial defects, severe developmental delay and mental retardation. At more moderate levels, subtle differences in brain morphology and behaviour have been observed. One clear effect of developmental alcohol exposure is an increase in the propensity to develop alcoholism and other addictions. The mechanisms by which this occurs, however, are not currently understood. In this study, we tested the hypothesis that adult zebrafish chronically exposed to moderate levels of ethanol during early brain ontogenesis would show an increase in conditioned place preference for alcohol and an increased propensity towards habit formation, a key component of drug addiction in humans. We found support for both of these hypotheses and found that the exposed fish had changes in mRNA expression patterns for dopamine receptor, nicotinic acetylcholine receptor and μ-opioid receptor encoding genes. Collectively, these data show an explicit link between the increased proclivity for addiction and addiction-related behaviour following exposure to ethanol during early brain development and alterations in the neural circuits underlying habit learning. © 2014 Society for the Study of Addiction.

Implementing a Mobile Health System to Integrate the Treatment of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study.

PubMed

Quanbeck, Andrew; Gustafson, David H; Marsch, Lisa A; Chih, Ming-Yuan; Kornfield, Rachel; McTavish, Fiona; Johnson, Roberta; Brown, Randall T; Mares, Marie-Louise; Shah, Dhavan V

2018-01-30

Despite the near ubiquity of mobile phones, little research has been conducted on the implementation of mobile health (mHealth) apps to treat patients in primary care. Although primary care clinicians routinely treat chronic conditions such as asthma and diabetes, they rarely treat addiction, a common chronic condition. Instead, addiction is most often treated in the US health care system, if it is treated at all, in a separate behavioral health system. mHealth could help integrate addiction treatment in primary care. The objective of this paper was to report the effects of implementing an mHealth system for addiction in primary care on both patients and clinicians. In this implementation research trial, an evidence-based mHealth system named Seva was introduced sequentially over 36 months to a maximum of 100 patients with substance use disorders (SUDs) in each of three federally qualified health centers (FQHCs; primary care clinics that serve patients regardless of their ability to pay). This paper reports on patient and clinician outcomes organized according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The outcomes according to the RE-AIM framework are as follows: Reach-Seva reached 8.31% (268/3226) of appropriate patients. Reach was limited by our ability to pay for phones and data plans for a maximum of 100 patients per clinic. Effectiveness-Patients who were given Seva had significant improvements in their risky drinking days (44% reduction, (0.7-1.25)/1.25, P=.04), illicit drug-use days (34% reduction, (2.14-3.22)/3.22, P=.01), quality of life, human immunodeficiency virus screening rates, and number of hospitalizations. Through Seva, patients also provided peer support to one another in ways that are novel in primary care settings. Adoption-Patients sustained high levels of Seva use-between 53% and 60% of the patients at the 3 sites accessed Seva during the last week of the 12-month implementation period. Among clinicians, use of the technology was less robust than use by patients, with only a handful of clinicians using Seva in each clinic and behavioral health providers making most referrals to Seva in 2 of the 3 clinics. Implementation-At 2 sites, implementation plans were realized successfully; they were delayed in the third. Maintenance-Use of Seva dropped when grant funding stopped paying for the mobile phones and data plans. Two of the 3 clinics wanted to maintain the use of Seva, but they struggled to find funding to support this. Implementing an mHealth system can improve care among primary care patients with SUDs, and patients using the system can support one another in their recovery. Among clinicians, however, implementation requires figuring out how information from the mHealth system will be used and making mHealth data available in the electronic health (eHealth) record. In addition, paying for an mHealth system remains a challenge. ©Andrew Quanbeck, David H Gustafson, Lisa A Marsch, Ming-Yuan Chih, Rachel Kornfield, Fiona McTavish, Roberta Johnson, Randall T Brown, Marie-Louise Mares, Dhavan V Shah. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.01.2018.

The Development and Validation of the Bergen-Yale Sex Addiction Scale With a Large National Sample.

PubMed

Andreassen, Cecilie S; Pallesen, Ståle; Griffiths, Mark D; Torsheim, Torbjørn; Sinha, Rajita

2018-01-01

The view that problematic excessive sexual behavior ("sex addiction") is a form of behavioral addiction has gained more credence in recent years, but there is still considerable controversy regarding operationalization of the concept. Furthermore, most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction-the Bergen-Yale Sex Addiction Scale (BYSAS)-based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control). Using a cross-sectional survey, the BYSAS was administered to a broad national sample of 23,533 Norwegian adults [aged 16-88 years; mean (± SD ) age = 35.8 ± 13.3 years], together with validated measures of the Big Five personality traits, narcissism, self-esteem, and a measure of sexual addictive behavior. Both an exploratory and a confirmatory factor analysis (RMSEA = 0.046, CFI = 0.998, TLI = 0.996) supported a one-factor solution, although a local dependence between two items (Items 1 and 2) was detected. Furthermore, the scale had good internal consistency (Cronbach's α = 0.83). The BYSAS correlated significantly with the reference scale ( r = 0.52), and demonstrated similar patterns of convergent and discriminant validity. The BYSAS was positively related to extroversion, neuroticism, intellect/imagination, and narcissism, and negatively related to conscientiousness, agreeableness, and self-esteem. High scores on the BYSAS were more prevalent among those who were men, single, of younger age, and with higher education. The BYSAS is a brief, and psychometrically reliable and valid measure for assessing sex addiction. However, further validation of the BYSAS is needed in other countries and contexts.

A contextual model of self-regulation change mechanisms among individuals with addictive disorders.

PubMed

Roos, Corey R; Witkiewitz, Katie

2017-11-01

Numerous behavioral treatments for addictive disorders include components explicitly aimed at targeting self-regulation (e.g., coping and emotion regulation). We first provide a summary of key findings to date among studies that have examined self-regulation as a mechanism of behavior change (MOBC) in behavioral treatments for addictive disorders. Based on our review, we conclude that the role of self-regulation as a MOBC across behavioral treatments for addictive disorders is not well-characterized and findings are inconsistent across studies. For example, our review indicates that there is still inconsistent evidence that coping is a unique MOBC in cognitive-behavioral approaches for addictive behaviors. We propose that there has been slow progress in understanding self-regulation as a MOBC in addiction treatment because of a lack of attention to contextual factors. Accordingly, in the second half of this paper, we propose a contextual model of self-regulation change mechanisms, which emphasizes that the role of various facets of self-regulation as MOBC may depend on contextual factors in the immediate situational context (e.g., fluctuating internal and external cues) and in the broader context in which an individual is embedded (e.g., major life stressors, environmental conditions, dispositions). Additionally, we provide specific recommendations to guide future research for understanding both between-person and within-person self-regulation MOBC in addiction treatment. In particular, we provide key recommendations for how to capitalize on intensive longitudinal measurement methods (e.g., ecological momentary assessment) when bringing a contextual perspective to the study of self-regulation as MOBC in various addiction treatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can one simple questionnaire assess substance-related and behavioural addiction problems? Results of a proposed new screener for community epidemiology.

PubMed

Schluter, Magdalen G; Hodgins, David C; Wolfe, Jody; Wild, T Cameron

2018-01-22

There is currently no well-validated measure that assesses a broad spectrum of substance-related and behavioural addictions in general populations. This study aimed to develop a brief self-attribution Screener for Substance and Behavioural Addictions (SSBA) to screen for four substances and six behaviours, and to compare its performance with established individual-behaviour screening instruments. A small, psychometrically optimal set of items to assess self-attributed indicators of addiction across alcohol, tobacco, cannabis, cocaine, gambling, shopping, videogaming, overeating, sexual activity and overworking were identified from a broader pool that was developed using a lay epidemiology qualitative approach. The suitability of the four-item single-factor solution was tested for each behaviour and scores were compared with those obtained from the sample using individual-behaviour screening instruments. Participants (n = 6000), broadly representative of the Canadian English-speaking adult population, were recruited through the Ipsos Reid Canadian Online Panel. Participants completed an item pool of 15 indicators of addiction for each target behaviour and a validation instrument for one randomly assigned behaviour. A set of four items identified using principal component and confirmatory factor analyses demonstrated good fit and excellent internal consistency (α = 0.87-0.95) across behaviours, and good convergent validity (rs = 0.44-0.8) with extant instruments measuring similar constructs, with only one exception (r = 0.26). The proposed Screener for Substance and Behavioural Addiction is a reliable and valid measure assessing the lay public's self-attributed indicators of addiction across 10 substances and behaviours. © 2018 Society for the Study of Addiction.

Stigma and the addiction paradigm for obesity: lessons from 1950s America.

PubMed

Rasmussen, Nicolas

2015-02-01

To discuss an historical episode in which obesity was conceptualized as an addictive disorder and declared to be a major epidemic in the early postwar United States. This history illuminates past consequences of framing obesity as an addiction in ways that may inform constructive policy responses today. Review of secondary and primary sources, including archival documents, relating to obesity in biomedical and popular thought of the 1940s and 1950s. In the United States in the late 1940s and 1950s, new medical thinking about obesity reinterpreted overweight and obesity as chiefly the consequence of addiction (understood in the then dominant psychodynamic theory as a psychological defect, oral fixation). This new conception was rapidly taken up in popular discourse and clinical practice, with adverse effects through amplification of weight stigma. Further, in the conservative political context, the addiction concept contributed to an ineffective policy response to the alarming new epidemiological evidence about obesity's consequences. Despite a lack of evidence for efficacy of the intervention, public health efforts focused on correcting individual eating behaviour among obese people by encouraging self-help in lay groups modelled, in part, on Alcoholics Anonymous. Population-level intervention was neglected. Current public health policy initiatives must be mindful of the risks of reframing obesity as an addiction. These include inadvertently reinforcing stigma, narrowing responses to those aiming to modify individual behaviour and biology and neglecting population policies aiming to reduce the consumption of energy-dense foods, as all occurred in the 1950s United States. © 2014 Society for the Study of Addiction.

Finding the right match: Mindfulness training may potentiate the therapeutic effect of non-judgment of inner experience on smoking cessation

PubMed Central

Schuman-Olivier, Zev D.; Hoeppner, Bettina B.; Evins, A. Eden; Brewer, Judson

2014-01-01

Mindfulness Training (MT) is an emerging therapeutic modality for addictive disorders. Non-judgment of inner experience, a component of mindfulness, may influence addiction treatment response. To test whether this component influences smoking cessation, tobacco smokers (n=85) in a randomized control trial of MT vs. Freedom from Smoking (FFS), a standard cognitive-behaviorally-oriented treatment, were divided into split-half subgroups based on baseline Five Facet Mindfulness Questionnaire non-judgment subscale. Smokers who rarely judge inner experience (non-judgment > 30.5) smoked less during follow-up when randomized to MT (3.9 cigs/d) vs. FFS (11.1 cigs/d), p <0.01. Measuring trait non-judgment may help personalize treatment assignments, improving outcomes. PMID:24611853

Wanting and liking: Separable components in problematic eating behavior?

PubMed

Polk, Sarah E; Schulte, Erica M; Furman, Celina R; Gearhardt, Ashley N

2017-08-01

Some individuals may have an addictive-like response to certain foods, possibly contributing to problematic eating. Highly processed foods, with added fats and/or refined carbohydrates, are suggested to be most associated with addictive-like eating. The incentive sensitization theory suggests that wanting (e.g. craving) may drive compulsive drug use rather than liking (e.g. enjoyment), but it is unknown whether highly processed foods elicit similar wanting and liking patterns as drugs of abuse, or whether individual differences exist. The current study examines the association of highly processed foods with craving and liking, and whether these relationships differ by food addiction symptomology, cognitive restraint, or body mass index (BMI). Participants (n = 216) reported craving and liking for 35 foods and completed the Yale Food Addiction Scale (YFAS) and Three Factor Eating Questionnaire (TFEQ). Highly processed foods were craved more overall. Craving of highly processed foods was predicted negatively by restraint and positively by YFAS score. Liking of highly processed foods was predicted negatively by restraint and positively by BMI. In conclusion, craving and liking appear distinct with respect to highly processed foods, and may be influenced by addictive-like eating, cognitive restraint, and BMI. This suggests that the incentive sensitization framework may also be relevant for problematic food consumption, especially for individuals reporting food addiction symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.

Addiction memory as a specific, individually learned memory imprint.

PubMed

Böning, J

2009-05-01

The construct of "addiction memory" (AM) and its importance for relapse occurrence has been the subject of discussion for the past 30 years. Neurobiological findings from "social neuroscience" and biopsychological learning theory, in conjunction with construct-valid behavioral pharmacological animal models, can now also provide general confirmation of addiction memory as a pathomorphological correlate of addiction disorders. Under multifactorial influences, experience-driven neuronal learning and memory processes of emotional and cognitive processing patterns in the specific individual "set" and "setting" play an especially pivotal role in this connection. From a neuropsychological perspective, the episodic (biographical) memory, located at the highest hierarchical level, is of central importance for the formation of the AM in certain structural and functional areas of the brain and neuronal networks. Within this context, neuronal learning and conditioning processes take place more or less unconsciously and automatically in the preceding long-term-memory systems (in particular priming and perceptual memory). They then regulate the individually programmed addiction behavior implicitly and thus subsequently stand for facilitated recollection of corresponding, previously stored cues or context situations. This explains why it is so difficult to treat an addiction memory, which is embedded above all in the episodic memory, from the molecular carrier level via the neuronal pattern level through to the psychological meaning level, and has thus meanwhile become a component of personality.

Effects of drugs of abuse on the central neuropeptide Y system.

PubMed

Gonçalves, Joana; Martins, João; Baptista, Sofia; Ambrósio, António Francisco; Silva, Ana Paula

2016-07-01

Neuropeptide Y (NPY), which is widely expressed in the central nervous system is involved in several neuropathologies including addiction. Here we comprehensively and systematically review alterations on the central NPY system induced by several drugs. We report on the effects of psychostimulants [cocaine, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA) and nicotine], ethanol, and opioids on NPY protein levels and expression of different NPY receptors. Overall, expression and function of NPY and its receptors are changed under conditions of drug exposure, thus affecting several physiologic behaviors, such as feeding, stress and anxiety. Drugs of abuse differentially affect the components of the NPY system. For example methamphetamine and nicotine lead to a consistent increase in NPY mRNA and protein levels in different brain sites whereas ethanol and opioids decrease NPY mRNA and protein expression. Drug-induced alterations on the different NPY receptors show more complex regulation pattern. Manipulation of the NPY system can have opposing effects on reinforcing and addictive properties of drugs of abuse. NPY can produce pro-addictive effects (nicotine and heroin), but can also exert inhibitory effects on addictive behavior (AMPH, ethanol). Furthermore, NPY can act as a neuroprotective agent in chronically methamphetamine and MDMA-treated rodents. In conclusion, manipulation of the NPY system seems to be a potential target to counteract neural alterations, addiction-related behaviors and cognitive deficits induced by these drugs. © 2015 Society for the Study of Addiction.

Novelty Seeking and Drug Addiction in Humans and Animals: From Behavior to Molecules

PubMed Central

Wingo, Taylor; Nesil, Tanseli; Choi, Jung-Seok; Li, Ming D.

2015-01-01

Global treatment of drug addiction costs society billions of dollars annually, but current psychopharmacological therapies have not been successful at desired rates. The increasing number of individuals suffering from substance abuse has turned attention to what makes some people more vulnerable to drug addiction than others. One personality trait that stands out as a contributing factor is novelty seeking. Novelty seeking, affected by both genetic and environmental factors, is defined as the tendency to desire novel stimuli and environments. It can be measured in humans through questionnaires and in rodents using behavioral tasks. On the behavioral level, both human and rodent studies demonstrate that high novelty seeking can predict the initiation of drug use and a transition to compulsive drug use and create a propensity to relapse. These predictions are valid for several drugs of abuse, such as alcohol, nicotine, cocaine, amphetamine, and opiates. On the molecular level, both novelty seeking and addiction are modulated by the central reward system in the brain. Dopamine is the primary neurotransmitter involved in the overlapping neural substrates of both parameters. In sum, the novelty-seeking trait can be valuable for predicting individual vulnerability to drug addiction and for generating successful treatment for patients with substance abuse disorders. PMID:26481371

Novelty Seeking and Drug Addiction in Humans and Animals: From Behavior to Molecules.

PubMed

Wingo, Taylor; Nesil, Tanseli; Choi, Jung-Seok; Li, Ming D

2016-09-01

Global treatment of drug addiction costs society billions of dollars annually, but current psychopharmacological therapies have not been successful at desired rates. The increasing number of individuals suffering from substance abuse has turned attention to what makes some people more vulnerable to drug addiction than others. One personality trait that stands out as a contributing factor is novelty seeking. Novelty seeking, affected by both genetic and environmental factors, is defined as the tendency to desire novel stimuli and environments. It can be measured in humans through questionnaires and in rodents using behavioral tasks. On the behavioral level, both human and rodent studies demonstrate that high novelty seeking can predict the initiation of drug use and a transition to compulsive drug use and create a propensity to relapse. These predictions are valid for several drugs of abuse, such as alcohol, nicotine, cocaine, amphetamine, and opiates. On the molecular level, both novelty seeking and addiction are modulated by the central reward system in the brain. Dopamine is the primary neurotransmitter involved in the overlapping neural substrates of both parameters. In sum, the novelty-seeking trait can be valuable for predicting individual vulnerability to drug addiction and for generating successful treatment for patients with substance abuse disorders.

State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade.

PubMed

Pbert, Lori; Farber, Harold; Horn, Kimberly; Lando, Harry A; Muramoto, Myra; O'Loughlin, Jennifer; Tanski, Susanne; Wellman, Robert J; Winickoff, Jonathan P; Klein, Jonathan D

2015-04-01

Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a "state-of-the-art" article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco. Copyright © 2015 by the American Academy of Pediatrics.

Addiction and Other Reasons Adolescent Smokers Give to Justify Smoking.

PubMed

Borderías, Luis; Duarte, Rosa; Escario, José Julián; Molina, José Alberto

2015-01-01

The primary purpose of this paper is to examine youth addiction and other justifications for adolescent smoking, and how they affect the level of consumption. Data from the Spanish 'State Survey on Drug Use among High School Students' aged between 14 and 18 years old were used in this paper. To account for the nature of the cigarette consumption data, several count data models were estimated in order to select the one that best fits adolescent smoking consumption. Most adolescent smokers smoke because it relaxes them, and about a quarter of them recognize that they are addicted. Moreover, the latter group smoke 44% more cigarettes than the rest (IRR = 1.444), revealing the strong addictive nature of tobacco, even at early ages. Moreover, parents' smoking increases the probability of smoking and has an impact on the level of consumption. The implications of these findings offer insight for parents, researchers, educators, and cessation interventionists, as awareness of self-reported and other predictors held by smoking youth creates a vantage point to facilitate changes in smoking behavior.

Cognitive Dysfunction, Affective States, and Vulnerability to Nicotine Addiction: A Multifactorial Perspective

PubMed Central

Besson, Morgane; Forget, Benoît

2016-01-01

Although smoking prevalence has declined in recent years, certain subpopulations continue to smoke at disproportionately high rates and show resistance to cessation treatments. Individuals showing cognitive and affective impairments, including emotional distress and deficits in attention, memory, and inhibitory control, particularly in the context of psychiatric conditions, such as attention-deficit hyperactivity disorder, schizophrenia, and mood disorders, are at higher risk for tobacco addiction. Nicotine has been shown to improve cognitive and emotional processing in some conditions, including during tobacco abstinence. Self-medication of cognitive deficits or negative affect has been proposed to underlie high rates of tobacco smoking among people with psychiatric disorders. However, pre-existing cognitive and mood disorders may also influence the development and maintenance of nicotine dependence, by biasing nicotine-induced alterations in information processing and associative learning, decision-making, and inhibitory control. Here, we discuss the potential forms of contribution of cognitive and affective deficits to nicotine addiction-related processes, by reviewing major clinical and preclinical studies investigating either the procognitive and therapeutic action of nicotine or the putative primary role of cognitive and emotional impairments in addiction-like features. PMID:27708591

Continuing care and long-term substance use outcomes in managed care: early evidence for a primary care-based model.

PubMed

Chi, Felicia W; Parthasarathy, Sujaya; Mertens, Jennifer R; Weisner, Constance M

2011-10-01

How best to provide ongoing services to patients with substance use disorders to sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered substance abuse treatment in a private, nonprofit managed care health plan, this study aimed to examine the components of a continuing care model (primary care, specialty substance abuse treatment, and psychiatric services) and their combined effect on outcomes over nine years after treatment entry. In a longitudinal observational study, follow-up measures included self-reported alcohol and drug use, Addiction Severity Index scores, and service utilization data extracted from the health plan databases. Remission, defined as abstinence or nonproblematic use, was the outcome measure. A mixed-effects logistic random intercept model controlling for time and other covariates found that yearly primary care, and specialty care based on need as measured at the prior time point, were positively associated with remission over time. Persons receiving continuing care (defined as having yearly primary care and specialty substance abuse treatment and psychiatric services when needed) had twice the odds of achieving remission at follow-ups (p<.001) as those without. Continuing care that included both primary care and specialty care management to support ongoing monitoring, self-care, and treatment as needed was important for long-term recovery of patients with substance use disorders.

Involving Teachers in Reducing Children's Media Risks

ERIC Educational Resources Information Center

Stiller, Anja; Schwendemann, Hanna; Bleckmann, Paula; Bitzer, Eva-Maria; Mößle, Thomas

2018-01-01

Purpose: The purpose of this paper is twofold: first, to introduce MEDIA PROTECT, a multi-modal intervention for parents and teachers with six components preventing problematic, and in the long run addictive, use of screen media by children; second, to present results of a formative evaluation of the teacher training, an important component of the…

Acute Care Use for Ambulatory Care-Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions.

PubMed

Hensel, Jennifer M; Taylor, Valerie H; Fung, Kinwah; Yang, Rebecca; Vigod, Simone N

2018-01-01

The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care. A retrospective, population-based cohort study using data from Ontario, Canada. Among the top 10% of medical care users ranked by cost, we determined rates of any and repeat care use (hospitalizations and emergency department [ED] visits) between April 1, 2011, and March 31, 2012, for 14 consensus established ACSCs and compared them between those with and without diagnosed mental illness or addiction during the 2 years prior. Risk ratios were adjusted (aRR) for age, sex, residence, and income quintile. Among 314,936 high-cost users, 35.9% had a mental illness or addiction. Compared to those without, individuals with mental illness or addiction were more likely to have an ED visit or hospitalization for any ACSC (22.8% vs. 19.6%; aRR, 1.21; 95% confidence interval [CI], 1.20-1.23). They were also more likely to have repeat ED visits or hospitalizations for the same ACSC (6.2% vs. 4.4% of those without; aRR, 1.48; 95% CI, 1.44-1.53). These associations were stronger in stratifications by mental illness diagnostic subgroup, particularly for those with a major mental illness. The presence of mental illness and addiction among high-cost users of medical services may represent an unmet need for quality ambulatory and primary care.

Multi-family group therapy for adolescent Internet addiction: exploring the underlying mechanisms.

PubMed

Liu, Qin-Xue; Fang, Xiao-Yi; Yan, Ni; Zhou, Zong-Kui; Yuan, Xiao-Jiao; Lan, Jing; Liu, Chao-Ying

2015-03-01

Internet addiction is one of the most common problems among adolescents and effective treatment is needed. This research aims to test the effectiveness and underlying mechanism of multi-family group therapy (MFGT) to reduce Internet addiction among adolescents. A total of 92 participants consisting of 46 adolescents with Internet addiction, aged 12-18years, and 46 their parents, aged 35-46years, were assigned to the experimental group (six-session MFGT intervention) or a waiting-list control. Structured questionnaires were administered at pre-intervention (T1), post-intervention (T2) and a three-month follow-up (T3). There was a significant difference in the decline both in the average score and proportion of adolescents with Internet addiction in MFGT group at post-intervention (MT1=3.40, MT2=2.46, p<0.001; 100 versus 4.8%, p<0.001) maintained for three months (MT3=2.06, p<0.001; 100 versus 11.1%, p<0.001). Reports from both adolescents and parents were significantly better than those in the control group. Further explorations of the underlying mechanisms of effectiveness based on the changed values of measured variables showed that the improvement in adolescent Internet use was partially explained by the satisfaction of their psychological needs and improved parent-adolescent communication and closeness. The six-session multi-family group therapy was effective in reducing Internet addiction behaviors among adolescents and could be implemented as part of routine primary care clinic services in similar populations. As family support system is critical in maintaining the intervention effect, fostering positive parent-adolescent interaction and addressing adolescents' psychological needs should be included in preventive programs for Internet addiction in the future. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neurobiology of addictive behaviors and its relationship to methadone maintenance.

PubMed

Stimmel, B; Kreek, M J

2000-01-01

Scientific information about the neurobiology of addictive behaviors provides an increasingly important rationale to support opioid agonist pharmacotherapy, primarily methadone maintenance treatment, for long-term heroin addiction. In late 1963 and 1964, the first research was performed at The Rockefeller Institute for Medical Research by Dole, Nyswander, and Kreek in an attempt to develop a new pharmacotherapy for opiate addiction. The hypothesis underlying that research was that heroin addiction was a disease. However, the evidence for heroin addiction being a disease was based primarily on clinical anecdotes and the natural history of opiate addiction. Until then chronic addiction was managed primarily using abstinence-based, medication-free behavioral approaches. Such approaches were uniformly successful in only a small percent of long-term heroin addicts. Subsequent research, both clinical research as well as laboratory-based research, using a variety of appropriate animal models as well as in vitro techniques, has shown that drugs of abuse in general, and specifically the short-acting opiates, such as heroin, may profoundly alter molecular and neurochemical indices, and thus physiologic functions. Also, research has shown that after chronic exposure to a short-acting opiate,these alterations may be persistent, or even permanent, and may contribute directly to the perpetuation of self-administration of opiates, and even the return to opiate use after achieving a drug-free and medication-free state. There is ample evidence now that disruption of several components of the endogenous opioid system, ranging from changes in gene expression to changes in behavior, may occur during cycles of short-acting opiate abuse. Also, there are very convincing studies that suggest that stress responsivity is profoundly altered by chronic abuse of short-acting opiates including: documentation of atypical hypo-responsivity to stressors during cycles of heroin addiction; evidence of sustained hyper-responsivity to stressors in the medication-free, illicit-opiate-free state; and in contrast, normalization of stress responsivity, as reflected by the hypothalamic-pituitary-adrenal axis function in long-term, methadone-maintained patients. Thus, both laboratory and clinical research studies provide firm documentation that the disruption of physiologic, as well as behavioral, functions occurs during chronic administration of short-acting opiates. Also, there is research evidence of an epidemiologic, and more recently of a molecular genetics type, that a genetic vulnerability to develop addictions in general, and opiate addiction specifically, may exist, and that early environmental factors may alter physiology to enhance vulnerability to develop opiate addiction when self-exposed.

To quit or not: Vulnerability of women to smoking tobacco.

PubMed

Park, Se-Jung; Yi, Bitna; Lee, Ho-Sun; Oh, Woo-Yeon; Na, Hyun-Kyung; Lee, Minjeong; Yang, Mihi

2016-01-01

Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among women, we focused on the vulnerability of women to smoking behaviors--smoking cessation or tobacco addiction--and performed a systematic review of the socioeconomic and intrinsic factors as well as tobacco ingredients that affect women's susceptibility to smoking tobacco. We observed that nicotine and other tobacco components including cocoa-relatives, licorice products, and menthol aggravate tobacco addiction in women rather than in men. Various genetic and epigenetic alterations in dopamine pathway and the pharmaco-kinetics and -dynamic factors of nicotine also showed potential evidences for high susceptibility to tobacco addiction in women. Therefore, we suggest systemic approaches to prevent tobacco smoking-related health risks, considering gene-environment-gender interaction.

Withdrawal: Expanding a Key Addiction Construct

PubMed Central

2015-01-01

Withdrawal is an essential component of classical addiction theory; it is a vital manifestation of dependence and motivates relapse. However, the traditional conceptualization of withdrawal as a cohesive collection of symptoms that emerge during drug deprivation and decline with either the passage of time or reinstatement of drug use, may be inadequate to explain scientific findings or fit with modern theories of addiction. This article expands the current understanding of tobacco withdrawal by examining: (1) withdrawal variability; (2) underlying causes of withdrawal variability, including biological and person factors, environmental influences, and the influence of highly routinized behavioral patterns; (3) new withdrawal symptoms that allow for enhanced characterization of the withdrawal experience; and (4) withdrawal-related cognitive processes. These topics provide guidance regarding the optimal assessment of withdrawal and illustrate the potential impact modern withdrawal conceptualization and assessment could have on identifying treatment targets. PMID:25744958

Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder.

PubMed

Wachholtz, Amy; Foster, Simmie; Cheatle, Martin

2015-01-01

Opioid therapy is one component of an effective pain management regimen for patients with chronic pain and the majority of these patients use their medications responsibly. However, there are a growing number of these patients who develop an opioid use disorder and in some cases require opioid replacement therapy. Managing these patients is complex and the underlying mechanisms of pain and addiction are not well understood. Developing an effective interdisciplinary treatment program for the individual with pain and an opioid use disorder will depend on enhancing our knowledge of the psychophysiology of pain and addiction. Authors gathered key empirical and theoretical papers examining the psychophysiology of comorbid pain and opioid misuse disorders. This article reviews the current theory of the effect of pain on patients with pain and concomitant addiction, the psychophysiology of pain, opioid use and addiction, and future research in this area. Individuals with a history of opioid misuse have greater levels of hyperalgesia which may be due to alterations in psychophysiological pathways. More research is needed into the psychophysiological biomarkers among individuals with comorbid pain and addiction in order to develop better treatment approaches and improve outcomes among this difficult to treat population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Insurance Companies Fighting the Peer Review Empire without any Validity: the Case for Addiction and Pain Modalities in the face of an American Drug Epidemic.

PubMed

Blum, K; Jacobs, W; Modestino, E J; DiNubile, N; Baron, D; McLaughlin, T; Siwicki, D; Elman, I; Moran, M; Braverman, E R; Thanos, P K; Badgaiyan, R D

2018-10-04

The United States are amid an opioid overdose epidemic; we are challenged to provide non-addicting/non-pharmacological alternatives to assist in pain attenuation. There are proven strategies available to manage chronic pain effectively without opioids. Utilization review providers for insurance companies often ignore medicine based scientific peer-reviewed studies that warn against the chronic use of opioid medications, as well as the lack of evidence to support long-term use of opioids for pain. This paradigm must change if we are to indeed change the drug-embracing culture in American chronic pain management. A barrier to treatment is pushback on the part of insurance companies especially as it relates to fighting against pain relief alternatives compared to classical analgesic agents. Pain specialists in the U.S., are compelled to find alternative solutions to help pain victims without promoting unwanted tolerance to analgesics and subsequent biological induction of the "addictive brain." It is noteworthy that reward center of the brain plays a crucial role in the modulation of nociception, and that adaptations in dopaminergic circuitry may affect several sensory and affective components of chronic pain syndromes. Possibly knowing a patient's genetic addiction risk score (GARS™) could eliminate guessing as it relates to becoming addicted.

[Computer games in childhood and adolescence: relations to addictive behavior, ADHD, and aggression].

PubMed

Frölich, Jan; Lehmkuhl, Gerd; Döpfner, Manfred

2009-09-01

Playing computer games has become one of the main leisure activities in children and adolescents and increasingly replaces traditional playing and interactional activities. There might exist developmental benefits or positive effects of computer games that can be used for educational or therapeutic purposes. More important several studies have well demonstrated that excessive computer game playing is associated with behavior that features all components of non-chemical addiction and the prevalences across all age groups seem to be impressingly high. This overview relies on a Medline research. Its objective is to describe motivational and developmental characteristics attributed to computer games as well as the prevalences of computer playing in children and adolescents to better understand the risks for addictive use. We especially focus on the relations of excessive computer playing with attention-deficit hyperactivity disorder (ADHD) and aggressive behavior. The results demonstrate that children with ADHD are especially vulnerable to addictive use of computer games due to their neuropsychological profile. Moreover excessive violent computer game playing might be a significant risk variable for aggressive behavior in the presence of personality traits with aggressive cognitions and behavior scripts in the consumers. The increasing clinical meaning of addictive computer games playing urgently necessitates the development of diagnostic and therapeutic tools for clinical practice as well as the cooperation with allied disciplines.

A critical review of "Internet addiction" criteria with suggestions for the future.

PubMed

Van Rooij, Antonius J; Prause, Nicole

2014-12-01

In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted.

The Voluntary Nature of Decision-Making in Addiction: Static Metaphysical Views Versus Epistemologically Dynamic Views.

PubMed

Racine, Eric; Rousseau-Lesage, Simon

2017-06-01

The degree of autonomy present in the choices made by individuals with an addiction, notably in the context of research, is unclear and debated. Some have argued that addiction, as it is commonly understood, prevents people from having sufficient decision-making capacity or self-control to engage in choices involving substances to which they have an addiction. Others have criticized this position for being too radical and have counter-argued in favour of the full autonomy of people with an addiction. Aligning ourselves with middle-ground positions between these two extremes, we flesh out an account of voluntary action that makes room for finer-grained analyses than the proposed all-or-nothing stances, which rely on a rather static metaphysical understanding of the nature of the voluntariness of action. In contrast, a dynamic concept of voluntary action better accounts for varying levels of voluntariness of the person with an addiction which takes into consideration internal (e.g. cravings) and external (e.g. perceptions of degrees of freedom related to different options) determinants of choice. Accordingly, like other components of autonomous choices such as level of information, voluntariness can fluctuate. Therefore, there are important implications for research and clinical ethics in matters of consent, recruitment, and therapeutic approaches. Overall, our proposal is inspired by a pragmatist understanding of voluntary action, notably with respect to how voluntariness is both informed by actions and experiences that shape one's view of the world. © 2017 John Wiley & Sons Ltd.

[Doping: health risks and relation to addictive behaviors].

PubMed

Siri, Françoise; Roques, Bernard P

2003-11-01

The paper presents the health hazards of the major doping substances and raises some questions about the relationship between doping and addictive behavior. Current definitions of doping and addictive behavior are examined. The paper's goal is: 1- to assess the risks of neurotoxicity and overall toxicity of doping substances: stimulants, narcotics (seldom used as doping substances), and hormones, and assess their addictive potential; 2- to present available data on drug-dependent patients with a record of early prolonged and intensive physical activity or athletic practice. Some doping substances present high risks for health at large doses, but usually low addictive potential and neurotoxicity. Dependency on doping substances and drift towards dependency to addictive drugs, if any, are therefore determined by genetic and environmental factors. A significant susceptibility to drug dependence has been observed in some cases of very intensive and competitive practice. Over-representation of intensive and competitive athletic antecedents among some drug-dependent patients could be accounted for in either of two ways. On the first account, the causal factor is a sensation-seeking character trait, with a likely genetic component, which predisposes the individual to the use of drugs or doping substances, as the opportunities arise. On the second account, the sudden interruption of intensive practice, and of the associated organic stress and hypersensitization of the hedonic pathway, creates a weaning syndrome and leads to the search for relief through drugs. Further exploration of this hypothesis is called for.

Barriers and facilitators to tobacco cessation in a nationwide sample of addiction treatment programs

PubMed Central

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-01-01

Introduction Smoking rates among addiction treatment clients are 3–4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. Methods The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semistructured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Conclusion Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. PMID:27296658

Neural mechanisms of reproduction in females as a predisposing factor for drug addiction.

PubMed

Hedges, Valerie L; Staffend, Nancy A; Meisel, Robert L

2010-04-01

There is an increasing awareness that adolescent females differ from males in their response to drugs of abuse and consequently in their vulnerability to addiction. One possible component of this vulnerability to drug addiction is the neurobiological impact that reproductive physiology and behaviors have on the mesolimbic dopamine system, a key neural pathway mediating drug addiction. In this review, we examine animal models that address the impact of ovarian cyclicity, sexual affiliation, sexual behavior, and maternal care on the long-term plasticity of the mesolimbic dopamine system. The thesis is that this plasticity in synaptic neurotransmission stemming from an individual's normal life history contributes to the pathological impact of drugs of abuse on the neurobiology of this system. Hormones released during reproductive cycles have only transient effects on these dopamine systems, whereas reproductive behaviors produce a persistent sensitization of dopamine release and post-synaptic neuronal responsiveness. Puberty itself may not represent a neurobiological risk factor for drug abuse, but attendant behavioral experiences may have a negative impact on females engaging in drug use.

Addiction, adolescence, and the integration of control and motivation.

PubMed

Gladwin, Thomas E; Figner, Bernd; Crone, Eveline A; Wiers, Reinout W

2011-10-01

The likelihood of initiating addictive behaviors is higher during adolescence than during any other developmental period. The differential developmental trajectories of brain regions involved in motivation and control processes may lead to adolescents' increased risk taking in general, which may be exacerbated by the neural consequences of drug use. Neuroimaging studies suggest that increased risk-taking behavior in adolescence is related to an imbalance between prefrontal cortical regions, associated with executive functions, and subcortical brain regions related to affect and motivation. Dual-process models of addictive behaviors are similarly concerned with difficulties in controlling abnormally strong motivational processes. We acknowledge concerns raised about dual-process models, but argue that they can be addressed by carefully considering levels of description: motivational processes and top-down biasing can be understood as intertwined, co-developing components of more versus less reflective states of processing. We illustrate this with a model that further emphasizes temporal dynamics. Finally, behavioral interventions for addiction are discussed. Insights in the development of control and motivation may help to better understand - and more efficiently intervene in - vulnerabilities involving control and motivation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Neural Mechanisms of Reproduction in Females as a Predisposing Factor for Drug Addiction

PubMed Central

Hedges, Valerie L.; Staffend, Nancy A.; Meisel, Robert L.

2010-01-01

There is an increasing awareness that adolescent females differ from males in their response to drugs of abuse and consequently in their vulnerability to addiction. One possible component of this vulnerability to drug addiction is the neurobiological impact that reproductive physiology and behaviors have on the mesolimbic dopamine system, a key neural pathway mediating drug addiction. In this review, we examine animal models that address the impact of ovarian cyclicity, sexual affiliation, sexual behavior, and maternal care on the long-term plasticity of the mesolimbic dopamine system. The thesis is that this plasticity in synaptic neurotransmission stemming from an individual’s normal life history contributes to the pathological impact of drugs of abuse on the neurobiology of this system. Hormones released during reproductive cycles have only transient effects on these dopamine systems, whereas reproductive behaviors produce a persistent sensitization of dopamine release and postsynaptic neuronal responsiveness. Puberty itself may not represent a neurobiological risk factor for drug abuse, but attendant behavioral experiences may have a negative impact on females engaging in drug use. PMID:20176045

The association of persistent pain with out-patient addiction treatment outcomes and service utilization.

PubMed

Caldeiro, Ryan M; Malte, Carol A; Calsyn, Donald A; Baer, John S; Nichol, Paul; Kivlahan, Daniel R; Saxon, Andrew J

2008-12-01

To estimate the prevalence of persistent pain among veterans in out-patient addiction treatment and examine associated addiction treatment outcomes and medical and psychiatric service use. Analysis of data from a prospective randomized controlled trial comparing on-site versus referral primary care of veterans with substance dependence (n = 582), excluding opioid dependence who had at least one follow-up interview during the 12-month study period in a Veterans Affairs (VA) out-patient addiction treatment center. Pain status was classified as persistent (pain was rated moderate to very severe at all time-points), low (pain was rated none to mild at all time-points) or intermittent (all others). Main outcome measures were addiction treatment retention, addiction severity index (ASI) alcohol and drug composite scores, VA service utilization and treatment costs. A total of 33.2% of veterans reported persistent pain and 47.3% reported intermittent pain. All groups benefited from addiction treatment, but veterans with persistent pain were in treatment for an estimated 35.1 fewer days [95% confidence interval (CI) = -64.1, -6.1, P = 0.018], less likely to be abstinent from alcohol or drugs at 12 months [odds ratio (OR)(adj) = 0.52; 95% CI = 0.30,0.89; P = 0.018], had worse ASI alcohol composite scores at 12 months (beta(adj) = 0.09; 95% CI = 0.02,0.15; P = 0.007), were more likely to be medically hospitalized (OR(adj) = 2.70; 95% CI = 1.02,7.13; P = 0.046) and had higher total service costs compared to those with low pain ($17 766 versus $13 261, P = 0.012). Persistent pain is common among veterans in out-patient addiction treatment and is associated with poorer rates of abstinence, worse alcohol use severity and greater service utilization and costs than those with low pain.

Traditional Chinese medicine for treatment of alcoholism: from ancient to modern.

PubMed

Liu, Qing; Lawrence, Andrew J; Liang, Jian-Hui

2011-01-01

Alcohol has long been used as a daily beverage in China and around the world. It is a medicinal substance with various biological activities. In fact, alcohol has played an important role in the development of traditional Chinese medicine (TCM), within which it is considered as the earliest exhilarant and anaesthetic. Yet, as a substance with great potency of misuse and addiction, the consumption of alcohol can lead to serious damage to individual health and the society. Over the past 20 years, alcohol abuse or alcoholism has become an increasing social problem in China along with the rapid economic development. China, the country of origin for TCM, has accumulated abundant clinical experience in the treatment of alcoholism with its ancient medicine. In the present research, we have summarized clinical and primary studies concerning various remedies of TCM for alcohol abuse, including herbal components (such as Kudzu/Pueraria Lobata, Pediculus melo, Hypericumpperforatum L.), decoctions and acupuncture.

Nicotine Inhibits Memory CTL Programming

PubMed Central

Sun, Zhifeng; Smyth, Kendra; Garcia, Karla; Mattson, Elliot; Li, Lei; Xiao, Zhengguo

2013-01-01

Nicotine is the main tobacco component responsible for tobacco addiction and is used extensively in smoking and smoking cessation therapies. However, little is known about its effects on the immune system. We confirmed that multiple nicotinic receptors are expressed on mouse and human cytotoxic T lymphocytes (CTLs) and demonstrated that nicotinic receptors on mouse CTLs are regulated during activation. Acute nicotine presence during activation increases primary CTL expansion in vitro, but impairs in vivo expansion after transfer and subsequent memory CTL differentiation, which reduces protection against subsequent pathogen challenges. Furthermore, nicotine abolishes the regulatory effect of rapamycin on memory CTL programming, which can be attributed to the fact that rapamycin enhances expression of nicotinic receptors. Interestingly, naïve CTLs from chronic nicotine-treated mice have normal memory programming, which is impaired by nicotine during activation in vitro. In conclusion, simultaneous exposure to nicotine and antigen during CTL activation negatively affects memory development. PMID:23844169

NEURAL SUBSTRATES OF CUE-REACTIVITY: ASSOCIATION WITH TREATMENT OUTCOMES AND RELAPSE

PubMed Central

Courtney, Kelly E.; Schacht, Joseph P.; Hutchison, Kent; Roche, Daniel J.O.; Ray, Lara A.

