Addiction medicine

About: Addiction medicine is a research topic. Over the lifetime, 1070 publications have been published within this topic receiving 23685 citations.

Faculty development in addiction medicine: project SAEFP, a one-year follow-up study.

Abstract: BACKGROUND AND OBJECTIVES The goal of Project SAEFP (Substance Abuse Education for Family Physicians, pronounced SAFE) was to increase the number of residency teaching faculty with expertise in addiction medicine. This paper reports the results of a 12-month follow-up study conducted to assess changes in residency teaching and clinical practice of 165 residency teaching faculty who participated in this project. METHODS The Project SAEFP work group conducted a series of 5-day courses in the fall of 1990 at 10 sites around the country. The 165 faculty participants were taught how to use a set of 12 residency teaching modules that focused on clinical areas important to primary care physicians. The follow-up study consisted of a structured telephone interview. The findings were compared to previous interviews conducted before, and 3 months after, faculty participation in the course. RESULTS The findings suggest long-term increases in the amount of teaching, clinical practice, and consultations conducted by the family medicine faculty who participated in this faculty development project. CONCLUSION The findings of this study suggest that an intensive 5-day course using learner-centered teaching techniques can have a significant impact on primary care teaching faculty.

The Journal of Inebriety (1876–1914): history, topical analysis, and photographic images

Abstract: Aims The publication of the Journal of Inebriety (1876–1914) chronicled the rise and fall of the first era of organized addiction medicine in the United States. Methods Findings from historical research, a content analysis of the Journal's 35 volumes and 141 issues and images from the Journal illustrate visually the medical treatment of addiction in the United States in the late 19th and early 20th centuries. Results Under the editorial direction of Dr T. D. Crothers, the Journal of Inebriety published papers and reviews focused primarily on the medical treatment of alcohol and opiate addiction within a growing international network of inebriate homes and asylums. Conclusions The history of the Journal of Inebriety mirrors efforts in America to forge a legitimized field of addiction medicine amid conflicting conceptualizations of the nature of severe alcohol and other drug problems.

Reinforcement principles for addiction medicine; from recreational drug use to psychiatric disorder.

Abstract: The transition from recreational drug use to addiction can be conceptualized as a pathological timeline whereby the psychological mechanisms responsible for disordered drug use evolve from positive reinforcement to favor elements of negative reinforcement. Abused substances (ranging from alcohol to psychostimulants) are initially ingested at regular occasions according to their positive reinforcing properties. Importantly, repeated exposure to rewarding substances sets off a chain of secondary reinforcing events, whereby cues and contexts associated with drug use may themselves become reinforcing and thereby contribute to the continued use and possible abuse of the substance(s) of choice. Indeed, the powerful reinforcing efficacy of certain drugs may eclipse that of competing social rewards (such as career and family) and lead to an aberrant narrowing of behavioral repertoire. In certain vulnerable individuals, escalation of drug use over time is thought to drive specific molecular neuroadaptations that foster the development of addiction. Research has identified neurobiological elements of altered reinforcement following excessive drug use that comprise within-circuit and between-circuit neuroadaptations, both of which contribute to addiction. Central to this process is the eventual potentiation of negative reinforcement mechanisms that may represent the final definitive criterion locking vulnerable individuals into a persistent state of addiction. Targeting the neural substrates of reinforcement likely represents our best chances for therapeutic intervention for this devastating disease.

Primary care management of alcohol use disorder and at-risk drinking: Part 2: counsel, prescribe, connect

Abstract: Objective To provide primary care physicians with evidence-based information and advice on the management of at-risk drinking and alcohol use disorder (AUD). Sources of information We conducted a nonsystematic literature review using search terms that included primary care; screening, interventions, management, and treatment; and at-risk drinking, alcohol use disorders, alcohol dependence, and alcohol abuse; as well as specific medical and counseling interventions of relevance to primary care. Main message For their patients with at-risk drinking and AUD, physicians should counsel and, when indicated (ie, in patients with moderate or severe AUD), prescribe and connect . Counsel: Offer all patients with at-risk drinking a brief counseling session and follow-up. Offer all patients with AUD counseling sessions and ongoing (frequent and regular) follow-up. Prescribe: Offer medications (disulfiram, naltrexone, acamprosate) to all patients with moderate or severe AUD. Connect: Encourage patients with AUD to attend counseling, day or residential treatment programs, and support groups. If indicated, refer patients to an addiction medicine physician, concurrent mental health and addiction services, or specialized trauma therapy. Conclusion Family physicians can effectively manage patients with at-risk drinking and AUD.