Showing papers on "Addiction medicine published in 1988"

Tobacco addiction as a psychiatric disease.

Abstract: Tobacco is the most widely used addictive substance in the world. Since the Surgeon General's 1964 report, medicine has sought out the genesis of tobacco addiction (TA) and has evolved methods of treatment and prevention. Psychiatry was slower than other medical specialties to acknowledge TA as a legitimate area for psychiatric intervention, probably because the many psychiatrists who were smokers identified with their smoking patients. Since 1980, the American Psychiatric Association has recognized nicotine dependence and nicotine withdrawal as diagnostic entities. The complications of TA are in the province of other medical specialists, but psychiatrists have unique tools for treating addictive disorders. This paper describes some of the addictive qualities of tobacco, and presents illustrative cases of successful treatment of TA using hypnosis. It describes an effective cooperative community program under medical aegis, focusing on education, therapy, and prevention, which has resulted in the virtual disappearance of tobacco consumption in hospitals and schools in the community. By sharing their expertise in the treatment of individual patients, and the design of effective community programs that include education, prevention, and treatment, psychiatrists will be active leaders in the medical community's program to reduce tobacco addiction.

Addiction treatment : promoting a medical approach to substance use

Abstract: Building on decades of Academy activities related to substance use, this report emphasizes three guiding principles: 1. Drug treatment should be accessible to all drug users seeking care, including those who are incarcerated. Because turning users away when programs are operating at or above capacity represents lost opportunities for care, programs should be prepared to commence treatment at the time users request it. 2. Addiction is a complex, chronic, relapsing illness for which various inpatient, residential, and outpatient treatments are used, depending on the substances involved, the intensity and duration of the addiction, the characteristics and tolerances of the patient, and the circumstances involved. Optimal addiction treatment requires generalists in medical care who are knowledgeable and capable in the areas of diagnosis and management; specialist consultation and care; specific programs dedicated to the acute and chronic care of drug users; and the multidisciplinary participation of appropriately qualified counselors, social workers, and other professionals. 3. Steps need to be taken to reduce the health-related harms associated with injection drug use, including the transmission of human immunodeficiency virus (HIV), hepatitis B and C, and other blood-borne pathogens. Harm reduction incorporates many modalities, such as HIV prevention education, including condom use and safer sex counseling and education; referrals for drug treatment and other health care and social services; interim methadone maintenance; and syringe and needle availability and exchange programs. Each of these interventions represents important medical and public health strategies that may decrease some of the secondary medical consequences of injection drug use.

Health and Medicine in the 1980s

Abstract: In 1948 China was described as having the greatest and most intractable health problems of any nation in the world. Less than forty years later, many of these problems have been dealt with. Life expectancy for adults and infants is approaching Western levels, and China’s ramshackle health-care system has been expanded and improved to produce rapid growth in medical facilities and personnel. Nutritional and sanitary improvements, together with economic growth, have accompanied these changes and augmented and consolidated their effects.