Showing papers on "Addiction medicine published in 2012"

Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views

Abstract: Introduction: Behavioral science experts believe that all entities capable of stimulating a person can be addictive; and whenever a habit changes into an obligation, it can be considered as an addiction. Researchers also believe that there are a number of similarities as well as some differences between drug addiction and behavioral addiction diagnostic symptoms. The purpose of this study is to consider different approaches in this field. Methods: This is a descriptive research using content analysis method. First, differences and similarities of various perspectives on addiction and addiction behavior in different substances were obtained, thereafter, the data was coded and categorized, subjects were discussed and major issues were extracted. Results: Behavioral addiction such as internet addiction is similar to drug addiction except that in the former, the individual is not addicted to a substance but the behavior or the feeling brought about by the relevant action. In addition, the physical signs of drug addiction, are absent in behavioral addiction. Others have stated that behaviorally addicted individuals have certain symptoms and will undergo the same consequences brought about by addiction to alcohol and drugs as well as other obsessive behaviors. Conclusion: Similar to substance abuse prevention, programs aimed at addicted individuals and specialized training can educate adolescents about the warning signs of online addiction, in order to assist the early detection of this disorder. For prevention of behavioral addiction (such as internet addiction) authorities, cultural institutions and parents should monitor the use of internet and teach to the adolescent and children, the useful and appropriate methods of internet use. Keywords: Addiction, addictive behavior, prevention

The process addictions and the new ASAM definition of addiction.

Abstract: Addiction is a primary, chronic disease involving brain reward, motivation, memory and related circuitry; it can lead to relapse, progressive development, and the potential for fatality if not treated. While pathological use of alcohol and, more recently, psychoactive substances have been accepted as addictive diseases, developing brain science has set the stage for inclusion of the process addictions, including food, sex, shopping and gambling problems, in a broader definition of addiction as set forth by the American Society of Addiction Medicine in 2011.

Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women.

Abstract: Background Methamphetamine (MA) use during pregnancy is associated with many pregnancy complications, including preterm birth, small for gestational age, preeclampsia, and abruption. Hawaii has lead the nation in MA use for many years, yet prior to 2007, did not have a comprehensive plan to care for pregnant substance-using women. In 2006, the Hawaii State Legislature funded a pilot perinatal addiction clinic. The Perinatal Addiction Treatment Clinic of Hawaii was built on a harm-reduction model, encompassing perinatal care, transportation, child-care, social services, family planning, motivational incentives, and addiction medicine. We present the implementation model and results from our first one hundred three infants (103) seen over 3 years of operation of the program.

Evolution of Concept, But Not Action, in Addiction Treatment

Abstract: The Western approach to addiction treatment involves a medical or disease orientation to understanding the onset, course, and management of addiction, and a clinical goal of abstinence or very significant reductions in drug use, usually with a combination of behavioral and pharmacological interventions. Even within this Western approach, and despite several consensually accepted features of addiction, a significant mismatch remains between what this culture has come to accept as the nature of the disease and how that same culture continues to treat the disease. This paper discusses the evolution of these Western concepts over the past decade without a corresponding evolution in the nature, duration, or evaluation standards for addiction treatment. Here, we take the position that continuing care and adaptive treatment protocols, combining behavioral therapies, family and social supports, and, where needed, medications show much promise to address the typically chronic, relapsing, and heterogeneous nature o...

The Treatment Effectiveness Assessment (TEA): an efficient, patient-centered instrument for evaluating progress in recovery from addiction.

Abstract: The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients' progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none). The resulting Treatment Effectiveness Assessment (TEA) elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients' sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.

Evaluation of an experiential curriculum for addiction education among medical students.

