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Showing papers on "Addiction medicine published in 2005"


Journal ArticleDOI
TL;DR: Advances in addiction research are highlighted that, if disseminated to the public, could reverse misconceptions and facilitate changes in policy to improve treatment access and care delivery for this highly prevalent disease.
Abstract: In the United States, efforts to treat addiction are hampered by prejudice and a public view that treats it as a disorder of self-control, not a disease. We highlight select advances in addiction research that, if disseminated to the public, could reverse these misconceptions and facilitate changes in policy to improve treatment access and care delivery for this highly prevalent disease.

260 citations


Journal ArticleDOI
TL;DR: Because addiction usually starts in adolescence or early adulthood and is frequently comorbid with mental illness, the authors need to expand their treatment interventions in this age group both for substance abuse and psychiatric disorders.

225 citations


Journal ArticleDOI
TL;DR: Given the increased use of computers in today's society, there is the potential for overuse of technology and neglect of others and self as a result of computer addiction.
Abstract: TOPIC. Nurse psychotherapists will encounter the impact of today's technology on the daily lives of people including computer addiction. Computer addiction may also present with comorbidities such as depression, gambling, substance abuse, and marital infidelity and divorce. PURPOSE. This overview article presents what is currently documented in the literature regarding the incidence, symptomatology, and nursing psychotherapy interventions relevant to computer addiction and its treatment. Issues presented include computer addiction, virtual relationships, online marital infidelity, and compulsive online sexual behavior. SOURCES. Review of literature from Medline, Psychoinfo, CINAHL, and current texts. CONCLUSIONS. Given the increased use of computers in today's society, there is the potential for overuse of technology and neglect of others and self as a result of computer addiction. Computer disorders also present themselves as marital or couple discord with the potential for online extramarital affairs and compulsive sexual online behavior. A summary and an assessment tool are provided to guide the nurse psychotherapist in practice.

55 citations



Journal Article
TL;DR: A client-directed, outcome-informed approach is presented that documents how this way of thinking about, and working with, problem drinkers facilitates better client engagement and improves treatment outcomes.
Abstract: A client-directed, outcome-informed approach is presented that documents how this way of thinking about, and working with, problem drinkers facilitates better client engagement and improves treatment outcomes. As is true of the field of therapy, the history of drug and alcohol treatment has been marked by contention and debate. Popular assumptions and models since proven to be flawed include: the 'disease' model; that the problem ran in families; the need for expensive hospital-based detoxification; and that people can recover, but can never be cured. The authors highlight the movement of the field away from diagnosis and program-driven treatment towards 'individualised assessment-driven treatment'. Research has made clear that, regardless of type or intensity of approach, client engagement is the single best predictor of outcome. A format, designed by the American Society of Addiction Medicine, for an individualised service plan based on multidimensional assessment criteria is presented, in addition to a detailed discussion of how to implement an outcome-informed, client- directed method of feedback within a treatment service. (editor abstract)

27 citations


Journal Article
TL;DR: The nature of the problem, how the osteopathic medical profession is currently addressing it, and a current strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine are reviewed.
Abstract: Substance use disorders (SUDs) have had a major impact on the health of the US population during the past decade Osteopathic physicians have an important role among those who can make a positive impact on this problem This article reviews the nature of the problem, how the osteopathic medical profession is currently addressing it, and a current strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine Early in 2004, the Office of National Drug Control Policy-backed by the US Surgeon General, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Highway Traffic Safety Administration-has requested improvement in physician education on this health problem This request culminated in the Office of National Drug Control Policy's establishing the Leadership Conference on Medical Education in Substance Abuse in December 2004 The osteopathic medical profession is represented in this critical review and formulation of recommendations for improving education on substance use disorders for the undergraduate, graduate, and practicing physician

15 citations


Journal ArticleDOI
TL;DR: The time is definitely right for an issue of this journal devoted to multiple addictions and addiction interactions, an issue that includes not only clinical research, but also detailed neurochemical explanations of how addictions affect the brain.
Abstract: Last spring, at the annual scientific conference of the American Society of Addiction Medicine (ASAM) in Dallas, it seemed that nearly every talk included a mention of the neurobiological aspects o...

