Journal ArticleDOI
Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation
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TLDR
Evidence that drug (including alcohol) dependence is a chronic medical illness is examined and results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits.Abstract:
The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses.read more
Citations
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Journal ArticleDOI
Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
TL;DR: Comorbidity of alcohol dependence with other substance disorders appears due in part to unique factors underlying etiology for each pair of disorders studied while comorbidities of alcohol addiction with mood, anxiety, and personality disorders appears more attributable to factors shared among these other disorders.
Journal ArticleDOI
NEURAL MECHANISMS OF ADDICTION: The Role of Reward-Related Learning and Memory
TL;DR: Progress in identifying candidate mechanisms of addiction is reviewed, including molecular and cellular mechanisms that underlie long-term associative memories in several forebrain circuits (involving the ventral and dorsal striatum and prefrontal cortex) that receive input from midbrain dopamine neurons.
Journal ArticleDOI
Neurobiology of addiction: A neurocircuitry analysis.
George F. Koob,Nora D. Volkow +1 more
TL;DR: Molecular genetic studies have identified transduction and transcription factors that act in neurocircuitry associated with the development and maintenance of addiction that might mediate initial vulnerability, maintenance, and relapse associated with addiction.
Journal ArticleDOI
Addiction and the brain: The neurobiology of compulsion and its persistence
TL;DR: Evidence is reviewed for the possibility that compulsion and its persistence are based on a pathological usurpation of molecular mechanisms that are normally involved in memory, which is often initiated by exposure to drug-related cues.
BookDOI
The growth of incarceration in the United States: exploring causes and consequences
TL;DR: Part of the courts, criminal law, criminal procedure, criminology, Law and Society Commons, Law Enforcement and Corrections Commons, Legislation Commons, Politics and Social Change Commons, and the Race and Ethnicity Commons.
References
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Journal ArticleDOI
Cellular and molecular mechanisms of drug dependence.
George F. Koob,Floyd E. Bloom +1 more
TL;DR: The molecular and cellular actions of three classes of abused drugs--opiates, psychostimulants, and ethanol--are reviewed in the context of behavioral studies of drug dependence.
Journal ArticleDOI
Naltrexone in the treatment of alcohol dependence
TL;DR: Naltrexone may be a safe and effective adjunct to treatment in alcohol-dependent subjects, particularly in preventing alcohol relapse, and was seen in patients who drank any alcohol while attending outpatient treatment.
Journal ArticleDOI
Limbic Activation During Cue-Induced Cocaine Craving
Anna Rose Childress,P. David Mozley,W. Mcelgin,Josh Fitzgerald,Martin Reivich,Charles P. O'Brien +5 more
TL;DR: Findings indicate that limbic activation is one component of cue-induced cocaine craving and may be similarly involved in appetitive craving for other drugs and for natural rewards.
Journal ArticleDOI
Naltrexone and Coping Skills Therapy for Alcohol Dependence: A Controlled Study
Stephanie S. O'Malley,Adam J. Jaffe,Adam J. Jaffe,Grace Chang,Richard S. Schottenfeld,Roger E. Meyer,Bruce J. Rounsaville,Bruce J. Rounsaville +7 more
TL;DR: Naltrexone proved superior to placebo in measures of drinking and alcohol- related problems, including abstention rates, number of drinking days, relapse, and severity of alcohol-related problems.
Book
Substance Abuse: A Comprehensive Textbook
TL;DR: This book discusses the determinants and perpetuators of substance abuse, medical aspects of immunodeficiency virus infections and its treatment in injecting drug users, and management of the psychosocial sequelae of Hiv infection among drug users effects of narcotics on immune function.