2016-01-01

Given the strong evidence for neurological alterations at the basis of drug dependence, functional magnetic resonance imaging (fMRI) represents an important tool in the clinical neuroscience of addiction. fMRI cue-reactivity paradigms represent an ideal platform to probe the involvement of neurobiological pathways subserving the reward/motivation system in addiction and potentially offer a translational mechanism by which interventions and behavioral predictions can be tested. Thus, this review summarizes the research that has applied fMRI cue-reactivity paradigms to the study of adult substance use disorder treatment responses. Studies utilizing fMRI cue-reactivity paradigms for the prediction of relapse, and as a means to investigate psychosocial and pharmacological treatment effects on cue-elicited brain activation are presented within four primary categories of substances: alcohol, nicotine, cocaine, and opioids. Lastly, suggestions for how to leverage fMRI technology to advance addiction science and treatment development are provided. PMID:26435524

Is Neural Processing of Negative Stimuli Altered in Addiction Independent of Drug Effects? Findings From Drug-Naïve Youth with Internet Gaming Disorder.

PubMed

Yip, Sarah W; Gross, James J; Chawla, Megha; Ma, Shan-Shan; Shi, Xing-Hui; Liu, Lu; Yao, Yuan-Wei; Zhu, Lei; Worhunsky, Patrick D; Zhang, Jintao

2018-05-01

Difficulties in emotion regulation are commonly reported among individuals with alcohol and drug addictions and contribute to the acquisition and maintenance of addictive behaviors. Alterations in neural processing of negative affective stimuli have further been demonstrated among individuals with addictions. However, it is unclear whether these alterations are a general feature of addictions or are a result of prolonged exposure to drugs of abuse. To test the hypothesis of altered negative affect processing independent of drug effects, this study assessed neural function among drug-naïve youth with a behavioral addiction-Internet gaming disorder (IGD). Fifty-six young adults (28 with IGD, 28 matched controls) participated in fMRI scanning during performance of a well-validated emotion regulation task. Between-group differences in neural activity during task performance were assessed using a whole-brain, mixed-effects ANOVA with correction for multiple comparisons at currently recommended thresholds (voxel-level p<0.001, pFWE<0.05). Compared to controls, youth with IGD exhibited significantly blunted neural responses within distributed subcortical and cortical regions including the striatum, insula, lateral prefrontal cortex and anterior cingulate in response to negative affective cues, as well as during emotion regulation. Independent component analysis (ICA) further identified between-group differences in engagement of a fronto-cingulo-parietal network, involving decreased engagement in IGD youth relative to controls. Study findings are largely consistent with those from prior neuroimaging studies in substance-use disorders, thus raising the possibility that neural processing of negative affect may be blunted across drug and behavioral addictions independent of acute or chronic drug effects.

Age-related changes in nicotine response of cholinergic and non-cholinergic laterodorsal tegmental neurons: implications for the heightened adolescent susceptibility to nicotine addiction

PubMed Central

Christensen, Mark H.; Ishibashi, Masaru; Nielsen, Michael L.; Leonard, Christopher S.; Kohlmeier, Kristi A.

2015-01-01

The younger an individual starts smoking, the greater the likelihood that addiction to nicotine will develop, suggesting that neurobiological responses vary across age to the addictive component of cigarettes. Cholinergic neurons of the laterodorsal tegmental nucleus (LDT) are importantly involved in the development of addiction, however, the effects of nicotine on LDT neuronal excitability across ontogeny are unknown. Nicotinic effects on several parameters affecting LDT cells across different age groups were examined using calcium imaging and whole-cell patch clamping. Within the youngest age group (P7-P15), nicotine was found to induce larger intracellular calcium transients and inward currents. Nicotine induced a greater number of excitatory synaptic currents in the youngest animals, whereas larger amplitude inhibitory synaptic events were induced in cells from the oldest animals (P15-P34). Nicotine increased neuronal firing of cholinergic cells to a greater degree in younger animals, possibly linked to development associated differences found in nicotinic effects on action potential shape and afterhyperpolarization. We conclude that in addition to age-associated alterations of several properties expected to affect resting cell excitability, parameters affecting cell excitability are altered by nicotine differentially across ontogeny. Taken together, our data suggest that nicotine induces a larger excitatory response in cholinergic LDT neurons from the youngest animals, which could result in a greater excitatory output from these cells to target regions involved in development of addiction. Such output would be expected to be promotive of addiction; therefore, ontogenetic differences in nicotine-mediated increases in the excitability of the LDT could contribute to the differential susceptibility to nicotine addiction seen across age. PMID:24863041

Ibogaine signals addiction genes and methamphetamine alteration of long-term potentiation.

PubMed

Onaivi, Emmanuel S; Ali, Syed F; Chirwa, Sanika S; Zwiller, Jean; Thiriet, Nathalie; Akinshola, B Emmanuel; Ishiguro, Hiroki

2002-06-01

The mapping of the human genetic code will enable us to identify potential gene products involved in human addictions and diseases that have hereditary components. Thus, large-scale, parallel gene-expression studies, made possible by advances in microarray technologies, have shown insights into the connection between specific genes, or sets of genes, and human diseases. The compulsive use of addictive substances despite adverse consequences continues to affect society, and the science underlying these addictions in general is intensively studied. Pharmacological treatment of drug and alcohol addiction has largely been disappointing, and new therapeutic targets and hypotheses are needed. As the usefulness of the pharmacotherapy of addiction has been limited, an emerging potential, yet controversial, therapeutic agent is the natural alkaloid ibogaine. We have continued to investigate programs of gene expression and the putative signaling molecules used by psychostimulants such as amphetamine in in vivo and in vitro models. Our work and that of others reveal that complex but defined signal transduction pathways are associated with psychostimulant administration and that there is broad-spectrum regulation of these signals by ibogaine. We report that the actions of methamphetamine were similar to those of cocaine, including the propensity to alter long-term potentiation (LTP) in the hippocampus of the rat brain. This action suggests that there may be a "threshold" beyond which the excessive brain stimulation that probably occurs with compulsive psychostimulant use results in the occlusion of LTP. The influence of ibogaine on immediate early genes (IEGs) and other candidate genes possibly regulated by psychostimulants and other abused substances requires further evaluation in compulsive use, reward, relapse, tolerance, craving and withdrawal reactions. It is therefore tempting to suggest that ibogaine signals addiction gene products.

Therapeutic Components and Differential Treatment Outcomes among Clients of Israeli Services for Substance Abusers

ERIC Educational Resources Information Center

Schiff, Miriam; Katz, Katalin

2007-01-01

Objective: This study is the first in a comprehensive examination of therapeutic components and outcome of interventions in a public, nonresidential service for drug addicts in Jerusalem (SHALEM). Method: Data were gathered from 153 clients (35 women, 128 men; 35 Arabs, 118 Jews; median age = 39) using clinical data mining. Results: Men who had…

New systems of care for substance use disorders: treatment, finance, and technology under health care reform.

PubMed

Pating, David R; Miller, Michael M; Goplerud, Eric; Martin, Judith; Ziedonis, Douglas M

2012-06-01

This article outlined ways in which persons with addiction are currently underserved by our current health care system. However, with the coming broad scale reforms to our health care system, the access to and availability of high-quality care for substance use disorders will increase. Addiction treatments will continue to be offered through traditional substance abuse care systems, but these will be more integrated with primary care, and less separated as treatment facilities leverage opportunities to blend services, financing mechanisms, and health information systems under federally driven incentive programs. To further these reforms, vigilance will be needed by consumers, clinicians, and policy makers to assure that the unmet treatment needs of individuals with addiction are addressed. Embedded in this article are essential recommendations to facilitate the improvement of care for substance use disorders under health care reform. Ultimately, as addiction care acquires more of the “look and feel” of mainstream medicine, it is important to be mindful of preexisting trends in health care delivery overall that are reflected in recent health reform legislation. Within the world of addiction care, clinicians must move beyond their self-imposed “stigmatization” and sequestration of specialty addiction treatment. The problem for addiction care, as it becomes more “mainstream,” is to not comfortably feel that general slogans like “Treatment Works,” as promoted by Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment during its annual Recovery Month celebrations, will meet the expectations of stakeholders outside the specialty addiction treatment community. Rather, the problem is to show exactly how addiction treatment works, and to what extent it works-there have to be metrics showing changes in symptom level or functional outcome, changes in health care utilization, improvements in workplace attendance and productivity, or other measures. At minimum, clinicians will be required to demonstrate that their new systems of care and future clinical activity are in conformance with overall standards of “best practice” in health care.

Genetic Addiction Risk Score (GARS): molecular neurogenetic evidence for predisposition to Reward Deficiency Syndrome (RDS).

PubMed

Blum, Kenneth; Oscar-Berman, Marlene; Demetrovics, Zsolt; Barh, Debmalya; Gold, Mark S

2014-12-01

We have published extensively on the neurogenetics of brain reward systems with reference to the genes related to dopaminergic function in particular. In 1996, we coined "Reward Deficiency Syndrome" (RDS), to portray behaviors found to have gene-based association with hypodopaminergic function. RDS as a useful concept has been embraced in many subsequent studies, to increase our understanding of Substance Use Disorder (SUD), addictions, and other obsessive, compulsive, and impulsive behaviors. Interestingly, albeit others, in one published study, we were able to describe lifetime RDS behaviors in a recovering addict (17 years sober) blindly by assessing resultant Genetic Addiction Risk Score (GARS™) data only. We hypothesize that genetic testing at an early age may be an effective preventive strategy to reduce or eliminate pathological substance and behavioral seeking activity. Here, we consider a select number of genes, their polymorphisms, and associated risks for RDS whereby, utilizing GWAS, there is evidence for convergence to reward candidate genes. The evidence presented serves as a plausible brain-print providing relevant genetic information that will reinforce targeted therapies, to improve recovery and prevent relapse on an individualized basis. The primary driver of RDS is a hypodopaminergic trait (genes) as well as epigenetic states (methylation and deacetylation on chromatin structure). We now have entered a new era in addiction medicine that embraces the neuroscience of addiction and RDS as a pathological condition in brain reward circuitry that calls for appropriate evidence-based therapy and early genetic diagnosis and that requires further intensive investigation.

Effects of nicotine and minor tobacco alkaloids on intracranial-self-stimulation in rats.

PubMed

Harris, Andrew C; Tally, Laura; Muelken, Peter; Banal, Andrew; Schmidt, Clare E; Cao, Qing; LeSage, Mark G

2015-08-01

While nicotine is the primary addictive compound in tobacco, other tobacco constituents including minor alkaloids (e.g., nornicotine, anabasine) may also contribute to tobacco addiction by mimicking or enhancing the effects of nicotine. Further evaluating the behavioral effects of minor alkaloids is essential for understanding their impact on tobacco addiction and informing development of tobacco product standards by the FDA. This study compared the addiction-related effects of nicotine and the minor alkaloids nornicotine, anabasine, myosmine, anatabine, and cotinine on intracranial self-stimulation (ICSS) thresholds in rats. Acute injection of nicotine produced reinforcement-enhancing (ICSS threshold-decreasing) effects at low to moderate doses, and reinforcement-attenuating/aversive (ICSS threshold-increasing) effects at high doses. Nornicotine and anabasine produced similar biphasic effects on ICSS thresholds, although with lower potency compared to nicotine. Myosmine only elevated ICSS thresholds at relatively high doses, while anatabine and cotinine did not influence ICSS thresholds at any dose. None of the alkaloids significantly influenced ICSS response latencies, indicating a lack of nonspecific motoric effects. These findings indicate that some minor tobacco alkaloids can either fully (nornicotine, anabasine) or partially (myosmine) mimic nicotine's addiction-related effects on ICSS, albeit at reduced potency. These findings emphasize the need for further study of the abuse potential of minor alkaloids, including evaluation of their effects when combined with nicotine and other tobacco constituents to better simulate tobacco exposure in humans. Such work is essential for informing FDA regulation of tobacco products and could also lead to the development of novel pharmacotherapies for tobacco addiction. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Time-dependent regional brain distribution of methadone and naltrexone in the treatment of opioid addiction.

PubMed

Teklezgi, Belin G; Pamreddy, Annapurna; Baijnath, Sooraj; Kruger, Hendrik G; Naicker, Tricia; Gopal, Nirmala D; Govender, Thavendran

2018-02-14

Opioid addiction is a serious public health concern with severe health and social implications; therefore, extensive therapeutic efforts are required to keep users drug free. The two main pharmacological interventions, in the treatment of addiction, involve management with methadone an mu (μ)-opioid agonist and treatment with naltrexone, μ-opioid, kappa (κ)-opioid and delta (δ)-opioid antagonist. MET and NAL are believed to help individuals to derive maximum benefit from treatment and undergo a full recovery. The aim of this study was to determine the localization and distribution of MET and NAL, over a 24-hour period in rodent brain, in order to investigate the differences in their respective regional brain distributions. This would provide a better understanding of the role of each individual drug in the treatment of addiction, especially NAL, whose efficacy is controversial. Tissue distribution was determined by using mass spectrometric imaging (MSI), in combination with quantification via liquid chromatography tandem mass spectrometry. MSI image analysis showed that MET was highly localized in the striatal and hippocampal regions, including the nucleus caudate, putamen and the upper cortex. NAL was distributed with high intensities in the mesocorticolimbic system including areas of the cortex, caudate putamen and ventral pallidum regions. Our results demonstrate that MET and NAL are highly localized in the brain regions with a high density of μ-receptors, the primary sites of heroin binding. These areas are strongly implicated in the development of addiction and are the major pathways that mediate brain stimulation during reward. © 2018 Society for the Study of Addiction.

The role of acetylcholine in cocaine addiction.

PubMed

Williams, Mark J; Adinoff, Bryon

2008-07-01

Central nervous system cholinergic neurons arise from several discrete sources, project to multiple brain regions, and exert specific effects on reward, learning, and memory. These processes are critical for the development and persistence of addictive disorders. Although other neurotransmitters, including dopamine, glutamate, and serotonin, have been the primary focus of drug research to date, a growing preclinical literature reveals a critical role of acetylcholine (ACh) in the experience and progression of drug use. This review will present and integrate the findings regarding the role of ACh in drug dependence, with a primary focus on cocaine and the muscarinic ACh system. Mesostriatal ACh appears to mediate reinforcement through its effect on reward, satiation, and aversion, and chronic cocaine administration produces neuroadaptive changes in the striatum. ACh is further involved in the acquisition of conditional associations that underlie cocaine self-administration and context-dependent sensitization, the acquisition of associations in conditioned learning, and drug procurement through its effects on arousal and attention. Long-term cocaine use may induce neuronal alterations in the brain that affect the ACh system and impair executive function, possibly contributing to the disruptions in decision making that characterize this population. These primarily preclinical studies suggest that ACh exerts a myriad of effects on the addictive process and that persistent changes to the ACh system following chronic drug use may exacerbate the risk of relapse during recovery. Ultimately, ACh modulation may be a potential target for pharmacological treatment interventions in cocaine-addicted subjects. However, the complicated neurocircuitry of the cholinergic system, the multiple ACh receptor subtypes, the confluence of excitatory and inhibitory ACh inputs, and the unique properties of the striatal cholinergic interneurons suggest that a precise target of cholinergic manipulation will be required to impact substance use in the clinical population.

The independent relationship between trouble controlling Facebook use, time spent on the site and distress.

PubMed

Muench, Fredrick; Hayes, Marie; Kuerbis, Alexis; Shao, Sijing

2015-09-01

There is an emerging literature base on the relationship between maladaptive traits and "addiction" to social networking sites. These studies have operationalized addiction as either spending excessive amounts of time on social networking sites (SNS) or trouble controlling SNS use, but have not assessed the unique contribution of each of these constructs on outcomes in the same models. Moreover, these studies have exclusively been conducted with younger people rather than a heterogeneous sample. This study examined the independent relationship of a brief Facebook addiction scale, time spent on Facebook, and Facebook checking on positive and negative social domains, while controlling for self-esteem and social desirability. Participants were recruited using e-mail, SNS posts and through Amazon's MTurk system. The sample included 489 respondents ages from 18 to approximately 70, who completed a 10-15 minute survey. Results indicate that neither time spent on Facebook nor Facebook checking was significantly associated with either self-esteem, fear of negative social evaluation or social comparison, while SNS addiction symptoms were each independently associated with Facebook usage. Neither time spent on Facebook nor SNS addiction symptoms were associated with positive social relationships. Overall results suggest that time on SNS and trouble controlling use should be considered independent constructs and that interventions should target underlying loss of control as the primary intervention target above ego syntonic time spent on the site.

Sources of motivation for abstinence: a replication analysis of the reasons for quitting questionnaire.

PubMed

Downey, L; Rosengren, D B; Donovan, D M

2001-01-01

The Reasons for Quitting Questionnaire (RFQ) as modified by McBride and colleagues (C. M. McBride et al., 1994) for use with substance users other than tobacco smokers, was administered to individuals approved for public-sector addiction treatment. Four motivation dimensions, similar to those found by McBride et al., were identified: self-concept issues, health concerns, legal issues, and social influence. A forced two-component solution yielded dimensions interpretable as intrinsic and extrinsic motivation. Self-concept issues provided the highest levels of motivation for abstinence in this sample, with moderate levels provided by health concerns, and the lowest levels provided by legal and social influence components. Intrinsic motivation was higher than extrinsic motivation. Logistic regression models, with adjustment for total motivation, tested the association of successful abstinence during a follow-up period with baseline extrinsic and intrinsic motivation, and with the difference between intrinsic and extrinsic levels. All three associations were significant: intrinsic motivation (positive association), extrinsic motivation (negative association), and the difference score (positive association). The results suggest the usefulness of the 20-item modified RFQ in evaluating motivation for abstinence among treatment seekers exhibiting severe negative consequences of addiction. Testing with samples varying in severity of addiction consequences is recommended.

A social marketing model for disseminating research-based treatments to addictions treatment providers.

PubMed

Martin, G W; Herie, M A; Turner, B J; Cunningham, J A

1998-11-01

Researchers must develop effective strategies for disseminating research-based treatments. This study evaluates the application of a dissemination model based on principles of social marketing and diffusion theory. A case study describes how the model was implemented. A qualitative design was employed to examine rates of adoption and adaptation of an early intervention program by a targeted system of addictions agencies. The interventions were developed at the Addiction Research Foundation in Toronto and disseminated to Assessment and Referral (A/R) Centres in Ontario, Canada. Study participants included the managers and a designated therapist for 33 participating A/R centres. Managers were asked mainly open-ended questions concerning whether their agency had made a formal decision to adopt the intervention and whether therapists in their agency were using the early intervention program. "Adoption" was operationalized as offering the complete four-session intervention to at least one client. At 12 months after the completion of training workshops, 68% of 34 agencies in the target system had adopted the program while 85% of the agencies were using some components of the intervention with clients. The dissemination model appeared to be effective although its application proved to be time-consuming and labour-intensive. The "market analysis", systems focus and field-test components of the model appeared to contribute to its success.

Subgroups Among Opiate Addicts

ERIC Educational Resources Information Center

Berzins, Juris I.; And Others

1974-01-01

The principal objective of the present investigation was to delineate homogeneous MMPI profile subgroups (types) through multivariate clustering procedures and to compare the derived (replicable) types on measures of the components of "sociopathy" as well as on other psychometric devices. (Author)

Using glutamate homeostasis as a target for treating addictive disorders

PubMed Central

Reissner, Kathryn J.; Kalivas, Peter W.

2010-01-01

Well-developed cellular mechanisms exist to preserve glutamate homeostasis and regulate extrasynaptic glutamate levels. Accumulating evidence indicates that disruptions in glutamate homeostasis are associated with addictive disorders. The disruptions in glutamate concentrations observed following prolonged exposure to drugs of abuse are associated with changes in the function and activity of several key components within the homeostatic control mechanism, including the cystine/glutamate exchanger xc− and the glial glutamate transporter EAAT2/GLT-1. Changes in the balance between synaptic and extrasynaptic glutamate levels in turn influence signaling through pre- and postsynaptic glutamate receptors, and thus affect synaptic plasticity and circuit-level activity. In this review we describe the evidence for impaired glutamate homestasis as a critical mediator of long-term drug-seeking behaviors, how chronic neuroadaptations in xc− and GLT-1 mediate a disruption in glutamate homeostasis, and how targeting these components restores glutamate levels and inhibits drug-seeking behaviors. PMID:20634691

Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity.

PubMed

Wakeman, Sarah E; Metlay, Joshua P; Chang, Yuchiao; Herman, Grace E; Rigotti, Nancy A

2017-08-01

Alcohol and drug use results in substantial morbidity, mortality, and cost. Individuals with alcohol and drug use disorders are overrepresented in general medical settings. Hospital-based interventions offer an opportunity to engage with a vulnerable population that may not otherwise seek treatment. To determine whether inpatient addiction consultation improves substance use outcomes 1 month after discharge. Prospective quasi-experimental evaluation comparing 30-day post-discharge outcomes between participants who were and were not seen by an addiction consult team during hospitalization at an urban academic hospital. Three hundred ninety-nine hospitalized adults who screened as high risk for having an alcohol or drug use disorder or who were clinically identified by the primary nurse as having a substance use disorder. Addiction consultation from a multidisciplinary specialty team offering pharmacotherapy initiation, motivational counseling, treatment planning, and direct linkage to ongoing addiction treatment. Addiction Severity Index (ASI) composite score for alcohol and drug use and self-reported abstinence at 30 days post-discharge. Secondary outcomes included 90-day substance use measures and self-reported hospital and ED utilization. Among 265 participants with 30-day follow-up, a greater reduction in the ASI composite score for drug or alcohol use was seen in the intervention group than in the control group (mean ASI-alcohol decreased by 0.24 vs. 0.08, p < 0.001; mean ASI-drug decreased by 0.05 vs. 0.02, p = 0.003.) There was also a greater increase in the number of days of abstinence in the intervention group versus the control group (+12.7 days vs. +5.6, p < 0.001). The differences in ASI-alcohol, ASI-drug, and days abstinent all remained statistically significant after controlling for age, gender, employment status, smoking status, and baseline addiction severity (p = 0.018, 0.018, and 0.02, respectively). In a sensitivity analysis, assuming that patients who were lost to follow-up had no change from baseline severity, the differences remained statistically significant. In a non-randomized cohort of medical inpatients, addiction consultation reduced addiction severity for alcohol and drug use and increased the number of days of abstinence in the first month after hospital discharge.

What is abnormal about addiction-related attentional biases?

PubMed

Anderson, Brian A

2016-10-01

The phenotype of addiction includes prominent attentional biases for drug cues, which play a role in motivating drug-seeking behavior and contribute to relapse. In a separate line of research, arbitrary stimuli have been shown to automatically capture attention when previously associated with reward in non-clinical samples. Here, I argue that these two attentional biases reflect the same cognitive process. I outline five characteristics that exemplify attentional biases for drug cues: resistant to conflicting goals, robust to extinction, linked to dorsal striatal dopamine and to biases in approach behavior, and can distinguish between individuals with and without a history of drug dependence. I then go on to describe how attentional biases for arbitrary reward-associated stimuli share all of these features, and conclude by arguing that the attentional components of addiction reflect a normal cognitive process that promotes reward-seeking behavior. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[The role of emotional intelligence in addiction disorders].

PubMed

Kun, Bernadette; Demetrovics, Zsolt

2010-01-01

Role of emotions in the background of addictions is a long-studied question. Clinical observations and comorbidity studies unambiguously indicate that psychoactive substance use and dependence are related to emotional problems as well. Emotional intelligence is a relatively new concept of the study of managing emotions. On the revelation of this construct's relationship with psychoactive substance use and dependence only a few studies have been carried out so far. Present study systematically reviews articles born between 1990 and October 1, 2010 dealing with the relationship of these two factors. Out of the identified altogether 54 studies, 37 fitted the criteria of analysis. Studies overall indicate that lower levels of emotional intelligence are associated with more intensive drinking, smoking and illicit substance use and also more likely correlate with internet addiction, bulimia, gambling and impulsive buying. According to their results, especially the components called "recognizing emotions" and "regulation of emotions" of emotional intelligence play important roles regarding substance use.

Randomized trial of the effectiveness of combined behavioral/pharmacological smoking cessation treatment in Syrian primary care clinics.

PubMed

Ward, Kenneth D; Asfar, Taghrid; Al Ali, Radwan; Rastam, Samer; Weg, Mark W Vander; Eissenberg, Thomas; Maziak, Wasim

2013-02-01

Effectiveness of nicotine replacement therapy (NRT) for smoking cessation has not been evaluated in low income countries, such as Syria, where it is expensive and not widely available. We evaluated whether nicotine patch boosts smoking cessation rates when used in conjunction with behavioral support in primary care clinics in Aleppo, Syria. Two arm, parallel group, randomized, placebo controlled, double-blinded multi-site trial. Four primary care clinics in Aleppo, Syria.  Two hundred and sixty-nine adult primary care patients received behavioral cessation counseling from a trained primary care physician and were randomized to receive six weeks of treatment with nicotine versus placebo patch. Primary end-points were prolonged abstinence (no smoking after a 2-week grace period) at end of treatment, and 6 and 12 months post-quit day, assessed by self-report and exhaled carbon monoxide levels of <10 p.p.m. Treatment adherence was excellent and nicotine patch produced expected reductions in urges to smoke and withdrawal symptoms, but no treatment effect was observed. The proportion of patients in the nicotine and placebo groups with prolonged abstinence was 21.6% and 20.0%, respectively, at end of treatment, 13.4% and 14.1% at 6 months, and 12.7% and 11.9% at 12 months.  Nicotine patches may not be effective in helping smokers in low-income countries to stop when given as an adjunct to behavioural support. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Food Addiction in Bulimia Nervosa: Clinical Correlates and Association with Response to a Brief Psychoeducational Intervention.

PubMed

Hilker, Ines; Sánchez, Isabel; Steward, Trevor; Jiménez-Murcia, Susana; Granero, Roser; Gearhardt, Ashley N; Rodríguez-Muñoz, Rita Cristina; Dieguez, Carlos; Crujeiras, Ana B; Tolosa-Sola, Iris; Casanueva, Felipe F; Menchón, José M; Fernández-Aranda, Fernando

2016-11-01

Food addiction (FA) has been examined in different populations. Although high FA levels are associated with greater eating disorder severity, few studies have addressed how FA relates to treatment outcome. The study aims (1) to determine whether a brief intervention for bulimia nervosa (BN) reduces FA diagnosis or severity compared with baseline and (2) to determine if FA is predictive of treatment outcome. Sixty-six female BN patients participated in the study. The Yale Food Addiction Scale was administered at two time points: prior to and following a 6-week intervention. The number of weekly binging/purging episodes, dropout and abstinence from bulimic behaviour were used as primary outcome measures. This brief intervention reduced FA severity and FA diagnosis in the 55 patients who completed treatment. FA severity was a short-term predictor of abstinence from binging/purging episodes after treatment (p = .018). Food addiction appears to be prevalent in BN although FA severity can improve following a short-term intervention. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

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.

Progesterone attenuates impulsive action in a Go/No-Go task for sucrose pellets in female and male rats

PubMed Central

Swalve, Natashia; Smethells, John R.; Carroll, Marilyn E.

2016-01-01

Impulsivity, or a tendency to act without anticipation of future consequences, is associated with drug abuse. Impulsivity is typically separated into two main measures, impulsive action and impulsive choice. Given the association of impulsivity and drug abuse, treatments that reduce impulsivity have been proposed as an effective method for countering drug addiction. Progesterone has emerged as a promising treatment, as it is associated with decreased addiction-related behaviors and impulsive action. The goal of the present study was to determine the effects of progesterone (PRO) on impulsive action for food: a Go/No-Go task. Female and male rats responded for sucrose pellets during a Go component when lever pressing was reinforced on a variable-interval 30-s schedule. During the alternate No-Go component, withholding a lever press was reinforced on a differential reinforcement of other (DRO) behavior 30-s schedule, where a lever press reset the DRO timer. Impulsive action was operationally defined as the inability to withhold a response during the No-Go component (i.e. the number of DRO resets). Once Go/No-Go behavior was stable, responding between rats treated with PRO (0.5 mg/kg) or vehicle was examined. Progesterone significantly decreased the total number of DRO resets in both males and females, but it did not affect VI responding for sucrose pellets. This suggests that PRO decreases motor impulsivity for sucrose pellets without affecting motivation for food. Thus, PRO may reduce motor impulsivity, a behavior underlying drug addiction. PMID:27497836

Activation of the ventral and dorsal striatum during cue reactivity in Internet gaming disorder.

PubMed

Liu, Lu; Yip, Sarah W; Zhang, Jin-Tao; Wang, Ling-Jiao; Shen, Zi-Jiao; Liu, Ben; Ma, Shan-Shan; Yao, Yuan-Wei; Fang, Xiao-Yi

2017-05-01

Studies conducted in drug addiction suggest a transition in processing of drug-related cues from the ventral to the dorsal component of the striatum. However, this process has not been studied in a behavioral addiction. Assessment of this process in a non-drug addiction can provide insight into the pathophysiology of both substance and behavioral addictions. Thirty-nine male Internet gaming disorder (IGD) subjects and 23 male matched healthy controls (HCs) participated in functional magnetic resonance imaging during performance of a cue-reactivity task involving alternating presentation of Internet gaming-related stimuli (game cues) and general Internet surfing-related stimuli (control cues). Cue-induced neural activations in the ventral and dorsal striatum (DS) were compared between IGD and HC participants. Associations between cue-reactivity within these regions and cue-induced craving and severity and duration of IGD were also explored. IGD participants exhibited higher cue-induced activations within both the ventral and DS when compared with HCs. Within the IGD group, activity within the left ventral striatum (VS) was correlated negatively with cue-induced craving; positive associations were found between activations within the DS (right putamen, pallidum and left caudate) and duration of IGD. Cue-induced activity within the left putamen was negatively associated with right VS volumes among IGD participants. Consistent with studies in substance addictions, our results suggest that a transition from ventral to dorsal striatal processing may occur among individuals with IGD, a condition without the impact of substance intake. © 2016 Society for the Study of Addiction.

Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs.

PubMed

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-08-01

Smoking rates among addiction treatment clients are 3-4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semi-structured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. Copyright © 2016 Elsevier Inc. All rights reserved.

A randomized controlled trial of treatments for co-occurring substance use disorders and post-traumatic stress disorder.

PubMed

McGovern, Mark P; Lambert-Harris, Chantal; Xie, Haiyi; Meier, Andrea; McLeman, Bethany; Saunders, Elizabeth

2015-07-01

Post-traumatic stress disorder (PTSD) is common among people with substance use disorders, and the comorbidity is associated with negative outcomes. We report on a randomized controlled trial comparing the effect of integrated cognitive-behavioral therapy (ICBT) plus standard care, individual addiction counseling plus standard care and standard care alone on substance use and PTSD symptoms. Three-group, multi-site randomized controlled trial. Seven addiction treatment programs in Vermont and New Hampshire, USA. Recruitment took place between December 2010 and January 2013. In this single-blind study, 221 participants were randomized to one of three conditions: ICBT plus standard care (SC) (n = 73), individual addiction counseling (IAC) plus SC (n = 75) or SC only (n = 73). One hundred and seventy-two patients were assessed at 6-month follow-up (58 ICBT; 61 IAC; 53 SC). Intervention and comparators: ICBT is a manual-guided therapy focused on PTSD and substance use symptom reduction with three main components: patient education, mindful relaxation and flexible thinking. IAC is a manual-guided therapy focused exclusively on substance use and recovery with modules organized in a stage-based approach: treatment initiation, early abstinence, maintaining abstinence and recovery. SC are intensive out-patient program services that include 9-12 hours of face-to-face contact per week over 2-4 days of group and individual therapies plus medication management. Primary outcomes were PTSD severity and substance use severity at 6 months. Secondary outcomes were therapy retention. PTSD symptoms reduced in all conditions with no difference between them. In analyses of covariance, ICBT produced more favorable outcomes on toxicology than IAC or SC [comparison with IAC, parameter estimate: 1.10; confidence interval (CI) = 0.17-2.04; comparison with SC, parameter estimate: 1.13; CI = 0.18-2.08] and had a greater reduction in reported drug use than SC (parameter estimate: -9.92; CI = -18.14 to -1.70). ICBT patients had better therapy continuation versus IAC (P<0.001). There were no unexpected or study-related adverse events. Integrated cognitive behavioral therapy may improve drug-related outcomes in post-traumatic stress disorder sufferers with substance use disorder more than drug-focused counseling, but probably not by reducing post-traumatic stress disorder symptoms to a greater extent. © 2015 Society for the Study of Addiction.

Mitigating risky sexual behaviors among Russian narcology hospital patients: the PREVENT (Partnership to Reduce the Epidemic Via Engagement in Narcology Treatment) randomized controlled trial

PubMed Central

Krupitsky, Evgeny M.; Cheng, Debbie M.; Raj, Anita; Egorova, Valentina Y.; Levenson, Suzette; Meli, Seville; Bridden, Carly; Verbitskaya, Elena V.; Kamb, Mary L.; Zvartau, Edwin E.

2008-01-01

Aim To assess the effectiveness of a sexual risk reduction intervention in the Russian narcology hospital setting. Design, setting and participants This was a randomized controlled trial from October 2004 to December 2005 among patients with alcohol and/or heroin dependence from two narcology hospitals in St Petersburg, Russia. Intervention Intervention subjects received two personalized sexual behavior counseling sessions plus three telephone booster sessions. Control subjects received usual addiction treatment, which did not include sexual behavior counseling. All received a research assessment and condoms at baseline. Measurements Primary outcomes were percentage of safe sex episodes (number of times condoms were used ÷ by number of sexual episodes) and no unprotected sex (100% condom use or abstinence) during the previous 3 months, assessed at 6 months. Findings Intervention subjects reported higher median percentage of safe sex episodes (unadjusted median difference 12.7%; P = 0.01; adjusted median difference 23%, P = 0.07); a significant difference was not detected for the outcome no unprotected sex in the past 3 months [unadjusted odds ratio (OR) 1.6, 95% confidence interval (CI) 0.8-3.1; adjusted OR 1.5, 95% CI 0.7-3.3]. Conclusions Among Russian substance-dependent individuals, sexual behavior counseling during addiction treatment should be considered as one potential component of efforts to decrease risky sexual behaviors in this HIV at-risk population. PMID:18636998

Reversal learning as a measure of impulsive and compulsive behavior in addictions.

PubMed

Izquierdo, Alicia; Jentsch, J David

2012-01-01

Our ability to measure the cognitive components of complex decision-making across species has greatly facilitated our understanding of its neurobiological mechanisms. One task in particular, reversal learning, has proven valuable in assessing the inhibitory processes that are central to executive control. Reversal learning measures the ability to actively suppress reward-related responding and to disengage from ongoing behavior, phenomena that are biologically and descriptively related to impulsivity and compulsivity. Consequently, reversal learning could index vulnerability for disorders characterized by impulsivity such as proclivity for initial substance abuse as well as the compulsive aspects of dependence. Though we describe common variants and similar tasks, we pay particular attention to discrimination reversal learning, its supporting neural circuitry, neuropharmacology and genetic determinants. We also review the utility of this task in measuring impulsivity and compulsivity in addictions. We restrict our review to instrumental, reward-related reversal learning studies as they are most germane to addiction. The research reviewed here suggests that discrimination reversal learning may be used as a diagnostic tool for investigating the neural mechanisms that mediate impulsive and compulsive aspects of pathological reward-seeking and -taking behaviors. Two interrelated mechanisms are posited for the neuroadaptations in addiction that often translate to poor reversal learning: frontocorticostriatal circuitry dysregulation and poor dopamine (D2 receptor) modulation of this circuitry. These data suggest new approaches to targeting inhibitory control mechanisms in addictions.

Latino/as in Substance Abuse Treatment: Substance Use Patterns, Family History of Addiction and Depression

PubMed Central

Rojas, Julio I.; Hallford, Gene; Brand, Michael W.; Tivis, Laura J.

2012-01-01

This study describes a sample of Latino/as in substance abuse treatment. We were interested in substance use patterns, gender differences, family history of addiction and depression. Questionnaires completed by Latino/as (N = 209) were identified from 12,000 sets completed by participants in treatment from 1993-2003. Significant gender differences emerged with Latinas reporting higher rates of stimulant use and depression. A family history of substance use disorders in primary and/or secondary family members was reported by 91% of participants. These data suggest that understanding gender differences related to substance use and depression among Latino/as in treatment warrants attention. PMID:22381124

A Substance Called Food: Long-Term Psychodynamic Group Treatment for Compulsive Overeating.

PubMed

Schwartz, Deborah C; Nickow, Marcia S; Arseneau, Ric; Gisslow, Mary T

2015-07-01

Obesity has proven difficult to treat. Many approaches neglect to address the deep-rooted underlying psychological issues. This paper describes a psychodynamically oriented approach to treating compulsive overeating as an addiction. Common to all addictions is a compulsion to consume a substance or engage in a behavior, a preoccupation with using behavior and rituals, and a lifestyle marked by an inability to manage the behavior and its harmful consequences. The approach represents a shift away from primarily medical models of intervention to integrated models focusing on the psychological underpinnings of obesity. Long-term psychodynamic group psychotherapy is recommended as a primary treatment.

75 FR 58404 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... sclerosis, CD74 deficiency, Ehlers Danlos syndrome (EDS), Marfan/Loewe Dietz syndrome, fibromuscular dysplasia, Kawasaki syndrome, pseudoxanthoma elasticum, and premature placental calcification. Applications... component of the addictive syndrome, with approximately two-thirds of patients relapsing within three months...

A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center.

PubMed

Min, Zhao; Xu, Li; Chen, Hanhui; Ding, Xu; Yi, Zhang; Mingyuang, Zhang

2011-05-01

To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. A randomized case-control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. This study suggests RP as a potentially effective component of treatment for heroin addicts.

The neurobiological and behavioral overlaps of nicotine and food addiction.

PubMed

Criscitelli, Kristen; Avena, Nicole M

2016-11-01

Both cigarette smoking and obesity are significant public health concerns and are associated with increased risk of early mortality. It is well established that the mesolimbic dopamine pathway is an important component of the reward system within the brain and is implicated in the development of addiction. Indeed, nicotine and highly palatable foods are capable of altering dopamine release within this system, engendering addictive like responses in susceptible individuals. Although additional research is warranted, findings from animal and human literature have elucidated many of neuroadaptions that occur from exposure to nicotine and highly palatable foods, leading to a greater understanding of the underlying mechanisms contributing to these aberrant behaviors. In this review we present the findings taken from preclinical and clinical literature of the known effects of exposure to nicotine and highly palatable foods on the reward related circuitry within the brain. Further, we compare the neurobiological and behavioral overlaps between nicotine, highly palatable foods and obesity. Lastly, we examine the stigma associated with smoking, obesity and food addiction, and the consequences stigma has on the overall health and wellbeing of an individual. Copyright © 2016. Published by Elsevier Inc.

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.

Chromothripsis and epigenomics complete causality criteria for cannabis- and addiction-connected carcinogenicity, congenital toxicity and heritable genotoxicity.

PubMed

Reece, Albert Stuart; Hulse, Gary Kenneth

2016-07-01

The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations. Tetrahydrocannabinol (THC) and other addictive agents have been shown to inhibit tubulin polymerization which perturbs the formation and function of the microtubules of the mitotic spindle. This disruption of the mitotic machinery perturbs proper chromosomal segregation during anaphase and causes micronucleus formation which is the primary locus and cause of the chromosomal pulverization of chromothripsis and downstream genotoxic events including oncogene induction and tumour suppressor silencing. Moreover the complementation of multiple positive cannabis-cancer epidemiological studies, and replicated dose-response relationships with established mechanisms fulfils causal criteria. This information is also consistent with data showing acceleration of the aging process by drugs of addiction including alcohol, tobacco, cannabis, stimulants and opioids. THC shows a non-linear sigmoidal dose-response relationship in multiple pertinent in vitro and preclinical genotoxicity assays, and in this respect is similar to the serious major human mutagen thalidomide. Rising community exposure, tissue storage of cannabinoids, and increasingly potent phytocannabinoid sources, suggests that the threshold mutagenic dose for cancerogenesis will increasingly be crossed beyond the developing world, and raise transgenerational transmission of teratogenicity as an increasing concern. Copyright © 2016 Elsevier B.V. All rights reserved.

Dopamine Receptor Activation Increases HIV Entry into Primary Human Macrophages

PubMed Central

Gaskill, Peter J.; Yano, Hideaki H.; Kalpana, Ganjam V.; Javitch, Jonathan A.; Berman, Joan W.

2014-01-01

Macrophages are the primary cell type infected with HIV in the central nervous system, and infection of these cells is a major component in the development of neuropathogenesis and HIV-associated neurocognitive disorders. Within the brains of drug abusers, macrophages are exposed to increased levels of dopamine, a neurotransmitter that mediates the addictive and reinforcing effects of drugs of abuse such as cocaine and methamphetamine. In this study we examined the effects of dopamine on HIV entry into primary human macrophages. Exposure to dopamine during infection increased the entry of R5 tropic HIV into macrophages, irrespective of the concentration of the viral inoculum. The entry pathway affected was CCR5 dependent, as antagonizing CCR5 with the small molecule inhibitor TAK779 completely blocked entry. The effect was dose-dependent and had a steep threshold, only occurring above 108 M dopamine. The dopamine-mediated increase in entry required dopamine receptor activation, as it was abrogated by the pan-dopamine receptor antagonist flupenthixol, and could be mediated through both subtypes of dopamine receptors. These findings indicate that the effects of dopamine on macrophages may have a significant impact on HIV pathogenesis. They also suggest that drug-induced increases in CNS dopamine may be a common mechanism by which drugs of abuse with distinct modes of action exacerbate neuroinflammation and contribute to HIV-associated neurocognitive disorders in infected drug abusers. PMID:25268786

Teaching Difficult Topics with Primary Sources

ERIC Educational Resources Information Center

Potter, Lee Ann

2011-01-01

"Difficult" or "challenging" topics to teach include racism, violence, genocide, bullying, gangs, abuse (physical, emotional, and substance), slavery, suffering, hatred, terrorism, war, disease, loss, addiction, and more. But by confronting them with students, in the safety of a classroom through thoughtfully constructed lessons (ones that take…

Mechanisms of modafinil: A review of current research

PubMed Central

Gerrard, Paul; Malcolm, Robert

2007-01-01

The novel wake-promoting agent modafinil has been in use for the treatment of several sleep disorders for a few years and is now undergoing clinical trials for its use in the treatment of stimulant addiction, but its primary mechanism of action remains elusive. Previous laboratory studies have shown that modafinil has antioxidative and neuroprotective effects, which have not previously been suggested to be related to its wake-promoting effects. However, recent research indicates that free radicals may be related to sleep induction as well as cellular damage, suggesting that a common target of action may mediate modafinil’s ability to oppose both of these effects. In this review we summarize and discuss previously published research on modafinil’s neural, cytoprotective, and cognitive effects, and we propose possible primary biochemical targets that could underlie the effects of modafinil observed in these studies. We also suggest neurocognitive mechanisms responsible for modafinil’s cognitive enhancing effects and its therapeutic potential in the treatment of stimulant addiction. PMID:19300566

“The chief of the services is very enthusiastic about it”: A qualitative study of the adoption of buprenorphine for opioid addiction treatment

PubMed Central

Green, Carla A.; McCarty, Dennis; Mertens, Jennifer; Lynch, Frances L.; Hilde, Anadam; Firemark, Alison; Weisner, Constance M.; Pating, David; Anderson, Bradley M.