10 citations


01 Jan 2005
TL;DR: Evidence from clinical observations and experimental research provides substantial support for the relationship between binge-eating obesity, addiction, and the DA reward system.
Abstract: The pathogenesis of obesity is multi-factorial; both genetics and the environment influence the many variables that regulate body weight, metabolism, and eating behavior. The loss of control of eating behavior associated with obesity is analogous to the compulsive drug taking behavior observed in drug-addicted individuals. The American Society of Addiction Medicine first proposed the hypothesis of a food addiction over 10 years ago. Evidence from clinical observations and experimental research, in particular neuroimaging studies, provides substantial support for the relationship between binge-eating obesity, addiction, and the DA reward system.

5 citations


Journal ArticleDOI
TL;DR: In the case of the 61‐year‐old patient, the problems of an extramarital relationship play a central part in the syndrome with a serious conflict situation and prolonged personal and family crisis, and the sexual behaviour meets the criteria of addiction.
Abstract: Background: In recent decades, the diagnosis of sexual or love addiction has increasingly become part of the spectrum of addiction medicine. Although it does not figure under this name in either the BNO‐10 or DSM‐IV, the present scientific position is that it can be regarded as a compulsive sexual behaviour disorder that does not show the criteria of paraphilia.Method: A case report.Results: In the case of the 61‐year‐old patient we observed, the problems of an extramarital relationship play a central part in the syndrome with a serious conflict situation and prolonged personal and family crisis. This sexual addiction can be interpreted as identification with the father and also as the means of masculine identity. The sexual behaviour meets the criteria of addiction. Follow‐up will decide the stability of the diagnosis. In connection with this case, the authors attempt a psychodynamic analysis of triangular relationships destabilizing couple relationships.

4 citations


Journal Article
TL;DR: Wang et al. as discussed by the authors proposed the following measures to prevent and cure Internet addiction disorder: to set a goal in life, to develop democratic and equal family culture, to intensify Internet quality education, and to establish the government's laws and regulations for the Internet as well as its ethics guidance mechanism.
Abstract: With the development of the Internet, the fact that Internet addiction disorder damages the physical and mental health of youngsters has drawn wide attention in the whole society. To seek cures for college students' Internet addiction disorder, the present essay analyses the manifestations of Internet addiction, its causes and its diagnosis criteria. On the basis of analysis, the author proposes the following measures to prevent and cure Internet addiction disorder: to set a goal in life, to develop democratic and equal family culture, to intensify Internet quality education, and to establish the government's laws and regulations for the Internet as well as its ethics guidance mechanism.

2 citations


Journal Article
TL;DR: In a specialized heroin addiction treatment setting, patient compliance is just as good as in other risk groups.
Abstract: Despite an extensive addiction treatment and rehabilitation system for heroin addicts, inadequate infectious disease care still prevails for this group of patients. The reasons are structural in nature since both of the required medical disciplines (addiction medicine and infectious diseases epidemiology) are rarely found at one treatment location. Appropriate interdisciplinary cooperation must first be established. In a specialized heroin addiction treatment setting, patient compliance isjust as good as in other risk groups. Prerequisites for this good compliance are: Elimination of social and psychiatric disruptive factors, the selection of a medication regimen that takes secondary diseases and concomitant medication into consideration and the employment of once-daily treatment regimens or simple regimens with twice-daily dosages.

Journal ArticleDOI
TL;DR: Clinical management of sex addiction is divided into four sections: one discussing the early stages of the "addiction" process, one discussing treatment and therapy, another discussing special populati as discussed by the authors.
Abstract: Clinical Management of Sex Addiction is divided into four sections: one discussing the early stages of the “addiction” process, one discussing treatment and therapy, one discussing special populati