Abstract: OBJECTIVES Undergraduate medical education about addictive disease can take many forms, but it is unclear which educational methods are most effective at shaping medical students into physicians who are interested in and competent at addressing addiction. The purpose of this study was to evaluate the efficacy of the Betty Ford Institute's Summer Institute for Medical Students (SIMS), a week-long program aimed at educating medical students about addiction through a combination of traditional didactic and novel experiential sessions. METHODS A written survey assessing beliefs, attitudes, and practices related to addictive disease was administered to physicians who previously participated in SIMS (n = 140) and to physicians matched for year of graduation from medical school who did not participate in SIMS (n = 105). RESULTS Compared with their peers, and controlling for sex, age, year of graduation from medical school, specialty, personal experience with addiction, and training in talking to patients about substance use, physicians who participated in SIMS were more likely to believe that they could help addicted patients, find working with addicted patients satisfying, be confident in knowing available resources for addicted patients, believe that addiction is a disease, and be confident in speaking to patients about substance use. Physicians who participated in SIMS were not more likely to practice addiction medicine or to view talking to patients about substance use as clinically relevant. CONCLUSIONS Undergraduate medical educational interventions combining traditional and experiential programming may render participants better equipped than peers receiving only traditional education to address addiction as physicians.

Medication-Assisted Recovery from Opioid Addiction: Historical and Contemporary Perspectives

Abstract: Recovery is being used as a conceptual fulcrum for the redesign of addiction treatment and related support services in the United States. Efforts by policy, research, and clinical leaders to define recovery and calls for assertive models of long-term recovery management raise critical questions about how transformation efforts of recovery-focused systems will affect the pharmacotherapeutic treatment of opioid addiction and the status of patients participating in such treatment. This article highlights recent work advocating a recovery-oriented approach to medication-assisted treatment.

The Medicalization of Addiction Treatment Professionals

Abstract: In a previous article, the authors described the changes initiated by recent health care legislation, and how those changes might affect the practice of medicine and the delivery of addiction services. This article reviews the same changes with respect to how they have the potential to change the practice activities of addiction physicians, addiction therapists, addiction counselors and addiction nurses, as well as the activities of administrators and service delivery financial personnel. Developments in delivery systems and the impact of those developments on professionals who work in addiction treatment are considered; current problems, potential solutions, and opportunities for clinicians under health reform are addressed. The goals envisioned for health system reform and the potential for realization of those goals via changes in addiction service delivery design and clinical practice are discussed.

Epidemiology and prevention of substance use disorders in the military.

Abstract: US military service members have been in active combat for more than 10 years Research reveals that combat exposure increases the risk of substance use disorders, post-traumatic stress disorder, major depression, and tobacco use The Services and the field of addiction medicine are working hard to find a common definition for prescription drug misuse, which is a growing concern in both the general US population and the force Meanwhile, leaders at all levels of Department of Defense are diligently working to address barriers to care, particularly stigma related to substance abuse care, by seeking a balance between improving service member privacy in order to encourage self-referral for medical care and a commander's need to know the status of the unit and its combat readiness The treatment and management of substance abuse disorders are a complex force health issue that requires the use of evidence-based medical interventions and policies that are consistent with them

Addiction is a disease: We must change our attitudes toward addicts

Abstract: Health professionals too often think and behave negatively toward addicts and addiction. In this, we share the attitudes of our society, in which substance abuse is one of the last remaining socially acceptable targets for public discrimination. But we ought to know better. If we are to succeed in

What are the public policy implications of a neurobiological view of addiction

Abstract: POST-PRINT This is a post-print (post-refereed, final accepted) version of the manuscript that has been published in Addiction. The citation details and the link to the final publisher version are below.