2013-01-01

Qualified physicians may prescribe buprenorphine to treat opioid dependence, but medication use remains controversial. We examined adoption of buprenorphine in two not-for-profit integrated health plans, over time, completing 101 semi-structured interviews with clinicians and clinician-administrators from primary and specialty care. Transcripts were reviewed, coded, and analyzed. A strong leader championing the new treatment was critical for adoption in both health plans. Once clinicians began using buprenorphine, patients’ and other clinicians’ experiences affected decisions more than did the champion. With experience, protocols developed to manage unsuccessful patients and changed to support maintenance rather than detoxification. Diffusion outside addiction and mental health settings was nonexistent; primary care clinicians cited scope-of-practice issues and referred patients to specialty care. With greater diffusion came questions about long-term use and safety. Recognizing how implementation processes develop may suggest where, when, and how to best expend resources to increase adoption of such treatments. PMID:24268947

Prescription opioid use and misuse: piloting an educational strategy for rural primary care physicians.

PubMed

Srivastava, Anita; Kahan, Meldon; Jiwa, Ashifa

2012-04-01

To evaluate the feasibility and effectiveness of a multifaceted educational intervention to improve the opioid prescribing practices of rural family physicians in a remote First Nations community. Prospective cohort study. Sioux Lookout, Ont. Family physicians. Eighteen family physicians participated in a 1-year study of a series of educational interventions on safe opioid prescribing. Interventions included a main workshop with a lecture and interactive case discussions, an online chat room, video case conferencing, and consultant support. Responses to questionnaires at baseline and after 1 year on knowledge, attitudes, and practices related to opioid prescribing. The main workshop was feasible and was well received by primary care physicians in remote communities. At 1 year, physicians were less concerned about getting patients addicted to opioids and more comfortable with opioid dosing. Multifaceted education and consultant support might play an important role in improving family physician comfort with opioid prescribing, and could improve the treatment of chronic pain while minimizing the risk of addiction.

Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.

PubMed

Vowles, Kevin E; McEntee, Mindy L; Julnes, Peter Siyahhan; Frohe, Tessa; Ney, John P; van der Goes, David N

2015-04-01

Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain. Because previous reviews have indicated substantial variability in this literature, several steps were taken to enhance precision and utility. First, problematic use was coded using explicitly defined terms, referring to different patterns of use (ie, misuse, abuse, and addiction). Second, average prevalence rates were calculated and weighted by sample size and study quality. Third, the influence of differences in study methodology was examined. In total, data from 38 studies were included. Rates of problematic use were quite broad, ranging from <1% to 81% across studies. Across most calculations, rates of misuse averaged between 21% and 29% (range, 95% confidence interval [CI]: 13%-38%). Rates of addiction averaged between 8% and 12% (range, 95% CI: 3%-17%). Abuse was reported in only a single study. Only 1 difference emerged when study methods were examined, where rates of addiction were lower in studies that identified prevalence assessment as a primary, rather than secondary, objective. Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.

With God's Help I Can Do It: Crack Users' Formal and Informal Recovery Experiences in El Salvador

PubMed Central

Dickson-Gomez, Julia; Bodnar, Gloria; Guevara, Carmen Eugenia; Rodriguez, Karla; De Mendoza, Lorena Rivas; Corbett, A. Michelle

2013-01-01

Crack use has increased dramatically in El Salvador in the last few decades. As with other developing countries with sudden onsets of drug problems, El Salvador has few medical staff trained in addictions treatment. Little research has examined drug users' attempts to reduce or abstain from drug use in countries where government-regulated formal medical treatment for drug addiction is scarce. This paper uses qualitative and quantitative data gathered from active crack users to explore their formal and informal strategies to reduce or abstain from drugs, and compares these with components of informal and formal treatment in developed countries. PMID:20735191

Allostasis and Addiction: Role of the Dopamine and Corticotropin-Releasing Factor Systems

PubMed Central

George, Olivier; Le Moal, Michel; Koob, George F.

2011-01-01

Allostasis, originally conceptualized to explain persistent morbidity of arousal and autonomic function, is defined as the process of achieving stability through physiological or behavioral change. Two types of biological processes have been proposed to describe the mechanisms underlying allostasis in drug addiction, a within-system adaptation and a between-system adaptation. In the within-system process, the drug elicits an opposing, neutralizing reaction within the same system in which the drug elicits its primary and unconditioned reinforcing actions, while in the between-system process, different neurobiological systems that the one initially activated by the drug are recruited. In this review, we will focus our interest on alterations in the dopaminergic and corticotropin releasing factor systems as within-system and between-system neuroadaptations respectively, that underlie the opponent process to drugs of abuse. We hypothesize that repeated compromised activity in the dopaminergic system and sustained activation of the CRF-CRF1R system with withdrawal episodes may lead to an allostatic load contributing significantly to the transition to drug addiction. PMID:22108506

Activation of the hypothalamic-pituitary-adrenal axis by addictive drugs: different pathways, common outcome.

PubMed

Armario, Antonio

2010-07-01

Addictive drugs (opiates, ethanol, cannabinoids (CBs), nicotine, cocaine, amphetamines) induce activation of the hypothalamic-pituitary-adrenal (HPA) axis, with the subsequent release of adrenocorticotropic hormone and glucocorticoids. The sequence of events leading to HPA activation appears to start within the brain, suggesting that activation is not secondary to peripheral homeostatic alterations. The precise neurochemical mechanisms and brain pathways involved are markedly dependent on the particular drug, although it is assumed that information eventually converges into the hypothalamic paraventricular nucleus (PVN). Whereas some drugs may act on the hypothalamus or directly within PVN neurons (i.e. ethanol), others exert their primary action outside the PVN (i.e. CBs, nicotine, cocaine). Corticotropin-releasing hormone (CRH) has a critical role in most cases, but the changes in c-fos and CRH gene expression in the PVN also reveal differences among drugs. More studies are needed to understand how addictive drugs act on this important neuroendocrine system and their functional consequences. Copyright 2010 Elsevier Ltd. All rights reserved.

United Nations Office on Drugs and Crime International Network of Drug Dependence Treatment and Rehabilitation Resource Centres: Treatnet.

PubMed

Tomás-Rosselló, Juana; Rawson, Richard A; Zarza, Maria J; Bellows, Anne; Busse, Anja; Saenz, Elizabeth; Freese, Thomas; Shawkey, Mansour; Carise, Deni; Ali, Robert; Ling, Walter

2010-10-01

Key to the dissemination of evidence-based addiction treatments is the exchange of experiences and mutual support among treatment practitioners, as well as the availability of accurate addiction training materials and effective trainers. To address the shortage of such resources, the United Nations Office on Drugs and Crime (UNODC) created Treatnet, a network of 20 drug dependence treatment resource centers around the world. Treatnet's primary goal is to promote the use of effective addiction treatment practices. Phase I of this project included (1) selecting and establishing a network of geographically distributed centers; (2) conducting a capacity-building program consisting of a training needs assessment, development of training packages, and the training of 2 trainers per center in 1 content area each; and (3) creating good-practice documents. Data on the training activities conducted by the trainers during their first 6 months in the field are presented. Plans for Phase II of the Treatnet project are also discussed.

The Development and Validation of the Bergen–Yale Sex Addiction Scale With a Large National Sample

PubMed Central

Andreassen, Cecilie S.; Pallesen, Ståle; Griffiths, Mark D.; Torsheim, Torbjørn; Sinha, Rajita

2018-01-01

The view that problematic excessive sexual behavior (“sex addiction”) is a form of behavioral addiction has gained more credence in recent years, but there is still considerable controversy regarding operationalization of the concept. Furthermore, most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction—the Bergen–Yale Sex Addiction Scale (BYSAS)—based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control). Using a cross-sectional survey, the BYSAS was administered to a broad national sample of 23,533 Norwegian adults [aged 16–88 years; mean (± SD) age = 35.8 ± 13.3 years], together with validated measures of the Big Five personality traits, narcissism, self-esteem, and a measure of sexual addictive behavior. Both an exploratory and a confirmatory factor analysis (RMSEA = 0.046, CFI = 0.998, TLI = 0.996) supported a one-factor solution, although a local dependence between two items (Items 1 and 2) was detected. Furthermore, the scale had good internal consistency (Cronbach's α = 0.83). The BYSAS correlated significantly with the reference scale (r = 0.52), and demonstrated similar patterns of convergent and discriminant validity. The BYSAS was positively related to extroversion, neuroticism, intellect/imagination, and narcissism, and negatively related to conscientiousness, agreeableness, and self-esteem. High scores on the BYSAS were more prevalent among those who were men, single, of younger age, and with higher education. The BYSAS is a brief, and psychometrically reliable and valid measure for assessing sex addiction. However, further validation of the BYSAS is needed in other countries and contexts. PMID:29568277

Psychosocial interventions for addiction-affected families in Low and Middle Income Countries: A systematic review.

PubMed

Rane, Anil; Church, Sydney; Bhatia, Urvita; Orford, Jim; Velleman, Richard; Nadkarni, Abhijit

2017-11-01

To review the literature on psychosocial interventions for addiction affected family members in Low and Middle Income Countries (LMIC). A systematic review with a detailed search strategy focussing on psychosocial interventions directed towards people affected by addiction without any gender, year or language specifications was conducted. Identified titles and abstracts were screened; where needed full papers retrieved, and then independently reviewed. Data was extracted based on the aims of the study, to describe the modalities, acceptability, feasibility and effectiveness of the interventions. Four papers met our selection criteria. They were published between 2003 and 2014; the total sample size was 137 participants, and two studies were from Mexico and one each from Vietnam and Malaysia. The predominantly female participants comprised of parents, spouses and siblings. The common components of all the interventions included providing information regarding addiction, teaching coping skills, and providing support. Though preliminary these small studies suggests a positive effect on affected family members (AFM). There was lowering of psychological and physical distress, along with a better understanding of addictive behaviour. The interventions led to better coping; with improvements in self-esteem and assertive behaviour. The interventions, mostly delivered in group settings, were largely acceptable. The limited evidence does suggest positive benefits to AFMs. The scope of research needs to be extended to other addictions, and family members other than spouse and female relatives. Indigenous and locally adapted interventions are needed to address this issue keeping in mind the limited resources of LMIC. This is a field indeed in its infancy and this under recognised and under-served group needs urgent attention of researchers and policy makers. Copyright © 2017 Elsevier Ltd. All rights reserved.

American Indian Perspectives on Addiction and Recovery.

ERIC Educational Resources Information Center

Lowery, Christine T.

1998-01-01

Components of healing are spiritual, relational, and intergenerational. This narrative report reaches beyond an intellectual understanding for a "healing spirit" for American Indian women in recovery. Four intersecting circles of spiritual and cultural understanding speak to balance and wellness, the colonization experience and addiction…

Health Care Psychology: Prospects for the Well-Being of Children.

ERIC Educational Resources Information Center

Wright, Logan

1979-01-01

Health care psychology is distinguished from traditional child psychology in that it emphasizes clinical application and is concerned with primary mental health care. Diagnosis, classification, prediction, and treatment and control strategies in the field offer definite solutions to problems such as tracheotomy addiction, encopresis, psychogenic…

Effective brain network analysis with resting-state EEG data: a comparison between heroin abstinent and non-addicted subjects

NASA Astrophysics Data System (ADS)

Hu, Bin; Dong, Qunxi; Hao, Yanrong; Zhao, Qinglin; Shen, Jian; Zheng, Fang

2017-08-01

Objective. Neuro-electrophysiological tools have been widely used in heroin addiction studies. Previous studies indicated that chronic heroin abuse would result in abnormal functional organization of the brain, while few heroin addiction studies have applied the effective connectivity tool to analyze the brain functional system (BFS) alterations induced by heroin abuse. The present study aims to identify the abnormality of resting-state heroin abstinent BFS using source decomposition and effective connectivity tools. Approach. The resting-state electroencephalograph (EEG) signals were acquired from 15 male heroin abstinent (HA) subjects and 14 male non-addicted (NA) controls. Multivariate autoregressive models combined independent component analysis (MVARICA) was applied for blind source decomposition. Generalized partial directed coherence (GPDC) was applied for effective brain connectivity analysis. Effective brain networks of both HA and NA groups were constructed. The two groups of effective cortical networks were compared by the bootstrap method. Abnormal causal interactions between decomposed source regions were estimated in the 1-45 Hz frequency domain. Main results. This work suggested: (a) there were clear effective network alterations in heroin abstinent subject groups; (b) the parietal region was a dominant hub of the abnormally weaker causal pathways, and the left occipital region was a dominant hub of the abnormally stronger causal pathways. Significance. These findings provide direct evidence that chronic heroin abuse induces brain functional abnormalities. The potential value of combining effective connectivity analysis and brain source decomposition methods in exploring brain alterations of heroin addicts is also implied.

Activation of the ventral and dorsal striatum during cue reactivity in Internet gaming disorder

PubMed Central

Liu, Lu; Yip, Sarah W.; Zhang, Jin-Tao; Wang, Ling-Jiao; Shen, Zi-Jiao; Liu, Ben; Ma, Shan-Shan; Yao, Yuan-Wei; Fang, Xiao-Yi

2017-01-01

Studies conducted in drug addiction suggest a transition in processing of drug-related cues from the ventral to the dorsal component of the striatum. However, this process has not been studied in a behavioral addiction. Assessment of this process in a non-drug addiction can provide insight into the pathophysiology of both substance and behavioral addictions. Thirty-nine male IGD subjects and 23 male matched healthy controls (HCs) participated in functional magnetic resonance imaging (fMRI) during performance of a cue-reactivity task involving alternating presentation of Internet gaming-related stimuli (game cues) and general Internet surfing-related stimuli (control cues). Cue-induced neural activations in the ventral and dorsal striatum were compared between IGD and HC participants. Associations between cue-reactivity within these regions and cue-induced craving and severity and duration of IGD were also explored. IGD participants exhibited higher cue-induced activations within both the ventral and dorsal striatum (DS) when compared to HCs. Within the IGD group, activity within the left ventral striatum (VS) was correlated negatively with cue-induced craving; positive associations were found between activations within the DS (right putamen, pallidum and left caudate) and duration of IGD. Cue-induced activity within the left putamen was negatively associated with right VS volumes among IGD participants. Consistent with studies in substance addictions, our results suggest that a transition from ventral to dorsal striatal processing may occur among individuals with Internet gaming disorder, a condition without the impact of substance intake. PMID:26732520

Effective brain network analysis with resting-state EEG data: a comparison between heroin abstinent and non-addicted subjects.

PubMed

Hu, Bin; Dong, Qunxi; Hao, Yanrong; Zhao, Qinglin; Shen, Jian; Zheng, Fang

2017-08-01

Neuro-electrophysiological tools have been widely used in heroin addiction studies. Previous studies indicated that chronic heroin abuse would result in abnormal functional organization of the brain, while few heroin addiction studies have applied the effective connectivity tool to analyze the brain functional system (BFS) alterations induced by heroin abuse. The present study aims to identify the abnormality of resting-state heroin abstinent BFS using source decomposition and effective connectivity tools. The resting-state electroencephalograph (EEG) signals were acquired from 15 male heroin abstinent (HA) subjects and 14 male non-addicted (NA) controls. Multivariate autoregressive models combined independent component analysis (MVARICA) was applied for blind source decomposition. Generalized partial directed coherence (GPDC) was applied for effective brain connectivity analysis. Effective brain networks of both HA and NA groups were constructed. The two groups of effective cortical networks were compared by the bootstrap method. Abnormal causal interactions between decomposed source regions were estimated in the 1-45 Hz frequency domain. This work suggested: (a) there were clear effective network alterations in heroin abstinent subject groups; (b) the parietal region was a dominant hub of the abnormally weaker causal pathways, and the left occipital region was a dominant hub of the abnormally stronger causal pathways. These findings provide direct evidence that chronic heroin abuse induces brain functional abnormalities. The potential value of combining effective connectivity analysis and brain source decomposition methods in exploring brain alterations of heroin addicts is also implied.

Impact of health literacy on depressive symptoms and mental health-related: quality of life among adults with addiction.

PubMed

Lincoln, Alisa; Paasche-Orlow, Michael K; Cheng, Debbie M; Lloyd-Travaglini, Christine; Caruso, Christine; Saitz, Richard; Samet, Jeffrey H

2006-08-01

Health literacy has been linked to health status in a variety of chronic diseases. However, evidence for a relationship between health literacy and mental health outcomes is sparse. We hypothesized that low literacy would be associated with higher addiction severity, higher levels of depressive symptoms, and worse mental health functioning compared with those with higher literacy in adults with alcohol and drug dependence. The association of literacy with multiple mental health outcomes was assessed using multivariable analyses. Measurement instruments included the Rapid Estimate of Adult Literacy in Medicine (REALM), the Center for Epidemiologic Studies-Depression (CES-D) scale, the Mental Component Summary scale of the Short Form Health Survey, and the Addiction Severity Index for drug and alcohol addiction. Subjects included 380 adults recruited during detoxification treatment and followed prospectively at 6-month intervals for 2 years. Based on the REALM, subjects were classified as having either low (< or = 8th grade) or higher (> or = 9th grade) literacy levels. In longitudinal analyses, low literacy was associated with more depressive symptoms. The adjusted mean difference in CES-D scores between low and high literacy levels was 4 (P<.01). Literacy was not significantly associated with mental health-related quality of life or addiction severity. In people with alcohol and drug dependence, low literacy is associated with worse depressive symptoms. The mechanisms underlying the relationship between literacy and mental health outcomes should be explored to inform future intervention efforts.

BRAIN MYELINATION IN PREVALENT NEUROPSYCHIATRIC DEVELOPMENTAL DISORDERS

PubMed Central

BARTZOKIS, GEORGE

2008-01-01

Current concepts of addiction focus on neuronal neurocircuitry and neurotransmitters and are largely based on animal model data, but the human brain is unique in its high myelin content and extended developmental (myelination) phase that continues until middle age. The biology of our exceptional myelination process and factors that influence it have been synthesized into a recently published myelin model of human brain evolution and normal development that cuts across the current symptom-based classification of neuropsychiatric disorders. The developmental perspective of the model suggests that dysregulations in the myelination process contribute to prevalent early-life neuropsychiatric disorders, as well as to addictions. These disorders share deficits in inhibitory control functions that likely contribute to their high rates of comorbidity with addiction and other impulsive behaviors. The model posits that substances such as alcohol and psychostimulants are toxic to the extremely vulnerable myelination process and contribute to the poor outcomes of primary and comorbid addictive disorders in susceptible individuals. By increasing the scientific focus on myelination, the model provides a rational biological framework for the development of novel, myelin-centered treatments that may have widespread efficacy across multiple disease states and could potentially be used in treating, delaying, or even preventing some of the most prevalent and devastating neuropsychiatric disorders. PMID:18668184

The Assessment of Recovery Capital: properties and psychometrics of a measure of addiction recovery strengths.

PubMed

Groshkova, Teodora; Best, David; White, William

2013-03-01

Sociological work on social capital and its impact on health behaviours have been translated into the addiction field in the form of 'recovery capital' as the construct for assessing individual progress on a recovery journey. Yet there has been little attempt to quantify recovery capital. The aim of the project was to create a scale that assessed addiction recovery capital. Initial focus group work identified and tested candidate items and domains followed by data collection from multiple sources to enable psychometric assessment of a scale measuring recovery capital. The scale shows moderate test-retest reliability at 1 week and acceptable concurrent validity. Principal component analysis determined single factor structure. The Assessment of Recovery Capital (ARC) is a brief and easy to administer measurement of recovery capital that has acceptable psychometric properties and may be a useful complement to deficit-based assessment and outcome monitoring instruments for substance dependent individuals in and out of treatment. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

PubMed

McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

Withdrawal: Expanding a Key Addiction Construct.

PubMed

Piper, Megan E

2015-12-01

Withdrawal is an essential component of classical addiction theory; it is a vital manifestation of dependence and motivates relapse. However, the traditional conceptualization of withdrawal as a cohesive collection of symptoms that emerge during drug deprivation and decline with either the passage of time or reinstatement of drug use, may be inadequate to explain scientific findings or fit with modern theories of addiction. This article expands the current understanding of tobacco withdrawal by examining: (1) withdrawal variability; (2) underlying causes of withdrawal variability, including biological and person factors, environmental influences, and the influence of highly routinized behavioral patterns; (3) new withdrawal symptoms that allow for enhanced characterization of the withdrawal experience; and (4) withdrawal-related cognitive processes. These topics provide guidance regarding the optimal assessment of withdrawal and illustrate the potential impact modern withdrawal conceptualization and assessment could have on identifying treatment targets. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

PubMed

Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

2015-05-01

Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. Published by Oxford University Press on behalf of Medical Council on Alcohol 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Rebuilding the Marriage during Recovery from Compulsive Sexual Behavior.

ERIC Educational Resources Information Center

Schneider, Jennifer P.

1989-01-01

Defines sexual addiction and describes its effects on individual and his/her primary relationship. Addresses problems of recognizing sexual compulsivity and offers suggestions for treatment which include use of both dyadic and group therapy. Recommends attendance at self-help groups based on Alcoholics Anonymous model. (Author/CM)

Use and abuse of opioid analgesics in chronic pain.

PubMed Central

Goldman, B.

1993-01-01

Primary care physicians are frequently required to treat patients with chronic debilitating pain. Opioid analgesics can successfully manage chronic pain. To prescribe opioid analgesics effectively, physicians must identify appropriate patients. Several methods can be used to identify and distinguish appropriate patients, addicted patients, and for-profit drug seekers. PMID:8097128

Risk Evaluation and Mitigation Strategies (REMS) for extended-release and long-acting opioid analgesics: considerations for palliative care practice.

PubMed

Gudin, Jeffrey

2012-06-01

Prescription opioid analgesics are an essential treatment option for patients with moderate to severe pain. Over the last decade the increased medical use of these agents has contributed to a public health epidemic of abuse, addiction, and overdose-related deaths. These medications remain mainstays in both primary care and pain management practices. As palliative services are incorporated at earlier stages of the disease process and the number of individuals with chronic illness increases, palliative care specialists may encounter an increasing number of patients with opioid abuse and addiction problems. Extended-release (ER) and long-acting (LA) opioid formulations are administered to patients with moderate to severe chronic pain requiring around-the-clock analgesia. Given the large quantity of active ingredient contained within some dosage strengths, this medication class is associated with serious risks when taken improperly. In response to growing reports of abuse and overdose deaths, the US Food and Drug Administration (FDA) announced the need for a risk mitigation strategy for the entire class of medication. The class-wide Risk Evaluation and Mitigation Strategy (REMS) for ER/LA opioids will emphasize prescriber training and patient education to ensure that the therapeutic benefits outweigh the risks of addiction, unintentional overdose, and death. As primary care, pain management, and palliative care clinicians often encounter patients who require ER/LA opioids, an understanding of the suggested requirements and potential impact of this regulation is essential.

Alcoholism: a systems approach from molecular physiology to addictive behavior.

PubMed

Spanagel, Rainer

2009-04-01

Alcohol consumption is an integral part of daily life in many societies. The benefits associated with the production, sale, and use of alcoholic beverages come at an enormous cost to these societies. The World Health Organization ranks alcohol as one of the primary causes of the global burden of disease in industrialized countries. Alcohol-related diseases, especially alcoholism, are the result of cumulative responses to alcohol exposure, the genetic make-up of an individual, and the environmental perturbations over time. This complex gene x environment interaction, which has to be seen in a life-span perspective, leads to a large heterogeneity among alcohol-dependent patients, in terms of both the symptom dimensions and the severity of this disorder. Therefore, a reductionistic approach is not very practical if a better understanding of the pathological processes leading to an addictive behavior is to be achieved. Instead, a systems-oriented perspective in which the interactions and dynamics of all endogenous and environmental factors involved are centrally integrated, will lead to further progress in alcohol research. This review adheres to a systems biology perspective such that the interaction of alcohol with primary and secondary targets within the brain is described in relation to the behavioral consequences. As a result of the interaction of alcohol with these targets, alterations in gene expression and synaptic plasticity take place that lead to long-lasting alteration in neuronal network activity. As a subsequent consequence, alcohol-seeking responses ensue that can finally lead via complex environmental interactions to an addictive behavior.

The Association between the Level of Plasma Oxytocin and Craving among Former Heroin Users.

PubMed

Lin, Shih-Hsien; Chen, Po See; Lee, Lan-Ting; Lee, Sheng-Yu; Tsai, Hsin Chun; Chen, Wei Tseng; Chen, Kao Chin; Lee, I Hui; Lu, Ru-Band; Yang, Yen Kuang

2018-06-14

Animal studies have demonstrated that oxytocin can influence addiction behaviors and might interact with the dopaminergic system, which is a key component of addiction behaviors. However, related evidence from clinical studies is scarce. The aim of our study was to explore the relationship between plasma oxytocin level and heroin craving among patients receiving methadone maintenance treatment, and to ascertain whether this relationship is moderated by novelty-seeking. The study was conducted in a methadone maintenance therapy clinic of a medical center in Taiwan. Seventy-seven patients with heroin addiction were enrolled. Plasma oxytocin was measured using an ELISA kit. Craving was assessed using an established instrument, the Chinese Craving Scale. A significant negative association was found between the plasma oxytocin level and craving score, which remained robust after controlling the effects of social support and low-density lipoprotein cholesterol. An interaction between oxytocin and novelty-seeking indicated that this relationship was stronger among patients with a lower level of novelty-seeking. This finding may be taken into account in future studies and may provide a basis for the development of potential treatment for addiction. The effect of oxytocin for the treatment of opioid dependence might be modulated by some psychological factors. © 2018 S. Karger AG, Basel.

Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services.

PubMed

Ahlberg, Rickard; Skårberg, Kurt; Brus, Ole; Kjellin, Lars

2016-07-25

A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse. Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests. Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months. No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study. Clinical Trials NCT02604706 (retrospectively registered).

Cannabis, cannabinoids, and health.

PubMed

Lafaye, Genevieve; Karila, Laurent; Blecha, Lisa; Benyamina, Amine

2017-09-01

Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world. Though it was long considered to be a "soft" drug, studies have proven the harmful psychiatric and addictive effects associated with its use. A number of elements are responsible for the increased complications of cannabis use, including the increase in the potency of cannabis and an evolution in the ratio between the two primary components, Δ 9 -tetrahydrocannabinol (Δ 9 -THC) and cannabidiol (toward a higher proportion of Δ 9 -THC), Synthetic cannabinoid (SC) use has rapidly progressed over the last few years, primarily among frequent cannabis users, because SCs provide similar psychoactive effects to cannabis. However, their composition and pharmacological properties make them dangerous substances. Cannabis does have therapeutic properties for certain indications. These therapeutic applications pertain only to certain cannabinoids and their synthetic derivatives. The objective of this article is to summarize current developments concerning cannabis and the spread of SCs. Future studies must further explore the benefit-risk profile of medical cannabis use.

Do electronic cigarettes help with smoking cessation?

PubMed

2014-11-01

Smoking causes around 100,000 deaths each year in the UK, and is the leading cause of preventable disease and early mortality. Smoking cessation remains difficult and existing licensed treatments have limited success. Nicotine addiction is thought to be one of the primary reasons that smokers find it so hard to give up, and earlier this year DTB reviewed the effects of nicotine on health. Electronic cigarettes (e-cigarettes) are nicotine delivery devices that aim to mimic the process of smoking but avoid exposing the user to some of the harmful components of traditional cigarettes. However, the increase in the use of e-cigarettes and their potential use as an aid to smoking cessation has been subject to much debate. In this article we consider the regulatory and safety issues associated with the use of e-cigarettes, and their efficacy in smoking cessation and reduction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cannabis, cannabinoids, and health

PubMed Central

Lafaye, Genevieve; Karila, Laurent; Blecha, Lisa; Benyamina, Amine

2017-01-01

Cannabis (also known as marijuana) is the most frequently used illicit psychoactive substance in the world. Though it was long considered to be a “soft” drug, studies have proven the harmful psychiatric and addictive effects associated with its use. A number of elements are responsible for the increased complications of cannabis use, including the increase in the potency of cannabis and an evolution in the ratio between the two primary components, Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (toward a higher proportion of Δ9-THC), Synthetic cannabinoid (SC) use has rapidly progressed over the last few years, primarily among frequent cannabis users, because SCs provide similar psychoactive effects to cannabis. However, their composition and pharmacological properties make them dangerous substances. Cannabis does have therapeutic properties for certain indications. These therapeutic applications pertain only to certain cannabinoids and their synthetic derivatives. The objective of this article is to summarize current developments concerning cannabis and the spread of SCs. Future studies must further explore the benefit-risk profile of medical cannabis use. PMID:29302228

What’s New in Addiction Prevention in Young People: A Literature Review of the Last Years of Research

PubMed Central

Kempf, Cédric; Llorca, Pierre-Michel; Pizon, Frank; Brousse, Georges; Flaudias, Valentin

2017-01-01

Rationale: Addiction prevention is a major public health problem, particularly concerning young people. Despite the consensus that primary prevention is essential, the evaluation of its impact is questioned. Objective: The objective of this paper is to assess the latest knowledge of addiction prevention programs for young people. Method: Review a collection of research articles using a keyword-based search on three databases: Pubmed, Eric, and PsycInfo. The research was carried out using three groups of keywords and the eligibility study was completed using two criteria: articles published between 2010 and 2017, and articles in refereed journals. Results: Of a total of 13,720 articles in the three databases, 32 studies were included in the review and listed in a grid with five themes: authors, type of population, total population, addictive behavior, and results. Four categories were created based on the objective of the studies: the evaluation of prevention strategies, the study of risk factors for consumption, the prevalence study and other subjects studied. The analysis of the corpus was used to establish a list of risk factors to be taken into consideration in future interventions and research. A list of key elements for performing effective interventions and future research is also proposed. Conclusion: The understanding of the prevention strategies implementation process is discussed as a central element for future research, which will combine stakeholders and researchers. The complexity of the situations and the multifactorial aspects of addiction prevention in young people require a multidisciplinary approach involving the various stakeholders and researchers. PMID:28729846

Treatment of child/adolescent obesity using the addiction model: a smartphone app pilot study.

PubMed

Pretlow, Robert A; Stock, Carol M; Allison, Stephen; Roeger, Leigh

2015-06-01

The aim of this study was to test a weight loss program for young people based on an addiction treatment approach. A pilot study (n=43) was conducted of a 20-week child/adolescent obesity intervention based on an addiction treatment model (staged, incremental withdrawal from problem foods, snacking/grazing, and excessive amounts at meals) and implemented by a server-integrated smartphone app with health professional support. The primary outcome was standardized %overBMI measured at four time points. Secondary outcomes were participants' self-ratings of self-esteem, control over food, and the degree they turned to food when stressed. User satisfaction data were collected with an online questionnaire. Latent growth modeling techniques were used to identify independent variables and possible mediating treatment process variables associated with weight change. Mean age of participants was 16 years (range, 10-21), 65% girls, and 84% Caucasian. Twenty-seven (63%) completed the program. There was a significant decrease in %overBMI over time of 7.1. There were significant improvements in participant ratings of self-esteem, control over food, and a reduction in turning to food when stressed. Males, younger participants, and participants with higher levels of program compliance achieved better weight loss. Participants who reported that calling obesity an addiction made their guilt worse experienced poorer weight loss. Females were more likely than males to report "addiction guilt," and this partly mediated the overall gender effect. The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys.

Problems associated with the use of social networks--a pilot study.

PubMed

Szczegielniak, Anna; Pałka, Karol; Krysta, Krzysztof

2013-09-01

The definition of addiction is that it is an acquired, strong need to perform a specific activity or continued use of mood alerting substances. Increasing discussion about the development of Internet addiction, which like other addictions, have their roots in depression, impaired assessment esteem and social anxiety shows that it affects all users of the global network, regardless of gender or age. The aim of the study was to assess the impact of social networking on the ongoing behavior of respondents- the first step of a study on the possibility of dependence on social networks. The study was based on an authors questionnaire placed on popular polish websites on February 2013. Questions related to the types and frequency of specific activities undertaken by the private profiles of users. The study involved 221 respondents, 193 questionnaires were filled in completely and correctly, without missing any questions. 83.24% admitted to using social networking sites, 16.76% indicated that they never had their own profile. An overwhelming number of respondents are a member of Facebook (79.17%), specialized portals related to their profession or work were used by only 13.89%, Our-class (6.25%) and Twitter was a primary portal for one person only. Nobody marked a participation in dating services. There is a big difference between the addiction to the Internet and addictions existing within the Internet; the same pattern applies to social networking. There is a need to recognize the "social networking" for a particular activity, irrespective of Facebook, Twitter and Nasza-Klasa, which are commercial products.

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

The Workaholism Syndrome: An Emerging Issue in the Psychological Literature

ERIC Educational Resources Information Center

Piotrowski, Chris; Vodanovich, Stephen J.

2008-01-01

The present paper provides a concise overview of the "workaholism syndrome." This includes a discussion of workaholism from an addiction perspective, it's overall components and consequences, and a conceptual framework. Suggestions are offered for effective strategies to confront and mediate the onerous impact of workaholism.

Characteristics of primary amphetamine users in Sweden: a criminal justice population examined with the Addiction Severity Index.

PubMed

Hakansson, A; Schlyter, F; Berglund, M

2009-01-01

Characteristics of primary amphetamine, heroin and cocaine users were compared in a criminal justice population. 7,085 clients with suspected or reported substance use were studied using the Addiction Severity Index. Variables separating amphetamine, heroin and cocaine users were analyzed in stepwise logistic regression. There were considerably more primary amphetamine users (n = 1,396) than heroin (n = 392) and cocaine (n = 119) users. Amphetamine users were older, a more rural population, and less likely to be non-Nordic immigrants. Compared with heroin, amphetamine use was associated with older age, Nordic origin, nonurban residence, memory/concentration problems, parental alcohol problems, and less history of other opioid use, overdose and detoxification. Compared with cocaine, amphetamine use was associated with older age, Nordic origin, nonurban residence, injecting, tobacco and institution treatment. Overlap of drug use between groups was relatively uncommon. This pattern of amphetamine use, common among Swedish criminals, has relatively distinct boundaries from heroin and cocaine use, commonly involves injecting, and differs from other countries. Psychiatric problems and alcohol heredity were common, and evidence-based treatment for amphetamine users is needed. The connection between amphetamine use and criminal behavior is insufficiently understood and should be further addressed. Copyright 2008 S. Karger AG, Basel.

Managing depression in primary care.

PubMed

Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

2017-08-01

Major depression is common in the primary care setting. In the final article of this series, we illustrate the approach to the management of depression in primary care. Psychotherapy has been shown to be as effective as antidepressants for mild to moderate major depression. The common myth that antidepressants are addictive should be addressed. Antidepressants should be started at a subtherapeutic dose to assess tolerability, then gradually increased until a minimally effective dose is achieved. Apart from pharmacotherapy and psychotherapy, management of depression should include managing stressors, engaging social and community support, dealing with stigma and discrimination, and managing concomitant comorbidities. A strong therapeutic relationship and empathic listening are important between the primary care physician and patient. Copyright: © Singapore Medical Association.

Managing depression in primary care

PubMed Central

Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

2017-01-01

Major depression is common in the primary care setting. In the final article of this series, we illustrate the approach to the management of depression in primary care. Psychotherapy has been shown to be as effective as antidepressants for mild to moderate major depression. The common myth that antidepressants are addictive should be addressed. Antidepressants should be started at a subtherapeutic dose to assess tolerability, then gradually increased until a minimally effective dose is achieved. Apart from pharmacotherapy and psychotherapy, management of depression should include managing stressors, engaging social and community support, dealing with stigma and discrimination, and managing concomitant comorbidities. A strong therapeutic relationship and empathic listening are important between the primary care physician and patient. PMID:28848991

Substance-use initiation moderates the effect of stress on white-matter microstructure in adolescents.

PubMed

Zhai, Zu Wei; Yip, Sarah W; Morie, Kristen P; Sinha, Rajita; Mayes, Linda C; Potenza, Marc N

2018-04-01

While childhood stress may contribute risk to substance-use initiation and differences in brain white-matter development, understanding of the potential impact of substance-use initiation on the relationship between experienced stress and white-matter microstructure remains limited. This study examined whether substance-use initiation moderated the effect of perceived stress on white-matter differences using measures of primary white-matter fiber anisotropy. Forty adolescents (age 14.75 ± .87 years) were assessed on the Perceived Stress Scale, and 50% were determined to have presence of substance-use initiation. White-matter microstructure was examined using primary-fiber orientations anisotropy, which may reflect white-matter integrity, modeled separately from other fiber orientations in the same voxels. Analyses were conducted on regions of interest previously associated with childhood stress and substance use. Lower perceived stress and presence of substance-use initiation were related to greater right cingulum primary-fiber measures. Substance-use-initiation status moderated the association between perceived stress and right cingulum primary-fiber measures, such that higher perceived stress was associated with lower right cingulum primary-fiber anisotropy in adolescents without substance-use initiation, but not in those with substance-use initiation. Findings in primary-fiber anisotropy suggest differences in right cingulum white-matter integrity is associated with substance-use initiation in higher-stress adolescents. This reflects a possible pre-existing risk factor, an impact of early substance use, or a combination thereof. Examination of potential markers associated with substance-use initiation in white-matter microstructure among stress-exposed youth warrant additional investigation as such biomarkers may inform efforts relating to tailored interventions. (Am J Addict 2018;27:217-224). © 2018 American Academy of Addiction Psychiatry.

Towards an understanding of Internet-based problem shopping behaviour: The concept of online shopping addiction and its proposed predictors

PubMed Central

ROSE, SUSAN; DHANDAYUDHAM, ARUN

2014-01-01

Background: Compulsive and addictive forms of consumption and buying behaviour have been researched in both business and medical literature. Shopping enabled via the Internet now introduces new features to the shopping experience that translate to positive benefits for the shopper. Evidence now suggests that this new shopping experience may lead to problematic online shopping behaviour. This paper provides a theoretical review of the literature relevant to online shopping addiction (OSA). Based on this selective review, a conceptual model of OSA is presented. Method: The selective review of the literature draws on searches within databases relevant to both clinical and consumer behaviour literature including EBSCO, ABI Pro-Quest, Web of Science – Social Citations Index, Medline, PsycINFO and Pubmed. The article reviews current thinking on problematic, and specifically addictive, behaviour in relation to online shopping. Results: The review of the literature enables the extension of existing knowledge into the Internet-context. A conceptual model of OSA is developed with theoretical support provided for the inclusion of 7 predictor variables: low self-esteem, low self-regulation; negative emotional state; enjoyment; female gender; social anonymity and cognitive overload. The construct of OSA is defined and six component criteria of OSA are proposed based on established technological addiction criteria. Conclusions: Current Internet-based shopping experiences may trigger problematic behaviours which can be classified on a spectrum which at the extreme end incorporates OSA. The development of a conceptual model provides a basis for the future measurement and testing of proposed predictor variables and the outcome variable OSA. PMID:25215218

Towards an understanding of Internet-based problem shopping behaviour: The concept of online shopping addiction and its proposed predictors.

PubMed

Rose, Susan; Dhandayudham, Arun

2014-06-01

Compulsive and addictive forms of consumption and buying behaviour have been researched in both business and medical literature. Shopping enabled via the Internet now introduces new features to the shopping experience that translate to positive benefits for the shopper. Evidence now suggests that this new shopping experience may lead to problematic online shopping behaviour. This paper provides a theoretical review of the literature relevant to online shopping addiction (OSA). Based on this selective review, a conceptual model of OSA is presented. The selective review of the literature draws on searches within databases relevant to both clinical and consumer behaviour literature including EBSCO, ABI Pro-Quest, Web of Science - Social Citations Index, Medline, PsycINFO and Pubmed. The article reviews current thinking on problematic, and specifically addictive, behaviour in relation to online shopping. The review of the literature enables the extension of existing knowledge into the Internet-context. A conceptual model of OSA is developed with theoretical support provided for the inclusion of 7 predictor variables: low self-esteem, low self-regulation; negative emotional state; enjoyment; female gender; social anonymity and cognitive overload. The construct of OSA is defined and six component criteria of OSA are proposed based on established technological addiction criteria. Current Internet-based shopping experiences may trigger problematic behaviours which can be classified on a spectrum which at the extreme end incorporates OSA. The development of a conceptual model provides a basis for the future measurement and testing of proposed predictor variables and the outcome variable OSA.

The endogenous opioid system in cocaine addiction: what lessons have opioid peptide and receptor knockout mice taught us?

PubMed Central

Yoo, Ji Hoon; Kitchen, Ian; Bailey, Alexis

2012-01-01

Cocaine addiction has become a major concern in the UK as Britain tops the European ‘league table’ for cocaine abuse. Despite its devastating health and socio-economic consequences, no effective pharmacotherapy for treating cocaine addiction is available. Identifying neurochemical changes induced by repeated drug exposure is critical not only for understanding the transition from recreational drug use towards compulsive drug abuse but also for the development of novel targets for the treatment of the disease and especially for relapse prevention. This article focuses on the effects of chronic cocaine exposure and withdrawal on each of the endogenous opioid peptides and receptors in rodent models. In addition, we review the studies that utilized opioid peptide or receptor knockout mice in order to identify and/or clarify the role of different components of the opioid system in cocaine-addictive behaviours and in cocaine-induced alterations of brain neurochemistry. The review of these studies indicates a region-specific activation of the µ-opioid receptor system following chronic cocaine exposure, which may contribute towards the rewarding effect of the drug and possibly towards cocaine craving during withdrawal followed by relapse. Cocaine also causes a region-specific activation of the κ-opioid receptor/dynorphin system, which may antagonize the rewarding effect of the drug, and at the same time, contribute to the stress-inducing properties of the drug and the triggering of relapse. These conclusions have important implications for the development of effective pharmacotherapy for the treatment of cocaine addiction and the prevention of relapse. PMID:22428846

Effect of electro-acupuncture intervention on cognition attention bias in heroin addiction abstinence-a dot-probe-based event-related potential study.