Journal Article
TL;DR: Addiction medicine training is relevant to the work of doctors training to become GPs and can increase knowledge and confidence and is sustained over time and is translated into practice, according to general practice registrars.
Abstract: INTRODUCTION: Illicit drug use is a significant problem within Australia. However, GPs are reluctant to treat these problems due to a perceived lack of knowledge and confidence. METHOD: All advanced general practice registrars training through the Victorian Metropolitan Alliance in 2004 attended a 1 day pilot addiction medicine workshop, followed by completion of a questionnaire to assess the acceptability of the training and its impact on their knowledge and confidence. RESULTS: Forty six general practice registrars attended the workshops with all but one (98%) completing the postworkshop questionnaire. More than 90% of registrars agreed that the material presented was relevant to their work and that they felt more confident dealing with addiction issues in practice. DISCUSSION: Addiction medicine training is relevant to the work of doctors training to become GPs and can increase knowledge and confidence. More extensive research is needed to assess whether this increase in knowledge and confidence is sustained over time and is translated into practice. (author abstract)

Journal ArticleDOI
TL;DR: The 10 steps of universal precautions in pain medicine should generate further debate, discussion, and discovery within the pain medicine and addiction medicine communities.
Abstract: The March/April 2005 commentary article by Gourlay et al. recommending a universal precautions approach in pain medicine may one day be regarded as one of the seminal works in the evolution of the specialty [1]. As stated in the article, the 10 steps of universal precautions in pain medicine should generate further debate, discussion, and discovery within the pain medicine and addiction medicine communities. I had the good fortune of attending Dr. Gourlay's presentation at the April 2004 “Pain & Addiction: Common Threads V” program, held in conjunction with the American Society of …

01 Nov 2005
TL;DR: The prevalence of addictive disorders in the pain population remains unknown, and substance abuse and addiction in older adults is underesti- mated and poorly understood as discussed by the authors, and few pub- lications clarify the magnitude of the problem or suggest methods of pre- mention or treatment.
Abstract: Addiction often results from using controlled (monitored by the Drug Enforcement Agency) or illicit sub- stances to produce pleasure or to dis- sociate from the consequences of life's events. Current evidence suggests that the addictive disease process stems from biogenetic predisposition, individual psychological profile, soci- ocultural influences, and drug expo- sure. Drug addiction places a signifi- cant burden on society due to its detrimental impact on health and its disturbance of social interactions in professional and personal contexts.. The prevalence of addictive disorders in the pain population remains unknown, and substance abuse and addiction in older adults is underesti- mated and poorly understood. By virtue of their disease states, older adults consume drugs of abuse at higher rates and, therefore, may be at increased risk of addiction. Few pub- lications clarify the magnitude of the problem or suggest methods of pre- vention or treatment.

01 Jan 2005
TL;DR: In this paper, the authors proposed that the loss of control of eating behavior associated with obesity is analogous to the compulsive drug taking behavior observed in drug-addicted individuals, and provided substantial support for the relationship between binge-eating obesity, addiction, and the DA reward system.
Abstract: The pathogenesis of obesity is multi-factorial; both genetics and the environment influence the many variables that regulate body weight, metabolism, and eating behavior. The loss of control of eating behavior associated with obesity is analogous to the compulsive drug taking behavior observed in drug-addicted individuals. The American Society of Addiction Medicine first proposed the hypothesis of a food addiction over 10 years ago. Evidence from clinical observations and experimental research, in particular neuroimaging studies, provides substantial support for the relationship between binge-eating obesity, addiction, and the DA reward system.