Addiction Counseling Licensure Issues for Licensed Professional Counselors

Abstract: Go To DigestThis article addresses the obstacles of effectively integrating addiction counseling into a nationwide definition of professional counseling scope of practice. The article covers an overview of issues, specific licensure and credentialing frameworks in two U.S. states, and recommendations to effectively bridge the gap between professional and addiction counseling.The question of professional identity within the counseling profession, first considered during the founding of the American Personnel and Guidance Association (Sweeney, 1995), still exists today (Calley & Hawley, 2008; Cashwell, Kleist, & Schofield, 2009; Mellin, Hunt, & Nichols, 2011; Myers, Sweeney, & White, 2002; Nassar-McMillan & Niles, 2011; Remley & Herlihy, 2009). One possible reason for the continual debate around professional identity may lie in the multitude of specialty fields (e.g., addiction, career, and school) within counseling (Gale & Austin, 2003; Myers, 1995; O'Brien, 2010). Remley (1995) underscores that unlike psychology, psychiatry and social work, counseling is the only mental health profession that licenses specialty areas. Specialty areas such as career and school counseling only denote a practice area or population; whereas addiction counseling actually entails a DSM-IV-TR Axis I disorder (i.e., Substance Use Disorders; American Psychiatric Association, 2000). No other Axis I or Axis II disorder receives such attention.Addiction is considered a part of professional counseling as implied by the latest CACREP standards (2009). However, a separate licensure track exists for the profession of addiction counseling. If the practice of addiction counseling really is a part of counseling (as implied by the latest 2009 CACREP standards), then the time has come to recalibrate the rest of the counseling profession to better fit an inclusive and unifying professional counseling identity that includes addiction counseling. Thus, the purpose of this paper is to start the dialogue regarding the mixed-messages on the issue of counselor identity and specialization for addiction counseling (Morgen, Miller, Culbreth, & Juhnke, 2011; Tabor, Camisa, Yu, & Doncheski, 2011). The article is divided into an overview of issues, specific licensure and credentialing frameworks in two sample states (New Jersey and North Carolina), and recommendations in response to the concerns discussed.Overview of IssuesHenriksen, Nelson, and Watts (2010) criticize the counseling specialty system by arguing that counseling specialties do not define counseling, but merely denote a practice area and that counseling specialty licensure/credentialing implies that only a small proportion of the counseling profession is qualified to work with this population. The addiction area is one such area of specialization that comes with a separate licensure/credentialing process. The authors believe that in regard to addiction counseling, the additional supervisory and training hours required for addiction licensure/credentialing (in addition to the supervisory and training hours required for licensure as a professional counselor) implies that addiction content falls outside the professional counseling scope of practice.For instance, if the graduate counseling program does not possess an addiction track, a cursory review of curriculum at CACREP and non-C ACREP programs found the typical option of one addiction course as an elective. However, curricular reviews of numerous programs find few to no electives on other DSM-IV-TR disorders (e.g., mood, anxiety). Thus, the authors argue this produces a confusing mixed-message in that licensure as a professional counselor covers practice areas that typically receive minimal exclusive attention (e.g., one-week discussion on anxiety disorders in a maladaptive behavior course), yet an area where one (or more) electives are typically offered for in-depth study of a disorder (such as addiction) comes with an entirely unique and separate licensure process. …

Why should we need a European Federation of Addiction Societies

Abstract: National societies for the study of addiction have been established in almost all European countries. However, as yet very little concerted action exists. A European Federation of Addiction Societies could play a leading role in fostering collaboration within Europe and beyond. The coordination and extension of lobbying activities for more funding of addiction research on a European level would be another important goal.

Science to improve care for people affected by unhealthy alcohol and other drug use.

Abstract: The last 20 years have brought two major changes in the field of addiction. First, the US Institute of Medicine (IOM) encouraged recognition of a spectrum of alcohol and other drug use that affects health and is not limited to those with the highest severity [1]. Unhealthy use (the spectrum from use that risks consequences through addiction [2]) among those without addiction is much more common than addiction itself. The second major shift also began in the 1990s with an emphasis on addiction as a chronic illness [3,4] and on unhealthy use as a health condition.

What is the Role of Urine Drug Testing (UDT) in the Management of Chronic Non‐Cancer Pain with Opioids?

Abstract: There is no longer doubt that the misuse, abuse, addiction, and diversion of prescription opioids comprise a national epidemic [1]. A simple solution is unlikely. As HL Mencken stated, “For every complex problem, there is an answer that is clear, simple, and wrong.” In retrospect, the quandary we are in was predictable. Physicians practicing in the 1990s received minimal education in pain management and almost no training in addiction medicine; they were given a Drug Enforcement Administration (DEA) certification without their having demonstrated any knowledge base of safe opioid prescribing. A few physicians with expertise in managing cancer pain with opioids suggested that a subpopulation of patients with chronic pain of nonmalignant nature might benefit from long-term opioid treatment to decrease pain and improve function. With little evidence base [2], this model became common practice among many physicians. This model was promoted by the pharmaceutical industry, which saw an opportunity to expand its market. Third-party payers and society were seduced by the relatively low cost of opioids as a simple solution to a complex problem. While the cost of opioids is relatively low, managing the adverse effects and the current opioid prescription epidemic is proving to be very costly in lives and treasure. In view of the alarming rise of emergency department admissions and unintentional overdose deaths due to prescription opioids, the Office of National Drug Control Policy (ONDCP) and the American Society of Addiction Medicine (ASAM) issued statements supporting mandatory education in safe opioid prescribing as a prerequisite for DEA certification. The American Academy of Pain Medicine (AAPM) demonstrated its leadership by developing a comprehensive prescriber education curriculum that provides responsible, multidimensional solutions for prescribers, patients, and society. It offered a 2-day Safe Opioid Prescribing course at its 2012 Annual Meeting [3], cochaired by Drs. Lynn …