PubMed

Jiang, Ying-Ping; Liu, Hao; Xu, Ping; Wang, Yan; Lu, Guang-Hua

2011-04-01

To study the changes of cognitive attention-related brain function in the heroin addicts before and after electro-acupuncture (EA) intervention for exploring the concerned neuro-mechanism of addictive relapse and the central action role of EA intervention. Adopting event-related potential (ERP) technique, the ERP at 64 electrode spots in 10 heroin addicts (test group) were recorded before and after EA intervention with dot-probe experimental form during implementing cognitive task on positive emotional clue (PEC), negative emotional clues (NEC), and heroin-related clue (HRC). The P200 amplitude components on the selected observation points (Fz, Cz, and Pz) were analyzed and compared with those obtained from 10 healthy subjects as the control. Before EA, the ERP of attention on HRC in the test group was higher than that on PEC and NEC (P<0.05) and significantly higher than that in the control group (P<0.05); after EA, the P200 amplitude of attention on HRC at Cz and Pz was significantly lowered (P<0.05) and that on PEC at Fz was significantly elevated (P<0.05). After EA, the P200 amplitude at Pz was ranked as NEC > PEC > HRC, but in the control group, it showed PEC > HRC at all three observation points and PEC > NEC at Pz. Heroin addicts show attention bias to HRC, which could be significantly reduced by EA intervention, illustrating that EA could effectively inhibit the attention bias to heroin and so might have potential for lowering the relapse rate.

Overlap of food addiction and substance use disorders definitions: analysis of animal and human studies.

PubMed

Hone-Blanchet, Antoine; Fecteau, Shirley

2014-10-01

Food has both homeostatic and hedonic components, which makes it a potent natural reward. Food related reward could therefore promote an escalation of intake and trigger symptoms associated to withdrawal, suggesting a behavioral parallel with substance abuse. Animal and human theoretical models of food reward and addiction have emerged, raising further interrogations on the validity of a bond between Substance Use Disorders, as clinically categorized in the DSM 5, and food reward. These models propose that highly palatable food items, rich in sugar and/or fat, are overly stimulating to the brain's reward pathways. Moreover, studies have also investigated the possibility of causal link between food reward and the contemporary obesity epidemic, with obesity being potentiated and maintained due to this overwhelming food reward. Although natural rewards are a hot topic in the definition and categorization of Substance Use Disorders, proofs of concept and definite evidence are still inconclusive. This review focuses on available results from experimental studies in animal and human models exploring the concept of food addiction, in an effort to determine if it depicts a specific phenotype and if there is truly a neurobiological similarity between food addiction and Substance Use Disorders. It describes results from sugar, fat and sweet-fat bingeing in rodent models, and behavioral and neurobiological assessments in different human populations. Although pieces of behavioral and neurobiological evidence supporting a food addiction phenotype in animals and humans are interesting, it seems premature to conclude on its validity. Copyright © 2014 Elsevier Ltd. All rights reserved.

A critical review of “Internet addiction” criteria with suggestions for the future

PubMed Central

VAN ROOIJ, ANTONIUS J.; PRAUSE, NICOLE

2014-01-01

Aims: In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Methods: Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. Results: The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. Conclusions: We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted. PMID:25592305

A Statewide School Tobacco Policy Review: Process, Results, and Implications.

ERIC Educational Resources Information Center

Stephens, Yvonne D.; English, Gary

2002-01-01

Reviewed all district tobacco policies in New York state, developing a policy rubric to assess five policy components (policy development/oversight/communication, purpose and goals, tobacco-free environment, tobacco use prevention education, and assistance to overcome addiction). School policies were evaluated for compliance with state and federal…

Gender differences among older heroin users.

PubMed

Hamilton, Alison B; Grella, Christine E

2009-01-01

This purpose of this study was to explore the following question: Are there gender differences among older individuals with a history of heroin addiction with regard to social and family relationships and health problems? Eight gender-specific focus groups were conducted with 38 (19 women, 19 men) older (50+ years) individuals with long-term histories of heroin dependence. Four groups were conducted in a methadone maintenance (MM) clinic and four groups were derived from the Los Angeles community. Modest gender differences were observed, but mainly in the focus-group dynamics. Women typically described the impact of their addiction on their families, while men typically described their surprise at still being alive. Hepatitis C was the primary health concern in all groups; mental health issues were also discussed. Remarkable gender differences were not apparent in the qualitative experiences of these participants. Instead, we found overriding similarities related to the interactive effects of drug use and aging. Longitudinal studies of this population as they age and interact with the health-care system and other social systems will help to untangle the complicated relationship between aging, drug addiction, gender, and health.

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.

A Review of Alprazolam Use, Misuse, and Withdrawal

PubMed Central

Ait-Daoud, Nassima; Hamby, Allan Scott; Sharma, Sana; Blevins, Derek

2018-01-01

Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its “abuse liability,” yet it is one of the most frequently prescribed benzodiazepines. “Abuse liability” is the degree to which a psychoactive drug has properties that facilitate people misusing it, or becoming addicted to it, and is commonly used in the literature. We have replaced it in our manuscript with “misuse liability” as it reflects a more updated terminology consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this paper, we have reviewed alprazolam’s indications for use, its effect on pregnant women, misuse liability, withdrawal syndrome, pharmacodynamic properties, and suggest better clinical prescription practice of alprazolam by presenting an indepth theory of its clinical effects with use and withdrawal. PMID:28777203

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

"In their perception we are addicts": social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam.

PubMed

Tomori, Cecilia; Go, Vivian F; Tuan, Le Nhan; Huong, Nguyen Mai; Binh, Nguyen Thanh; Zelaya, Carla E; Celentano, David D; Dat, Do Tuan; Quan, Vu Minh

2014-09-01

Amid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or "06 centers", for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from "06 centers" and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population. In-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from "06 centers" in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n=22) and through peer referral from self-help groups for PWID (n=21). Interviews were audiotaped, transcribed, translated, entered into Atlas.TI qualitative data analysis software and analyzed for key themes. The interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants' social isolation and exacerbated their struggles with addiction. Families were participants' primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability. Our study suggests that PWID released from "06 centers" would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with employment-support and family centered mental health services. Copyright © 2014 Elsevier B.V. All rights reserved.

[Telephone Counseling for Pathological Gamblers as Immediate Access to the Health Care System: Acceptance and Use of The Mainzer Behavioral Addiction Helpline].

PubMed

Aster, Rebecca; Quack, Anke; Wejbera, Martin; Beutel, Manfred E

2018-05-14

Despite extensive psychosocial consequences, just a small number of pathological gamblers participates in counseling or treatment. Telephone helplines should facilitate pathological gamblers' access to the health care system. There is a lack of research on the use and the effects of such facilities in Germany. The present research focuses on the question whether telephone helplines facilitate pathological gamblers' access to the health care system. All first time calls due to a gambling problem received by the behavioral addiction helpline of the University Medical Center Mainz between 2013 and 2016 were analyzed by SPSS. Of the 773 calls analyzed, 89% were from male gamblers. 79.7% reported gambling in slot machine arcades as the primary problem. 66.6% received a referral for a diagnostic in-person assessment at the outpatient clinic for behavioral addiction of the University Medical Center Mainz. 80.4% made an appointment, of which 81.3% were kept. Men were more likely to keep the appointment. Only a few callers had found out about the behavioral addiction helpline by gambling providers. Telephone helplines facilitate pathological gamblers' access to the health care system.There is a deficit in the propagation of such an offer by gambling providers. Telephone helplines should be communicated more actively to problem gamblers in all gambling venues. © Georg Thieme Verlag KG Stuttgart · New York.

Coupling Neurogenetics (GARS™) and a Nutrigenomic Based Dopaminergic Agonist to Treat Reward Deficiency Syndrome (RDS): Targeting Polymorphic Reward Genes for Carbohydrate Addiction Algorithms

PubMed Central

Blum, Kenneth; Simpatico, Thomas; Badgaiyan, Rajendra D.; Demetrovics, Zsolt; Fratantonio, James; Agan, Gozde; Febo, Marcelo; Gold, Mark S.

2016-01-01

Earlier work from our laboratory, showing anti-addiction activity of a nutraceutical consisting of amino-acid precursors and enkephalinase inhibition properties and our discovery of the first polymorphic gene (Dopamine D2 Receptor Gene [DRD2]) to associate with severe alcoholism serves as a blue-print for the development of “Personalized Medicine” in addiction. Prior to the later genetic finding, we developed the concept of Brain Reward Cascade, which continues to act as an important component for stratification of addiction risk through neurogenetics. In 1996 our laboratory also coined the term “Reward Deficiency Syndrome (RDS)” to define a common genetic rubric for both substance and non-substance related addictive behaviors. Following many reiterations we utilized polymorphic targets of a number of reward genes (serotonergic, Opioidergic, GABAergic and Dopaminergic) to customize KB220 [Neuroadaptogen- amino-acid therapy (NAAT)] by specific algorithms. Identifying 1,000 obese subjects in the Netherlands a subsequent small subset was administered various KB220Z formulae customized according to respective DNA polymorphisms individualized that translated to significant decreases in both Body Mass Index (BMI) and weight in pounds. Following these experiments, we have been successfully developing a panel of genes known as “Genetic Addiction Risk Score” (GARSpDX)™. Selection of 10 genes with appropriate variants, a statistically significant association between the ASI-Media Version-alcohol and drug severity scores and GARSpDx was found A variant of KB220Z in abstinent heroin addicts increased resting state functional connectivity in a putative network including: dorsal anterior cingulate, medial frontal gyrus, nucleus accumbens, posterior cingulate, occipital cortical areas, and cerebellum. In addition, we show that KB220Z significantly activates, above placebo, seed regions of interest including the left nucleus accumbens, cingulate gyrus, anterior thalamic nuclei, hippocampus, pre-limbic and infra-limbic loci. KB220Z demonstrates significant functional connectivity, increased brain volume recruitment and enhanced dopaminergic functionality across the brain reward circuitry. We propose a Reward Deficiency System Solution that promotes early identification and stratification of risk alleles by utilizing GARSDx, allowing for customized nutrigenomic targeting of these risk alleles by altering KB220Z ingredients as an algorithmic function of carrying these polymorphic DNA–SNPS, potentially yielding the first ever nutrigenomic solution for addiction and pain. PMID:27617300

Reasons for Substance Use: A Comparative Study of Alcohol Use in Tribals and Non-tribals

PubMed Central

Sreeraj, V. S.; Prasad, Surjit; Khess, Christoday Raja Jayant; Uvais, N. A.

2012-01-01

Background: Consumption of alcohol has been attributed to different reasons by consumers. Attitude and knowledge about the substance and addiction can be influenced by the cultural background of the individual. The tribal population, where alcohol intake is culturally accepted, can have different beliefs and attributes causing one to take alcohol. This study attempts to examine the reasons for alcohol intake and the belief about addiction and their effect on the severity of addiction in people with a different ethnic background. Materials and Methods: The study was conducted at a Psychiatric institute with a cross-sectional design. The study population included patients hailing from the Jharkhand state, twenty each, belonging to tribal and non-tribal communities. Patients fulfilling the ICD 10 diagnostic criteria of mental and behavioral disorders due to the alcohol dependence syndrome, with active dependence, were taken, excluding those having any comorbidity or complications. The subjects were assessed with specially designed Sociodemographic-Clinical Performa, modified version of Reasons for Substance Use scale, Addiction Belief scale, and the Alcohol Dependence scale. Statistical Analysis and Results: A significantly high number of tribals cited reasons associated with social enhancement and coping with distressing emotions rather than individual enhancement, as a reason for consuming alcohol. Addiction was severe in those consuming alcohol to cope with distressing emotions. Belief in the free-will model was noted to be stronger across the cultures, without any correlation with the reason for intake. This cross-sectional study design, which was based on patients, cannot be easily generalized to the community. Conlusion: Societal acceptance and pressure as well as high emotional problems appears to be the major etiology leading to higher prevalce of substance depedence in tribals. Primary prevention should be planned to fit the needs of the ethnics. PMID:23439720

An International Systematic Review of Smoking Prevalence in Addiction Treatment

PubMed Central

Guydish, Joseph; Passalacqua, Emma; Pagano, Anna; Martínez, Cristina; Le, Thao; Chun, JongSerl; Tajima, Barbara; Docto, Lindsay; Garina, Daria; Delucchi, Kevin

2016-01-01

Aims Smoking prevalence is higher among persons enrolled in addiction treatment as compared to the general population, and very high rates of smoking are associated with opiate drug use and receipt of opiate replacement therapy (ORT). We assessed whether these findings are observed internationally. Methods PubMed, PsycINFO and the Alcohol and Alcohol Problems Science Database were searched for papers reporting smoking prevalence among addiction treatment samples, published in English, from 1987 to 2013. Search terms included tobacco use, cessation, and substance use disorders using AND/OR Boolean connectors. For 4,549 papers identified, abstracts were reviewed by multiple raters. 239 abstracts met inclusion criteria and these full papers were reviewed for exclusion. 54 studies, collectively including 37,364 participants, were included. For each paper we extracted country, author, year, sample size and gender, treatment modality, primary drug treated, and smoking prevalence. Results The random-effect pooled estimate of smoking across persons in addiction treatment was 84% (CI 79%, 88%), while the pooled estimate of smoking prevalence across matched population samples was 31% (CI 29%, 33%). The difference in the pooled estimates was 52% (CI 48%, 57%, p < .0001). Smoking rates were higher in programs treating opiate use as compared to alcohol use (OR = 2.52, CI 2.00, 3.17), and higher in ORT compared to outpatient programs (OR = 1.42, CI 1.19, 1.68). Conclusions Smoking rates among people in addiction treatment are more than double those of people with similar demographic characteristics. Smoking rates are also higher in people being treated for opiate dependence compared with people being treated for alcohol use disorder. PMID:26392127

Tolerance and Effectiveness of Forced and Prolonged Smoking Cessation Among French Submariners.

PubMed

Derkenne, Clément; Bylicki, Olivier; Darléguy, Adrien; Garnier, Mathieu; Baert, Patrice; Lamblin, Antoine

2016-05-01

This study investigates nicotine withdrawal symptoms and resumption rates of tobacco abuse among French submariners during and after a 7-week mission without using tobacco. A prospective study was conducted in 2010 during two missions aboard nuclear-powered ballistic missile submarines. Over a 6-month follow-up, the study subjects completed five standardized questionnaires (Fagerström test, Hospital Anxiety Depression, and the Minnesota Nicotine Withdrawal Scale). Out of 222 prospective study subjects, 168 were included, 52 of whom were smokers. For 84.9% of the smokers, the Fagerström test score was lower than 2 (no dependency). Additionally, 92% of the smokers did not experience withdrawal symptoms following an abrupt and mandatory cessation of cigarette smoking. Two-thirds of the smokers resumed their addiction within 2 months, 78% of whom did so the first day they had the opportunity. In the physically and mentally constraining environment of submarines, the behavioral component of cigarette dependency largely dominates over the psychological and physical components of nicotine dependence. This phenomenon occurs because the behavioral component of addiction is the source of smoking resumption and, therefore, must be better addressed to achieve sustained withdrawal. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Dramatic decreases in brain reward function during nicotine withdrawal.

PubMed

Epping-Jordan, M P; Watkins, S S; Koob, G F; Markou, A

1998-05-07

Tobacco smoking is a worldwide public health problem. In the United States alone, over 400,000 deaths and $50 billion in medical costs annually are directly attributed to smoking. Accumulated evidence indicates that nicotine is the component of tobacco smoke that leads to addiction, but the means by which nicotine produces addiction remain unclear. Nicotine is less effective as a positive reinforcer than other drugs of abuse in non-dependent animals. Nevertheless, nicotine-withdrawal symptoms, including depressed mood, anxiety, irritability and craving in dependent subjects may contribute to the addictive liability of nicotine. We show here that spontaneous nicotine withdrawal in rats resulted in a significant decrease in brain reward function, as measured by elevations in brain reward thresholds, which persisted for four days. Further, systemic injections of a competitive nicotinic-receptor antagonist led to a dose-dependent increase in brain reward thresholds in chronic nicotine-treated rats. The decreased function in brain reward systems during nicotine withdrawal is comparable in magnitude and duration to that of other major drugs of abuse, and may constitute an important motivational factor that contributes to craving, relapse and continued tobacco consumption in humans.

The Psychometric Properties of the Smartphone Application-Based Addiction Scale (SABAS).

PubMed

Csibi, Sándor; Griffiths, Mark D; Cook, Brian; Demetrovics, Zsolt; Szabo, Attila

2018-01-01

The goal of the study was to validate the English version of the Smartphone Application-Based Addiction Scale (SABAS; Csibi et al. 2016), which is a short and easy-to-use tool for screening the risk of smartphone application-based addiction. Another aim was to identify the most frequently used smartphone applications and their perceived importance by the participants. Data were collected online from 240 English-speaking volunteers, aged 18 to 69 years. The instruments used were the SABAS, the Nomophobia Questionnaire (NMP-Q), the Brief Sensation Seeking Scale (BSSS), the Deprivation Sensation Scale (DSS), and the Patient Health Questionnaire (PHQ-9). Participants also ranked the importance of their most frequently used smartphone applications. The six items of the SABAS yielded one component, which accounted for 52.38% of the total variance. The internal reliability of the scale was good (Cronbach's alpha 0.81). NMP-Q was a significant predictor of SABAS, explaining 17.6% of the total variance. The regression analysis, with SABAS score as the dependent variable and NMP-Q, DSS, PHQ-9, and BSSS scores as predictors, indicated that approximately 47% of the variance in SABAS was accounted for by the predictors ( R 2  = 0.47). The English version of the SABAS appears to be a valid and reliable ultra-brief tool for a quick and easy assessment of smartphone application-based addiction symptoms.

The 21st Century Cures Act Implications for the Reduction of Racial Health Disparities in the US Criminal Justice System: a Public Health Approach.

PubMed

Cole, Donna M; Thomas, Dawna Marie; Field, Kelsi; Wool, Amelia; Lipiner, Taryn; Massenberg, Natalie; Guthrie, Barbara J

2017-11-09

Past drug epidemics have disproportionately criminalized drug addiction among African Americans, leading to disparate health outcomes, increased rates of HIV/AIDS, and mass incarceration. Conversely, the current opioid addiction crisis in the USA focuses primarily on white communities and is being addressed as a public health problem. The 21st Century Cures Act has the potential to reduce racial health disparities in the criminal justice system through the Act's public health approach to addiction and mental health issues. The 21st Century Cures Act is a progressive step in the right direction; however, given the historical context of segregation and the criminalization of drug addiction among African Americans, the goals of health equity are at risk of being compromised. This paper discusses the implications of this landmark legislation and its potential to decrease racial health disparities, highlighting the importance of ensuring that access to treatment and alternatives to incarceration must include communities of color. In this paper, the authors explain the key components of the 21st Century Cures Act that are specific to criminal justice reform, including a key objective, which is treatment over incarceration. We suggest that without proper attention to how, and where, funding mechanisms are distributed, the 21st Century Cures Act has the potential to increase racial health disparities rather than alleviate them.

Addictive drugs and their relationship with infectious diseases.

PubMed

Friedman, Herman; Pross, Susan; Klein, Thomas W

2006-08-01

The use of drugs of abuse, both recreationally and medicinally, may be related to serious public health concerns. There is a relationship between addictive drugs of abuse such as alcohol and nicotine in cigarette smoke, as well as illegal drugs such as opiates, cocaine and marijuana, and increased susceptibility to infections. The nature and mechanisms of immunomodulation induced by such drugs of abuse are described in this review. The effects of opiates and marijuana, using animal models as well as in vitro studies with immune cells from experimental animals and humans, have shown that immunomodulation induced by these drugs is mainly receptor-mediated, either directly by interaction with specific receptors on immune cells or indirectly by reaction with similar receptors on cells of the nervous system. Similar studies also show that cocaine and nicotine have marked immunomodulatory effects, which are mainly receptor-mediated. Both cocaine, an illegal drug, and nicotine, a widely used legal addictive component of cigarettes, are markedly immunomodulatory and increase susceptibility to infection. The nature and mechanism of immunomodulation induced by alcohol, the most widely used addictive substance of abuse, are similar but immunomodulatory effects, although not receptor-mediated. The many research studies on the effects of these drugs on immunity and increased susceptibility to infectious diseases, including AIDS, are providing a better understanding of the complex interactions between immunity, infections and substance abuse.

An exploratory research on the role of family in youth's drug addiction.

PubMed

Masood, Sobia; Us Sahar, Najam

2014-01-01

Most of the researches in Pakistan are concerned with the aetiological factors of drug addiction among the youth. However, few studies seek to explore the social aspects of this phenomenon. The present study aimed to explore the role of family, the influence of parental involvement, and communication styles in youth's drug addiction in a qualitative manner. Twenty drug addicts (age range 18-28 years) were taken as a sample from drug rehabilitation centres in Rawalpindi and Islamabad, Pakistan. A structured interview guide was administered comprising questions related to the individual's habits, relationship with family and friends, and modes of communication within the family. Case profiles of the participants were also taken. The rehabilitation centres offered family therapy and the researcher, as a non-participant, observed these sessions as part of the analysis. The demographic information revealed that majority of the participants were poly-substance abusers (80%) and the significant reasons for starting drugs were the company of peers and curiosity. The thematic analysis revealed parental involvement and emotional expressiveness as two major components in family communication. It was found that parents were concerned about their children, but were not assertive in the implementation of family rules. It was also found that the major life decisions of the participants were taken by their parents, which is a characteristic of collectivist Pakistani society.

The relationships between behavioral addictions and the five-factor model of personality.

PubMed

Andreassen, Cecilie Schou; Griffiths, Mark D; Gjertsen, Siri Renate; Krossbakken, Elfrid; Kvam, Siri; Pallesen, Ståle

2013-06-01

Aims Although relationships between addiction and personality have previously been explored, no study has ever simultaneously investigated the interrelationships between several behavioral addictions, and related these to the main dimensions of the five-factor model of personality. Methods In this study, 218 university students completed questionnaires assessing seven different behavioral addictions (i.e., Facebook addiction, video game addiction, Internet addiction, exercise addiction, mobile phone addiction, compulsive buying, and study addiction) as well as an instrument assessing the main dimensions of the five-factor model of personality. Results Of the 21 bivariate intercorrelations between the seven behavioral addictions, all were positive (and nine significantly). The results also showed that (i) Neuroticism was positively associated with Internet addiction, exercise addiction, compulsive buying, and study addiction, (ii) Extroversion was positively associated with Facebook addiction, exercise addiction, mobile phone addiction, and compulsive buying, (iii) Openness to experience was negatively associated with Facebook addiction and mobile phone addiction, (iv) Agreeableness was negatively associated with Internet addiction, exercise addiction, mobile phone addiction, and compulsive buying, and (v) Conscientiousness was negatively associated with Facebook addiction, video game addiction, Internet addiction, and compulsive buying and positively associated with exercise addiction and study addiction. Conclusions The positive associations between the seven behavioral addictions suggest one or several underlying pathological factors. Hierarchical multiple regressions showed that personality traits explained between 6% and 17% of the variance in the seven behavioral addictions, suggesting that personality to a varying degree explains scores on measures of addictive behaviors.

Problematic mobile phone use in adolescents: derivation of a short scale MPPUS-10.

PubMed

Foerster, Milena; Roser, Katharina; Schoeni, Anna; Röösli, Martin

2015-02-01

Our aim was to derive a short version of the Mobile Phone Problem Use Scale (MPPUS) using data from 412 adolescents of the Swiss HERMES (Health Effects Related to Mobile phonE use in adolescentS) cohort. A German version of the original MPPUS consisting of 27 items was shortened by principal component analysis (PCA) using baseline data collected in 2012. For confirmation, the PCA was carried out again with follow-up data 1 year later. PCA revealed four factors related to symptoms of addiction (Loss of Control, Withdrawal, Negative Life Consequences and Craving) and a fifth factor reflecting the social component of mobile phone use (Peer Dependence). The shortened scale (MPPUS-10) highly reflects the original MPPUS (Kendalls' Tau: 0.80 with 90% concordant pairs). Internal consistency of MPPUS-10 was good with Cronbach's alpha: 0.85. The results were confirmed using the follow-up data. The MPPUS-10 is a suitable instrument for research in adolescents. It will help to further clarify the definition of problematic mobile phone use in adolescents and explore similarities and differences to other technological addictions.

Death Anxiety in Young Adulthood: Ineffective Ways of Coping with the Terror and the Dread.

ERIC Educational Resources Information Center

Ballard, Mary B.; Halbrook, Bernadette M.

1992-01-01

Familiarizes counselors with role of death fear as primary source of anxiety for all individuals. Attempts to define death anxiety and demonstrate how defense mechanisms used to deny it can affect development in young adulthood. Provides three examples of maladaptive modes of behavior resulting from ineffective defense mechanisms (addiction,…

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.

Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective

PubMed Central

Ekhtiari, Hamed; Rezapour, Tara; Aupperle, Robin L.; Paulus, Martin P.

2018-01-01

Psychoeducation (PE) is defined as an intervention with systematic, structured, and didactic knowledge transfer for an illness and its treatment, integrating emotional and motivational aspects to enable patients to cope with the illness and to improve its treatment adherence and efficacy. PE is considered an important component of treatment in both medical and psychiatric disorders, especially for mental health disorders associated with lack of insight, such as alcohol and substance use disorders (ASUDs). New advancements in neuroscience have shed light on how various aspects of ASUDs may relate to neural processes. However, the actual impact of neuroscience in the real-life clinical practice of addiction medicine is minimal. In this chapter, we provide a perspective on how PE in addiction medicine can be informed by neuroscience in two dimensions: content (knowledge we transfer in PE) and structure (methods we use to deliver PE). The content of conventional PE targets knowledge about etiology of illness, treatment process, adverse effects of prescribed medications, coping strategies, family education, and life skill training. Adding neuroscience evidence to the content of PE could be helpful in communicating not only the impact of drug use but also the beneficial impact of various treatments (i.e., on brain function), thus enhancing motivation for compliance and further destigmatizing their symptoms. PE can also be optimized in its “structure” by implicitly and explicitly engaging different neurocognitive processes, including salience/attention, memory, and self-awareness. There are many interactions between these two dimensions, structure and content, in the delivery of neuroscience-informed psychoeducation (NIPE). We explore these interactions in the development of a cartoon-based NIPE to promote brain recovery during addiction treatment as a part of the brain awareness for addiction recovery initiative. PMID:29054291

Neurobiological Substrates for the Dark Side of Compulsivity in Addiction

PubMed Central

Koob, George F.

2009-01-01

Drug addiction can be defined by a compulsion to seek and take drug, loss of control in limiting intake, and the emergence of a negative emotional state when access to the drug is prevented. Drug addiction impacts multiple motivational mechanisms and can be conceptualized as a disorder that progresses from impulsivity (positive reinforcement) to compulsivity (negative reinforcement). The construct of negative reinforcement is defined as drug taking that alleviates a negative emotional state. The negative emotional state that drives such negative reinforcement is hypothesized to derive from dysregulation of key neurochemical elements involved in reward and stress within the basal forebrain structures involving the ventral striatum and extended amygdala. Specific neurochemical elements in these structures include not only decreases in reward neurotransmission, such as decreases in dopamine and opioid peptide function in the ventral striatum, but also recruitment of brain stress systems, such as corticotropin-releasing factor (CRF), in the extended amygdala. Acute withdrawal from all major drugs of abuse produces increases in reward thresholds, increases in anxiety-like responses, and increases in extracellular levels of CRF in the central nucleus of the amygdala. CRF receptor antagonists also block excessive drug intake produced by dependence. A brain stress response system is hypothesized to be activated by acute excessive drug intake, to be sensitized during repeated withdrawal, to persist into protracted abstinence, and to contribute to the compulsivity of addiction. Other components of brain stress systems in the extended amygdala that interact with CRF and may contribute to the negative motivational state of withdrawal include norepinephrine, dynorphin, and neuropeptide Y. The combination of loss of reward function and recruitment of brain stress systems provides a powerful neurochemical basis for a negative emotional state that is responsible for the negative reinforcement driving, at least in part, the compulsivity of addiction. PMID:18725236

Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective.

PubMed

Ekhtiari, Hamed; Rezapour, Tara; Aupperle, Robin L; Paulus, Martin P

2017-01-01

Psychoeducation (PE) is defined as an intervention with systematic, structured, and didactic knowledge transfer for an illness and its treatment, integrating emotional and motivational aspects to enable patients to cope with the illness and to improve its treatment adherence and efficacy. PE is considered an important component of treatment in both medical and psychiatric disorders, especially for mental health disorders associated with lack of insight, such as alcohol and substance use disorders (ASUDs). New advancements in neuroscience have shed light on how various aspects of ASUDs may relate to neural processes. However, the actual impact of neuroscience in the real-life clinical practice of addiction medicine is minimal. In this chapter, we provide a perspective on how PE in addiction medicine can be informed by neuroscience in two dimensions: content (knowledge we transfer in PE) and structure (methods we use to deliver PE). The content of conventional PE targets knowledge about etiology of illness, treatment process, adverse effects of prescribed medications, coping strategies, family education, and life skill training. Adding neuroscience evidence to the content of PE could be helpful in communicating not only the impact of drug use but also the beneficial impact of various treatments (i.e., on brain function), thus enhancing motivation for compliance and further destigmatizing their symptoms. PE can also be optimized in its "structure" by implicitly and explicitly engaging different neurocognitive processes, including salience/attention, memory, and self-awareness. There are many interactions between these two dimensions, structure and content, in the delivery of neuroscience-informed psychoeducation (NIPE). We explore these interactions in the development of a cartoon-based NIPE to promote brain recovery during addiction treatment as a part of the brain awareness for addiction recovery initiative. © 2017 Elsevier B.V. All rights reserved.

Validity and reliability of the Persian version of mobile phone addiction scale.

PubMed

Mazaheri, Maryam Amidi; Karbasi, Mojtaba

2014-02-01

With regard to large number of mobile users especially among college students in Iran, addiction to mobile phone is attracting increasing concern. There is an urgent need for reliable and valid instrument to measure this phenomenon. This study examines validity and reliability of the Persian version of mobile phone addiction scale (MPAIS) in college students. this methodological study was down in Isfahan University of Medical Sciences. One thousand one hundred and eighty students were selected by convenience sampling. The English version of the MPAI questionnaire was translated into Persian with the approach of Jones et al. (Challenges in language, culture, and modality: Translating English measures into American Sign Language. Nurs Res 2006; 55: 75-81). Its reliability was tested by Cronbach's alpha and its dimensionality validity was evaluated using Pearson correlation coefficients with other measures of mobile phone use and IAT. Construct validity was evaluated using Exploratory subscale analysis. Cronbach's alpha of 0.86 was obtained for total PMPAS, for subscale1 (eight items) was 0.84, for subscale 2 (five items) was 0.81 and for subscale 3 (two items) was 0.77. There were significantly positive correlations between the score of PMPAS and IAT (r = 0.453, P < 0.001) and other measures of mobile phone use. Principal component subscale analysis yielded a three-subscale structure including: inability to control craving; feeling anxious and lost; mood improvement accounted for 60.57% of total variance. The results of discriminate validity showed that all the item's correlations with related subscale were greater than 0.5 and correlations with unrelated subscale were less than 0.5. Considering lack of a valid and reliable questionnaire for measuring addiction to the mobile phone, PMPAS could be a suitable instrument for measuring mobile phone addiction in future research.

"New Choices" for women with addictions: perceptions of program participants

PubMed Central

Sword, Wendy; Niccols, Alison; Fan, Aimei

2004-01-01

Background Substance use in pregnancy is a major public health problem. It can have profound effects on pregnancy outcomes, and childhood health and development. Additionally, women who use substances have their own health-related issues. Although intervention is important, these women often have difficulty using traditional systems of care. The New Choices program is a centralized, multi-sector approach to service delivery that has attempted to overcome barriers to care by offering one-stop shopping in a supportive environment. As part of an evaluation of this program designed for women who are pregnant and/or parenting young children, interviews were conducted with participants to gain insight into their experiences in New Choices and perceptions of any changes attributed to program involvement. Methods A qualitative, exploratory design was used to guide data collection and analysis. Four women participated in a focus group interview and seven women agreed to individual interviews over the course of the program evaluation (N = 11). A semi-structured interview guide was used to explore women's experiences in New Choices and their perceptions of the program and its impact. The interview data were analyzed using NVivo software and an inductive approach to data analysis. Results The emergent themes captured women's motivations for attending New Choices, benefits of participation, and overall quality of the program. Children were the primary motivating factor for program enrollment. Perceived benefits included decreased substance use, improved maternal health, enhanced opportunity for employment, increased access to other resources, enhanced parenting skills, and improved child behaviour and development. Women highly valued the comprehensive and centralized approach to service delivery that provided a range of informal and formal supports. Conclusions Interview findings endorse the appropriateness and potential efficacy of a collaborative, centralized approach to service provision for women with substance use issues. Although the findings provide insight into an alternative model of service delivery for women with addictions, future research is needed to evaluate the effectiveness of the intervention. Research also is needed to determine which program components or constellation of components contribute to desired outcomes, and to learn more about processes that underlie changes in behaviour. PMID:15086957

An Inventory of Methods for the Assessment of Additive Increased Addictiveness of Tobacco Products

PubMed Central

van de Nobelen, Suzanne; Kienhuis, Anne S.

2016-01-01

Background: Cigarettes and other forms of tobacco contain the addictive drug nicotine. Other components, either naturally occurring in tobacco or additives that are intentionally added during the manufacturing process, may add to the addictiveness of tobacco products. As such, these components can make cigarette smokers more easily and heavily dependent. Efforts to regulate tobacco product dependence are emerging globally. Additives that increase tobacco dependence will be prohibited under the new European Tobacco Product Directive. Objective: This article provides guidelines and recommendations for developing a regulatory strategy for assessment of increase in tobacco dependence due to additives. Relevant scientific literature is summarized and criteria and experimental studies that can define increased dependence of tobacco products are described. Conclusions: Natural tobacco smoke is a very complex matrix of components, therefore analysis of the contribution of an additive or a combination of additives to the level of dependence on this product is challenging. We propose to combine different type of studies analyzing overall tobacco product dependence potential and the functioning of additives in relation to nicotine. By using a combination of techniques, changes associated with nicotine dependence such as behavioral, physiological, and neurochemical alterations can be examined to provide sufficient information. Research needs and knowledge gaps will be discussed and recommendations will be made to translate current knowledge into legislation. As such, this article aids in implementation of the Tobacco Product Directive, as well as help enable regulators and researchers worldwide to develop standards to reduce dependence on tobacco products. Implications: This article provides an overall view on how to assess tobacco product constituents for their potential contribution to use and dependence. It provides guidelines that help enable regulators worldwide to develop standards to reduce dependence on tobacco products and guide researches to set research priorities on this topic. PMID:26817491

Effectiveness of a stepped primary care smoking cessation intervention: cluster randomized clinical trial (ISTAPS study).

PubMed

Cabezas, Carmen; Advani, Mamta; Puente, Diana; Rodriguez-Blanco, Teresa; Martin, Carlos

2011-09-01

To evaluate the effectiveness in primary care of a stepped smoking cessation intervention based on the transtheoretical model of change. Cluster randomized trial; unit of randomization: basic care unit (family physician and nurse who care for the same group of patients); and intention-to-treat analysis. All interested basic care units (n = 176) that worked in 82 primary care centres belonging to the Spanish Preventive Services and Health Promotion Research Network in 13 regions of Spain. A total of 2,827 smokers (aged 14-85 years) who consulted a primary care centre for any reason, provided written informed consent and had valid interviews. The outcome variable was the 1-year continuous abstinence rate at the 2-year follow-up. The main variable was the study group (intervention/control). Intervention involved 6-month implementation of recommendations from a Clinical Practice Guideline which included brief motivational interviews for smokers at the precontemplation-contemplation stage, brief intervention for smokers in preparation-action who do not want help, intensive intervention with pharmacotherapy for smokers in preparation-action who want help and reinforcing intervention in the maintenance stage. Control group involved usual care. Among others, characteristics of tobacco use and motivation to quit variables were also collected. The 1-year continuous abstinence rate at the 2-year follow-up was 8.1% in the intervention group and 5.8% in the control group (P = 0.014). In the multivariate logistic regression, the odds of quitting of the intervention versus control group was 1.50 (95% confidence interval = 1.05-2.14). A stepped smoking cessation intervention based on the transtheoretical model significantly increased smoking abstinence at a 2-year follow-up among smokers visiting primary care centres. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Effects of the mental health parity and addictions equality act on depression treatment choice in primary care facilities.

PubMed

Goldberg, Daniel M; Lin, Hsien-Chang

2017-01-01

Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians' choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007-2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients. Using the Heckman two-step selection procedure, a logistic and a multinomial regression were conducted to examine the association of the MHPAEA with physicians' two-step process of deciding whether and which type of treatment was prescribed. Sociological factors were controlled. Results Treatment was significantly more likely to be provided after the MHPAEA. Psychotherapy was used for treatment for 10.0% of the sample while medication was used for 75.0% of the sample. Patient race/ethnicity, practice setting, physician specialty, and primary source of payment were associated with diverging likelihood of being prescribed depression treatment. Non-Hispanic White patients were more likely to be provided treatment than non-Hispanic Black patients. Patients were less likely to be prescribed only medication than only psychotherapy after the MHPAEA enactment. Conclusions The MHPAEA was associated with primary care providers' decision and choice on depression treatment. Educational and policy interventions aimed at improving physician's understanding of their own treatment tendencies and decreasing barriers to depression treatment may impact the disparities in underserved, minority, and older populations.

Emotion-based decision-making in healthy subjects: short-term effects of reducing dopamine levels.

PubMed

Sevy, Serge; Hassoun, Youssef; Bechara, Antoine; Yechiam, Eldad; Napolitano, Barbara; Burdick, Katherine; Delman, Howard; Malhotra, Anil

2006-10-01

Converging evidences from animal and human studies suggest that addiction is associated with dopaminergic dysfunction in brain reward circuits. So far, it is unclear what aspects of addictive behaviors are related to a dopaminergic dysfunction. We hypothesize that a decrease in dopaminergic activity impairs emotion-based decision-making. To demonstrate this hypothesis, we investigated the effects of a decrease in dopaminergic activity on the performance of an emotion-based decision-making task, the Iowa gambling task (IGT), in 11 healthy human subjects. We used a double-blind, placebo-controlled, within-subject design to examine the effect of a mixture containing the branched-chain amino acids (BCAA) valine, isoleucine and leucine on prolactin, IGT performance, perceptual competency and visual aspects of visuospatial working memory, visual attention and working memory, and verbal memory. The expectancy-valence model was used to determine the relative contributions of distinct IGT components (attention to past outcomes, relative weight of wins and losses, and choice strategies) in the decision-making process. Compared to placebo, the BCAA mixture increased prolactin levels and impaired IGT performance. BCAA administration interfered with a particular component process of decision-making related to attention to more recent events as compared to more distant events. There were no differences between placebo and BCAA conditions for other aspects of cognition. Our results suggest a direct link between a reduced dopaminergic activity and poor emotion-based decision-making characterized by shortsightedness, and thus difficulties resisting short-term reward, despite long-term negative consequences. These findings have implications for behavioral and pharmacological interventions targeting impaired emotion-based decision-making in addictive disorders.

Identification of brain nuclei implicated in cocaine-primed reinstatement of conditioned place preference: a behaviour dissociable from sensitization.

PubMed

Brown, Robyn Mary; Short, Jennifer Lynn; Lawrence, Andrew John

2010-12-29

Relapse prevention represents the primary therapeutic challenge in the treatment of drug addiction. As with humans, drug-seeking behaviour can be precipitated in laboratory animals by exposure to a small dose of the drug (prime). The aim of this study was to identify brain nuclei implicated in the cocaine-primed reinstatement of a conditioned place preference (CPP). Thus, a group of mice were conditioned to cocaine, had this place preference extinguished and were then tested for primed reinstatement of the original place preference. There was no correlation between the extent of drug-seeking upon reinstatement and the extent of behavioural sensitization, the extent of original CPP or the extinction profile of mice, suggesting a dissociation of these components of addictive behaviour with a drug-primed reinstatement. Expression of the protein product of the neuronal activity marker c-fos was assessed in a number of brain regions of mice that exhibited reinstatement (R mice) versus those which did not (NR mice). Reinstatement generally conferred greater Fos expression in cortical and limbic structures previously implicated in drug-seeking behaviour, though a number of regions not typically associated with drug-seeking were also activated. In addition, positive correlations were found between neural activation of a number of brain regions and reinstatement behaviour. The most significant result was the activation of the lateral habenula and its positive correlation with reinstatement behaviour. The findings of this study question the relationship between primed reinstatement of a previously extinguished place preference for cocaine and behavioural sensitization. They also implicate activation patterns of discrete brain nuclei as differentiators between reinstating and non-reinstating mice.

Insula Demonstrates a Non-Linear Response to Varying Demand for Cognitive Control and Weaker Resting Connectivity With the Executive Control Network in Smokers.

PubMed

Fedota, John R; Matous, Allison L; Salmeron, Betty Jo; Gu, Hong; Ross, Thomas J; Stein, Elliot A

2016-09-01

Deficits in cognitive control processes are a primary characteristic of nicotine addiction. However, while network-based connectivity measures of dysfunction have frequently been observed, empirical evidence of task-based dysfunction in these processes has been inconsistent. Here, in a sample of smokers (n=35) and non-smokers (n=21), a previously validated parametric flanker task is employed to characterize addiction-related alterations in responses to varying (ie, high, intermediate, and low) demands for cognitive control. This approach yields a demand-response curve that aims to characterize potential non-linear responses to increased demand for control, including insensitivities or lags in fully activating the cognitive control network. We further used task-based differences in activation between groups as seeds for resting-state analysis of network dysfunction in an effort to more closely link prior inconsistencies in task-related activation with evidence of impaired network connectivity in smokers. For both smokers and non-smokers, neuroimaging results showed similar increases in activation in brain areas associated with cognitive control. However, reduced activation in right insula was seen only in smokers and only when processing intermediate demand for cognitive control. Further, in smokers, this task-modulated right insula showed weaker functional connectivity with the superior frontal gyrus, a component of the task-positive executive control network. These results demonstrate that the neural instantiation of salience attribution in smokers is both more effortful to fully activate and has more difficulty communicating with the exogenous, task-positive, executive control network. Together, these findings further articulate the cognitive control dysfunction associated with smoking and illustrate a specific brain circuit potentially responsible.

The independent relationship between trouble controlling Facebook use, time spent on the site and distress

PubMed Central

Muench, Fredrick; Hayes, Marie; Kuerbis, Alexis; Shao, Sijing

2015-01-01

Background and Aims There is an emerging literature base on the relationship between maladaptive traits and “addiction” to social networking sites. These studies have operationalized addiction as either spending excessive amounts of time on social networking sites (SNS) or trouble controlling SNS use, but have not assessed the unique contribution of each of these constructs on outcomes in the same models. Moreover, these studies have exclusively been conducted with younger people rather than a heterogeneous sample. This study examined the independent relationship of a brief Facebook addiction scale, time spent on Facebook, and Facebook checking on positive and negative social domains, while controlling for self-esteem and social desirability. Methods Participants were recruited using e-mail, SNS posts and through Amazon’s MTurk system. The sample included 489 respondents ages from 18 to approximately 70, who completed a 10–15 minute survey. Results Results indicate that neither time spent on Facebook nor Facebook checking was significantly associated with either self-esteem, fear of negative social evaluation or social comparison, while SNS addiction symptoms were each independently associated with Facebook usage. Neither time spent on Facebook nor SNS addiction symptoms were associated with positive social relationships. Discussion Overall results suggest that time on SNS and trouble controlling use should be considered independent constructs and that interventions should target underlying loss of control as the primary intervention target above ego syntonic time spent on the site. PMID:26551906

Internet Gaming Disorder: An Emergent Health Issue for Men.