01 Jan 2005
TL;DR: This paper found that treatment center clients would present beliefs that correspond to the disease concept of addiction, while members of the university sample would express more personal or environmental attitudes towards addiction, and found that the attitudes do not suggest scientific truth and do not necessarily represent the current state of addiction treatment.
Abstract: This study sought to identify differences in the beliefs about addiction between a sample of university students (N=81) and a sample of clients diagnosed with substance abuse or dependence from a drug/alcohol treatment center (N=14). It was hypothesized that treatment center clients would present beliefs that correspond to the disease concept of addiction (Jellinek 1960), while members of the university sample would express more personal or environmental attitudes towards addiction. To assess these potential differences, a survey questionnaire based on the Addiction Belief Inventory (ABI) was administered to both samples (Luke, Ribisl, Walton, and Davidson, 2002). Results of t­ tests showed that university students and treatment center clients differed in their responses on the Inability to Control [t(93)= -4.12, p<0.05], Chronic Disease [t(93)= ­ 3.22, p<0.05], and Responsibility for Action [t(93)=3.22, p<0.05] subscales. Limitations of the current study and suggestions for future research are also discussed. Concepts of Addiction 3 Concepts of Addiction: Assessing the Beliefs of Addiction in University and Treatment Center Populations Americans spend an astounding $112.6 billion on alcohol each year (Helmuth, 2003, ~ 1), with college students contributing $5.5 billion to that sum (http://www.psu.edu/deptiATOD/aip.html, ~ 1). On illicit drugs, Americans spend $64 billion (DEA Intelligence Division, 2002, ~ 10): $39 to $77 billion on cocaine and $10 to $22 billion on heroin (Abt Associates, 2000, as cited in http://drugwarfacts.orgleconomi.htm, 2004, ~ 9). Approximately six percent of the American household population over 12 years old use illegal drugs on a regular basis (http://www.ncjrs.org/htm/chapter2.htm. ~ 1). Though most Americans believe that drug abuse is not their problem, about 45% of the population knows someone with a substance abuse problem (http://www.ncjrs.org/htm/chapter2.htm. ~ 2). The prevalence of substance abuse has given rise to many different concepts of alcoholism and addiction. Concepts, or attitudes, people have towards the nature of addiction vary greatly and are typically based upon an existing theory on the causes, etiology, and treatment of addiction. However, the attitudes do not suggest scientific truth and do not necessarily represent the current state of addiction treatment. Many concepts have emerged through the years (i.e. moral/volitional, psychoanalytic, family­ interaction, Alcoholics Anonymous, adaptive, etc.); yet much of recent research supports the disease concept, or medical model of addiction. In light of the multitude of models focused on explaining alcoholism and addiction, the current study examines the attitudes of an alcohol or substance abusing Concepts of Addiction 4 group and those of a non-abusing group. Residential clients in a treatment center comprised the substance abusing sample, while university students were surveyed to form the non-abusing sample. The study seeks to identify aspects of the disease and adaptive models of addiction in the attitudes of respondents from both samples. Overview ofExisting Concepts ofAddiction Moral/Volitional concept. The moral model finds alcoholics lacking in moral fortitude and suffering from alcoholism is a result of their drinking (Siegler, 1968; Miller and Kurtz, 1994). Proponents of this model deny that alcoholism is in any wayan illness. Any reported "loss of control" is interpreted as evidence of the alcoholic's weak character and depravity. Psychoanalytic concept. The psychoanalytic model defines alcoholism as the result of an underlying neurosis (Siegler, 1968; Ward, 1985). Treatment consists of psychotherapy which seeks to lead the alcoholic to a mature lifestyle by penetrating early childhood emotions and memories. Therapy is typically a long and involved process with minimal success. The psychoanalytic m del gave rise to notion of the alcoholic personality, which is the idea that certain immature negative personality traits are common to all alcoholics (Miller, 1994). Family interaction concept. Family-interaction proponents conceive of alcoholism as a role assigned to an individual member of a family while the other relatives play complementary parts in the lifestyle of addiction (Siegler, 1968; Ward, 1985). Because the family members define themselves by the roles they play, removing the key actor-the alcoholic-results in the other members trying to restore him/her to an alcoholic state. A life of sobriety is possible with family therapy. Concepts of Addiction 5 Alcoholics Anonymous concept. The Alcoholics Anonymous (AA) model states that alcoholism is a spiritual problem (Siegler, 1968; Miller, 1994). They identify a need for a spiritual recovery in order to lead a life of sobriety. Participation in the