Clinical and Ethical Considerations for the Treatment of Cybersex Addiction for Marriage and Family Therapists

Abstract: The Internet has become a forum for various kinds of sexual activity, and an addiction to sexual activities on the Internet has become increasingly common. Cybersex addiction is not currently included in the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision, and research on the ethical treatment of cybersex addiction is limited. As cybersex addiction is entering the therapeutic arena with more frequency, a myriad of clinical and ethical issues can pervade individual and couples counseling surrounding this issue. It benefits marriage and family therapists to be aware of the ethical issues that may arise in treatment. Common ethical issues include trivializing the effects the addiction has on couple and family cohesiveness, unconscious self-of-therapist values such as opinions toward pornography, and lack of therapeutic competence regarding cybersex addiction. These ethical concerns are not common within the literature and are not addressed in therapist training programs....

Optimizing Pain Management Through Collaborations with Behavioral and Addiction Medicine in Primary Care

Abstract: Chronic non-cancer pain (CNCP) affects a high proportion of primary care patients and carries a large human and economic burden. In response to the widespread perception that pain has been under-diagnosed and undertreated, regulatory bodies have encouraged more comprehensive services addressing pain syndromes. Significant hurdles exist in treating CNCP in primary care settings including a relative lack of training, lower physician satisfaction in treating pain patients, lack of objective measures and the risks associated with opioid treatment including addiction. Additionally, interventional therapies and pharmacotherapy often do not provide complete symptomatic relief. Here, we describe a multidimensional and interdisciplinary approach to the treatment of CNCP. The utility of collaborations with behavioral and addiction medicine specialists optimizes care and advances models of patient treatment within a primary care patient-centered medical home.

Process addictions in 2012: food, internet and gambling

Abstract: Traditional addiction studies have focused specifically on the use of chemical substances, while more recent studies have begun to focus on behavioral processes. Process addiction is an addiction to a natural and in many cases essential behavior such as eating and sex. Acquired continued and compulsive overeating is one process addiction similar to other activities or behaviors, such as excessive video gaming, pathological gambling, hyper-sexuality or excessive internet use where the addict shows loss of control, an inability to stop or modify the activity, and a range of signs and symptoms that can be as debilitating as those associated with substance abuse or addiction. Individuals with process addiction would meet criteria for addiction if their substance of abuse was considered a drug. They present characteristics like other addicts, have a chronic and relapsing course and often the addiction leaves them with loss of health, happiness and a difficulty treating the disease. Gambling has been the least contentious process addiction and will appear in the Diagnostic and Statistical Manual of Mental Disorders. Food and sex have been the most difficult for the field to consider as addictions. However, food may have the clearest, long-standing scientific research behind it. In this review, we provide a summary of the literature on process (behavior) addictions and a discussion of food addiction, as well as pathological gambling and internet addiction disorder.

Federal policy on criminal offenders who have substance use disorders: how can we maximize public health and public safety?

Abstract: The Obama Administration is striving to promote both public health and public safety by improving the public policy response to criminal offenders who have substance use disorders. This includes supporting drug courts, evidence-based probation and parole programs, addiction treatment and re-entry programs. Scientists and clinicians in the addiction field have a critical role to play in this much-needed effort to break the cycle of addiction, crime and incarceration.