PubMed

Chen, Kevin H; Oliffe, John L; Kelly, Mary T

2018-03-01

Internet gaming is a legitimate leisure activity worldwide; however, there are emerging concerns that vast numbers of gamers are becoming addicted. In 2013, the American Psychiatric Association (APA) classified Internet Gaming Disorder (IGD) as a condition warranting more clinical research ahead of formalizing it as a mental disorder. Proposed as a behavioral addiction, IGD shares many similarities in both physical and psychosocial manifestations with substance use disorder, including cerebral changes on functional magnetic resonance imaging (fMRI). Among the gaming population, compared to females, adolescent and adult males demonstrate far more addictive internet gaming use in terms of screen hours, craving, and negative impacts on health, which have, in isolated incidents, also caused death. The current article draws findings from a scoping review of literature related to IGD as a means to raising awareness about an emergent men's health issue. Included are three themes: (a) unveiling the nature, impacts and symptoms of IGD; (b) conceptualizing IGD through neuroscience; and (c) treatment approaches to IGD. Afforded by these themes is an overview and synthesis of the existing literature regarding IGD as a means of providing direction for much needed research on gaming addiction and orientating primary care providers (PCPs) to the specificities of IGD in men's health. The findings are applied to a discussion of the connections between IGD and masculinity and the importance of recognizing how behaviors such as social isolation and game immersion can be maladaptive coping strategies for males.

Effect of implementing the 5As of obesity management framework on provider-patient interactions in primary care.

PubMed

Rueda-Clausen, C F; Benterud, E; Bond, T; Olszowka, R; Vallis, M T; Sharma, A M

2014-02-01

Obesity counselling in primary care is positively associated with self-reported behaviour change in patients with obesity. Obesity counselling is rare, and when it does occur, it is often of low quality because of poor training and/or competency of providers' obesity management, lack of time and economical disincentives, and negative attitude towards obesity and obesity management. 5As frameworks are routinely used for behaviour-change counselling and addiction management (e.g. smoking cessation), but few studies have examined its efficacy for weight management. This study presents pilot data from the implementation and evaluation of an obesity management tool (5As of Obesity Management developed by the Canadian Obesity Network) in a primary care setting. Results show that the tool facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care. Obesity remains poorly managed in primary care. The 5As of Obesity Management is a theory-driven, evidence-based minimal intervention designed to facilitate obesity counselling and management by primary care practitioners. This project tested the impact of implementing this tool in primary care clinics. Electronic self-administered surveys were completed by pre-screened obese subjects at the end of their appointments in four primary care clinics (over 25 healthcare providers [HCPs]). These measurements were performed before (baseline, n = 51) and 1 month after implementing the 5As of Obesity Management (post-intervention, n = 51). Intervention consisted of one online training session (90 min) and distribution of the 5As toolkit to HCPs of participating clinics. Subjects completing the survey before and after the intervention were comparable in terms of age, sex, body mass index, comorbidities, satisfaction and self-reported health status (P > 0.2). Implementing the 5As of Obesity Management resulted in a twofold increase in the initiation of obesity management (19 vs. 39%, P = 0.03), and caused a statistically significant increase in the perceived follow-up/coordination efforts (self-reported Patient Assessment of Chronic Illness Care components, 45 ± 22 vs. 67 ± 12 points, P = 0.002), as well as two components of the 5As framework: Assess (50 ± 29 vs. 66 ± 15 points, P = 0.03) and Assist (54 ± 26 vs. 72 ± 13 points, P = 0.01). Our results suggest that using the 5As of Obesity Management facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care. © 2013 The Authors. Clinical Obesity © 2013 International Association for the Study of Obesity.

[SEMERGEN positioning for the treatment of alcohol disorders in primary care].

PubMed

Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

2015-12-01

The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

Examining Concurrent Validity and Predictive Utility for the Addiction Severity Index and Texas Christian University (TCU) Short Forms

PubMed Central

PANKOW, JENNIFER; SIMPSON, D. DWAYNE; JOE, GEORGE W.; ROWAN-SZAL, GRACE A.; KNIGHT, KEVIN; MEASON, PAUL

2012-01-01

Treatment providers need tools which are designed to identify risk, treatment needs, and monitor client engagement. These are essential components in substance abuse treatment for offender populations. This study evaluated a flexible set of 1-page modular assessments known as the TCU Short Forms and compared them with the measures of global domains contained in the Addiction Severity Index (ASI). The sample was based on 540 adult males and females in corrections-based substance abuse treatment services located in Arkansas and Missouri. Results suggest the set of TCU forms and ASI both reliably represent core clinical domains, but TCU Short Forms explained more variance in therapeutic engagement criteria measured during treatment. Similarities and differences of the assessment tools are discussed, along with applications PMID:23087588

The Role of Sexual Compulsivity, Impulsivity, and Experiential Avoidance in Internet Pornography Use

ERIC Educational Resources Information Center

Wetterneck, Chad T.; Burgess, Angela J.; Short, Mary B.; Smith, Angela H.; Cervantes, Maritza E.

2012-01-01

Previous research has found that a significant proportion of individuals who use Internet pornography (IP) report that their use is problematic in some area of functioning. Problematic IP use has been conceptualized as an aspect of sexual addiction and as having components of impulsivity and compulsivity. Experiential avoidance also has been…

Adenosine A2a blockade prevents synergy between mu-opiate and cannabinoid CB1 receptors and eliminates heroin-seeking behavior in addicted rats.

PubMed

Yao, Lina; McFarland, Krista; Fan, Peidong; Jiang, Zhan; Ueda, Takashi; Diamond, Ivan

2006-05-16

Relapse is the most serious limitation of effective medical treatment of opiate addiction. Opiate-related behaviors appear to be modulated by cannabinoid CB1 receptors (CB1) through poorly understood cross-talk mechanisms. Opiate and CB1 receptors are coexpressed in the nucleus accumbens (NAc) and dorsal striatum. These regions also have the highest density of adenosine A2a receptors (A2a) in the brain. We have been investigating the postsynaptic signaling mechanisms of mu-opiate receptors (MORs) and CB1 receptors in primary NAc/striatal neurons. In this article, we present evidence that MOR and CB1 act synergistically on cAMP/PKA signaling in NAc/striatal neurons. In addition, we find that synergy requires adenosine and A2a. Importantly, an A2a antagonist administered either directly into the NAc or indirectly by i.p. injection eliminates heroin-induced reinstatement in rats trained to self-administer heroin, a model of human craving and relapse. These findings suggest that A2a antagonists might be effective therapeutic agents in the management of abstinent heroin addicts.

Adenosine A2a blockade prevents synergy between μ-opiate and cannabinoid CB1 receptors and eliminates heroin-seeking behavior in addicted rats

PubMed Central

Yao, Lina; McFarland, Krista; Fan, Peidong; Jiang, Zhan; Ueda, Takashi; Diamond, Ivan

2006-01-01

Relapse is the most serious limitation of effective medical treatment of opiate addiction. Opiate-related behaviors appear to be modulated by cannabinoid CB1 receptors (CB1) through poorly understood cross-talk mechanisms. Opiate and CB1 receptors are coexpressed in the nucleus accumbens (NAc) and dorsal striatum. These regions also have the highest density of adenosine A2a receptors (A2a) in the brain. We have been investigating the postsynaptic signaling mechanisms of μ-opiate receptors (MORs) and CB1 receptors in primary NAc/striatal neurons. In this article, we present evidence that MOR and CB1 act synergistically on cAMP/PKA signaling in NAc/striatal neurons. In addition, we find that synergy requires adenosine and A2a. Importantly, an A2a antagonist administered either directly into the NAc or indirectly by i.p. injection eliminates heroin-induced reinstatement in rats trained to self-administer heroin, a model of human craving and relapse. These findings suggest that A2a antagonists might be effective therapeutic agents in the management of abstinent heroin addicts. PMID:16684876

ADHD Symptoms in Pathological and Problem Gamblers in Singapore.

PubMed

Mak, Charles; Tan, Kok Kah; Guo, Song

2018-06-22

Background : There is relatively little research examining the relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and gambling addiction. This study seeks to explore for ADHD symptoms in adult gambling addiction patients and to evaluate their gambling-related cognitions. Materials and Methods : A cross-sectional survey was conducted at National Addictions Management Service, Institute of Mental Health, in Singapore. Patients presenting for gambling treatment were screened for ADHD symptoms and assessed for severity of gambling-related cognitions. The primary objective was to observe the rate of patients screening positive for ADHD. Results : 20% of the sample screened positive for ADHD. These individuals also had lower levels of gambling-related cognitions. No significant correlation was noted between ADHD symptoms and gambling-related cognition scores. Conclusions : Positive screening results for ADHD occurred frequently in our sample of Pathological Gambling (PG) and Problem Gambling patients and these affected individuals also exhibited lower levels of gambling-related cognitions. This finding may suggest that the gambling behavior in patients with ADHD-PG comorbidity is driven by impulsivity rather than gambling-related cognitions, which has implication on treatment considerations. Further research with a larger sample size is indicated.

The SEEKING mind: primal neuro-affective substrates for appetitive incentive states and their pathological dynamics in addictions and depression.

PubMed

Alcaro, Antonio; Panksepp, Jaak

2011-10-01

Appetitive motivation and incentive states are essential functions sustained by a common emotional brain process, the SEEKING disposition, which drives explorative and approach behaviors, sustains goal-directed activity, promotes anticipatory cognitions, and evokes feelings of positive excitement which control reward-learning. All such functions are orchestrated by the same "archetypical" neural processes, activated in ancient subcortical areas and transported to the forebrain by the mesolimbic dopamine (ML-DA) system. In mammals, the neurophysiology of the SEEKING urge is expressed by DA-promoted high-frequency oscillations, in the form of transient and synchronized gamma waves (>30Hz) emerging in limbic forebrain and diffusing throughout basal ganglia-thalamocortical (BG-T-C) circuits. These patterns may be considered basic "SEEKING neurodynamic impulses" which represent the primary-process exploratory disposition getting integrated with information relative to the external and the internal environment. Abnormal manifestation of SEEKING and its neural substrates are evident in clinical depression and addiction. Specifically, depression is characterized by reduced recruitment of SEEKING, while addictions reflect re-organizations of the SEEKING disposition around ultra-specific appetitive memories and compulsive activities. Copyright © 2011 Elsevier Ltd. All rights reserved.

Linking Infectious and Narcology Care (LINC) in Russia: design, intervention and implementation protocol.

PubMed

Gnatienko, Natalia; Han, Steve C; Krupitsky, Evgeny; Blokhina, Elena; Bridden, Carly; Chaisson, Christine E; Cheng, Debbie M; Walley, Alexander Y; Raj, Anita; Samet, Jeffrey H

2016-05-04

Russia and Eastern Europe have one of the fastest growing HIV epidemics in the world. While countries in this region have implemented HIV testing within addiction treatment systems, linkage to HIV care from these settings is not yet standard practice. The Linking Infectious and Narcology Care (LINC) intervention utilized peer-led strengths-based case management to motivate HIV-infected patients in addiction treatment to obtain HIV care. This paper describes the protocol of a randomized controlled trial evaluating the effectiveness of the LINC intervention in St. Petersburg, Russia. Participants (n = 349) were recruited from the inpatient wards at the City Addiction Hospital in St. Petersburg, Russia. After completing a baseline assessment, participants were randomly assigned to receive either the LINC intervention or standard of care. Participants returned for research assessments 6 and 12 months post-baseline. Primary outcomes were assessed via chart review at HIV treatment locations. LINC holds the potential to offer an effective approach to coordinating HIV care for people who inject drugs in Russia. The LINC intervention utilizes existing systems of care in Russia, minimizing adoption of substantial infrastructure for implementation. Trial Registration NCT01612455.

School-Based Recovery Support: The Time Is Now!

ERIC Educational Resources Information Center

Gibson, Richard L.

The School-Based Recovery Support (SBRS) is a curriculum plan that assists students who return to school after addiction treatment or a conscious effort to become drug free. It is a daily course in life skills that a student can take for credit. The primary goals of SBRS for facilitators are as follows: (1) attempt to create a climate of support…

Global mental health: transformative capacity building in Nicaragua

PubMed Central

Sapag, Jaime C.; Herrera, Andrés; Trainor, Ruth; Caldera, Trinidad; Khenti, Akwatu

2013-01-01

Background Mental health is increasingly recognised as integral to good public health, but this area continues to lack sufficient planning, resources, and global strategy. It is a pressing concern in Latin America, where social determinants of health aggravate existing inequities in access to health services. Nicaragua faces serious mental health needs and challenges. One key strategy for addressing gaps in mental health services is building capacity at the primary healthcare and system levels. Objective Using the framework of best practice literature, this article analyses the four-year collaborative process between the National Autonomous University of Nicaragua in León (UNAN-León) and the Centre for Addiction and Mental Health (CAMH) in Canada, which is aimed at improving mental healthcare in Nicaragua. Design Based on a critical analysis of evaluation reports, key documents, and discussion among partners, the central steps of the collaboration are analysed and main successes and challenges identified. Results A participatory needs assessment identified local strengths and weaknesses, expected outcomes regarding competencies, and possible methodologies and recommendations for the development of a comprehensive capacity-building programme. The partners delivered two international workshops on mental health and addiction with an emphasis on primary healthcare. More recently, an innovative Diploma and Master programme was launched to foster interprofessional leadership and effective action to address mental health and addiction needs. Collaborative activities have taken place in Nicaragua and Canada. Discussion To date, international collaboration between Nicaragua and CAMH has been successful in achieving the jointly defined goals. The process has led to mutual knowledge sharing, strong networking, and extensive educational opportunities. Evidence of effective and respectful global health capacity building is provided. Lessons learned and implications for global health action are identified and discussed. PMID:24088364

Training addiction professionals in empirically supported treatments: perspectives from the treatment community.

PubMed

Hartzler, Bryan; Rabun, Carl

2014-01-01

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. In this mixed-method study, data were collected in 64 semistructured 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 2 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 (GLMMs), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. 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, GLMMs 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. 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 well as practical obstacles that challenge their receipt of training.

Definition of Substance and Non-substance Addiction.

PubMed

Zou, Zhiling; Wang, Huijun; d'Oleire Uquillas, Federico; Wang, Xiaomei; Ding, Jianrui; Chen, Hong

2017-01-01

Substance addiction (or drug addiction) is a neuropsychiatric disorder characterized by a recurring desire to continue taking the drug despite harmful consequences. Non-substance addiction (or behavioral addiction) covers pathological gambling, food addiction, internet addiction, and mobile phone addiction. Their definition is similar to drug addiction but they differ from each other in specific domains. This review aims to provide a brief overview of past and current definitions of substance and non-substance addiction, and also touches on the topic of diagnosing drug addiction and non-drug addiction, ultimately aiming to further the understanding of the key concepts needed for a foundation to study the biological and psychological underpinnings of addiction disorders.

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.

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

Vaccines against stimulants: cocaine and MA

PubMed Central

Kosten, Thomas; Domingo, Coreen; Orson, Frank; Kinsey, Berma

2014-01-01

While the worldwide prevalence of cocaine use remains significant, medications, or small molecule approaches, to treat drug addictions have met with limited success. Anti-addiction vaccines, on the other hand, have demonstrated great potential for treating drug abuse using a distinctly different mechanism of eliciting an antibody response that blocks the pharmacological effects of drugs. We provide a review of vaccine-based approaches to treating stimulant addictions; specifically and cocaine addictions. This selective review article focuses on the one cocaine vaccine that has been into clinical trials and presents new data related to pre-clinical development of a methamphetamine (MA) vaccine. We also review the mechanism of action for vaccine induced antibodies to abused drugs, which involves kinetic slowing of brain entry as well as simple blocking properties. We present pre-clinical innovations for MA vaccines including hapten design, linkage to carrier proteins and new adjuvants beyond alum. We provide some new information on hapten structures and linkers and variations in protein carriers. We consider a carrier, outer membrance polysaccharide coat protein (OMPC), that provides some self-adjuvant through lipopolysaccharide components and provide new results with a monophosopholipid adjuvant for the more standard carrier proteins with cocaine and MA. The review then covers the clinical trials with the cocaine vaccine TA-CD. The clinical prospects for advances in this field over the next few years include a multi-site cocaine vaccine clinical trial to be reported in 2013 and phase 1 clinical trials of a MA vaccine in 2014. PMID:23509915

Vaccines against stimulants: cocaine and MA.

PubMed

Kosten, Thomas; Domingo, Coreen; Orson, Frank; Kinsey, Berma

2014-02-01

While the worldwide prevalence of cocaine use remains significant, medications, or small molecule approaches, to treat drug addictions have met with limited success. Anti-addiction vaccines, on the other hand, have demonstrated great potential for treating drug abuse using a distinctly different mechanism of eliciting an antibody response that blocks the pharmacological effects of drugs. We provide a review of vaccine-based approaches to treating stimulant addictions; specifically and cocaine addictions. This selective review article focuses on the one cocaine vaccine that has been into clinical trials and presents new data related to pre-clinical development of a methamphetamine (MA) vaccine. We also review the mechanism of action for vaccine induced antibodies to abused drugs, which involves kinetic slowing of brain entry as well as simple blocking properties. We present pre-clinical innovations for MA vaccines including hapten design, linkage to carrier proteins and new adjuvants beyond alum. We provide some new information on hapten structures and linkers and variations in protein carriers. We consider a carrier, outer membrance polysaccharide coat protein (OMPC), that provides some self-adjuvant through lipopolysaccharide components and provide new results with a monophosopholipid adjuvant for the more standard carrier proteins with cocaine and MA. The review then covers the clinical trials with the cocaine vaccine TA-CD. The clinical prospects for advances in this field over the next few years include a multi-site cocaine vaccine clinical trial to be reported in 2013 and phase 1 clinical trials of a MA vaccine in 2014. © 2013 The British Pharmacological Society.

Amphetamine primes motivation to gamble and gambling-related semantic networks in problem gamblers.

PubMed

Zack, Martin; Poulos, Constantine X

2004-01-01

Previous research suggests that gambling can induce effects that closely resemble a psychostimulant drug effect. Modest doses of addictive drugs can prime motivation for drugs with similar properties. Together, these findings imply that a dose of a psychostimulant drug could prime motivation to gamble in problem gamblers. This study assessed priming effects of oral D-amphetamine (AMPH) (30 mg) in a within-subject, counter-balanced, placebo-controlled design in problem gamblers (n=10), comorbid gamblerdrinkers (n=6), problem drinkers (n=8), and healthy controls (n=12). Modified visual analog scales assessed addictive motivation and subjective effects. A modified rapid reading task assessed pharmacological activation of words from motivationally relevant and irrelevant semantic domains (Gambling, Alcohol, Positive Affect, Negative Affect, Neutral). AMPH increased self-reported motivation for gambling in problem gamblers. Severity of problem gambling predicted positive subjective effects of AMPH and motivation to gamble under the drug. There was little evidence that AMPH directly primed motivation for alcohol in problem drinkers. On the reading task, AMPH produced undifferentiated improvement in reading speed to all word classes in Nongamblers. By contrast, in the two problem gambler groups, AMPH improved reading speed to Gambling words while profoundly slowing reading speed to motivationally irrelevant Neutral words. The latter finding was interpreted as directly congruent with models, which contend that priming of addictive motivation involves a linked suppression of motivationally irrelevant stimuli. This study provides experimental evidence that psychostimulant-like neurochemical activation is an important component of gambling addiction.

A Qualitative Analysis of Medical Students' Reflection on Attending an Alcoholics Anonymous Meeting: Insights for Future Addiction Curricula.

PubMed

Kastenholz, Kurt J; Agarwal, Gaurava

2016-06-01

This paper describes medical students' views of alcoholism and their response to attending an Alcoholics Anonymous (AA) meeting during their psychiatry clerkship. This may assist other educators in planning their addiction curricula. Medical students were required to attend an AA meeting during their psychiatry clerkship and then to write a reflection piece on this experience. We selected a random sample of 40 pieces and performed a qualitative analysis to identify the prominent ideas and themes in this sample. Medical students found their experience attending an AA meeting to be educationally valuable. They reported their familiarity with AA prior to this experience was largely limited to popular media depictions. Students reported understanding alcoholism as a disease with both biological and psychosocial components. They were often concerned with the presence of religiosity and spirituality at the meetings. Following the experience, students felt more comfortable referring patients to AA and identified empathy, honesty, and openness as crucial contributors to the efficacy of AA. Students felt that attending an AA meeting during their psychiatry clerkship was an educationally valuable experience. Medical students' familiarity with addiction treatment is limited, and attending an AA meeting may be helpful in increasing their comfort with treating addicted patients in the future. In addition, educators may want to explicitly address the spirituality issue related to some treatment programs to increase the likelihood that future physicians feel comfortable referring their patients to recovery programs.

Longitudinal changes in drug use severity and physical health-related quality of life among untreated stimulant users.

PubMed

Borders, Tyrone F; Booth, Brenda M; Falck, Russel S; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G

2009-11-01

The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8 Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well as among stimulant users.

TAp73 is a marker of glutamine addiction in medulloblastoma

PubMed Central

Niklison-Chirou, Maria Victoria; Erngren, Ida; Engskog, Mikael; Haglöf, Jakob; Picard, Daniel; Remke, Marc; McPolin, Phelim Hugh Redmond; Selby, Matthew; Williamson, Daniel; Clifford, Steven C.; Michod, David; Hadjiandreou, Michalis; Arvidsson, Torbjörn; Pettersson, Curt; Melino, Gerry; Marino, Silvia

2017-01-01

Medulloblastoma is the most common solid primary brain tumor in children. Remarkable advancements in the understanding of the genetic and epigenetic basis of these tumors have informed their recent molecular classification. However, the genotype/phenotype correlation of the subgroups remains largely uncharacterized. In particular, the metabolic phenotype is of great interest because of its druggability, which could lead to the development of novel and more tailored therapies for a subset of medulloblastoma. p73 plays a critical role in a range of cellular metabolic processes. We show overexpression of p73 in a proportion of non-WNT medulloblastoma. In these tumors, p73 sustains cell growth and proliferation via regulation of glutamine metabolism. We validated our results in a xenograft model in which we observed an increase in survival time in mice on a glutamine restriction diet. Notably, glutamine starvation has a synergistic effect with cisplatin, a component of the current medulloblastoma chemotherapy. These findings raise the possibility that glutamine depletion can be used as an adjuvant treatment for p73-expressing medulloblastoma. PMID:28971956

TAp73 is a marker of glutamine addiction in medulloblastoma.

PubMed

Niklison-Chirou, Maria Victoria; Erngren, Ida; Engskog, Mikael; Haglöf, Jakob; Picard, Daniel; Remke, Marc; McPolin, Phelim Hugh Redmond; Selby, Matthew; Williamson, Daniel; Clifford, Steven C; Michod, David; Hadjiandreou, Michalis; Arvidsson, Torbjörn; Pettersson, Curt; Melino, Gerry; Marino, Silvia

2017-09-01

Medulloblastoma is the most common solid primary brain tumor in children. Remarkable advancements in the understanding of the genetic and epigenetic basis of these tumors have informed their recent molecular classification. However, the genotype/phenotype correlation of the subgroups remains largely uncharacterized. In particular, the metabolic phenotype is of great interest because of its druggability, which could lead to the development of novel and more tailored therapies for a subset of medulloblastoma. p73 plays a critical role in a range of cellular metabolic processes. We show overexpression of p73 in a proportion of non-WNT medulloblastoma. In these tumors, p73 sustains cell growth and proliferation via regulation of glutamine metabolism. We validated our results in a xenograft model in which we observed an increase in survival time in mice on a glutamine restriction diet. Notably, glutamine starvation has a synergistic effect with cisplatin, a component of the current medulloblastoma chemotherapy. These findings raise the possibility that glutamine depletion can be used as an adjuvant treatment for p73-expressing medulloblastoma. © 2017 Niklison-Chirou et al.; Published by Cold Spring Harbor Laboratory Press.

Methamphetamine-induced alterations in monoamine transport: implications for neurotoxicity, neuroprotection and treatment.

PubMed

Volz, Trent J; Fleckenstein, Annette E; Hanson, Glen R

2007-04-01

To review studies delineating the neurotoxic effects of methamphetamine on monoamine transport in dopaminergic neurons of the striatum and nucleus accumbens. The scope of this review includes the English language dopamine transporter and vesicular monoamine transporter-2 primary literature to April 2006 identified by Pubmed, Science Citation Index and SciFinder Scholar literature searches. Changes in the function of the plasmalemmal dopamine transporter and the vesicular monoamine transporter-2 are key components of methamphetamine-induced persistent dopaminergic deficits. These deficits include persistent reductions in dopamine content, dopamine transporter density and tyrosine hydroxylase activity. The striatum is susceptible to these effects of methamphetamine while the nucleus accumbens is resistant. Differences in dopamine transporter density and activity, extracellular dopamine levels and antioxidant levels in these two brain regions may, in part, account for the resistance of the nucleus accumbens. These findings concerning the nature of methamphetamine-induced changes in plasmalemmal and vesicular dopamine transport have very important implications for drug targets and for understanding the etiology of dopaminergic neurodegenerative processes, such as those associated with methamphetamine addiction and Parkinson's disease.

Longitudinal Changes in Drug Use Severity and Physical Health-Related Quality of Life among Untreated Stimulant Users

PubMed Central

Borders, Tyrone F.; Booth, Brenda M.; Falck, Russel S.; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G.

2009-01-01

The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8™ Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well among stimulant users. PMID:19560873

Correlation between addictive behaviors and mental health in university students.

PubMed

Okasaka, Yoshiko; Morita, Nobuaki; Nakatani, Yoji; Fujisawa, Kunihiko

2008-02-01

The present study aims to clarify the relationships of addictive behaviors and addiction overlap to stress, acceptance from others and purpose in life. A survey was conducted on 691 students at eight universities. The Eating Attitude Test-20 was used to identify students with food addiction or food addictive tendencies. The Kurihama Alcoholism Screening Test was used to identify students with alcohol addiction or alcohol addictive tendencies. The Fagerström Test for Nicotine Dependence was used to identify students with nicotine addictive tendencies or nicotine addiction. The Visual Analog Scale was used to assess stress and acceptance from others. The Purpose in Life Test was used to measure meaning and purpose in life. Results were compared between students with addictive behaviors, with addictive tendencies and without addictive behaviors. Significant differences among the three groups were observed for stress, acceptance from others, and Purpose in Life scores for students with food and nicotine addiction, but no significant differences existed in relation to alcohol addiction. In addition, 28.8% of students displayed addictive behaviors in one of the three areas (food, alcohol or nicotine), 8.5% displayed addictive behaviors in two of the three areas, and 0.4% had addictive behaviors in all three areas. Significant differences existed in stress and acceptance from others among students with one addictive behavior, >or=two addictive behaviors and no addictive behaviors. However, no significant differences existed in Purpose in Life scores with respect to overlapping addictions. The results suggest a relationship between mental health, addictive behaviors and overlapping addiction among university students.

[Epidemiology, etiology and treatment of patients with psychosis and co-morbid substance use disorder].

PubMed

Moggi, Franz

2018-06-01

Epidemiology, etiology and treatment of patients with psychosis and co-morbid substance use disorder Abstract. More than 25 years ago, when the research on the efficacy of treatments for patients with a comorbidity of psychosis and substance use disorder has been systematically started, some authors described the treatment of these patients as a "mission impossible". Approximately half of all individuals with schizophrenia develop substance use disorders in the course of their life; about one third of them a comorbid alcohol use disorder and about one quarter a comorbid substance use disorder with other addictive substances. There is no universally valid aetiology model to explain the relationship between psychosis and addiction. Contrary to expectations, the self-medication model was not empirically confirmed, while the psychological affect regulation model, the vulnerability-stress model of a specific sensitivity to addictive substances given a predisposition of psychosis, or the neurobiological common factor model of a dysfunction of dopamine regulation in the mesocorticolimbic reward system that predispose to primary substance use disorder found some empirical support. Research on the psychosocial-psychotherapeutic and pharmacological treatment of patients with psychosis and addiction are so heterogeneous in terms of characteristics of patients, disorders, treatments, settings and outcomes that hardly two comparable studies can be found. Thus, it is hardly possible to make scientifically based statements on the efficacy and effectiveness of therapies. Integrative treatment programs are promising, which combine psycho- and pharmacotherapeutic interventions for the treatment of psychotic and substance use disorders in a coherent manner and which can be flexibly adapted to the individual patient's needs. Such treatments are carried out at the same time, in the same setting and by the same treatment providers and practioners. Successful integrative treatment programs usually include motivational interventions, cognitive-behavioral interventions specific to schizophrenia and addiction, interventions that may reduce the substance use such as relapse prevention, contingency management and / or family interventions. These interventions are best combined with second-generation antipsychotics, if necessary with medication to reduce substance use. Although no "mission impossible" treating patients with psychosis and addiction remains a complex challenge for research and practice.

Testing use of payers to facilitate evidence-based practice adoption: protocol for a cluster-randomized trial

PubMed Central

2013-01-01

Background More effective methods are needed to implement evidence-based findings into practice. The Advancing Recovery Framework offers a multi-level approach to evidence-based practice implementation by aligning purchasing and regulatory policies at the payer level with organizational change strategies at the organizational level. Methods The Advancing Recovery Buprenorphine Implementation Study is a cluster-randomized controlled trial designed to increase use of the evidence-based practice buprenorphine medication to treat opiate addiction. Ohio Alcohol, Drug Addiction, and Mental Health Services Boards (ADAMHS), who are payers, and their addiction treatment organizations were recruited for a trial to assess the effects of payer and treatment organization changes (using the Advancing Recovery Framework) versus treatment organization changes alone on the use of buprenorphine. A matched-pair randomization, based on county characteristics, was applied, resulting in seven county ADAMHS boards and twenty-five treatment organizations in each arm. Opioid dependent patients are nested within cluster (treatment organization), and treatment organization clusters are nested within ADAMHS county board. The primary outcome is the percentage of individuals with an opioid dependence diagnosis who use buprenorphine during the 24-month intervention period and the 12-month sustainability period. The trial is currently in the baseline data collection stage. Discussion Although addiction treatment providers are under increasing pressure to implement evidence-based practices that have been proven to improve patient outcomes, adoption of these practices lags, compared to other areas of healthcare. Reasons frequently cited for the slow adoption of EBPs in addiction treatment include, regulatory issues, staff, or client resistance and lack of resources. Yet the way addiction treatment is funded, the payer’s role—has not received a lot of attention in research on EBP adoption. This research is unique because it investigates the role of payers in evidence-based practice implementation using a randomized controlled design instead of case examples. The testing of the Advancing Recovery Framework is designed to broaden the understanding of the impact payers have on evidence-based practice (EBP) adoption. Trial registration http://NCT01702142 (ClinicalTrials.gov registry, USA) PMID:23663749

Atypical Dopamine Uptake Inhibitors that Provide Clues About Cocaine's Mechanism at the Dopamine Transporter

NASA Astrophysics Data System (ADS)

Hauck Newman, Amy; Katz, Jonathan L.

The dopamine transporter (DAT) has been a primary target for cocaine abuse/addiction medication discovery. However predicted addiction liability and limited clinical evaluation has provided a formidable challenge for development of these agents for human use. The unique and atypical pharmacological profile of the benztropine (BZT) class of dopamine uptake inhibitors, in preclinical models of cocaine effects and abuse, has encouraged further development of these agents. Moreover, in vivo studies have challenged the original DAT hypothesis and demonstrated that DAT occupancy and subsequent increases in dopamine produced by BZT analogues are significantly delayed and long lasting, as compared to cocaine. These important and distinctive elements are critical to the lack of abuse liability among BZT analogues, and improve their potential for development as treatments for cocaine abuse and possibly other neuropsychiatric disorders.

Perceived risks and benefits of cigarette smoking among Nepalese adolescents: a population-based cross-sectional study.

PubMed

Aryal, Umesh Raj; Petzold, Max; Krettek, Alexandra

2013-03-02

The perceived risks and benefits of smoking may play an important role in determining adolescents' susceptibility to initiating smoking. Our study examined the perceived risks and benefits of smoking among adolescents who demonstrated susceptibility or non susceptibility to smoking initiation. In October-November 2011, we conducted a population-based cross-sectional study in Jhaukhel and Duwakot Villages in Nepal. Located in the mid-hills of Bhaktapur District, 13 kilometers east of Kathmandu, Jhaukhel and Duwakot represent the prototypical urbanizing villages that surround Nepal's major urban centers, where young people have easy access to tobacco products and are influenced by advertising. Jhaukhel and Duwakot had a total population of 13,669, of which 15% were smokers. Trained enumerators used a semi-structured questionnaire to interview 352 randomly selected 14- to 16-year-old adolescents. The enumerators asked the adolescents to estimate their likelihood (0%-100%) of experiencing various smoking-related risks and benefits in a hypothetical scenario. Principal component analysis extracted four perceived risk and benefit components, excluding addiction risk: (i) physical risk I (lung cancer, heart disease, wrinkles, bad colds); (ii) physical risk II (bad cough, bad breath, trouble breathing); (iii) social risk (getting into trouble, smelling like an ashtray); and (iv) social benefit (looking cool, feeling relaxed, becoming popular, and feeling grown-up). The adjusted odds ratio of susceptibility increased 1.20-fold with each increased quartile in perception of physical Risk I. Susceptibility to smoking was 0.27- and 0.90-fold less among adolescents who provided the highest estimates of physical Risk II and social risk, respectively. Similarly, susceptibility was 2.16-fold greater among adolescents who provided the highest estimates of addiction risk. Physical risk I, addiction risk, and social benefits of cigarette smoking related positively, and physical risk II and social risk related negatively, with susceptibility to smoking. To discourage or prevent adolescents from initiating smoking, future intervention programs should focus on communicating not only the health risks but also the social and addiction risks as well as counteract the social benefits of smoking.

Alcoholics Anonymous and other mutual help organizations: Impact of a 45-minute didactic for primary care and categorical internal medicine residents.

PubMed

Marcovitz, David; Cristello, Julie V; Kelly, John F

2017-01-01

Substance use disorders (SUDs) are highly prevalent among primary care patients. One evidence-based, cost-effective referral option is ubiquitous mutual help organizations (MHOs) such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and SMART Recovery; however, little is known about how to effectively increase trainee knowledge and confidence with these referrals. The primary aim of this study was to evaluate whether a single 45-minute combined lecture and role play-based didactic for primary care residents could enhance knowledge, improve attitudes, and bolster confidence in referring patients with addictions to community MHOs. The authors developed a 45-minute lecture and role play addressing the evidence for MHOs, their respective background/content, and how to make effective referrals. Participants were administered a brief survey of their MHO-related knowledge, attitudes, and confidence before and after the session to evaluate the didactic impact. Participants were 55 primary care and categorical internal medicine residents divided among postgraduate year 1 (PGY1; 27.3%), PGY2 (38.2%), and PGY3 (34.5%). They had a mean age of 29 (SD = 2.62); 49% were female, 69% were Caucasian, and 78% reported some religious affiliation. Participants' subjective knowledge about MHOs increased significantly (P < .001), as did their confidence in making referrals (P < .001). Changes in participants' attitudes about the importance of MHOs in aiding successful addiction recovery approached significance (P = .058). The proportion of participants with correct responses to each of 4 knowledge-based questions increased substantially. Primary care and internal medicine residents reported variable baseline knowledge of MHOs and confidence in making referrals, both of which were improved in response to a 45-minute didactic. Role play may be a useful supplementary tool in enhancing residents' knowledge and skill in treating patients with SUD.

New Implications for the Melanocortin System in Alcohol Drinking Behavior in Adolescents: The Glial Dysfunction Hypothesis.

PubMed

Orellana, Juan A; Cerpa, Waldo; Carvajal, Maria F; Lerma-Cabrera, José M; Karahanian, Eduardo; Osorio-Fuentealba, Cesar; Quintanilla, Rodrigo A

2017-01-01

Alcohol dependence causes physical, social, and moral harms and currently represents an important public health concern. According to the World Health Organization (WHO), alcoholism is the third leading cause of death worldwide, after tobacco consumption and hypertension. Recent epidemiologic studies have shown a growing trend in alcohol abuse among adolescents, characterized by the consumption of large doses of alcohol over a short time period. Since brain development is an ongoing process during adolescence, short- and long-term brain damage associated with drinking behavior could lead to serious consequences for health and wellbeing. Accumulating evidence indicates that alcohol impairs the function of different components of the melanocortin system, a major player involved in the consolidation of addictive behaviors during adolescence and adulthood. Here, we hypothesize the possible implications of melanocortins and glial cells in the onset and progression of alcohol addiction. In particular, we propose that alcohol-induced decrease in α-MSH levels may trigger a cascade of glial inflammatory pathways that culminate in altered gliotransmission in the ventral tegmental area and nucleus accumbens (NAc). The latter might potentiate dopaminergic drive in the NAc, contributing to increase the vulnerability to alcohol dependence and addiction in the adolescence and adulthood.

Opioid Use Disorders

PubMed Central

Sharma, Bikash; Bruner, Ann; Barnett, Gabrielle; Fishman, Marc

2016-01-01

Opioid use and addiction in adolescents and young adults, including heroin and non-medical use of prescription opioids, is a serious and growing health problem of epidemic proportions. Opioid use has devastating consequences for youth and their families, including: progression to full addiction, severe psychosocial impairment, HCV and HIV transmission with injection use, exacerbation of co-occurring psychiatric disorders, overdose, and death. This chapter will provide an overview of opioid use disorders (OUDs) in youth, including: etiologic factors, epidemiology, consequences, clinical presentation and course, assessment and diagnosis, overdose, detoxification, and treatment. Opioid overdose is a life-threatening emergency. Respiratory depression should be treated with naloxone, and respiratory support if necessary. Overdose should always be utilized as an opportunity to initiate addiction treatment. Opioid withdrawal management (detoxification) is often a necessary, but never sufficient, component of treatment for OUDs. Medications used in the treatment of withdrawal may include buprenorphine, clonidine and others for relief of symptoms. Treatment for OUDs is effective but treatment capacity is alarmingly limited and under-developed. Although there is a limited evidence base for youth specific treatment, emerging consensus supports the incorporation of relapse prevention medications such as buprenorphine and extended release naltrexone into comprehensive psychosocial treatment including counseling and family involvement. PMID:27338968

Enhanced Primary Care Treatment of Behavioral Disorders With ECHO Case-Based Learning.

PubMed

Komaromy, Miriam; Bartlett, Judy; Manis, Kathryn; Arora, Sanjeev

2017-09-01

The Extension for Community Healthcare Outcomes (ECHO) model offers a way for primary care providers to develop expertise in addressing behavioral health issues of primary care patients. It provides an alternative to traditional continuing medical education (CME) for ongoing training and support for health care providers. ECHO uses videoconferencing to connect multiple primary care teams simultaneously with academic specialists and builds capacity via mentorship and case-based learning. ECHO aims to expand access to care by developing capacity to treat common, complex conditions in underserved areas. Participants in an integrated addictions and psychiatry teleECHO program reported that when they presented a patient case, the feedback they received was highly valuable and led them to change their care plans more than 75% of the time. ECHO is an effective model for teaching primary care teams about behavioral health and may be more effective than traditional CME approaches.

The Transformative-Learning Potential of Feminist-Inspired Guided Art Gallery Visits for People Diagnosed with Mental Illness and Addiction

ERIC Educational Resources Information Center

Spring, Lauren; Smith, Melissa; DaSilva, Maureen

2018-01-01

Consciousness-raising practices at the heart of feminism remain one of the most vital components of transformative learning theory and provide the foundation for its constructivist underpinnings. Recently, there has been a call for educators to employ consciousness-raising practices outside of traditional classroom settings and to focus greater…

The Efficacy of Coerced Treatment for Offenders: An Evaluation of Two Residential Forensic Drug and Alcohol Treatment Programs.

ERIC Educational Resources Information Center

Baird, Francis X.; Frankel, Arthur J.

2001-01-01

Reviews the history of community-based treatment for offenders with drug and alcohol addiction. Describes the treatment regimen in two residential programs for offenders with drug and alcohol problems, including a description of the components of the residential treatment model utilized in these two programs. Findings support the efficacy of…

Emotion-based decision-making in healthy subjects: short-term effects of reducing dopamine levels

PubMed Central

Sevy, Serge; Hassoun, Youssef; Bechara, Antoine; Yechiam, Eldad; Napolitano, Barbara; Burdick, Katherine; Delman, Howard; Malhotra, Anil

2007-01-01

Introduction Converging evidences from animal and human studies suggest that addiction is associated with dopaminergic dysfunction in brain reward circuits. So far, it is unclear what aspects of addictive behaviors are related to a dopaminergic dysfunction. Discussion We hypothesize that a decrease in dopaminergic activity impairs emotion-based decision-making. To demonstrate this hypothesis, we investigated the effects of a decrease in dopaminergic activity on the performance of an emotion-based decision-making task, the Iowa gambling task (IGT), in 11 healthy human subjects. Materials and methods We used a double-blind, placebo-controlled, within-subject design to examine the effect of a mixture containing the branched-chain amino acids (BCAA) valine, isoleucine and leucine on prolactin, IGT performance, perceptual competency and visual aspects of visuospatial working memory, visual attention and working memory, and verbal memory. The expectancy-valence model was used to determine the relative contributions of distinct IGT components (attention to past outcomes, relative weight of wins and losses, and choice strategies) in the decision-making process. Observations and results Compared to placebo, the BCAA mixture increased prolactin levels and impaired IGT performance. BCAA administration interfered with a particular component process of decision-making related to attention to more recent events as compared to more distant events. There were no differences between placebo and BCAA conditions for other aspects of cognition. Our results suggest a direct link between a reduced dopaminergic activity and poor emotion-based decision-making characterized by shortsightedness, and thus difficulties resisting short-term reward, despite long-term negative consequences. These findings have implications for behavioral and pharmacological interventions targeting impaired emotion-based decision-making in addictive disorders. PMID:16915385

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

National addictions vigilance intervention and prevention program (NAVIPPRO): a real-time, product-specific, public health surveillance system for monitoring prescription drug abuse.