brotherhood of AA helps the recovering alcoholic to maintain hislher relationship with a healing Higher Power. The AA model also states that untreated, alcoholism is a progressive and fatal disease, specifically a disease of the mind (Ward, 1985). The disease concept. The disease concept, or medical model, describes alcoholism as a progressive disease with its own set of symptoms (Jellinek, 1960; Miller, 1994; Siegler, 1960; Ward, 1985). Often, the disease is hereditary and can be fatal. Alcoholics are people whose body chemistry allows them to become addicted more readily than the general population. Under the medical model, alcoholism must be identified as a primary disorder and treated as such (Siegler, 1968). Early research on alcoholism as a disease was done by Jellinek (1960) who authored The Disease Concept ofAlcoholi m, a seminal work in the field, which is a compilation of data obtained by surveying over 2000 Alcoholics Anonymous members. The study revealed a pattern to the appearance of symptoms reported by the participants and a progression of increasing dysfunction. Jellinek (1960) grouped these symptoms, including physiological tolerance and withdrawal, into four phases of alcoholism: prealcoholic, prodromal, crucial, and chronic stages Current research on addiction has supported the disease concept of addiction (Davis, 1974; Witte, Pinto, Ansseau, and Verbanck, 2003; Jacob, Waterman, Heath, True, Bucholz, Haber, Scherrer, and Qiang, 2003). Because research has been upholding the medical model, many treatment centers teach and conduct therapy by the disease concept. Concepts of Addiction 6 It also has much clinical appeal because it gives both the treatment provider and client a definite starting point (Shaffer, 1991), and permits the treatment provider to develop a prescriptive treatment plan. The adaptive model. The disease concept of alcoholism and addiction has dominated the public's view of addiction and is often employed by 12-step programs and other treatment providers; however, it has fallen out of favor with some researchers (Alexander, 1987; Fingarette, 1991; Fingarette, 1988; Shaffer, 1985). Alexander (1987) proposed the adaptive model of addiction, which defines addiction at a failure to reach adult levels of integration. This failure drives the individual to find substitutes to provide meaning, social support, and organization. Fingarette (1991) and Shaffer (1985) eschew the disease concept of alcoholism because it lacks a true medical definition. As a heuristic for clinical intervention and treatment, the disease concept serves a purpose; however, if its purpose is only to be an antidote for the guilt an individual feels over his/her substance use, then other models should be considered. Fingarette challenges Jellinek's (1960) research since the data were drawn from a sample of Alcoholics Anonymous members who may not be representative of all heavy drinkers. Research on the adaptive model of addiction proposes an alternative to the disease concept. However, the model does not account for physiological dependence or any of the biological bases of addiction. Summary These different concepts of addiction were created out of research; however, some have fallen out of professional acceptance, such as the moral/volitional model. Even Concepts of Addiction 7 though these outdated concepts do not accurately describe the nature of addiction, individuals may hold beliefs related to these concepts. That is, research suggests that addiction does not result from weak morals, yet a person may believe that addicts lack moral fortitude. Addiction BeliefMeasures There are several measurement instruments to assess participants' attitudes or beliefs about addiction (Schaler, 1995; Luke, Ribisl, Walton, and Davidson, 2002). Schaler's Addiction Belief Scale assesses the beliefs among treatment providers, while the Addiction BeliefInventory (ABI) by Luke et aI. is designed for the drug rehabilitation clients and the general public. Both surveys differentiate between the disease and adaptive models of addiction. Addiction BeliefInventory. Because the current study does not assess treatment providers' attitudes, it uses a variation of the 64-item ABI to assess the concepts of addiction between university and treatment center samples. The ABI consists of questions pertaining to eight subscales: inability to control usage, chronic disease, reliance on experts, responsibility for actions and substance use, responsibility for recovery, genetic basis, coping skill, moral weakness (Luke et aI., 2002). Refer to Table 1 for a list of definitions. The researchers found that the ABI had high internal consistency as well as test-retest stability. The ABI has been used in other studies on addiction beliefs (Jordan, Davidson, Herman, and BootsMiller, 2002; Agrawal, Neale, Prescott, and Kendler, 2004). Jordan et aI. (2002) used the ABI to assess the addiction beliefs of patients with both single and dual diagnoses with mental disorders. The study by Agrawal et aI. (2004) assessed the Concepts of Addiction 8 comorbid use of cannabis and other illicit drugs and referenced the ABI and its evaluation of numerous concep