Perioperative Addiction: Clinical Management of the Addicted Patient

Abstract: This publication by Springer provides readers with a valuable textbook concerning the clinical management of the addicted patient in the perioperative period. The focus of the information presented is on the physiological and pharmacological challenges of these patients and how these difficulties are best managed. The text is centred predominantly on acute perioperative care and does not explore other management issues commonly encountered in addiction medicine, such as cognitive behavioural or psychiatric therapies. The contributing authors are predominantly physicians practicing anesthesiology. The book is divided into three parts. Part I provides readers with a general background on the disease of addiction. The text ranges from historical accounts of the introduction of drugs to ancient civilizations to descriptions of contemporary functional magnetic resonance imaging and genetic studies of the addicted brain. The final chapter in Part 1 is on pharmacological approaches to the treatment of addiction with a focus on the use of methadone and buprenorphine. This chapter presents a clear and understandable discussion for those not accustomed to the use of these drugs. Issues surrounding the perioperative administration of these drugs are also addressed and suitably explored for perioperative care providers. Part II of the book offers readers an overview of specific drug classes of abuse, including chapters on opioids, club drugs, cocaine, and alcohol. The text is well written with a focus on the pertinent pharmacological and physiological issues of each drug in the perioperative environment. The discussions, which are divided into the preoperative, intraoperative, and postoperative phases of surgery, are written in a clear, concise, and comprehensive manner. The chapter on propofol addiction is especially significant and likely the most comprehensive summary of the subject matter to date. Although Part II is well written, it falls somewhat short in that some drug classes are conspicuously absent or the detail may be less comprehensive than desired. For example, no mention is made of the barbiturates or anabolic steroids. Both categories of drugs can produce profound pharmacological and physiological challenges in perioperative care that would have been valuable to discuss. The focus of Part III, the final section of the book, is on discussions of specific populations in the context of addiction. Some of these chapters include drug-seeking healthcare professionals, pregnant women, adolescent populations, or individuals recovering from substance abuse. Fundamental principles on managing these populations are summarized in this section, and it makes a suitable resource for the perioperative clinician. The chapters are varied in their content in terms of the amount and type of clinical information provided. For example, the chapter on the drug-seeking healthcare professional discusses many social issues (legal, financial, family, and intervention), while the chapter on the patient recovering from substance abuse has a more pharmacological focus with discussions regarding adjunctive anesthetic agents and drug-drug interactions. G. A. Bellingham, MD (&) Schulich School of Medicine & Dentistry, Western University, London, ON, Canada

Training General Psychiatry Residents To Prescribe Buprenorphine in Treatment of Patients With Opioid Dependence

Abstract: The most commonly abused substances in southwest Virginia are prescription medications. One of the most significant trends in Virginia is the percent of the population aged 12 and older using pain relievers for nonmedical purposes. Although the rate for the state as a whole (4.42%) is less than the national rate (4.89%), the southwest Virginia regional rate of 5.51% exceeds the national rate.1 The American Academy of Addiction Psychiatry, the American Osteopathic Academy of Addiction Medicine, and the American Psychiatric Association have been awarded a 3-year grant by the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment to operate the Physicians' Clinical Support System for Buprenorphine (PCSS-B), effective July 1, 2011.2 This initiative provides training and clinical mentorship to practicing physicians and physicians-in-training who wish to include office-based treatment of opioid use disorders in their practices.2 The state of Virginia has 5 general psychiatry residency programs, of which Carilion Clinic–Virginia Tech Carilion Psychiatry Residency Program (CC-VTCSOM) may be the first to teach their general psychiatry residents about office-based treatment of opioid dependence by using this initiative. The program coordinates PCSS-B training for 17 of CC-VTCSOM's 32 psychiatry residents. The size of the training group was capped at 20, and 3 members of the faculty took the training as well. Residents and faculty completed a 3.75-hour training course, according to guidelines from PCSS-B, followed by a 4.25-hour face-to-face session by board- certified addiction psychiatrists, which included the program director for the addictions fellowship at CC-VTCSOM. This session included an interactive component with clinical case vignettes. Topics included an overview of office-based treatment of substance use disorders, review of opioids, introduction to buprenorphine/naloxone, special aspects of treatment of substance abuse disorders, and use of buprenorphine in special patient populations. This workshop was intended to prepare psychiatry residents to understand the complex demands of southwest Virginia's patient population, given the region's higher risk for opioid dependence.