PubMed

Butler, Stephen F; Budman, Simon H; Licari, Andrea; Cassidy, Theresa A; Lioy, Katherine; Dickinson, James; Brownstein, John S; Benneyan, James C; Green, Traci Craig; Katz, Nathaniel

2008-12-01

The National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) is a scientific, comprehensive risk management program for scheduled therapeutics. NAVIPPRO provides post-marketing surveillance, signal detection, signal verification and prevention and intervention programs. Here we focus on one component of NAVIPPRO surveillance, the Addiction Severity Index-Multimedia Version (ASI-MV) Connect, a continuous, real-time, national data stream that assesses pharmaceutical abuse by patients entering substance abuse treatment by collecting product-specific, geographically-detailed information. We evaluate population characteristics for data collected through the ASI-MV Connect in 2007 and 2008 and assess the representativeness, geographic coverage, and timeliness of report of the data. Analyses based on 41,923 admissions to 265 treatment centers in 29 states were conducted on product-specific opioid abuse rates, source of drug, and route of administration. ASI-MV Connect data revealed that 11.5% of patients reported abuse of at least one opioid analgesic product in the 30 days prior to entering substance abuse treatment; differences were observed among sub-populations of prescription opioid abusers, among products, and also within various geographic locations. The ASI-MV Connect component of NAVIPPRO represents a potentially valuable data stream for post-marketing surveillance of prescription drugs. Analyses conducted with data obtained from the ASI-MV Connect allow for the characterization of product-specific and geospatial differences for drug abuse and can serve as a tool to monitor responses of the abuse population to newly developed "abuse deterrent" drug formulations. Additional data, evaluation, and comparison to other systems are important next steps in establishing NAVIPPRO as a comprehensive, post-marketing surveillance system for prescription drugs. Copyright (c) 2008 John Wiley & Sons, Ltd.

Synaptic Plasticity in the Bed Nucleus of the Stria Terminalis: Underlying Mechanisms and Potential Ramifications for Reinstatement of Drug- and Alcohol-Seeking Behaviors.

PubMed

Harris, Nicholas A; Winder, Danny G

2018-06-13

The bed nucleus of the stria terminalis (BNST) is a component of the extended amygdala that shows significant changes in activity and plasticity through chronic exposure to drugs and stress. The region is critical for stress- and cue-induced reinstatement of drug-seeking behaviors and is thus a candidate region for the plastic changes that occur in abstinence that prime addicted patients for reinstatement behaviors. Here, we discuss the various forms of long-term potentiation (LTP) and long-term depression (LTD) in the rodent BNST and highlight the way that these changes in excitatory transmission interact with exposure to alcohol and other drugs of abuse, as well as other stressors. In addition, we highlight potential areas for future research in this area, including investigating input- and cell-specific bidirectional changes in activity. As we continue to accrue foundational knowledge in the mechanisms and effects of plasticity in the BNST, molecular targets and treatment strategies that are relevant to reinstatement behaviors will also begin to emerge. Here, we briefly discuss the effects of catecholamine receptor modulators on synaptic plasticity in the BNST due to the role of norepinephrine in LTD and dopamine on the short-term component of LTP as well as the role that signaling at these receptors plays in reinstatement of drug- and alcohol-seeking behaviors. We hope that insights gained on the specific changes in plasticity that occur within the BNST during abstinence from alcohol and other drugs of abuse will provide insight into the biological underpinnings of relapse behavior in human addicts and inform future treatment modalities for addiction that tackle this complex biological problem.

Internet addiction and its facets: The role of genetics and the relation to self-directedness.

PubMed

Hahn, Elisabeth; Reuter, Martin; Spinath, Frank M; Montag, Christian

2017-02-01

A growing body of research focuses on problematic behavior patterns related to the use of the Internet to identify contextual as well as individual risk factors of this new phenomenon called Internet addiction (IA). IA can be described as a multidimensional syndrome comprising aspects such as craving, development of tolerance, loss of control and negative consequences. Given that previous research on other addictive behaviors showed substantial heritability, it can be expected that the vulnerability to IA may also be due to a person's genetic predisposition. However, it is questionable whether distinct components of IA have different etiologies. Using data from a sample of adult monozygotic and dizygotic twins and non-twin siblings (N=784 individuals, N=355 complete pairs, M=30.30years), we investigated the magnitude of genetic and environmental influences on generalized IA as well as on specific facets such as excessive use, self-regulation, preference for online social interaction or negative consequences. To explain the heritability in IA, we further examined the relation to Self-Directedness as potential mediating source. Results showed that relative contributions of genetic influences vary considerable for different components of IA. For generalized IA factors, individual differences could be explained by shared and non-shared environmental influences while genetic influences did not play a role. For specific facets of IA and private Internet use in hours per week, heritability estimates ranged between 21% and 44%. Bivariate analysis indicated that Self-Directedness accounted for 20% to 65% of the genetic variance in specific IA facets through overlapping genetic pathways. Implications for future research are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychiatric Diagnosis, Substance Use and Dependence, and Arrests among Former Recipients of Supplemental Security Income for Drug Abuse and Alcoholism

ERIC Educational Resources Information Center

Swartz, James A.; Lurigio, Arthur J.

2004-01-01

This study examines the associations among substance use and psychiatric disorders on arrests in a sample of 187 former recipients of Supplemental Security Income for drug addiction and alcoholism. Participants were interviewed at baseline and at 12, 18, and 24 months. Primary measures included urine tests for recent drug use, psychiatric and…

The Relationship of Early Maladaptive Schemas, Attributional Styles and Learned Helplessness among Addicted and Non-Addicted Men.

PubMed

Shaghaghy, Farhad; Saffarinia, Majid; Iranpoor, Mohadeseh; Soltanynejad, Ali

2011-01-01

Addiction is considered as one of the major problems in family and community in the world. According to cognitive view, organizing the experiences determines how to behave. Due to their importance in interpretation of special situations, cognitive schemas and attributional styles have a significant role in cognitive theories. The aim of this study was to compare early maladaptive schemas and attributional styles in addicts and non-addicts to recognize their role in addiction. In this causal-comparative study, 200 addicted and non-addicted men were randomly selected. Young early maladaptive schema and attributional styles questionnaires were used. Data analysis was performed by independent t-test, Pearson correlation and regression. The study population included 81 addicted and 90 non-addicted men. There were significant differences between early maladaptive schemas and attributional styles in the two groups of addicted and non-addicted men (P < 0.001). In addition, addicts had higher levels of learned helplessness. A direct relationship was found between learned helplessness and frequency of addiction treatments (r ═ 0.234, P < 0.05). Our study showed that addicts suffer from high levels of early maladaptive schemas. They had a more pessimistic attributional style. Moreover, addicts who developed higher levels of learned helplessness were less successful in addiction treatment and more likely to use drugs again after treatment. These issues show that addiction institutions and therapists have to pay attention to cognitive factors for addiction prevention.

Online social networking addiction among college students in Singapore: Comorbidity with behavioral addiction and affective disorder.

PubMed

Tang, Catherine So-Kum; Koh, Yvaine Yee Woen

2017-02-01

This study aimed to determine the prevalence of addiction to social networking sites/platforms (SNS) and its comorbidity with other behavioral addiction and affective disorder among college students in Singapore. 1110 college students (age: M=21.46, SD=1.80) in Singapore completed measures assessing online social networking, unhealthy food intake and shopping addiction as well as depression, anxiety and mania. Descriptive analyses were conducted to investigate the prevalence and comorbidity of behavioral addiction and affective disorder. Chi-square tests were used to examine gender differences. The prevalence rates of SNS, food and shopping addiction were 29.5%, 4.7% and 9.3% respectively for the total sample. SNS addiction was found to co-occur with food addiction (3%), shopping addiction (5%), and both food and shopping addiction (1%). The comorbidity rates of SNS addiction and affective disorder were 21% for depression, 27.7% for anxiety, and 26.1% for mania. Compared with the total sample, students with SNS addiction reported higher comorbidity rates with other behavioral addiction and affective disorder. In general, females as compared to males reported higher comorbidity rates of SNS addiction and affective disorder. SNS addiction has a high prevalence rate among college students in Singapore. Students with SNS addiction were vulnerable to experience other behavior addiction as well as affective disorder, especially among females. Copyright © 2016. Published by Elsevier B.V.

The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis.

PubMed

McCarty, Dennis; Rieckmann, Traci; Baker, Robin L; McConnell, K John

2017-03-01

Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.

Neuroscience of Internet Pornography Addiction: A Review and Update.

PubMed

Love, Todd; Laier, Christian; Brand, Matthias; Hatch, Linda; Hajela, Raju

2015-09-18

Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction.

Neuroscience of Internet Pornography Addiction: A Review and Update

PubMed Central

Love, Todd; Laier, Christian; Brand, Matthias; Hatch, Linda; Hajela, Raju

2015-01-01

Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction. PMID:26393658

Precursor or Sequela: Pathological Disorders in People with Internet Addiction Disorder

PubMed Central

Dong, Guangheng; Lu, Qilin; Zhou, Hui; Zhao, Xuan

2011-01-01

Background This study aimed to evaluate the roles of pathological disorders in Internet addiction disorder and identify the pathological problems in IAD, as well as explore the mental status of Internet addicts prior to addiction, including the pathological traits that may trigger Internet addiction disorder. Methods and Findings 59 students were measured by Symptom CheckList-90 before and after they became addicted to the Internet. A comparison of collected data from Symptom Checklist-90 before Internet addiction and the data collected after Internet addiction illustrated the roles of pathological disorders among people with Internet addiction disorder. The obsessive-compulsive dimension was found abnormal before they became addicted to the Internet. After their addiction, significantly higher scores were observed for dimensions on depression, anxiety, hostility, interpersonal sensitivity, and psychoticism, suggesting that these were outcomes of Internet addiction disorder. Dimensions on somatisation, paranoid ideation, and phobic anxiety did not change during the study period, signifying that these dimensions are not related to Internet addiction disorder. Conclusions We can not find a solid pathological predictor for Internet addiction disorder. Internet addiction disorder may bring some pathological problems to the addicts in some ways. PMID:21358822

Brain Mapping of Low and High Implusivity based P300 Signals

NASA Astrophysics Data System (ADS)

Turnip, Arjon; Dwi, Esti K.; Hidayat, Taufik; Hidayat, Teddy

2018-04-01

Impulsiveness is defined as action without good planning and with little consideration the consequences. Impulsive actions are typically poorly conceived, prematurely expressed, or inappropriate to the undesirable situation such as abuse of drugs. Instead of taking treatment for an addiction subject, it is better take prevention. In this paper, an implusivity detection based EEG-P300 potential is proposed. Twenty four subjects consist of three groups (addiction, methadone, and control) are involved in the experiment. Five different pictures (one picture related drug is used as a target) were randomly flashed to the subjects. The subject is asked to comfortly sit in a chair and to silently count the appearance number of the target. The high amplitude of the P300 component with shortest latency and dominant brain activity are indicated by high implusive group.

Interest in Genetic Counseling and Testing for Adolescent Nicotine Addiction Susceptibility among a Sample of Adolescent Medicine Providers Attending a Scientific Conference on Adolescent Health

PubMed Central

Tercyak, Kenneth P.; Peshkin, Beth N.; Abraham, Anisha; Wine, Lauren; Walker, Leslie R.

2007-01-01

Purpose Preventing adolescents from smoking and becoming addicted to nicotine is an important public health issue. New research on the genetics of susceptibility to nicotine addition is emerging and may someday help identify adolescents at high risk. Over time, genetic counseling and testing for nicotine addiction susceptibility may become incorporated into tobacco control practice, and providers in primary care settings are likely to be at the forefront of these services. As such, it is important to understand the attitudes and practices of adolescent medicine providers toward tobacco control and genetic testing to better anticipate their needs and interests and prepare for the future. This study describes adolescent medicine providers’ interest, and correlates of their interest, in genetic counseling and testing for nicotine addiction susceptibility among their adolescent patients--a test which is not yet clinically available. Methods Adolescent medicine providers attending a national scientific conference (N = 232) completed a survey about their patient tobacco control and other screening behaviors, perceptions of their patients’ attitudes and beliefs toward tobacco control, and their own attitudes and beliefs about smoking and genetics. Results Providers who engaged in more regular tobacco screening behaviors with their adolescent patients (Odds Ratio [OR] = 4.07, 95% Confidence Interval [CI] = 2.20, 7.751, p = .00) and those who were more optimistic that biobehavioral research would lead to significant improvements in adolescent smoking prevention and treatment (OR = 2.47, 95% CI = 1.40, 4.37, p = .00), were more interested in counseling and testing. Conclusions Someday, adolescent wellness visits may present an opportunity to offer genetic counseling and testing for nicotine addiction susceptibility. Implementation at the provider level may depend on tobacco screening behavior and research optimism. Educating providers about safe and effective adolescent tobacco control strategies incorporating genetics will be essential. PMID:17577533

“In their perception we are addicts”: Social vulnerabilities and sources of support for men released from drug treatment centers in Vietnam

PubMed Central

Tomori, Cecilia; Go, Vivian F.; Tuan, Le Nhan; Huong, Nguyen Mai; Binh, Nguyen Thanh; Zelaya, Carla E.; Celentano, David D.; Dat, Do Tuan; Quan, Vu Minh

2014-01-01

Background Amid the global transition to treat opioid addiction as an illness, many people who inject drugs (PWID) face heterogeneous legal environments that include both punitive and harm reduction measures. In Vietnam, many PWID, who have a high burden of HIV, are sent to drug treatment centers, or “06 centers”, for compulsory detoxification, vocational training, and labor for up to four years. This study investigates the challenges and facilitators of reentry into community and family life among men who are released from “06 centers” and provides insights and recommendations for developing policies and interventions that address special needs of this vulnerable population. Methods In-depth interviews were conducted in 2011 by trained interviewers among a sample of 43 male PWID released within the past 2 years from “06 centers” in Hanoi, Vietnam to investigate the above issues and to recommend potential interventions. Participants were recruited from outpatient HIV clinics that serve PWID (n=22) and through peer referral from self-help groups for PWID (n=21). Interviews were audiotaped, transcribed, translated, entered into Atlas. TI qualitative data analysis software and analyzed for key themes. Results The interviews revealed persistent drug-related stigmatization, frequently paired with HIV-related stigmatization and discrimination, which hindered employment, increased participants’ social isolation and exacerbated their struggles with addiction. Families were participants’ primary source of financial, employment, and emotional support, but addiction-related family tensions also had negative psychological effects. Participants identified methadone maintenance treatment as an effective means of overcoming addiction, yet few could fully benefit from this treatment due to its limited availability. Conclusion Our study suggests that PWID released from “06 centers” would greatly benefit from the scale-up of community-based harm reduction measures that include addiction and HIV treatment, coupled with employment-support and family-centered mental health services. PMID:24857185

Craving behavioral intervention for internet gaming disorder: remediation of functional connectivity of the ventral striatum.

PubMed

Zhang, Jin-Tao; Ma, Shan-Shan; Li, Chiang-Shan R; Liu, Lu; Xia, Cui-Cui; Lan, Jing; Wang, Ling-Jiao; Liu, Ben; Yao, Yuan-Wei; Fang, Xiao-Yi

2018-01-01

Psychobehavioral intervention is an effective treatment of Internet addiction, including Internet gaming disorder (IGD). However, the neural mechanisms underlying its efficacy remain unclear. Cortical-ventral striatum (VS) circuitry is a common target of psychobehavioral interventions in drug addiction, and cortical-VS dysfunction has been reported in IGD; hence, the primary aim of the study was to investigate how the VS circuitry responds to psychobehavioral interventions in IGD. In a cross-sectional study, we examined resting-state functional connectivity of the VS in 74 IGD subjects (IGDs) and 41 healthy controls (HCs). In a follow-up craving behavioral intervention (CBI) study, of the 74 IGD subjects, 20 IGD subjects received CBI (CBI+) and 16 IGD subjects did not (CBI-). All participants were scanned twice with similar time interval to assess the effects of CBI. IGD subjects showed greater resting-state functional connectivity of the VS to left inferior parietal lobule (lIPL), right inferior frontal gyrus and left middle frontal gyrus, in positive association with the severity of IGD. Moreover, compared with CBI-, CBI+ showed significantly greater decrease in VS-lIPL connectivity, along with amelioration in addiction severity following the intervention. These findings demonstrated that functional connectivity between VS and lIPL, each presumably mediating gaming craving and attentional bias, may be a potential biomarker of the efficacy of psychobehavioral intervention. These results also suggested that non-invasive techniques such as transcranial magnetic or direct current stimulation targeting the VS-IPL circuitry may be used in the treatment of Internet gaming disorders. © 2016 Society for the Study of Addiction.

Marijuana Use and Achievement of Abstinence from Alcohol and Other Drugs among People with Substance Dependence: A Prospective Cohort Study

PubMed Central

Mojarrad, Mohammadali; Samet, Jeffrey H; Cheng, Debbie M.; Winter, Michael R.; Saitz, Richard

2014-01-01

Background Many with alcohol and other drug dependence have concurrent marijuana use, yet it is not clear how to address it during addiction treatment. This is partially due to the lack of clarity about whether marijuana use impacts one’s ability to achieve abstinence from the target of addiction treatment. We examined the association between marijuana use and abstinence from other substances among individuals with substance dependence. Methods A secondary analysis of the Addiction Health Evaluation And Disease management study, a randomized trial testing the effectiveness of chronic disease management. Individuals met criteria for drug or alcohol dependence and reported recent drug (i.e. opioid or stimulant) or heavy alcohol use. Recruitment occurred at an inpatient detoxification unit, and all participants were referred to primary medical care. The association between marijuana use and later abstinence from drug and heavy alcohol use was assessed using longitudinal multivariable models. Results Of 563 study participants, 98% completed at least one follow-up assessment and 535 (95%) had at least one pair of consecutive assessments and were included. In adjusted analyses, marijuana use was associated with a 27% reduction in the odds of abstinence from drug and heavy alcohol use (adjusted odds ratio 0.73 [95% CI, 0.56–0.97], P=0.03). Conclusions Marijuana use among individuals with alcohol or other drug dependence is associated with a lower odds of achieving abstinence from drug and heavy alcohol use. These findings add evidence that suggests concomitant marijuana use among patients with addiction to other drugs merits attention from clinicians. PMID:24986785

Smoking and its treatment in addiction services: clients' and staff behaviour and attitudes.

PubMed

Cookson, Camilla; Strang, John; Ratschen, Elena; Sutherland, Gay; Finch, Emily; McNeill, Ann

2014-07-14

High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings. Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment. Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p < 0.001), and only 29% of staff thought it should be addressed early in a client's primary addiction treatment, compared with 48% of clients. A large unmet clinical need is evident with a widespread failure to deliver smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.

Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention.

PubMed

Witkiewitz, Katie; Lustyk, M Kathleen B; Bowen, Sarah

2013-06-01

Addiction has generally been characterized as a chronic relapsing condition (Leshner, 1999). Several laboratory, preclinical, and clinical studies have provided evidence that craving and negative affect are strong predictors of the relapse process. These states, as well as the desire to avoid them, have been described as primary motives for substance use. A recently developed behavioral treatment, mindfulness-based relapse prevention (MBRP), was designed to target experiences of craving and negative affect and their roles in the relapse process. MBRP offers skills in cognitive-behavioral relapse prevention integrated with mindfulness meditation. The mindfulness practices in MBRP are intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting "automatically." A recent efficacy trial found that those randomized to MBRP, as compared with those in a control group, demonstrated significantly lower rates of substance use and greater decreases in craving following treatment. Furthermore, individuals in MBRP did not report increased craving or substance use in response to negative affect. It is important to note, areas of the brain that have been associated with craving, negative affect, and relapse have also been shown to be affected by mindfulness training. Drawing from the neuroimaging literature, we review several plausible mechanisms by which MBRP might be changing neural responses to the experiences of craving and negative affect, which subsequently may reduce risk for relapse. We hypothesize that MBRP may affect numerous brain systems and may reverse, repair, or compensate for the neuroadaptive changes associated with addiction and addictive-behavior relapse. 2013 APA, all rights reserved

Teaching community program clinicians motivational interviewing using expert and train-the-trainer strategies.

PubMed

Martino, Steve; Ball, Samuel A; Nich, Charla; Canning-Ball, Monica; Rounsaville, Bruce J; Carroll, Kathleen M

2011-02-01

The effectiveness of expert-led (EX) and train-the-trainer (TT) strategies was compared to a self-study approach (SS) for teaching clinicians motivational interviewing (MI). Twelve community treatment programs were assigned randomly to the three conditions. EX and TT conditions used skill-building workshops and three monthly supervision sessions guided by treatment integrity ratings, performance feedback and coaching techniques. Trainers in TT were first trained and certified in MI and then prepared carefully to deliver the workshops and supervise MI at their programs. Clinicians in SS only received the training materials. Licensed out-patient and residential addiction and mental health treatment programs in the US state of Connecticut were involved in the study. Ninety-two clinicians who provided addiction treatment within these programs and had limited experience with MI participated in the study. Primary outcomes were the clinicians' MI adherence and competence and the percentage of clinicians meeting clinical trial standards of MI performance. Assessments occurred at baseline, post-workshop, post-supervision and at 12-week follow-up. The study found EX and TT, in comparison to SS, improved clinicians' adherence and competence significantly, with higher percentages of clinicians reaching clinical trial standards of MI performance and few differences between EX and TT. This study supports the combined use of workshops and supervision to teach community program clinicians MI and suggests the train-the-trainer approach may be a feasible and effective strategy for disseminating empirically supported treatments. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Re-Training the Addicted Brain: A Review of Hypothesized Neurobiological Mechanisms of Mindfulness-Based Relapse Prevention

PubMed Central

Witkiewitz, Katie; Lustyk, M. Kathleen B.; Bowen, Sarah

2013-01-01

Addiction has generally been characterized as a chronic relapsing condition. Several laboratory, preclinical, and clinical studies have provided evidence that craving and negative affect are strong predictors of the relapse process. These states, as well as the desire to avoid them, have been described as primary motives for substance use. A recently developed behavioral treatment, Mindfulness-Based Relapse Prevention (MBRP), was designed to target experiences of craving and negative affect and their roles in the relapse process. MBRP offers skills in cognitive behavioral relapse prevention integrated with mindfulness meditation. The mindfulness practices in MBRP are intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting “automatically.” A recent efficacy trial found that those randomized to MBRP, as compared to those in a control group, demonstrated significantly lower rates of substance use and greater decreases in craving following treatment. Furthermore, individuals in MBRP did not report increased craving or substance use in response to negative affect. Importantly, areas of the brain that have been associated with craving, negative affect, and relapse have also been shown to be affected by mindfulness training. Drawing from the neuroimaging literature, we review several plausible mechanisms by which MBRP might be changing neural responses to the experiences of craving and negative affect, which subsequently may reduce risk for relapse. We hypothesize that MBRP may affect numerous brain systems and may reverse, repair, or compensate for the neuroadaptive changes associated with addiction and addictive behavior relapse. PMID:22775773

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. Copyright © 2014 Elsevier B.V. All rights reserved.

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.

Similarities and Differences in Neuroimaging.

PubMed

Sun, Yan-Kun; Sun, Yan; Lin, Xiao; Lu, Lin; Shi, Jie

2017-01-01

Addiction is a chronically relapsing disease characterized by drug intoxication, craving, bingeing, and withdrawal with loss of control. An increasing number of studies have indicated that non-substance addiction, like internet addiction and pathological gambling, share clinical, phenomenological, and biological features with substance addiction. With the development of imaging technology in the past three decades, neuroimaging studies have provided information on the neurobiological effects, and revealed neurochemical and functional changes in the brains of both drug-addicted and non-substance addicted subjects. Imaging techniques play a more critical role in understanding the neuronal processes of addiction and will lead the direction in future research for medication development of addiction treatment, especially for non-substance addiction, which shares an increasing percentage of addiction disorder. This article will review the similarities and differences between substance and non-substance addiction based on neuroimaging studies that may provide clues for future study on these two main kinds of addiction, especially the growing non-substance addiction.

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

Behavioral activation and inhibition system's role in predicting addictive behaviors of patients with bipolar disorder of Roozbeh Psychiatric Hospital

PubMed Central

Abbasi, Moslem; Sadeghi, Hasan; Pirani, Zabih; Vatandoust, Leyla

2016-01-01

Background: Nowadays, prevalence of addictive behaviors among bipolar patients is considered to be a serious health threat by the World Health Organization. The aim of this study is to investigate the role of behavioral activation and inhibition systems in predicting addictive behaviors of male patients with bipolar disorder at the Roozbeh Psychiatric Hospital. Materials and Methods: The research method used in this study is correlation. The study population consisted of 80 male patients with bipolar disorder referring to the psychiatrics clinics of Tehran city in 2014 who were referred to the Roozbeh Psychiatric Hospital. To collect data, the international and comprehensive inventory diagnostic interview, behavioral activation and inhibition systems scale, and addictive behaviors scale were used. Results: The results showed that there is a positive and significant relationship between behavioral activation systems and addictive behaviors (addictive eating, alcohol addiction, television addiction, cigarette addiction, mobile addiction, etc.). In addition, correlation between behavioral inhibition systems and addictive behaviors (addictive eating, alcohol addiction, TV addiction, cigarette addiction, mobile addiction) is significantly negative. Finally, regression analysis showed that behavioral activation and inhibition systems could significantly predict 47% of addictive behaviors in patients with bipolar disorder. Conclusions: It can be said that the patients with bipolar disorder use substance and addictive behaviors for enjoyment and as pleasure stimulants; they also use substances to suppress unpleasant stimulants and negative emotions. These results indicate that behavioral activation and inhibition systems have an important role in the incidence and exacerbation of addictive behaviors. Therefore, preventive interventions in this direction seem to be necessary. PMID:28194203

Addiction and rehabilitation in autobiographical books by rock artists, 1974-2010.

PubMed

Oksanen, Atte

2013-01-01

This paper explores excessive appetites, addiction and rehabilitation as described in the autobiographies, memoirs and diaries of rock artists. The data collection focused on autobiographical rock books written in English by internationally recognised rock artists before 2011. In total, 96 autobiographical books were published between 1974 and 2010. The mean age of the authors was 50 years and 17% of the books were by female authors. Data were encoded for: (i) addiction; (ii) the object of addiction; (iii) personal addiction; (iv) rehabilitation; (v) personal rehabilitation; and (vi) the type of recovery from the addiction. Of the books, 82% described addiction, 62% personal addiction, 57% rehabilitation and 40% personal participation in rehabilitation. The most common addictions were alcoholism, opiate addiction and cocaine addiction. Addicted rock stars described addictions differently from non-addicts. Of addicted rock artists, 51% recovered with the help of rehabilitation, 42% self-recovered and 7% continued the excess. There has been an increase in the prevalence of addiction in autobiographical rock books over time. In addition, it was found that gender affected the type of recovery. Autobiographical books by rock artists have been published in increasing numbers in the last two decades. The artists in question have described their personal experiences of addiction and rehabilitation and discussed the problems related to alcohol, drugs and excessive behaviour. The books do not glamorise addiction or excessive lifestyles. Rather, they indicate that attitudes towards drugs and alcohol are changing in the rock business. © 2012 Australasian Professional Society on Alcohol and other Drugs.

E-cigarettes: Impact of E-Liquid Components and Device Characteristics on Nicotine Exposure.

PubMed

DeVito, Elise E; Krishnan-Sarin, Suchitra

2018-01-01

Electronic cigarette (e-cigarette) use has increased substantially in recent years. While e-cigarettes have been proposed as a potentially effective smoking cessation tool, dualuse in smokers is common and e-cigarettes are widely used by non-smokers, including youth and young-adult non-smokers. Nicotine, the primary addictive component in cigarettes, is present at varying levels in many e-liquids. E-cigarettes may lead to initiation of nicotine use in adult and youth non-smokers, re-initiation of nicotine dependence in ex-smokers or increased severity of nicotine dependence in dual-users of cigarettes and e-cigarettes. As such, there are important clinical and policy implications to understanding factors impacting nicotine exposure from e-cigarettes. However, the broad and rapidly changing range of e-liquid constituents and e-cigarette hardware which could impact nicotine exposure presents a challenge. Recent changes in regulatory oversight of e-cigarettes underscore the importance of synthesizing current knowledge on common factors which may impact nicotine exposure. This review focuses on factors which may impact nicotine exposure by changing e-cigarette use behavior, puff topography, altering the nicotine yield (amount of nicotine exiting the e-cigarette mouth piece including nicotine exhaled as vapor) or more directly by altering nicotine absorption and bioavailability. Topics reviewed include e-liquid components or characteristics including flavor additives (e.g., menthol), base e-liquid ingredients (propylene glycol, vegetable glycerin), components commonly used to dissolve flavorants (e.g., ethanol), and resulting properties of the e-liquid (e.g., pH), e-cigarette device characteristics (e.g., wattage, temperature, model) and user behavior (e.g., puff topography) which may impact nicotine exposure. E-liquid characteristics and components, e-cigarette hardware and settings, and user behavior can all contribute substantially to nicotine exposure from e-cigarettes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Internet addiction: Prevalence and relation with mental states in adolescents.

PubMed

Kawabe, Kentaro; Horiuchi, Fumie; Ochi, Marina; Oka, Yasunori; Ueno, Shu-Ichi

2016-09-01

Internet addiction disrupts the daily lives of adolescents. We investigated the prevalence of Internet addiction in junior high school students, elucidated the relation between Internet addiction and mental states, and determined the factors associated with Internet addiction in adolescents. Junior high school students (aged 12-15 years) were assessed using Young's Internet Addiction Test (IAT), the Japanese version of the General Health Questionnaire (GHQ), and a questionnaire on access to electronic devices. Based on total IAT scores, 2.0% (male, 2.1%; female, 1.9%) and 21.7% (male, 19.8%; female, 23.6%) of the total 853 participants (response rate, 97.6%) were classified as addicted and possibly addicted, respectively. Total GHQ scores were significantly higher in the addicted (12.9 ± 7.4) and possibly addicted groups (8.8 ± 6.0) than in the non-addicted group (4.3 ± 4.6; P < 0.001, both groups). A comparison of the percentage of students in the pathological range of GHQ scores revealed significantly higher scores in the possibly addicted group than in the non-addicted group. Further, accessibility to smartphones was significantly associated with Internet addiction. Students in the addicted and possibly addicted groups were considered 'problematic' Internet users. Use of smartphones warrants special attention, being among the top factors contributing to Internet addiction. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

The Addict in Us all

PubMed Central

Dill, Brendan; Holton, Richard

2014-01-01

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1–3) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. PMID:25346699

Desistance and Treatment Seeking Among Women With Substance Use Disorders.

PubMed

Rhodes, Blythe E; Gottfredson, Nisha C; Hill, Lauren M

2018-04-01

Addiction rates are rising faster among women than men. However, women with substance use disorders are less likely to enter treatment than males. This study seeks to understand how turning-point events and other maturational processes affect "life course persistent" women's motivations for seeking treatment for their disorder. We conducted semi-structured in-depth interviews with 30 women who were receiving treatment for addiction using thematic analysis. Recurring themes were as follows: experiences of rock-bottom events prior to entering treatment, feeling "sick and tired" in regard to both their physical and mental health, and shifting identities or perceptions of themselves. We discuss the importance of motivating shifts in identity to prevent women from entering treatment as a result of more traumatic mechanisms as well as the possibility of intercepting women with substance dependence and chronic health conditions in primary care or hospital settings with the aim of encouraging treatment.

Religiosity and Participation in Mutual-Aid Support Groups for Addiction

PubMed Central

Atkins, Randolph G.; Hawdon, James E.

2007-01-01

Mutual-aid support groups play a vital role in substance abuse treatment in the United States. A national survey of mutual-aid support groups for addiction was conducted to identify key differences between participants in recovery groups. Survey data indicate that active involvement in support groups significantly improves one's chances of remaining clean and sober, regardless of the group in which one participates. Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober. Religious respondents were more likely to participate in 12-Step groups and Women for Sobriety. Non-religious respondents were significantly less likely to participate in 12-Step groups. Religiosity had little impact on SMART Recovery participation, but actually decreased participation in SOS. These results have important implications for treatment planning and matching individuals to appropriate support groups. PMID:17889302

Factors associated with attrition rate in a supportive care service for substance using pregnant women in Brazil.

PubMed

Avilla, Rosa Marina; Surjan, Juliana; de Fátima Ratto Padin, Maria; Canfield, Martha; Laranjeira, Ronaldo Ramos; Mitsuhiro, SandroSendin

2017-10-01

Retaining substance using women in antenatal care remains a major challenge. This study explored factors associated with attrition rate among women with substance use problems attending a supportive care service during pregnancy and soon after the birth of the infant. Records of 166 women's antenatal consultations were analyzed. Attrition rate was high (75/166, 45.2%), and was associated with women having no schooling/primary schooling only, no family contact, having child(ren), crack-cocaine use, poly drug use, and substance use problems by the expected child's father. Attrition may be the outcome of socio-demographic, family, individual, and substance use issues not fully addressed in prenatal interventions. Identification of who are at risk for dropping out affords services with an opportunity to prevent its occurrence. (Am J Addict 2017;26:676-679). © 2017 American Academy of Addiction Psychiatry.

Epidemiology of Substance Use in Reproductive-Age Women

PubMed Central

McHugh, R. Kathryn; Wigderson, Sara; Greenfield, Shelly F.

2014-01-01

Synopsis A significant number of women of reproductive age in the U.S. use addictive substances. In 2012 more than 50% reported current use of alcohol, 20% used tobacco products, and approximately 13% used other drugs. Among women, use of these substances is associated with a number of significant medical, psychiatric, and social consequences, and the course of illness may progress more rapidly in women than men. The lifetime prevalence of alcohol and drug use disorders in women is 19.5% and 7.1%, respectively. In addition, as most addictive substances cross the placenta and have deleterious effects on fetal development, substance use has additional potential adverse consequences for women of reproductive age who may become pregnant. Specific barriers to accessing effective substance use treatment exist for women. The prevalence of substance use and evidence of accelerated illness progression in women highlight the importance of universal substance use screening in women in primary care settings. PMID:24845483

Effects of the kappa opioid receptor antagonist nor-binaltorphimine (nor-BNI) on cocaine versus food choice and extended-access cocaine intake in rhesus monkeys.

PubMed

Hutsell, Blake A; Cheng, Kejun; Rice, Kenner C; Negus, Sidney Stevens; Banks, Matthew L

2016-03-01

The dynorphin/kappa opioid receptor (KOR) system has been implicated as one potential neurobiological modulator of the abuse-related effects of cocaine and as a potential target for medications development. This study determined effects of the KOR antagonist nor-binaltorphimine (nor-BNI) on cocaine self-administration under a novel procedure that featured two daily components: (1) a 2-hour 'choice' component (9:00-11:00 am) when monkeys could choose between food pellets and cocaine injections (0-0.1 mg/kg per injection, intravenous) and (2) a 20-hour 'extended-access' component (noon to 8:00 am) when cocaine (0.1 mg/kg per injection) was available under a fixed-ratio schedule to promote high daily cocaine intakes. Rhesus monkeys (n = 4) were given 14 days of exposure to the choice + extended-access procedure then treated with nor-BNI (3.2 or 10.0 mg/kg, intramuscular), and cocaine choice and extended-access cocaine intake were evaluated for an additional 14 days. Consistent with previous studies, cocaine maintained both a dose-dependent increase in cocaine choice during choice components and a high level of cocaine intake during extended-access components. Neither 3.2 nor 10 mg/kg nor-BNI significantly altered cocaine choice or extended-access cocaine intake. In two additional monkeys, nor-BNI also had no effect on cocaine choice or extended-access cocaine intake when it was administered at the beginning of exposure to the extended-access components. Overall, these results do not support a major role for the dynorphin/KOR system in modulating cocaine self-administration under these conditions in non-human primates nor do they support the clinical utility of KOR antagonists as a pharmacotherapeutic strategy for cocaine addiction. © 2015 Society for the Study of Addiction.

Validity and reliability of the Persian version of mobile phone addiction scale

PubMed Central

Mazaheri, Maryam Amidi; Karbasi, Mojtaba

2014-01-01

Background: With regard to large number of mobile users especially among college students in Iran, addiction to mobile phone is attracting increasing concern. There is an urgent need for reliable and valid instrument to measure this phenomenon. This study examines validity and reliability of the Persian version of mobile phone addiction scale (MPAIS) in college students. Materials and Methods: this methodological study was down in Isfahan University of Medical Sciences. One thousand one hundred and eighty students were selected by convenience sampling. The English version of the MPAI questionnaire was translated into Persian with the approach of Jones et al. (Challenges in language, culture, and modality: Translating English measures into American Sign Language. Nurs Res 2006; 55: 75-81). Its reliability was tested by Cronbach's alpha and its dimensionality validity was evaluated using Pearson correlation coefficients with other measures of mobile phone use and IAT. Construct validity was evaluated using Exploratory subscale analysis. Results: Cronbach's alpha of 0.86 was obtained for total PMPAS, for subscale1 (eight items) was 0.84, for subscale 2 (five items) was 0.81 and for subscale 3 (two items) was 0.77. There were significantly positive correlations between the score of PMPAS and IAT (r = 0.453, P < 0.001) and other measures of mobile phone use. Principal component subscale analysis yielded a three-subscale structure including: inability to control craving; feeling anxious and lost; mood improvement accounted for 60.57% of total variance. The results of discriminate validity showed that all the item's correlations with related subscale were greater than 0.5 and correlations with unrelated subscale were less than 0.5. Conclusion: Considering lack of a valid and reliable questionnaire for measuring addiction to the mobile phone, PMPAS could be a suitable instrument for measuring mobile phone addiction in future research. PMID:24778668

Assessing the place of neurobiological explanations in accounts of a family member's addiction.

PubMed

Meurk, Carla; Fraser, Doug; Weier, Megan; Lucke, Jayne; Carter, Adrian; Hall, Wayne

2016-07-01

The brain disease model of addiction posits that addiction is a persistent form of neural dysfunction produced by chronic drug use, which makes it difficult for addicted persons to become and remain abstinent. As part of an anticipatory policy analysis of addiction neuroscience, we engaged family members of addicted individuals to assess their views on the place and utility of brain-based accounts of addiction. Fifteen in-depth qualitative interviews were conducted and used to develop a quantitative online survey that was completed by 55 family members. This article reports responses on what addiction is and how it is caused and responses to explanations of the brain disease model of addiction. Participants gave multiple reasons for their family members developing an addiction and there was no single dominant belief about the best way to describe addiction. Participants emphasised the importance of both scientific and non-scientific perspectives on addiction by providing multifactorial explanations of their family members' addictions. Most family members acknowledged that repeated drug use can cause changes to the brain, but they varied in their reactions to labelling addiction a 'brain disease'. They believed that understanding addiction, and how it is caused, could help them support their addicted relative. Participants' beliefs about neurobiological information and the brain disease model of addiction appeared to be driven by empathetic, utilitarian considerations rather than rationalist ones. We discuss the importance of providing information about the nature and causes of addiction. [Meurk C, Fraser D, Weier M, Lucke J, Carter A, Hall W. Assessing the place of neurobiological explanations in accounts of a family member's addiction. Drug Alcohol Rev 2016;35:461-469]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Insight Into the Relationship Between Impulsivity and Substance Abuse From Studies Using Animal Models

PubMed Central

Winstanley, Catharine A.; Olausson, Peter; Taylor, Jane R.; Jentsch, J. David

2010-01-01

Drug use disorders are often accompanied by deficits in the capacity to efficiently process reward-related information and to monitor, suppress, or override reward-controlled behavior when goals are in conflict with aversive or immediate outcomes. This emerging deficit in behavioral flexibility and impulse control may be a central component of the progression to addiction, as behavior becomes increasingly driven by drugs and drug-associated cues at the expense of more advantageous activities. Understanding how neural mechanisms implicated in impulse control are affected by addictive drugs may therefore prove a useful strategy in the search for new treatment options. Animal models of impulsivity and addiction could make a significant contribution to this endeavor. Here, some of the more common behavioral paradigms used to measure different aspects of impulsivity across species are outlined, and the importance of the response to reward-paired cues in such paradigms is discussed. Naturally occurring differences in forms of impulsivity have been found to be predictive of future drug self-administration, but drug exposure can also increase impulsive responding. Such data are in keeping with the suggestion that impulsivity may contribute to multiple stages within the spiral of addiction. From a neurobiological perspective, converging evidence from rat, monkey, and human studies suggest that compromised functioning within the orbitofrontal cortex may critically contribute to the cognitive sequelae of drug abuse. Changes in gene transcription and protein expression within this region may provide insight into the mechanism underlying drug-induced cortical hypofunction, reflecting new molecular targets for the treatment of uncontrolled drug-seeking and drug-taking behavior. PMID:20491734

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

PubMed

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

2014-01-01

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. We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. 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. 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.

Cannabidiol Oil for Decreasing Addictive Use of Marijuana: A Case Report.

PubMed

Shannon, Scott; Opila-Lehman, Janet

2015-12-01

This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana and provide anxiolytic and sleep benefits. Addiction to marijuana is a chronic, relapsing disorder, which is becoming a prevalent condition in the United States. The most abundant compound in the marijuana, which is called tetrahydrocannabinol (THC), has been widely studied and known for its psychoactive properties. The second most abundant component-CBD-has been suggested to have the medicinal effects of decreasing anxiety, improving sleep, and other neuro-protective effects. The mechanism of action for CBD has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system. Such action raises the issue of whether it might be beneficial to use CBD in isolation to facilitate withdrawal of marijuana use. The specific use of CBD for marijuana reduction has not been widely studied. The patient was a 27-y-old male who presented with a long-standing diagnosis of bipolar disorder and a daily addiction to marijuana use. In the described intervention, the only change made to the patient's treatment was the addition of CBD oil with the dosage gradually decreasing from 24 to 18 mg. With use of the CBD oil, the patient reported being less anxious, as well as settling into a regular pattern of sleep. He also indicated that he had not used any marijuana since starting the CBD oil. With the decrease in the dosage to 18 mg, the patient was able to maintain his nonuse of marijuana.

Stress as a common risk factor for obesity and addiction

PubMed Central

2013-01-01

Stress is associated with obesity and the neurobiology of stress overlaps significantly with that of appetite and energy regulation. This review will discuss stress, allostasis, the neurobiology of stress and its overlap with neural regulation of appetite and energy homeostasis. Stress is a key risk factor in the development of addiction and in addiction relapse. High levels of stress changes eating patterns and augments consumption of highly palatable (HP) foods, which in turn, increases incentive salience of HP foods and allostatic load. The neurobiological mechanisms by which stress affects reward pathways to potentiate motivation and consumption of HP foods as well as addictive drugs is discussed. With enhanced incentive salience of HP foods and over-consumption of these foods, there are adaptations in stress and reward circuits that promote stress-related and HP food-related motivation as well as concomitant metabolic adaptations, including alterations in glucose metabolism, insulin sensitivity, and other hormones related to energy homeostatsis. These metabolic changes in turn may also affect dopaminergic activity to influence food motivation and intake of HP foods. An integrative heuristic model is proposed wherein repeated high levels of stress alter the biology of stress and appetite/energy regulation, with both components directly affecting neural mechanisms contributing to stress-induced and food cue-induced HP food motivation and engagement in overeating of such foods to enhance risk of weight gain and obesity. Future directions in research are identified to increase understanding of the mechanisms by which stress may increase risk of weight gain and obesity. PMID:23541000

Stress as a common risk factor for obesity and addiction.

