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Addiction medicine
About: Addiction medicine is a research topic. Over the lifetime, 1070 publications have been published within this topic receiving 23685 citations.
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01 Jan 1988
TL;DR: In 1948 China was described as having the greatest and most intractable health problems of any nation in the world, and less than forty years later, many of these problems have been dealt with.
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.
1 citations
TL;DR: In Australia, patients with substance use and high-prevalence mental health disorders tend to be treated by alcohol and other drug agencies, while those with low prevalence disorders, many of whom have significant associated drug problems, are core clinical business for public mental health services as mentioned in this paper.
Abstract: ver the past decade or so, care of people affected by comorbidities of substance use disorder and mental health problems has been a focus of Australian state, territory and national campaigns. Despite these efforts, true coordinated treatment models remain the exception rather than the rule. Patients with “dual diagnosis” (a term that must now be close to its use-by date) present substantial challenges to existing treatment models. Various mechanisms conspire against these patients getting better: addictive substances exacerbate psychiatric symptoms; patients with mental illness may continue to use psychoactive drugs in an effort to attenuate symptoms; and substances of misuse in themselves can induce psychiatric disorders. 1 Active use of substances often substantially interferes with psychiatric pharmacotherapies. For example, standard antidepressant treatment may not provide the expected benefits in patients with mood disorder and comorbid untreated addiction. 2 The field of addiction medicine struggles to recruit doctors, while the level of complexity of patients and the expectations of the community for evidence-supported care across all health fields have increased. Workforce challenges are fed by the perception of clinical complexity, such as that associated with DSM-IV Axis II disorders and substance use (page S16). 3 These “heart-sink” patients are often referred to alcohol and drug treatment services, where staff expertise in managing behaviours that interfere with treatment delivery may vary. In Australia, patients with substance use and high-prevalence mental health disorders tend to be treated by alcohol and other drug agencies, while those with low-prevalence disorders, many of whom have significant associated drug problems, are core clinical business for public mental health services. The heterogeneous nature of these services and the complexity of much of this patient group make it hard to know how well either sector performs this clinical work.
1 citations
TL;DR: The fundamental model of addiction has been expanded to include newer concepts such as multiple levels of severity of illness, motivational circuitry, and anti-reward pathways, which can explain some of the successes and failures of addiction treatment in the second half of the 20th century and the beginning of the 21st century.
Abstract: The current understanding of addiction is based on a biopsychosocial model of illness. From a neurobiological perspective, addiction can be seen as the hijacking of the pleasure-reward pathways of the brain with a concomitant weakening of its executive function. The fundamental model has been expanded to include newer concepts such as multiple levels of severity of illness, motivational circuitry, and anti-reward pathways. These neurobiological concepts can explain some of the successes and failures of addiction treatment in the second half of the 20th century and the beginning of the 21st century. Psychosocial interventions (primarily cognitive behavior therapy, mutual help groups, and motivational interviewing) and pharmacological treatments (such as agonists, antagonists, and partial agonists) form the basis of addiction treatment today.
1 citations
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)
1 citations