Primary and Behavioral Healthcare Integration: Threat or Opportunity for Addiction Treatment Organizations?

Abstract: Nationwide, health care systems are experiencing an increasingly rapid pace of health reforms, especially in burgeoning areas such as health homes, accountable care organizations, which emphasize the growing need for bidirectional integration of primary care and behavioral health. Several articles in this issue of the Journal of Behavioral Health Services & Research explore care that requires collaboration between primary and behavioral health: “Predictors of primary care physicians’ self-reported intention to conduct suicide risk assessments” by Lisa M Hooper et al., “Outcomes associated with a cognitive-behavioral chronic pain management program implemented in three public HIV primary care clinics” by Jodie Anne Trafton et al., and the “Relationship between neighborhood characteristics and recruitment into adolescent family-based substance use prevention programs” by Hilary F. Byrnes et al. However, is this emphasis on integration a threat or opportunity for specialty addiction treatment organizations? A recent U.S. Substance Abuse and Mental Health Services Administration–U.S. Health Resources and Services Administration Center for Integrated Health Solutions survey 1 identified a growing number of specialty addictions treatment organizations that partner with community health centers, methadone treatment centers that qualify as Federally Qualified Health Centers, and residential treatment programs that offer primary care services onsite. Even state alcohol and drug authorities are focusing on integration at annual provider meetings and state training academies. In communities, specialty addiction treatment organizations have long held relationships with primary care practices. Historically, these relationships have ensured physicals for individuals entering residential care, interim services for pregnant women and individuals using intravenous drugs, and, more recently, medication interventions as a part of addiction treatment. New integration models serve to enhance providers’ opportunities to reach individuals in earlier stages of addiction, and the earlier treatment that follows could assuage damage to their bodies and improve overall treatment outcomes. Developing recovery plans which incorporate overall health, including exercise, prevention, and specific public health goals for chronic health problems, support recovery. In terms of Screening, Brief Intervention, and Referral to Treatment (SBIRT), specialty addiction professionals fill a gap in primary care settings by supporting “referral to treatment.” Without this involvement of addiction professionals, SBIRT programs often fail when a patient requires a

Service users' and service providers' understandings of addiction and their impact on treatment plans and treatment outcomes.

Abstract: The word addiction is almost immediately associated with notions of drug dependency and alcoholism, and drug addiction is often referred to as a pandemic that affects individuals, families, communities and society at large. Aetiological approaches to understanding and treating addiction have changed dramatically throughout history, and currently the most contemporary approach is that of the disease model which views addiction as an illness rather than as a ‘badness’. While the underpinnings of Narcotics Anonymous’ 12 step philosophy employs non-specific drug language as it views all drugs as having the capacity to become addictive, and while it does not distinguish between the capacity for substances and certain behaviours to become addictive, activities such as overeating, having sex and gambling are yet to be classified as legitimate addictions by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). As a result, it appears as if some confusion exists as to whether these behaviours should be classified as impulse control disorders or as genuine addictions due to the various similarities they share in common with substance based disorders. The research conducted explored how people recovering from addiction, as well as how people working with addiction understand addiction and multiple dependency, together with the factors that contribute to relapse and the ability to abstain. Various 12 Step meetings from a variety of 12 Step Fellowships were attended and members were invited to participate in the study. Ultimately seventy eight participants completed a self developed questionnaire which was utilised to assess how people recovering from addiction understood addiction and multiple dependency and the factors that contribute to relapse and the ability to abstain. Quantitative data were analysed via descriptive and inferential statistics. Furthermore twenty participants working with addiction were interviewed with the use of a semi structured interview schedule in order to explore their perceptions around addiction and the factors that contribute to relapse and sobriety. Qualitative data were analysed using thematic content analysis. Results indicated that the majority of recovering addicts and professionals working with addiction understand addiction as a disease. However, discrepancy was apparent with regards to whether or not all recovering addicts have the same disease and subsequently whether all addictions can be treated in the same manner. The above result suggested that there was no standardised, uniform way in which the disease model is understood and interpreted. Factors such as cross addiction,