PubMed

Sinha, Rajita; Jastreboff, Ania M

2013-05-01

Stress is associated with obesity, and the neurobiology of stress overlaps significantly with that of appetite and energy regulation. This review will discuss stress, allostasis, the neurobiology of stress and its overlap with neural regulation of appetite, and energy homeostasis. Stress is a key risk factor in the development of addiction and in addiction relapse. High levels of stress changes eating patterns and augments consumption of highly palatable (HP) foods, which in turn increases incentive salience of HP foods and allostatic load. The neurobiological mechanisms by which stress affects reward pathways to potentiate motivation and consumption of HP foods as well as addictive drugs is discussed. With enhanced incentive salience of HP foods and overconsumption of these foods, there are adaptations in stress and reward circuits that promote stress-related and HP food-related motivation as well as concomitant metabolic adaptations, including alterations in glucose metabolism, insulin sensitivity, and other hormones related to energy homeostasis. These metabolic changes in turn might also affect dopaminergic activity to influence food motivation and intake of HP foods. An integrative heuristic model is proposed, wherein repeated high levels of stress alter the biology of stress and appetite/energy regulation, with both components directly affecting neural mechanisms contributing to stress-induced and food cue-induced HP food motivation and engagement in overeating of such foods to enhance risk of weight gain and obesity. Future directions in research are identified to increase understanding of the mechanisms by which stress might increase risk of weight gain and obesity. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Internet overuse and excessive daytime sleepiness in adolescents.

PubMed

Choi, Kwisook; Son, Hyunsook; Park, Myunghee; Han, Jinkyu; Kim, Kitai; Lee, Byungkoo; Gwak, Hyesun

2009-08-01

The purpose of this study was to examine the association of Internet overuse with excessive daytime sleepiness (EDS). A total of 2336 high school students in South Korea (boys, 57.5%; girls, 42.5%) completed the structured questionnaire. The severity of Internet addiction was evaluated using Young's Internet addiction test. The proportions of boys who were classified as Internet addicts and possible Internet addicts were 2.5% and 53.7%, respectively. For girls, the corresponding proportions were 1.9% and 38.9%, respectively. The prevalence of EDS was 11.2% (boys, 11.2%; girls, 11.1%). When Internet addicts were compared with non-addicts, they consisted of more boys, drank alcohol more, and considered their own health condition as poor. But smoking was not related with Internet addiction. The prevalence rate of EDS for Internet addicts was 37.7%, whereas that for possible Internet addicts and non-addicts was 13.9% and 7.4%, respectively. The prevalence of insomnia, witnessed snoring, apnea, teeth grinding, and nightmares was highest in Internet addicts, middle in possible addicts, and lowest in non-addicts. With adjustment for duration of Internet use, duration of sleep time, age, gender, smoking, taking painkillers due to headache, insomnia symptoms, witnessed apnea, and nightmares, the odds of EDS were 5.2-fold greater (95% confidence interval [CI]: 2.7-10.2) in Internet addicts and 1.9-fold greater (95%CI: 1.4-2.6) in possible Internet addicts compared to non-addicts. Internet addiction is strongly associated with EDS in adolescents. Clinicians should consider examining Internet addiction in adolescent cases of EDS.

Assessing the psychometric properties of two food addiction scales.

PubMed

Lemeshow, Adina R; Gearhardt, Ashley N; Genkinger, Jeanine M; Corbin, William R

2016-12-01

While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach's alphas and 95% confidence intervals (CIs) for internal reliability and Cohen's Kappa coefficients and 95% CIs for test-retest reliability. Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48-0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66-1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale's sensitivity was 92.3% (95% CI, 64%-99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%-100%). Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychological problems and family functioning as risk factors in addiction.

PubMed

Agha, Sajida; Zia, Hamid; Irfan, Syed

2008-01-01

The purpose of the present research was to determine the role of family functioning and psychological problems of drug addicts and non addicts by assessing the difference between the two groups. After detailed literature review it was hypothesized that scores on the variable of communication, affective expression and control among family members of addicts will be higher than non addicts. Furthermore scores on the variables of anger control problems, emotional distress and positive self will also be higher of addicts. This was a cohort study. A cluster sampling method was used. Sample of present research consisted of 240 adolescents divided into two groups of 120 addicts and 120 non-addicts each from different socio-economic status. General scale of Family Assessment Measure-Version III (FAM-III) was administered in order to measure the level of communication, value and norms whereas dyadic Relationship Scale was used to measure affective expression and control among the family members of addicts and non addicts. Renold Adolescent Adjustment Screening Inventory was administered in order to assess anger control problems, emotional distress and positive self in addicts and non addicts. t-test was calculated in order to determine the difference in the level of communication, value and norms, affective expression and control among families of addicts and non addicts. Furthermore difference in anger control problems, emotional distress and positive self between the addicts and non addicts was also determined by calculating t-test. Results showed significant differences in the variables among the family members and there is also a significant difference between addicts and non addicts. Avenues for further research have been suggested.

Opioids, Chronic Pain, and Addiction in Primary Care

PubMed Central

Barry, Declan T.; Irwin, Kevin S.; Jones, Emlyn S.; Becker, William C.; Tetrault, Jeanette M.; Sullivan, Lynn E.; Hansen, Helena; O’Connor, Patrick G.; Schottenfeld, Richard S.; Fiellin, David A.

2010-01-01

Research has largely ignored the systematic examination of physicians’ attitudes towards providing care for patients with chronic non-cancer pain. The objective of this study was to identify barriers and facilitators to opioid treatment of chronic non-cancer pain patients by office-based medical providers. We used a qualitative study design using individual and group interviews. Participants were twenty-three office-based physicians in New England. Interviews were audiotaped, transcribed, and systematically coded by a multidisciplinary team using the constant comparative method. Physician barriers included lack of expertise in the treatment of chronic pain and co-existing disorders, including addiction; lack of interest in pain management; patients’ aberrant behaviors; and physicians’ attitudes toward prescribing opioid analgesics. Physician facilitators included promoting continuity of patient care and the use of opioid agreements. Physicians’ perceptions of patient-related barriers included lack of physician responsiveness to patients’ pain reports, negative attitudes toward opioid analgesics, concerns about cost, and patients’ low motivation for pain treatment. Perceived logistical barriers included lack of appropriate pain management and addiction referral options, limited information regarding diagnostic workup, limited insurance coverage for pain management services, limited ancillary support for physicians, and insufficient time. Addressing these barriers to pain treatment will be crucial to improving pain management service delivery. PMID:20627817

Is smartphone addiction really an addiction?

PubMed

Panova, Tayana; Carbonell, Xavier

2018-06-13

Aims In light of the rise in research on technological addictions and smartphone addiction in particular, the aim of this paper was to review the relevant literature on the topic of smartphone addiction and determine whether this disorder exists or if it does not adequately satisfy the criteria for addiction. Methods We reviewed quantitative and qualitative studies on smartphone addiction and analyzed their methods and conclusions to make a determination on the suitability of the diagnosis "addiction" to excessive and problematic smartphone use. Results Although the majority of research in the field declares that smartphones are addictive or takes the existence of smartphone addiction as granted, we did not find sufficient support from the addiction perspective to confirm the existence of smartphone addiction at this time. The behaviors observed in the research could be better labeled as problematic or maladaptive smartphone use and their consequences do not meet the severity levels of those caused by addiction. Discussion and conclusions Addiction is a disorder with severe effects on physical and psychological health. A behavior may have a similar presentation as addiction in terms of excessive use, impulse control problems, and negative consequences, but that does not mean that it should be considered an addiction. We propose moving away from the addiction framework when studying technological behaviors and using other terms such as "problematic use" to describe them. We recommend that problematic technology use is to be studied in its sociocultural context with an increased focus on its compensatory functions, motivations, and gratifications.

"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. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Resisting temptation: a psychological analysis.

PubMed

Hodgson, R J

1989-03-01

It is proposed that self control involves several related processes including vivid awareness of future consequences, overcoming learned helplessness and tunnel vision, developing commitment and accepting anxiety/frustration. Facing up to temptation and resisting the compulsive urge is considered to be a crucial therapeutic experience. Evidence is presented to support the view that cue exposure should therefore be a central component of treatments for compulsions and addictions.

Ten myths about work addiction.

PubMed

Griffiths, Mark D; Demetrovics, Zsolt; Atroszko, Paweł A

2018-02-07

Background and aims Research into work addiction has steadily grown over the past decade. However, the literature is far from unified and there has been much debate on many different issues. Aim and methods This paper comprises a narrative review and focuses on 10 myths about work addiction that have permeated the psychological literature and beyond. The 10 myths examined are (a) work addiction is a new behavioral addiction, (b) work addiction is similar to other behavioral addictions, (c) there are only psychosocial consequences of work addiction, (d) work addiction and workaholism are the same thing, (e) work addiction exclusively occurs as a consequence of individual personality factors, (f) work addiction only occurs in adulthood, (g) some types of work addiction are positive, (h) work addiction is a transient behavioral pattern related to situational factors, (i) work addiction is a function of the time spent engaging in work, and (j) work addiction is an example of overpathogizing everyday behavior and it will never be classed as a mental disorder in the DSM. Results Using the empirical literature to date, it is demonstrated that there is evidence to counter each of the 10 myths. Conclusion It appears that the field is far from unified and that there are different theoretical constructs underpinning different strands of research.

Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users.

PubMed

Konopka, Anna; Pełka-Wysiecka, Justyna; Grzywacz, Anna; Samochowiec, Jerzy

2013-01-10

Although the addictive potential of benzodiazepine drugs has been known for a long time, new cases of benzodiazepine addictions keep emerging in clinical practice. The etiology of benzodiazepine addiction seems to be multifactorial. The objective of this study was to investigate and measure psychological and situational factors differentiating benzodiazepine addicts from not addicted users. A psychological profile and situational factors of patients with the diagnosis of benzodiazepine addiction and a carefully matched control group of not addicted former benzodiazepine users were defined and investigated. The investigated benzodiazepine addicts differed significantly from the control group in particular psychological dimensions, such as higher neuroticism and introversion, prevalence of emotional rather than task based coping mechanisms. There were also significant correlations between the addiction and situational factors such as BZD - treatment circumstances and adverse life events previous to the treatment. The results show psychological and situational factors which differentiate benzodiazepine addicts from not addicted benzodiazepine users. This data suggest that benzodiazepine addiction might be associated with higher neuroticism, introversion and less effective coping mechanisms as well as with previous accumulation of adverse life events and/or inadequate BZD treatment. The psychological and situational factors mentioned above might be considered as potential risk factors for benzodiazepine addiction. Copyright © 2012 Elsevier Inc. All rights reserved.

[The manual "Problematic use and dependence of prescipted drugs" in daily routine care - a study among participants in a training to qualify in "primary addiction treatment"].

PubMed

Ulbricht, S; Gross, B; Kunstmann, W; Meyer, C; John, U

2011-12-01

To strengthen the position of physicians regarding problematic use and dependence of prescripted drugs a manual was issued by the German Medical Association in 2007.  A study among participants in a training to qualify in "primary addiction treatment" was conducted. The utilisation of the manual, its relevance for routine care and self-estimated changes in drug prescription were examined. All 542 participants in training courses between 1.9.2008 and 31.12.2009 were asked about participation in a survey 12 weeks later. A number of 267 took part in this investigation. A proportion of 60,7 % among GPs that received the manual dealt with them beyond the training course. From 178 physicians, who confirmed the provision of drug prescription, a number of 56 stated changes in their drug prescription. A higher probabilty for changes in drug prescription was given in case of a high percentage of new informations that could be culled from the manual. The interest for the manual beyond the training course and the amount of self-estimated changes in drug prescription should encourage to use this within training measures in a systematic way. © Georg Thieme Verlag KG Stuttgart · New York.

The Family and Addictions: An Introduction.

ERIC Educational Resources Information Center

Lewis, Robert A.

1989-01-01

Discusses issues related to families and addictions in the context of family-related helping professions and addictions counseling. Describes family systems approach to addictions and some family-based addiction interventions. Notes research articles that have made significant contributions to families and addictions field. (Author/CM)

Drug Therapy.

PubMed

He, Ri-Hui; Tao, Ran

2017-01-01

This chapter first summarizes the therapy of addiction disorder, and elaborates on the progress of medication. First, the difference between dependency and addiction are introduced. The basic principles of the therapy of substance and non-substance addiction are then put forward. It is also pointed out in this chapter that with the progress of the study, the goal of addiction disorder therapy is expected to transfer from reducing the relapse and harm of the addiction to completely eliminating and recovering from it. This chapter also introduces the progress of psychological addiction elimination technology, especially the "Unconditioned Stimulus Retrieval Extinction Paradigm and Conditioned Stimulus Retrieval Extinction Paradigm" and PITDH technology. Finally it is pointed out that in addiction disorder therapy, comprehensive intervention has become a trend. With regard to the medication for addiction disorders, this chapter also includes the progress and deficiencies of substance and non-substance addiction. In terms of addiction disorder rehabilitation, the foundation of substance addiction is medication which is, however, limited for non-substance addiction. The key to the rehabilitation of addiction disorder is psycho-behavioral therapy, which is especially effective in eliminating craving.

Assessing the Psychometric Properties of Two Food Addiction Scales

PubMed Central

Lemeshow, Adina; Gearhardt, Ashley; Genkinger, Jeanine; Corbin, William R.

2016-01-01

Background While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. Methods We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach’s alphas and 95% confidence intervals (CIs) for internal reliability and Cohen’s Kappa coefficients and 95% CIs for test-retest reliability. Results Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48–0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66–1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale’s sensitivity was 92.3% (95% CI, 64%–99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%–100%). Conclusions Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction. PMID:27623221

[Pregnant women and mothers using alcohol, tobacco and illegal drugs].

PubMed

Nechanská, B; Mravčík, V; Sopko, B; Velebil, P

2012-10-01

This analysis is focused on use of addictive substances among women hospitalised during delivery or puerperium. Analysed data come from National Registry of Mothers at Childbirth and from National Registry of Newborns, which are managed by the Institute of Health Information and Statistics. To describe the prevalence of addictive substances use among women during gestation and to study its relation to health complications during pregnancy, delivery or puerperium and to health status of foetus and newborns. The reporting to registries is provided in the Report on mother at childbirth and in the Report on newborn. Both registers provide basic socio-demographic information about mother, information about previous pregnancies and abortions, about current pregnancy, course of delivery, birth and neonatal treatment and health of newborn during hospitalization of mother during delivery or puerperium. Use of addictive substances is monitored in the National Registry of Mothers at Childbirth since 2000. Addictive substances are divided to tobacco, alcohol and drugs. Descriptive analysis of data was performed and binary logistic regression was used to test association of substance use with education and marital status (adjusted for age), analysis of variance was used to test association of substance use with selected health complications of pregnancy, delivery or puerperium and with health status of foetus/newborns (adjusted for age, education, marital status and interaction between addictive substances). In 2000-2009, 1,008,821 mothers were reported of whom 60,502 women were registered as cigarette smokers, 1,528 used alcohol and 1,836 used other (illegal) drugs. Total of 1,027,200 newborns were reported. The average age of mothers using addictive substances were about 0.5-3 years lower in comparison with nonusers, in average mothers using illegal drugs were the youngest. Mothers using addictive substances were more often unmarried and had lower education than nonusers - almost 2/3 of mothers using addictive substances were unmarried or didn't live in permanent partnership and more than 82% of mothers-users have lower education (primary or secondary school without a diploma). The association between substance use and induced and spontaneous abortions was observed only in smokers. Serious complications of pregnancy were associated with all monitored addictive substances - in mothers-smokers, a probability of serious complications were about 40 %, in users of illicit drugs about 13 % and in alcohol users about 5 % higher as compared to nonusers. Substance use showed almost no association with problems during childbirth. Alcohol and illegal drugs use increased probability of complications in puerperium. Health status of foetus/newborn was negatively significantly altered mainly in those born to mothers-smokers in almost all observed characteristics. Mothers alcohol use during pregnancy was associated primarily with the overall health status of foetus immediately after delivery, congenital anomalies, stillbirth or need for treatment of newborn in the theatre. Infants of mothers using addictive substances had higher probability of consequent hospitalization after discharge from the neonatal department, transfer to infant home and death of infant. Association between complications during pregnancy, delivery and puerperium and health status of newborns and substance use of mothers during pregnancy was found mainly in cigarette smoking. Alcohol use was found significant in some (but serious) health problems of mothers and newborns. The association between illegal drugs and monitored indicators wasn't found. Following the results of this work, criteria for reporting of illegal drug use in mothers during pregnancy should be improved.

Correlates of food addiction in obese individuals seeking bariatric surgery.

PubMed

Meule, A; Heckel, D; Jurowich, C F; Vögele, C; Kübler, A

2014-08-01

Recent evidence suggests that palatable, high-calorie foods may have an addictive potential. Accordingly, obesity and overconsumption of such foods have been associated with addiction-like eating behaviour. The present study investigated whether individuals with obesity can be classified as food-addicted and which factors would differentiate between food-addicted and non-addicted individuals. We administered the German version of the Yale Food Addiction Scale and other questionnaires to obese individuals seeking bariatric surgery (N = 96). Results showed that 40% of the sample could be diagnosed as food-addicted. Food-addicted individuals reported more frequent food cravings, higher eating disorder psychopathology and more depressive symptoms than the non-addicted group. Age, body mass and gender distribution did not differ between groups. The food addiction group had higher attentional but similar motor and non-planning impulsivity, and had lower scores on the Alcohol Use Disorders Identification Test (AUDIT) compared with the non-addicted group. Scores on the AUDIT were associated with impulsivity in the non-addicted group only. We conclude that the prevalence of food addiction is higher in candidates for bariatric surgery compared with the general population and obese individuals not seeking bariatric surgery. A diagnosis of food addiction is associated with higher eating pathology and depression. Moreover, only attentional impulsivity, but not other dimensions of impulsivity, is associated with addictive eating. Finally, food addiction and impulsivity interactively predicted alcohol use, suggesting a crucial role of psychological variables and eating style in determining alcohol consumption in pre-bariatric patients, independent of body mass. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

Understanding the disease of addiction.

PubMed

Detar, D Todd

2011-03-01

Addiction is a chronic brain disease. Drug addiction manifests as a compulsive obsession to use a substance despite serious detrimental and sometimes irreversible consequences. Drug addiction is not the same as drug dependency because dependency may not manifest as an addictive behavior. This problem is fundamental to understanding the disease of addiction. This article discusses the neurobiology and genetics of drug addiction. Copyright © 2011. Published by Elsevier Inc.

The issue of consent in research that administers drugs of addiction to addicted persons.

PubMed

Carter, Adrian; Hall, Wayne

2008-01-01

In addiction, impaired control over drug use raises questions about the capacity of addicted persons to consent to participate in research studies in which they are given their drug of addiction. We review the case for doing such research, and the arguments that addiction does, and does not, prevent addicted persons from consenting to such research. We argue for a more nuanced view that acknowledges that while in some situations addiction impairs decision-making capacity, it does not eliminate such capacity. We conclude with some suggestions for recruiting addicted subjects and designing experiments in ways to obtain free and informed consent.

Treatment Considerations in Internet and Video Game Addiction: A Qualitative Discussion.

PubMed

Greenfield, David N

2018-04-01

Internet and video game addiction has been a steadily developing consequence of modern living. Behavioral and process addictions and particularly Internet and video game addiction require specialized treatment protocols and techniques. Recent advances in addiction medicine have improved our understanding of the neurobiology of substance and behavioral addictions. Novel research has expanded the ways we understand and apply well-established addiction treatments as well as newer therapies specific to Internet and video game addiction. This article reviews the etiology, psychology, and neurobiology of Internet and video game addiction and presents treatment strategies and protocols for addressing this growing problem. Copyright © 2017 Elsevier Inc. All rights reserved.

The Shame of Addiction

PubMed Central

Flanagan, Owen

2013-01-01

Addiction is a person-level phenomenon that involves twin normative failures. A failure of normal rational effective agency or self-control with respect to the substance; and shame at both this failure, and the failure to live up to the standards for a good life that the addict himself acknowledges and aspires to. Feeling shame for addiction is not a mistake. It is part of the shape of addiction, part of the normal phenomenology of addiction, and often a source of motivation for the addict to heal. Like other recent attempts in the addiction literature to return normative concepts such as “choice” and “responsibility” to their rightful place in understanding and treating addiction, the twin normative failure model is fully compatible with investigation of genetic and neuroscientific causes of addiction. Furthermore, the model does not re-moralize addiction. There can be shame without blame. PMID:24115936

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. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk personality traits of Internet addiction: a longitudinal study of Internet-addicted Chinese university students.

PubMed

Dong, Guangheng; Wang, Jiangyang; Yang, Xuelong; Zhou, Hui

2013-12-01

As the world's fastest growing "addiction", Internet addiction is still controversial. The present study aimed to examine the potential personality predictors of Internet addicts. Eight hundred and sixty-eight students were tested using the Eysenck Personality Questionnaire after they had just entered university. Two years later, 49 were found to be addicted to the Internet as defined by high Internet addiction test scores. Comparisons of means and logistic regression analysis were used to explore their relationship. Students addicted to the Internet showed higher Neuroticism/Stability scores, higher Psychoticism/Socialization scores, and lower Lie scores than their normal peers before their addiction. Regression results showed that Internet addiction was accounted by three independent variables: Neuroticism/Stability, Psychoticism/Socialization, and Lie. These results suggest that the risk personality traits of Internet addiction include neuroticism, psychoticism, and immaturity. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Sexual addiction or hypersexual disorder: different terms for the same problem? A review of the literature.

PubMed

Karila, Laurent; Wéry, Aline; Weinstein, Aviv; Cottencin, Olivier; Petit, Aymeric; Reynaud, Michel; Billieux, Jöel

2014-01-01

Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people. A lack of empirical evidence on sexual addiction is the result of the disease's complete absence from versions of the Diagnostic and Statistical Manual of Mental Disorders. However, people who were categorized as having a compulsive, impulsive, addictive sexual disorder or a hypersexual disorder reported having obsessive thoughts and behaviors as well as sexual fantasies. Existing prevalence rates of sexual addiction-related disorders range from 3% to 6%. Sexual addiction/ hypersexual disorder is used as an umbrella construct to encompass various types of problematic behaviors, including excessive masturbation, cybersex, pornography use, sexual behavior with consenting adults, telephone sex, strip club visitation, and other behaviors. The adverse consequences of sexual addiction are similar to the consequences of other addictive disorders. Addictive, somatic and psychiatric disorders coexist with sexual addiction. In recent years, research on sexual addiction has proliferated, and screening instruments have increasingly been developed to diagnose or quantify sexual addiction disorders. In our systematic review of the existing measures, 22 questionnaires were identified. As with other behavioral addictions, the appropriate treatment of sexual addiction should combine pharmacological and psychological approaches. Psychiatric and somatic comorbidities that frequently occur with sexual addiction should be integrated into the therapeutic process. Group-based treatments should also be attempted.

The Relationship of Decision-Making Styles and Attributional Styles in Addicted and Non-addicted Men.

PubMed

Shaghaghy, Farhad; Saffarinia, Majid; Iranpoor, Mohadeseh; Soltanynejad, Ali

2011-01-01

One of social problems which has affected our society and resulted in problems for different groups of people is drug abuse. This issue indicates a serious psychological, physical and social problem in community. Social skills have positive and successful influences in prevention of substance abuse. This includes the ability to explain events correctly and then appropriate decision making. This study compares decision making styles and attributional styles between addicted and non addicted men to recognize their role in addiction. In this study, 200 addicted and non addicted men were randomly selected. Decision-making style and attributional style questionnaires were used. Data analysis was performed by independent Student's t and Pearson correlation tests. The study population included 81 addicted and 90 non-addicted men. Addicted and non addicted men were significantly different in rational decision-making style (P < 0.05). Negative relationship was found between rational decision making and optimistic attribution style (r = -0.305, P < 0.01) and direct relationship was found between rational decision making and learned helplessness (r = 0.309, P < 0.01). Our study showed that addicts are less rational in decision making and addicts that developed learned helplessness were less rational and did not have optimistic attribution style. These issues show that addiction institutions and therapists have to pay attention to cognitive factors for addiction prevention.

The electronic cigarette: the new cigarette of the 21st century?

PubMed

Knorst, Marli Maria; Benedetto, Igor Gorski; Hoffmeister, Mariana Costa; Gazzana, Marcelo Basso

2014-10-01

The electronic nicotine delivery system, also known as the electronic cigarette, is generating considerable controversy, not only in the general population but also among health professionals. Smokers the world over have been increasingly using electronic cigarettes as an aid to smoking cessation and as a substitute for conventional cigarettes. There are few available data regarding the safety of electronic cigarettes. There is as yet no evidence that electronic cigarettes are effective in treating nicotine addiction. Some smokers have reported using electronic cigarettes for over a year, often combined with conventional cigarettes, thus prolonging nicotine addiction. In addition, the increasing use of electronic cigarettes by adolescents is a cause for concern. The objective of this study was to describe electronic cigarettes and their components, as well as to review the literature regarding their safety; their impact on smoking initiation and smoking cessation; and regulatory issues related to their use.

The electronic cigarette: the new cigarette of the 21st century?*

PubMed Central

Knorst, Marli Maria; Benedetto, Igor Gorski; Hoffmeister, Mariana Costa; Gazzana, Marcelo Basso

2014-01-01

The electronic nicotine delivery system, also known as the electronic cigarette, is generating considerable controversy, not only in the general population but also among health professionals. Smokers the world over have been increasingly using electronic cigarettes as an aid to smoking cessation and as a substitute for conventional cigarettes. There are few available data regarding the safety of electronic cigarettes. There is as yet no evidence that electronic cigarettes are effective in treating nicotine addiction. Some smokers have reported using electronic cigarettes for over a year, often combined with conventional cigarettes, thus prolonging nicotine addiction. In addition, the increasing use of electronic cigarettes by adolescents is a cause for concern. The objective of this study was to describe electronic cigarettes and their components, as well as to review the literature regarding their safety; their impact on smoking initiation and smoking cessation; and regulatory issues related to their use. PMID:25410845

[Identification of pathologic alcohol use and its prevention. Results of employee interviews in a clinic].

PubMed

Ennenbach, M; Soyka, M

2007-05-01

After a short review of the literature about addiction in the working place, a study is presented that evaluates the alcohol use of all employees (n=301) in a clinic. The readiness to cooperate was very strong (72%). The openness (investigated with the FPI subscale for openness) was also satisfactory. Results showed a surprisingly high proportion of notable alcohol use by employees (26%). Especially the group of young female employees showed a high range of stress indicators: alcohol use (28.6%), nicotine (24.2%) and eating disorders (22.9%), and moderate-to-strong consumption of medication (12.1%). A sex-specific model of the development of addiction will be suggested based on these study results. A program of preventive measures was implemented integrating well-known components of established successful preventive measures and considering the special environment of the clinic.

Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

PubMed

Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge

2017-09-01

Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

Global statistics on addictive behaviours: 2014 status report.

PubMed

Gowing, Linda R; Ali, Robert L; Allsop, Steve; Marsden, John; Turf, Elizabeth E; West, Robert; Witton, John

2015-06-01

Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this. Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours. An estimated 4.9% of the world's adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability-adjusted life years lost per 100 000 population. An estimated 22.5% of adults in the world (1 billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of 'unsanctioned psychoactive drugs', cannabis is the most prevalent at 3.5% globally, with each of the others at < 1%; 0.3% of the world's adult population (15 million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability-adjusted life years lost per 100 000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%. Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach. © 2015 Reviews.

Attitudes about Addiction: A National Study of Addiction Educators

ERIC Educational Resources Information Center

Broadus, Angela D.; Hartje, Joyce A.; Roget, Nancy A.; Cahoon, Kristy L.; Clinkinbeard, Samantha S.

2010-01-01

The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the "Addiction Belief Inventory" (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n = 215). Results suggest that addiction educators view…

Rebalancing the Addicted Brain: Oxytocin Interference with the Neural Substrates of Addiction.

PubMed

Bowen, Michael T; Neumann, Inga D

2017-12-01

Drugs that act on the brain oxytocin (OXT) system may provide a much-needed treatment breakthrough for substance-use disorders. Targeting the brain OXT system has the potential to treat addiction to all major classes of addictive substance and to intervene across all stages of the addiction cycle. Emerging evidence suggests that OXT is able to interfere with such a wide range of addictive behaviours for such a wide range of addictive substances by rebalancing core neural systems that become dysregulated over the course of addiction. By improving our understanding of these interactions between OXT and the neural substrates of addiction, we will not only improve our understanding of addiction, but also our ability to effectively treat these devastating disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modeling Addictive Consumption as an Infectious Disease*

PubMed Central

Alamar, Benjamin; Glantz, Stanton A.

2011-01-01

The dominant model of addictive consumption in economics is the theory of rational addiction. The addict in this model chooses how much they are going to consume based upon their level of addiction (past consumption), the current benefits and all future costs. Several empirical studies of cigarette sales and price data have found a correlation between future prices and consumption and current consumption. These studies have argued that the correlation validates the rational addiction model and invalidates any model in which future consumption is not considered. An alternative to the rational addiction model is one in which addiction spreads through a population as if it were an infectious disease, as supported by the large body of empirical research of addictive behaviors. In this model an individual's probability of becoming addicted to a substance is linked to the behavior of their parents, friends and society. In the infectious disease model current consumption is based only on the level of addiction and current costs. Price and consumption data from a simulation of the infectious disease model showed a qualitative match to the results of the rational addiction model. The infectious disease model can explain all of the theoretical results of the rational addiction model with the addition of explaining initial consumption of the addictive good. PMID:21339848

New Implications for the Melanocortin System in Alcohol Drinking Behavior in Adolescents: The Glial Dysfunction Hypothesis

PubMed Central

Orellana, Juan A.; Cerpa, Waldo; Carvajal, Maria F.; Lerma-Cabrera, José M.; Karahanian, Eduardo; Osorio-Fuentealba, Cesar; Quintanilla, Rodrigo A.

2017-01-01

Alcohol dependence causes physical, social, and moral harms and currently represents an important public health concern. According to the World Health Organization (WHO), alcoholism is the third leading cause of death worldwide, after tobacco consumption and hypertension. Recent epidemiologic studies have shown a growing trend in alcohol abuse among adolescents, characterized by the consumption of large doses of alcohol over a short time period. Since brain development is an ongoing process during adolescence, short- and long-term brain damage associated with drinking behavior could lead to serious consequences for health and wellbeing. Accumulating evidence indicates that alcohol impairs the function of different components of the melanocortin system, a major player involved in the consolidation of addictive behaviors during adolescence and adulthood. Here, we hypothesize the possible implications of melanocortins and glial cells in the onset and progression of alcohol addiction. In particular, we propose that alcohol-induced decrease in α-MSH levels may trigger a cascade of glial inflammatory pathways that culminate in altered gliotransmission in the ventral tegmental area and nucleus accumbens (NAc). The latter might potentiate dopaminergic drive in the NAc, contributing to increase the vulnerability to alcohol dependence and addiction in the adolescence and adulthood. PMID:28424592

The Standard for Clinicians’ Interview in Psychiatry (SCIP): A Clinician-administered Tool with Categorical, Dimensional, and Numeric Output—Conceptual Development, Design, and Description of the SCIP

PubMed Central

Nasrallah, Henry; Muvvala, Srinivas; El-Missiry, Ahmed; Mansour, Hader; Hill, Cheryl; Elswick, Daniel; Price, Elizabeth C.

2016-01-01

Existing standardized diagnostic interviews (SDIs) were designed for researchers and produce mainly categorical diagnoses. There is an urgent need for a clinician-administered tool that produces dimensional measures, in addition to categorical diagnoses. The Standard for Clinicians’ Interview in Psychiatry (SCIP) is a method of assessment of psychopathology for adults. It is designed to be administered by clinicians and includes the SCIP manual and the SCIP interview. Clinicians use the SCIP questions and rate the responses according to the SCIP manual rules. Clinicians use the patient’s responses to questions, observe the patient’s behaviors and make the final rating of the various signs and symptoms assessed. The SCIP method of psychiatric assessment has three components: 1) the SCIP interview (dimensional) component, 2) the etiological component, and 3) the disorder classification component. The SCIP produces three main categories of clinical data: 1) a diagnostic classification of psychiatric disorders, 2) dimensional scores, and 3) numeric data. The SCIP provides diagnoses consistent with criteria from editions of the Diagnostic and Statistical Manual (DSM) and International Classification of Disease (ICD). The SCIP produces 18 dimensional measures for key psychiatric signs or symptoms: anxiety, posttraumatic stress, obsessions, compulsions, depression, mania, suicidality, suicidal behavior, delusions, hallucinations, agitation, disorganized behavior, negativity, catatonia, alcohol addiction, drug addiction, attention, and hyperactivity. The SCIP produces numeric severity data for use in either clinical care or research. The SCIP was shown to be a valid and reliable assessment tool, and the validity and reliability results were published in 2014 and 2015. The SCIP is compatible with personalized psychiatry research and is in line with the Research Domain Criteria framework. PMID:27800284

The Standard for Clinicians' Interview in Psychiatry (SCIP): A Clinician-administered Tool with Categorical, Dimensional, and Numeric Output-Conceptual Development, Design, and Description of the SCIP.

PubMed

Aboraya, Ahmed; Nasrallah, Henry; Muvvala, Srinivas; El-Missiry, Ahmed; Mansour, Hader; Hill, Cheryl; Elswick, Daniel; Price, Elizabeth C

2016-01-01

Existing standardized diagnostic interviews (SDIs) were designed for researchers and produce mainly categorical diagnoses. There is an urgent need for a clinician-administered tool that produces dimensional measures, in addition to categorical diagnoses. The Standard for Clinicians' Interview in Psychiatry (SCIP) is a method of assessment of psychopathology for adults. It is designed to be administered by clinicians and includes the SCIP manual and the SCIP interview. Clinicians use the SCIP questions and rate the responses according to the SCIP manual rules. Clinicians use the patient's responses to questions, observe the patient's behaviors and make the final rating of the various signs and symptoms assessed. The SCIP method of psychiatric assessment has three components: 1) the SCIP interview (dimensional) component, 2) the etiological component, and 3) the disorder classification component. The SCIP produces three main categories of clinical data: 1) a diagnostic classification of psychiatric disorders, 2) dimensional scores, and 3) numeric data. The SCIP provides diagnoses consistent with criteria from editions of the Diagnostic and Statistical Manual (DSM) and International Classification of Disease (ICD). The SCIP produces 18 dimensional measures for key psychiatric signs or symptoms: anxiety, posttraumatic stress, obsessions, compulsions, depression, mania, suicidality, suicidal behavior, delusions, hallucinations, agitation, disorganized behavior, negativity, catatonia, alcohol addiction, drug addiction, attention, and hyperactivity. The SCIP produces numeric severity data for use in either clinical care or research. The SCIP was shown to be a valid and reliable assessment tool, and the validity and reliability results were published in 2014 and 2015. The SCIP is compatible with personalized psychiatry research and is in line with the Research Domain Criteria framework.

[Construction of the addiction prevention core competency model for preventing addictive behavior in adolescents].

PubMed

Park, Hyun Sook; Jung, Sun Young

2013-12-01

This study was done to provide fundamental data for the development of competency reinforcement programs to prevent addictive behavior in adolescents through the construction and examination of an addiction prevention core competency model. In this study core competencies for preventing addictive behavior in adolescents through competency modeling were identified, and the addiction prevention core competency model was developed. It was validated methodologically. Competencies for preventing addictive behavior in adolescents as defined by the addiction prevention core competency model are as follows: positive self-worth, self-control skill, time management skill, reality perception skill, risk coping skill, and positive communication with parents and with peers or social group. After construction, concurrent cross validation of the addiction prevention core competency model showed that this model was appropriate. The study results indicate that the addiction prevention core competency model for the prevention of addictive behavior in adolescents through competency modeling can be used as a foundation for an integral approach to enhance adolescent is used as an adjective and prevent addictive behavior. This approach can be a school-centered, cost-efficient strategy which not only reduces addictive behavior in adolescents, but also improves the quality of their resources.

[The SGO Health Research Promotion Program. XIII. Evaluation of the section 'Addiction Research'].

PubMed

van Rees-Wortelboer, M M

1999-01-02

As a part of the SGO Health Research Promotion Programme a research programme on addiction research was realized. Aim of the programme was to strengthen and concentrate the Dutch research into addiction. Within the Amsterdam Institute for Addiction Research (AIAR), a structural collaboration between the Jellinek Treatment Centre for Addiction, the University of Amsterdam and the Academic Hospital of the University of Amsterdam, strategic research programmes were developed on the borderland of addiction and psychiatry, notably 'Clinical epidemiology addiction' and 'Developmental disorders, addiction and psychotraumas'. The institution of a co-ordinating platform of research groups conducting socio-epidemiological addiction research improved the co-ordination of research lines in this field.

Eating to live or living to eat? Exploring the causal attributions of self-perceived food addiction.

PubMed

Ruddock, Helen K; Dickson, Joanne M; Field, Matt; Hardman, Charlotte A

2015-12-01

Previous studies indicate that many people perceive themselves to be addicted to food. However, little is known about how the concept of 'food addiction' is defined amongst members of the lay public. The current study examined beliefs about the cognitive and behavioural manifestations of food addiction. Participants (N = 210) completed an internet-delivered questionnaire in which they indicated whether or not they perceived themselves to be a food addict and provided a brief explanation for their response. Over a quarter of participants (28%) perceived themselves to be food addicts and self-diagnosis was predicted by increased BMI and younger age, but not by gender. Thematic analysis was conducted to explore the causal attributions provided by self-perceived food addicts and non-addicts. Six characteristics were identified: 1) Reward-driven eating (i.e. eating for psychological rather than physiological reasons), 2) A functional or psychological preoccupation with food, 3) A perceived lack of self-control around food, 4) Frequent food cravings, 5) Increased weight or an unhealthy diet, and 6) A problem with a specific type of food. The emergent themes, and their frequency, did not differ between self-perceived food addicts and non-addicts. However, self-perceived food addicts and non-addicts reported divergent cognitions, behaviours and attitudes within each common theme. This study is the first to provide qualitative insight into beliefs about food addiction in both self-perceived food addicts and non-addicts. The findings appear to reflect a view of food addiction that is identifiable through several core behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.

Food addiction: its prevalence and significant association with obesity in the general population.

PubMed

Pedram, Pardis; Wadden, Danny; Amini, Peyvand; Gulliver, Wayne; Randell, Edward; Cahill, Farrell; Vasdev, Sudesh; Goodridge, Alan; Carter, Jacqueline C; Zhai, Guangju; Ji, Yunqi; Sun, Guang

2013-01-01

'Food addiction' shares a similar neurobiological and behavioral framework with substance addiction. However whether, and to what degree, 'food addiction' contributes to obesity in the general population is unknown. to assess 1) the prevalence of 'food addiction' in the Newfoundland population; 2) if clinical symptom counts of 'food addiction' were significantly correlated with the body composition measurements; 3) if food addicts were significantly more obese than controls, and 4) if macronutrient intakes are associated with 'food addiction'. A total of 652 adults (415 women, 237 men) recruited from the general population participated in this study. Obesity was evaluated by Body Mass Index (BMI) and Body Fat percentage measured by dual-energy X-ray absorptiometry. 'Food addiction' was assessed using the Yale Food Addiction Scale and macronutrient intake was determined from the Willet Food Frequency Questionnaire. The prevalence of 'food addiction' was 5.4% (6.7% in females and 3.0% in males) and increased with obesity status. The clinical symptom counts of 'food addiction' were positively correlated with all body composition measurements across the entire sample (p<0.001). Obesity measurements were significantly higher in food addicts than controls; Food addicts were 11.7 (kg) heavier, 4.6 BMI units higher, and had 8.2% more body fat and 8.5% more trunk fat. Furthermore, food addicts consumed more calories from fat and protein compared with controls. Our results demonstrated that 'food addiction' contributes to severity of obesity and body composition measurements from normal weight to obese individuals in the general population with higher rate in women as compared to men.

Increased risk for substance use and health-related problems among homeless veterans.

PubMed

Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W

2015-10-01

The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.

Social Meanings of Disease: Changing Concepts of Addiction in the Twentieth Century.

ERIC Educational Resources Information Center

Acker, Caroline J.

1991-01-01

Compares scientific explanations of addiction of the 1920s and 1930s to today's. Details the history of addiction testing and research, the development of criteria for defining addiction, and both physiological and psychological definitions of addiction. Suggests that the changing status of addiction as a disease reflects different meanings…

A Comparison of Male and Female Addicts and Non-Addicts on the Tennessee Self Concept Scale.

ERIC Educational Resources Information Center

Jarka, Joyce M.

Many mental health professionals ignore chemical addiction, whereas many chemical dependency professionals see addiction as the entire problem and ignore everything else. This study investigated differences between addicts and non-addicts on the Tennessee Self Concept Scale. Subjects were undergraduate and graduate students, selected from a…

Relationship between Internet Addiction, Gaming Addiction and School Engagement among Adolescents

ERIC Educational Resources Information Center

Tas, Ibrahim

2017-01-01

This research examined the relationship of Internet addiction and gaming addiction with school engagement and effects of Internet addiction and gaming addiction on school engagement. The research was conducted with 365 students (140, 38.4%, males; 225, 61.6%, females) studying at an Anatolian high school in Gaziantep province. Personal Information…

Instant messaging addiction among teenagers in China: shyness, alienation, and academic performance decrement.

PubMed

Huang, Hanyun; Leung, Louis

2009-12-01

This exploratory research proposes the concept of instant messaging (IM) addiction and examines (a) whether IM addiction exists among Chinese teenagers and, if so, who the addicts are, what their symptoms are, and to what extent they are addicted; (b) whether psychological variables such as shyness and alienation can predict IM use or addiction among teenagers; and (c) whether IM use or IM addiction can impair the academic performance of teenagers. Using Young's classic definition of Internet addiction, results of a stratified random sample of 330 teenagers in China in 2007 found 95.8% of participants use IM, and 9.8% of them can be classified as IM addicts. Factor analysis identified four major IM addiction symptoms among teenagers: preoccupation with IM, loss of relationships due to overuse, loss of control, and escape. Results also showed that shyness and alienation from family, peers, and school are significantly and positively associated with levels of IM addiction. As expected, both the level of IM use and level of IM addiction are significantly linked to teenagers' academic performance decrement.

Sugar addiction: the state of the science.

PubMed

Westwater, Margaret L; Fletcher, Paul C; Ziauddeen, Hisham

2016-11-01

As obesity rates continue to climb, the notion that overconsumption reflects an underlying 'food addiction' (FA) has become increasingly influential. An increasingly popular theory is that sugar acts as an addictive agent, eliciting neurobiological changes similar to those seen in drug addiction. In this paper, we review the evidence in support of sugar addiction. We reviewed the literature on food and sugar addiction and considered the evidence suggesting the addictiveness of highly processed foods, particularly those with high sugar content. We then examined the addictive potential of sugar by contrasting evidence from the animal and human neuroscience literature on drug and sugar addiction. We find little evidence to support sugar addiction in humans, and findings from the animal literature suggest that addiction-like behaviours, such as bingeing, occur only in the context of intermittent access to sugar. These behaviours likely arise from intermittent access to sweet tasting or highly palatable foods, not the neurochemical effects of sugar. Given the lack of evidence supporting it, we argue against a premature incorporation of sugar addiction into the scientific literature and public policy recommendations.

Online video game addiction: identification of addicted adolescent gamers.

PubMed

Van Rooij, Antonius J; Schoenmakers, Tim M; Vermulst, Ad A; Van den Eijnden, Regina J J M; Van de Mheen, Dike

2011-01-01

To provide empirical data-driven identification of a group of addicted online gamers. Repeated cross-sectional survey study, comprising a longitudinal cohort, conducted in 2008 and 2009. Secondary schools in the Netherlands.   Two large samples of Dutch schoolchildren (aged 13-16 years). Compulsive internet use scale, weekly hours of online gaming and psychosocial variables. This study confirms the existence of a small group of addicted online gamers (3%), representing about 1.5% of all children aged 13-16 years in the Netherlands. Although these gamers report addiction-like problems, relationships with decreased psychosocial health were less evident. The identification of a small group of addicted online gamers supports efforts to develop and validate questionnaire scales aimed at measuring the phenomenon of online video game addiction. The findings contribute to the discussion on the inclusion of non-substance addictions in the proposed unified concept of 'Addiction and Related Disorders' for the DSM-V by providing indirect identification and validation of a group of suspected online video game addicts. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

The Comparison of Self-regulation and Affective Control in Methamphetamine and Narcotics Addicts and Non-Addicts

PubMed Central

Tayyebi, Kolthoum; Abolghasemi, Abbas; Mahmood Alilu, Majid; Monirpoor, Nader

2013-01-01

Background Increased prevalence and widespread use of methamphetamine is the public challenge and worry in the world. It seems that low levels of self-regulation and affective control to carry up probability of psychoactive drugs abuse. Objectives The purpose of the present study is the comparison of self-regulation and affective control in methamphetamine and narcotics addicts and non-addicts. Materials and Methods In this causative-comparative study, 80 addicts (40 methamphetamine addicts and 40 narcotic addicts) who referred to self-reference quitting addictive centers in Miyaneh, Iran, participated in convenience sampling. Then, they matched up with 40 non-addicts according to age, sex, educational level, and marital status. To collect data, we used self-regulation questionnaire and affective control scale. The data was analyzed by multivariate analysis of variance (MANOVA) and LSD test. Results Result shows that there is a significant difference between methamphetamine addicts and narcotics addicts and non-addicts in self-regulation and affective control (P = 0.001). Conclusions This finding indicates that low self-regulation and affective control is a risky factor in psychoactive drugs abuse. PMID:24971258

An alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting (ADAPTA): study protocol for a randomized, controlled pilot trial.

PubMed

Watson, Judith; Tober, Gillian; Raistrick, Duncan; Mdege, Noreen; Dale, Veronica; Crosby, Helen; Godfrey, Christine; Lloyd, Charlie; Toner, Paul; Parrott, Steve

2013-04-30

Alcohol misuse is a major cause of premature mortality and ill health. Although there is a high prevalence of alcohol problems among patients presenting to general hospital, many of these people are not help seekers and do not engage in specialist treatment. Hospital admission is an opportunity to steer people towards specialist treatment, which can reduce health-care utilization and costs to the public sector and produce substantial individual health and social benefits. Alcohol misuse is associated with other lifestyle problems, which are amenable to intervention. It has been suggested that the development of a healthy or balanced lifestyle is potentially beneficial for reducing or abstaining from alcohol use, and relapse prevention. The aim of the study is to test whether or not the offer of a choice of health-related lifestyle interventions is more acceptable, and therefore able to engage more problem drinkers in treatment, than an alcohol-focused intervention. This is a pragmatic, randomized, controlled, open pilot study in a UK general hospital setting with concurrent economic evaluation and a qualitative component. Potential participants are those admitted to hospital with a diagnosis likely to be responsive to addiction interventions who score equal to or more than 16 on the Alcohol Use Disorders Identification Test (AUDIT). The main purpose of this pilot study is to evaluate the acceptability of two sorts of interventions (healthy living related versus alcohol focused) to the participants and to assess the components and processes of the design. Qualitative research will be undertaken to explore acceptability and the impact of the approach, assessment, recruitment and intervention on trial participants and non-participants. The effectiveness of the two treatments will be compared at 6 months using AUDIT scores as the primary outcome measure. There will be additional economic, qualitative and secondary outcome measurements. Development of the study was a collaboration between academics, commissioners and clinicians in general hospital and addiction services, made possible by the Collaboration in Leadership in Applied Health Research and Care (CLAHRC) program of research. CLAHRC was a necessary vehicle for overcoming the barriers to answering an important NHS question--how better to engage problem drinkers in a hospital setting. ISRCTN47728072.

Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects

PubMed Central

Russo, Ethan B

2011-01-01

Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expressing high titres of each component for future study. This review will explore another echelon of phytotherapeutic agents, the cannabis terpenoids: limonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol and phytol. Terpenoids share a precursor with phytocannabinoids, and are all flavour and fragrance components common to human diets that have been designated Generally Recognized as Safe by the US Food and Drug Administration and other regulatory agencies. Terpenoids are quite potent, and affect animal and even human behaviour when inhaled from ambient air at serum levels in the single digits ng·mL−1. They display unique therapeutic effects that may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts. Particular focus will be placed on phytocannabinoid-terpenoid interactions that could produce synergy with respect to treatment of pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus). Scientific evidence is presented for non-cannabinoid plant components as putative antidotes to intoxicating effects of THC that could increase its therapeutic index. Methods for investigating entourage effects in future experiments will be proposed. Phytocannabinoid-terpenoid synergy, if proven, increases the likelihood that an extensive pipeline of new therapeutic products is possible from this venerable plant. LINKED ARTICLES This article is part of a themed issue on Cannabinoids in Biology and Medicine. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21749363

Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects.

PubMed

Russo, Ethan B

2011-08-01

Tetrahydrocannabinol (THC) has been the primary focus of cannabis research since 1964, when Raphael Mechoulam isolated and synthesized it. More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin, cannabigerol and cannabichromene, exert additional effects of therapeutic interest. Innovative conventional plant breeding has yielded cannabis chemotypes expressing high titres of each component for future study. This review will explore another echelon of phytotherapeutic agents, the cannabis terpenoids: limonene, myrcene, α-pinene, linalool, β-caryophyllene, caryophyllene oxide, nerolidol and phytol. Terpenoids share a precursor with phytocannabinoids, and are all flavour and fragrance components common to human diets that have been designated Generally Recognized as Safe by the US Food and Drug Administration and other regulatory agencies. Terpenoids are quite potent, and affect animal and even human behaviour when inhaled from ambient air at serum levels in the single digits ng·mL(-1) . They display unique therapeutic effects that may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts. Particular focus will be placed on phytocannabinoid-terpenoid interactions that could produce synergy with respect to treatment of pain, inflammation, depression, anxiety, addiction, epilepsy, cancer, fungal and bacterial infections (including methicillin-resistant Staphylococcus aureus). Scientific evidence is presented for non-cannabinoid plant components as putative antidotes to intoxicating effects of THC that could increase its therapeutic index. Methods for investigating entourage effects in future experiments will be proposed. Phytocannabinoid-terpenoid synergy, if proven, increases the likelihood that an extensive pipeline of new therapeutic products is possible from this venerable plant. http://dx.doi.org/10.1111/bph.2011.163.issue-7. © 2011 The Author. British Journal of Pharmacology © 2011 The British Pharmacological Society.

Smartphone use and smartphone addiction among young people in Switzerland.

PubMed

Haug, Severin; Castro, Raquel Paz; Kwon, Min; Filler, Andreas; Kowatsch, Tobias; Schaub, Michael P

2015-12-01

Smartphone addiction, its association with smartphone use, and its predictors have not yet been studied in a European sample. This study investigated indicators of smartphone use, smartphone addiction, and their associations with demographic and health behaviour-related variables in young people. A convenience sample of 1,519 students from 127 Swiss vocational school classes participated in a survey assessing demographic and health-related characteristics as well as indicators of smartphone use and addiction. Smartphone addiction was assessed using a short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Logistic regression analyses were conducted to investigate demographic and health-related predictors of smartphone addiction. Smartphone addiction occurred in 256 (16.9%) of the 1,519 students. Longer duration of smartphone use on a typical day, a shorter time period until first smartphone use in the morning, and reporting that social networking was the most personally relevant smartphone function were associated with smartphone addiction. Smartphone addiction was more prevalent in younger adolescents (15-16 years) compared with young adults (19 years and older), students with both parents born outside Switzerland, persons reporting lower physical activity, and those reporting higher stress. Alcohol and tobacco consumption were unrelated to smartphone addiction. Different indicators of smartphone use are associated with smartphone addiction and subgroups of young people have a higher prevalence of smartphone addiction. The study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from a European country, which should be extended in further studies.

[Yale Food Addiction Scale - review of literature].

PubMed

Magyar, Éva Erzsébet; Csábi, Györgyi; Tényi, Tamás; Tényi, Dalma

Food addiction is a condition presenting with a similar symptomatology to that of drug addiction, with an underlying individual sensitivity and special adaptation to certain foods, being consumed regularly. The concept of food addiction created one of the central issues in addiction research, owing to the pandemic spreading of obesity causing serious public health concerns. Development of an objective, standardized measuring tool of food addiction has become markedly necessary for both research and public health purposes. Literature overview in the fields of food addiction and Yale Food Addiction Scale (1956-2016). For the establishment of food addiction diagnosis, the Yale Food Addiction Scale has become the most widely used method. It is an English questionnaire consisting of 25 questions, having been developed according to the 7 substance use disorder criteria in DSM-IV. The scale provides the possibility of diagnosis establishment, as well as measurement of food addiction severity. Development of the scale has given way to a number of new scientific results. The mean prevalence of food addiction is 19.7%, being more common in women, obese individuals, people >35 years and patients with already established eating disorders (binge eating disorder, bulimia). The most common symptom is the 'persistent desire or repeated unsuccessful attempts to quit'. A positive association has been recognized between food addiction symptomcount and the reward system dysfunction. The Yale Food Addiction Scale is a psychometrically valid, objective and standardized tool, being not only useful in addiction research but also helping in diagnosis establishment in clinical practice.

Primary healthcare-based integrated care with opioid agonist treatment: First experience from Ukraine.

PubMed

Morozova, Olga; Dvoriak, Sergey; Pykalo, Iryna; Altice, Frederick L

2017-04-01

Ukraine's HIV epidemic is concentrated among people who inject drugs (PWID), however, coverage with opioid agonist therapies (OATs) available mostly at specialty addiction clinics is extremely low. OAT integrated into primary healthcare clinics (PHCs) provides an opportunity for integrating comprehensive healthcare services and scaling up OAT. A pilot study of PHC-based integrated care for drug users conducted in two Ukrainian cities between 2014 and 2016 included three sub-studies: 1) cross-sectional treatment site preference assessment among current OAT patients (N=755); 2) observational cohort of 107 PWID who continued the standard of care versus transition of stabilized and newly enrolled PWID into PHC-based integrated care; and 3) pre/post analysis of attitudes toward PWID and HIV patients by PHC staff (N=26). Among 755 OAT patients, 53.5% preferred receiving OAT at PHCs, which was independently correlated with convenience, trust in physician, and treatment with methadone (vs. buprenorphine). In 107 PWID observed over 6 months, retention in treatment was high: 89% in PWID continuing OAT in specialty addiction treatment settings (standard of care) vs 94% in PWID transitioning to PHCs; and 80% among PWID newly initiating OAT in PHCs. Overall, satisfaction with treatment, subjective self-perception of well-being, and trust in physician significantly increased in patients prescribed OAT in PHCs. Among PHC staff, attitudes towards PWID and HIV patients significantly improved over time. OAT can be successfully integrated into primary care in low and middle-income countries and improves outcomes in both patients and clinicians while potentially scaling-up OAT for PWID. Copyright © 2017 Elsevier B.V. All rights reserved.

Extended cocaine-seeking produces a shift from goal-directed to habitual responding in rats.

PubMed

Leong, Kah-Chung; Berini, Carole R; Ghee, Shannon M; Reichel, Carmela M

2016-10-01

Cocaine addiction is often characterized by a rigid pattern of behavior in which cocaine users continue seeking and taking drug despite negative consequences associated with its use. As such, full acquisition and relapse of drug-seeking behavior may be attributed to a shift away from goal-directed responding and a shift towards the maladaptive formation of rigid and habit-like responses. This rigid nature of habitual responding can be developed with extended training and is typically characterized by insensitivity to changes in outcome value. The present study determined whether cocaine (primary reinforcer) and cocaine associated cues (secondary reinforcer) could be devalued in rats with different histories of cocaine self-administration. Specifically, rats were trained on two schedules of cocaine self-administration (long-access vs. short-access). Following training the cocaine reinforcer was devalued through three separate pairings of lithium chloride with cocaine infusions. Cocaine history did not have an impact on devaluation of cocaine-associated cues. However, the reinforcing properties of cocaine were devalued only in rats on a short-access cocaine schedule but not those trained on a long-access schedule. Taken together this pattern of findings suggests that, in short access rats, devaluation is specific to the primary reinforcer and not associative stimuli such as cues. Importantly, rats that received extended training during self-administration displayed insensitivity to outcome devaluation of the primary reinforcer as well as all associative stimuli, thus displaying rigid behavioral responding similar to behavioral patterns found in addiction. Alternatively, long access cocaine exposure may have altered the devaluation threshold. Copyright © 2016 Elsevier Inc. All rights reserved.

[Pathological gambling and computergame-addiction. Current state of research regarding two subtypes of behavioural addiction].

PubMed

Wölfling, K; Müller, K W

2010-04-01

Behavioral addictions, like pathological gambling and computer game addiction (or internet addiction), have become a growing concern in research and public interest. Currently similarities between behavioral addictions and substance dependency are controversially discussed in the scientific community. Unfortunately a mismatch exists between the large number of people seeking treatment and the small number of scientific studies on pathological gambling and computer game addiction. Prevalence of pathological gambling among the German population is estimated to be 0.2-0.5%. These estimations are comparable to prevalence rates reported for drug dependency. Latest research states that about 3% of German adolescents and young adults are believed to suffer from computer game addiction. Therefore, it is important to enhance investigations regarding the clinical and neuroscientific basis of computer game addiction. This review offers a summary of current results of research regarding pathological gambling and internet addiction. The phenomenological description of these two disorders is meant to allow a deeper understanding of behavioral addictions.

Diffracting addicting binaries: An analysis of personal accounts of alcohol and other drug 'addiction'.

PubMed

Pienaar, Kiran; Moore, David; Fraser, Suzanne; Kokanovic, Renata; Treloar, Carla; Dilkes-Frayne, Ella

2017-09-01

Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the volition/compulsion binary, conceptualising addiction as a disorder of compulsion. In order to interrogate this prevailing view, this article draws on qualitative data from interviews with people who describe themselves as having an alcohol or other drug 'addiction', 'dependence' or 'habit'. Applying the concept of 'diffraction' elaborated by science studies scholar Karen Barad, we examine the process of 'addicting', or the various ways in which addiction is constituted, in accounts of daily life with regular alcohol and other drug use. Our analysis suggests not only that personal accounts of addiction exceed the absolute opposition of volition/compulsion but also that the polarising assumptions of existing addicting discourses produce many of the negative effects typically attributed to the 'disease of addiction'.

[The dual process model of addiction. Towards an integrated model?].

PubMed

Vandermeeren, R; Hebbrecht, M

2012-01-01

Neurobiology and cognitive psychology have provided us with a dual process model of addiction. According to this model, behavior is considered to be the dynamic result of a combination of automatic and controlling processes. In cases of addiction the balance between these two processes is severely disturbed. Automated processes will continue to produce impulses that ensure the continuance of addictive behavior. Weak, reflective or controlling processes are both the reason for and the result of the inability to forgo addiction. To identify features that are common to current neurocognitive insights into addiction and psychodynamic views on addiction. The picture that emerges from research is not clear. There is some evidence that attentional bias has a causal effect on addiction. There is no evidence that automatic associations have a causal effect, but there is some evidence that automatic action-tendencies do have a causal effect. Current neurocognitive views on the dual process model of addiction can be integrated with an evidence-based approach to addiction and with psychodynamic views on addiction.

The exacerbation of depression, hostility, and social anxiety in the course of Internet addiction among adolescents: a prospective study.

PubMed

Ko, Chih-Hung; Liu, Tai-Ling; Wang, Peng-Wei; Chen, Cheng-Sheng; Yen, Cheng-Fang; Yen, Ju-Yu

2014-08-01

In adolescent populations worldwide, Internet addiction is prevalent and is often comorbid with depression, hostility, and social anxiety of adolescents. This study aimed at evaluating the exacerbation of depression, hostility, and social anxiety in the course of getting addiction to Internet or remitting from Internet addiction among adolescents. This study recruited 2293 adolescents in grade 7 to assess their depression, hostility, social anxiety and Internet addiction. The same assessments were repeated one year later. The incidence group was defined as subjects classified as non-addicted in the first assessment and as addicted in the second assessment. The remission group was defined as subjects classified as addicted in the first assessment and as non-addicted in the second assessment. The incidence group exhibited increased depression and hostility more than the non-addiction group and the effect of on depression was stronger among adolescent girls. Further, the remission group showed decreased depression, hostility, and social anxiety more than the persistent addiction group. Depression and hostility worsen in the addiction process for the Internet among adolescents. Intervention of Internet addiction should be provided to prevent its negative effect on mental health. Depression, hostility, and social anxiety decreased in the process of remission. It suggested that the negative consequences could be reversed if Internet addiction could be remitted within a short duration. Copyright © 2014 Elsevier Inc. All rights reserved.

A genome-wide investigation of food addiction.

PubMed

Cornelis, Marilyn C; Flint, Alan; Field, Alison E; Kraft, Peter; Han, Jiali; Rimm, Eric B; van Dam, Rob M

2016-06-01

Evidence of parallels between drug addiction and eating behavior continues to accumulate. Genetic studies of addictive substances have yielded a number of susceptibility loci that point to common higher order genetic pathways underlying addiction. It was hypothesized that a genome-wide association study (GWAS) of food addiction would yield significant enrichment in genes and pathways linked to addiction. A GWAS of food addiction, determined by the modified Yale Food Addiction Scale (mYFAS), was conducted among 9,314 women of European ancestry, and results for enrichment of single-nucleotide polymorphisms (SNPs) (n = 44), genes (n = 238), and pathways (n = 11) implicated in drug addiction were examined. Two loci met GW-significance (P < 2.5 × 10(-8) ) mapping to 17q21.31 and 11q13.4 that harbor genes with no obvious roles in eating behavior. GW results were significantly enriched for gene members of the MAPK signaling pathway (P = 0.02). No candidate SNP or gene for drug addiction was significantly associated with food addiction after correction for multiple testing. In the first GWAS of mYFAS, suggestive loci worthy of further follow-up were identified, but limited support was provided for shared genetic underpinnings of food addiction and drug addiction. The latter might be due to limited study power and knowledge of the genetics of drug addiction. © 2016 The Obesity Society.

Cognitive-Behavioral Therapy.

PubMed

An, Hong; He, Ri-Hui; Zheng, Yun-Rong; Tao, Ran

2017-01-01

Cognitive-behavioral therapy (CBT) is the main method of psychotherapy generally accepted in the field of substance addiction and non-substance addiction. This chapter mainly introduces the methods and technology of cognitive-behavior therapy of substance addiction, especially in order to prevent relapse. In the cognitive-behavior treatment of non-substance addiction, this chapter mainly introduces gambling addiction and food addiction.

Binge eating disorder and food addiction.

PubMed

Gearhardt, Ashley N; White, Marney A; Potenza, Marc N

2011-09-01

Binge eating disorder (BED) shares many characteristics with addictive behaviors (e.g., diminished control, continued use despite negative consequences), and a body of scientific literature is building to support addiction conceptualizations of problematic eating. Despite similarities, BED and "food addiction" may represent unique yet overlapping conditions. Although the exploration of food addiction is relatively new, understanding the relationship between food addiction and BED may be informative in understanding the mechanisms underlying the development and maintenance of problematic eating. In the following paper, we 1) examine the theoretical similarities and differences between BED and addiction, 2) review recent empirical evidence that speak to the relationship between BED and food addiction and 3) discuss the implications of associations between BED and food addiction with respect to clinical interventions.

Therapeutic Role of Bmi-1 Inhibitors in Eliminating Prostate Tumor Stem Cells

DTIC Science & Technology

2015-10-01

209 induced cell senescence, G1 cell cycle arrest, and reduced intratumor BMI-1 levels, while displaying antitumor activity in mouse xenografts did...achieved from mouse xenograft studies (Bertino Lab), therefore suggesting that this compound may be further pursued for PCa therapy. We have published...confirmed the activity of C-209 in zebrafish and mouse xenografts . We will continue to collect more primary PCa tissues to study oncogenic addiction of

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 seems that the OT system is a critical factor for the development of addiction. So we then discuss strategies to treat drug addiction with OT, and suggest that future research should further investigate OT system interventions aiming to improve cognitive control and/or social cognition functions, in order to develop strategies designed to more effectively treat drug addiction. PMID:27713720

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

PubMed

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 seems that the OT system is a critical factor for the development of addiction. So we then discuss strategies to treat drug addiction with OT, and suggest that future research should further investigate OT system interventions aiming to improve cognitive control and/or social cognition functions, in order to develop strategies designed to more effectively treat drug addiction.

Relationship among family environment, self-control, friendship quality, and adolescents’ smartphone addiction in South Korea: Findings from nationwide data

PubMed Central

Kim, Hye-Jin; Min, Jin-Young; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Background Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents’ smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. Methods We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Results Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23–2.45) and parental addiction (OR = 2.01; 95% CI: 1.24–3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68–4.90 and OR = 1.95; 95% CI: 1.34–2.83) and friendship quality (OR = 2.33; 95% CI: 1.41–3.85 and OR = 1.83; 95% CI: 1.26–2.64). Conclusion Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents’ smartphone addiction. PMID:29401496

Relationship among family environment, self-control, friendship quality, and adolescents' smartphone addiction in South Korea: Findings from nationwide data.

PubMed

Kim, Hye-Jin; Min, Jin-Young; Min, Kyoung-Bok; Lee, Tae-Jin; Yoo, Seunghyun

2018-01-01

Many studies have examined the negative impact on smartphone addiction in adolescents. Recent concerns have focused on predictors of smartphone addiction. This study aimed to investigate the association of adolescents' smartphone addiction with family environment (specifically, domestic violence and parental addiction). We further investigated whether self-control and friendship quality, as predictors of smartphone addiction, may reduce the observed risk. We used the 2013 national survey on internet usage and utilization data from the National Information Agency of Korea. Information on exposure and covariates included self-reported experience of domestic violence and parental addiction, sociodemographic variables, and other variables potentially related to smartphone addiction. Smartphone addiction was estimated using a smartphone addiction proneness scale, a standardized measure developed by national institutions in Korea. Adolescents who had experienced domestic violence (OR = 1.74; 95% CI: 1.23-2.45) and parental addiction (OR = 2.01; 95% CI: 1.24-3.27) were found to be at an increased risk for smartphone addiction after controlling for all potential variables. Furthermore, on classifying adolescents according to their level of self-control and friendship quality the association between domestic violence and parental addiction, and smartphone addiction was found to be significant in the group with adolescents with lower levels of self-control (OR = 2.87; 95% CI: 1.68-4.90 and OR = 1.95; 95% CI: 1.34-2.83) and friendship quality (OR = 2.33; 95% CI: 1.41-3.85 and OR = 1.83; 95% CI: 1.26-2.64). Our findings suggest that family dysfunction was significantly associated with smartphone addiction. We also observed that self-control and friendship quality act as protective factors against adolescents' smartphone addiction.

The relationship between study addiction and work addiction: A cross-cultural longitudinal study.

PubMed

Atroszko, Paweł A; Andreassen, Cecilie Schou; Griffiths, Mark D; Pallesen, Ståle

2016-12-01

Aims Recent empirical studies investigating "study addiction" have conceptualized it as a behavioral addiction, defined within the framework of work addiction. This study is the first attempt to examine the longitudinal relationship between study addiction and work addiction. Methods The Bergen Study Addiction Scale (BStAS), the Bergen Work Addiction Scale (BWAS), and the Ten-Item Personality Inventory were administered online together with questions concerning demographics and study-related variables in two waves. In Wave 1, a total of 2,559 students in Norway and 2,177 students in Poland participated. A year later, in Wave 2, 379 Norwegians and 401 Polish who began to work professionally completed the survey. Results The intraclass correlation between BStAS and BWAS revealed that the scores were somewhat related; however, the relationship was slightly weaker than the temporal stability of both constructs. In the Norwegian sample, scoring higher on neuroticism and lower on learning time outside educational classes in Wave 1 was positively related to work addiction in Wave 2, whereas gender was unrelated to work addiction in Wave 2 when controlling for other studied variables in either samples. Conclusion Study addiction and work addiction appear to be closely related suggesting that the former may be a precursor for (or an early form of) the latter.

Instagram addiction and the Big Five of personality: The mediating role of self-liking.

PubMed

Kircaburun, Kagan; Griffiths, Mark D

2018-03-01

Background and aims Recent research has suggested that social networking site use can be addictive. Although extensive research has been carried out on potential addiction to social networking sites, such as Facebook, Twitter, YouTube, and Tinder, only one very small study has previously examined potential addiction to Instagram. Consequently, the objectives of this study were to examine the relationships between personality, self-liking, daily Internet use, and Instagram addiction, as well as exploring the mediating role of self-liking between personality and Instagram addiction using path analysis. Methods A total of 752 university students completed a self-report survey, including the Instagram Addiction Scale (IAS), the Big Five Inventory (BFI), and the Self-Liking Scale. Results Results indicated that agreeableness, conscientiousness, and self-liking were negatively associated with Instagram addiction, whereas daily Internet use was positively associated with Instagram addiction. The results also showed that self-liking partially mediated the relationship of Instagram addiction with agreeableness and fully mediated the relationship between Instagram addiction with conscientiousness. Discussion and conclusions This study contributes to the small body of literature that has examined the relationship between personality and social networking site addiction and is one of only two studies to examine the addictive use of Instagram and the underlying factors related to it.

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

The moral relevance of addiction.

PubMed

Husak, Douglas N

2004-02-01

I attempt to understand and assess the widespread belief that addiction is relevant to morality. I examine several accounts of how addiction might be significant from a moral point of view. Although I briefly discuss theories of virtue, I focus on three possible ways addiction might be relevant to moral blame. First, blame might be imposed for the act of using addictive drugs. Second, blame might be imposed for the condition of being addicted. Third, blame might be imposed for further risks persons are likely to undertake once they have become addicts. I conclude that each of these accounts has some plausibility, but none is entirely unproblematic. Addiction probably is relevant to morality, although its degree of importance is not as great as some commentators appear to believe. The moral relevance of addiction does not appear to rise to whatever level would justify a punitive response to addictive drug users.

Food cravings in food addiction: the distinct role of positive reinforcement.

PubMed

Meule, Adrian; Kübler, Andrea

2012-08-01

Craving for a particular substance is an essential characteristic of addictive behavior. Increasing evidence suggests that food cravings and excessive food consumption could similarly be due to addictive processes. Recently, the Yale Food Addiction Scale (YFAS) was introduced for identifying individuals with addictive eating patterns. We conducted an online study (n=616, 75.8% female) in which participants filled out the YFAS and the Food Cravings Questionnaire-Trait (FCQ-T). Participants diagnosed as being addicted to food using the YFAS had higher scores on all food craving subscales except for anticipation of positive reinforcement that may result from eating. In a subsequent regression analysis, all food craving subscales positively predicted food addiction symptoms while positive reinforcement negatively predicted food addiction symptoms. Similar to other addictive behaviors, results indicate that individuals with addictive eating patterns experience more food cravings, but concurrently do not expect a positive reinforcement through eating. Copyright © 2012 Elsevier Ltd. All rights reserved.

E-cigarettes and expectancies: why do some users keep smoking?

PubMed

Harrell, Paul T; Simmons, Vani N; Piñeiro, Barbara; Correa, John B; Menzie, Nicole S; Meltzer, Lauren R; Unrod, Marina; Brandon, Thomas H

2015-11-01

Many smokers who have tried electronic cigarettes ('e-cigarettes') continue to smoke, perhaps influenced by their beliefs about the outcomes of using e-cigarettes ('e-cigarette expectancies'). The primary aims of this study were to compare expectancies of dual users to former smokers, and to examine the association between expectancies and intentions to quit or reduce 'vaping' among former smokers. A large cross-sectional online survey of e-cigarette users conducted in the United States. We surveyed current e-cigarette users (n = 1815), including both current cigarette smokers ('dual users', n = 381) and former smokers (n = 1434). We further subdivided former smokers into those with (n = 686) and without (n = 748) intentions to reduce or quit e-cigarette use. The primary outcomes were self-reported past-month smoking status and, among former smokers, current intentions to reduce or quit e-cigarette use, both adjusted for potential confounders. E-cigarette expectancy items were derived primarily from a previously validated measure of smoking expectancies. Dual users reported less positive expectancies than former smokers about e-cigarettes, rating e-cigarettes as more physically irritating (β = 0.10, P < 0.001) and addictive (β = 0.06, P = 0.016), as well as less satisfying (β = -0.11, P < 0.001). Former smokers with intentions to quit e-cigarettes also rated e-cigarettes less positively than former smokers without intentions to quit e-cigarettes, rating them more likely to damage health (β = 0.16, P < 0.001) and cause addiction (β = 0.10, P < 0.001), but less likely to taste good (β = -0.08, P = 0.006). Positive e-cigarette expectancies among e-cigarette users are associated with a greater likelihood of having quit smoking, but lower likelihood of intention to quit e-cigarette use. © 2015 Society for the Study of Addiction.

Smartphone use and smartphone addiction among young people in Switzerland

PubMed Central

Haug, Severin; Castro, Raquel Paz; Kwon, Min; Filler, Andreas; Kowatsch, Tobias; Schaub, Michael P.

2015-01-01

Background and Aims Smartphone addiction, its association with smartphone use, and its predictors have not yet been studied in a European sample. This study investigated indicators of smartphone use, smartphone addiction, and their associations with demographic and health behaviour-related variables in young people. Methods A convenience sample of 1,519 students from 127 Swiss vocational school classes participated in a survey assessing demographic and health-related characteristics as well as indicators of smartphone use and addiction. Smartphone addiction was assessed using a short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Logistic regression analyses were conducted to investigate demographic and health-related predictors of smartphone addiction. Results Smartphone addiction occurred in 256 (16.9%) of the 1,519 students. Longer duration of smartphone use on a typical day, a shorter time period until first smartphone use in the morning, and reporting that social networking was the most personally relevant smartphone function were associated with smartphone addiction. Smartphone addiction was more prevalent in younger adolescents (15–16 years) compared with young adults (19 years and older), students with both parents born outside Switzerland, persons reporting lower physical activity, and those reporting higher stress. Alcohol and tobacco consumption were unrelated to smartphone addiction. Discussion Different indicators of smartphone use are associated with smartphone addiction and subgroups of young people have a higher prevalence of smartphone addiction. Conclusions The study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from a European country, which should be extended in further studies. PMID:26690625

Social judgments of behavioral versus substance-related addictions: a population-based study.

PubMed

Konkolÿ Thege, Barna; Colman, Ian; el-Guebaly, Nady; Hodgins, David C; Patten, Scott B; Schopflocher, Don; Wolfe, Jody; Wild, T Cameron

2015-03-01

Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions. A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work). Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions. The general public appreciates the complex bio-psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own. Copyright © 2014 Elsevier Ltd. All rights reserved.

Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial.

PubMed

Saitz, Richard; Cheng, Debbie M; Winter, Michael; Kim, Theresa W; Meli, Seville M; Allensworth-Davies, Don; Lloyd-Travaglini, Christine A; Samet, Jeffrey H

2013-09-18

People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes. To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care. The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up. Participants were randomized to receive CCM (n=282) or no CCM (n=281). Chronic care management included longitudinal care coordinated with a primary care clinician; motivational enhancement therapy; relapse prevention counseling; and on-site medical, addiction, and psychiatric treatment, social work assistance, and referrals (including mutual help). The no CCM (control) group received a primary care appointment and a list of treatment resources including a telephone number to arrange counseling. The primary outcome was self-reported abstinence from opioids, stimulants, or heavy drinking. Biomarkers were secondary outcomes. There was no significant difference in abstinence from opioids, stimulants, or heavy drinking between the CCM (44%) and control (42%) groups (adjusted odds ratio, 0.84; 95% CI, 0.65-1.10; P=.21). No significant differences were found for secondary outcomes of addiction severity, health-related quality of life, or drug problems. No subgroup effects were found except among those with alcohol dependence, in whom CCM was associated with fewer alcohol problems (mean score, 10 vs 13; incidence rate ratio, 0.85; 95% CI, 0.72-1.00; P=.048). Among persons with alcohol and other drug dependence, CCM compared with a primary care appointment but no CCM did not increase self-reported abstinence over 12 months. Whether more intensive or longer-duration CCM is effective requires further investigation. clinicaltrials.gov Identifier: NCT00278447.

Modelling the Happiness Classification of Addicted, Addiction Risk, Threshold and Non-Addicted Groups on Internet Usage

ERIC Educational Resources Information Center

Sapmaz, Fatma; Totan, Tarik

2018-01-01

The aim of this study is to model the happiness classification of university students--grouped as addicted, addiction risk, threshold and non-addicted to internet usage--with compatibility analysis on a map as happiness, average and unhappiness. The participants in this study were 400 university students from Turkey. According to the results of…

Addiction to the internet and online gaming.

PubMed

Ng, Brian D; Wiemer-Hastings, Peter

2005-04-01

As computer and Internet use become a staple of everyday life, the potential for overuse is introduced, which may lead to addiction. Research on Internet addiction has shown that users can become addicted to it. Addiction to the Internet shares some of the negative aspects of substance addiction and has been shown to lead to consequences such as failing school, family, and relationship problems.

Kleptomania and Co-morbid addictive disorders.

PubMed

Kim, Hyoun S; Christianini, Aparecida Rangon; Bertoni, Daniela; de Oliveira, Maria do Carmo Medeiros; Hodgins, David C; Tavares, Hermano

2017-04-01

We examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi-structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Review. The incentive sensitization theory of addiction: some current issues.

PubMed

Robinson, Terry E; Berridge, Kent C

2008-10-12

We present a brief overview of the incentive sensitization theory of addiction. This posits that addiction is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems that attribute incentive salience to reward-associated stimuli. If rendered hypersensitive, these systems cause pathological incentive motivation ('wanting') for drugs. We address some current questions including: what is the role of learning in incentive sensitization and addiction? Does incentive sensitization occur in human addicts? Is the development of addiction-like behaviour in animals associated with sensitization? What is the best way to model addiction symptoms using animal models? And, finally, what are the roles of affective pleasure or withdrawal in addiction?

Social Networking Sites and Addiction: Ten Lessons Learned

PubMed Central

Kuss, Daria J.; Griffiths, Mark D.

2017-01-01

Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided. PMID:28304359

Social Networking Sites and Addiction: Ten Lessons Learned.

PubMed

Kuss, Daria J; Griffiths, Mark D

2017-03-17

Online social networking sites (SNSs) have gained increasing popularity in the last decade, with individuals engaging in SNSs to connect with others who share similar interests. The perceived need to be online may result in compulsive use of SNSs, which in extreme cases may result in symptoms and consequences traditionally associated with substance-related addictions. In order to present new insights into online social networking and addiction, in this paper, 10 lessons learned concerning online social networking sites and addiction based on the insights derived from recent empirical research will be presented. These are: (i) social networking and social media use are not the same; (ii) social networking is eclectic; (iii) social networking is a way of being; (iv) individuals can become addicted to using social networking sites; (v) Facebook addiction is only one example of SNS addiction; (vi) fear of missing out (FOMO) may be part of SNS addiction; (vii) smartphone addiction may be part of SNS addiction; (viii) nomophobia may be part of SNS addiction; (ix) there are sociodemographic differences in SNS addiction; and (x) there are methodological problems with research to date. These are discussed in turn. Recommendations for research and clinical applications are provided.

Attachment and emotion regulation in substance addictions and behavioral addictions.

PubMed

Estévez, Ana; Jáuregui, Paula; Sánchez-Marcos, Inmaculada; López-González, Hibai; Griffiths, Mark D

2017-12-01

Background Risky behaviors have been related to emotional regulation and attachment, which may constitute risk factors for developing an addictive behavior. However, there may also be differences between substance and non-substance-related addictions. Aims This study aimed to examine the relationship of emotional regulation and attachment, with substance (alcohol and drug abuse), and non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use) in adolescents and emerging adults. The study also aimed to examine gender differences for such predictors. Methods The sample comprised 472 students aged 13-21 years recruited from high schools and vocational education centers. Results Findings demonstrated that emotion regulation was predictive of all addictive behaviors assessed in this study (alcohol and drug abuse, gambling disorder, video game addiction, and problematic Internet use), whereas attachment predicted non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use). In addition, gender differences were found, with females scoring significantly higher in maternal and peer attachment, whereas males scored significantly higher in gambling disorder and video game addiction. Conclusion The findings may be useful for preventive and clinical interventions conducted with youth regarding addictive behaviors.

Exploring personality characteristics of Chinese adolescents with internet-related addictive behaviors: trait differences for gaming addiction and social networking addiction.

PubMed

Wang, Chong-Wen; Ho, Rainbow T H; Chan, Cecilia L W; Tse, Samson

2015-03-01

This study investigated the associations between personality traits, based on the Big Five model, and addictive behaviors to different online activities among adolescents. A sample of 920 participants was recruited from four secondary schools in different districts using random cluster sampling. A structured questionnaire, including demographic information, internet usage pattern, the Internet Addiction Test, the Game Addiction Scale, the Bergen Facebook Addiction Scale - Revised, and the Big Five Inventory, was administered to each participant. The results demonstrated a significant difference in personality traits for addictive behaviors related to different online activities. Specifically, higher neuroticism (β=0.15, p<0.001) and less conscientiousness (β=0.12, p<0.001) displayed significant associations with internet addiction in general; less conscientiousness (β=0.09, p<0.01) and low openness (β=0.06, p<0.05) were significantly associated with gaming addiction; and neuroticism (β=0.15, p<0.001) and extraversion (β=0.10, p<0.01) were significantly associated with social networking addiction. Our findings may provide a better understanding of the etiopathology of internet-related addictive behaviors and have implications for psychoeducation and psychotherapy programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does food addiction exist? A phenomenological discussion based on the psychiatric classification of substance-related disorders and addiction.

PubMed

Albayrak, Ozgür; Wölfle, Sebastian Mathias; Hebebrand, Johannes

2012-01-01

The relationship between overeating, substance abuse and (behavioral) addiction is controversial. Medically established forms of addiction so far pertain to substance use disorders only. But the preliminary Diagnostic and Statistical Manual for Mental Disorders V (DSM V) suggests replacing the previous category 'Substance-Related Disorders' with 'Addiction and Related Disorders', thus for the first time allowing the diagnosis of behavioral addictions. In the past psychiatrists and psychologists have been reluctant to systematically delineate and classify the term behavioral addiction. However, there is a broad overlap between chemical and behavioral addiction including phenomenological, therapeutic, genetic, and neurobiological aspects. It is of interest to point out that the hormone leptin in itself has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and 'chemical' addiction. Thus, leptin-deficient individuals could be classified as fulfilling criteria for food addiction. In our overview we first review psychological findings in chemical (substance-based) and subsequently in behavioral addiction to analyze the overlap. We discuss the diagnostic validity of food addiction, which in theory can be chemically and/or behaviorally based. Copyright © 2012 S. Karger GmbH, Freiburg.

A new insight into food addiction in childhood obesity.

PubMed

Keser, Alev; Yüksel, Ayşegül; Yeşiltepe-Mutlu, Gül; Bayhan, Asuman; Özsu, Elif; Hatun, Şükrü

2015-01-01

Uncontrolled eating behavior in obese subjects is very similar to behavior in food addiction, suggesting a relationship. This study was designed to evaluate the relationship between childhood obesity and food addiction and to determine the frequency of food addiction among obese children and adolescents. The study included 100 overweight and obese children. Food addiction was evaluated by the Yale Food Addiction Scale (YFAS). The cutoff value for food addiction was defined as the presence of 3 or more symptoms. Participants were between 10 and 18 years of age; 63% were girls. Of the participants, 71% had food addiction. The most addictive foods were chocolate, ice cream, carbonated beverages, French fries, white bread, rice, candy, chips and pasta, in decreasing order of frequency. Experiencing a frequent feeling of hunger was associated with a 2.2-fold increase in food addiction risk, while consumption of French fries ≥1-2 times per week was associated with a 2.3-fold increase in risk (p<0.05). The high YFAS scores in obese and overweight adolescents suggest that food addiction plays an important role in childhood obesity. Evaluation of food addiction in more detail may open a new perspective on the prevention and treatment of obesity.

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

Genetic variation of the growth hormone secretagogue receptor gene is associated with alcohol use disorders identification test scores and smoking.

PubMed

Suchankova, Petra; Nilsson, Staffan; von der Pahlen, Bettina; Santtila, Pekka; Sandnabba, Kenneth; Johansson, Ada; Jern, Patrick; Engel, Jörgen A; Jerlhag, Elisabet

2016-03-01

The multifaceted gut-brain peptide ghrelin and its receptor (GHSR-1a) are implicated in mechanisms regulating not only the energy balance but also the reward circuitry. In our pre-clinical models, we have shown that ghrelin increases whereas GHSR-1a antagonists decrease alcohol consumption and the motivation to consume alcohol in rodents. Moreover, ghrelin signaling is required for the rewarding properties of addictive drugs including alcohol and nicotine in rodents. Given the hereditary component underlying addictive behaviors and disorders, we sought to investigate whether single nucleotide polymorphisms (SNPs) located in the pre-proghrelin gene (GHRL) and GHSR-1a gene (GHSR) are associated with alcohol use, measured by the alcohol use disorders identification test (AUDIT) and smoking. Two SNPs located in GHRL, rs4684677 (Gln90Leu) and rs696217 (Leu72Met), and one in GHSR, rs2948694, were genotyped in a subset (n = 4161) of a Finnish population-based cohort, the Genetics of Sexuality and Aggression project. The effect of these SNPs on AUDIT scores and smoking was investigated using linear and logistic regressions, respectively. We found that the minor allele of the rs2948694 SNP was nominally associated with higher AUDIT scores (P = 0.0204, recessive model) and smoking (P = 0.0002, dominant model). Furthermore, post hoc analyses showed that this risk allele was also associated with increased likelihood of having high level of alcohol problems as determined by AUDIT scores ≥ 16 (P = 0.0043, recessive model). These convergent findings lend further support for the hypothesized involvement of ghrelin signaling in addictive disorders. © 2015 Society for the Study of Addiction.