Addiction medicine

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

Heroin: The Treatment of Addiction in Twentieth-century Britain

Abstract: Heroin, often viewed as the 'hardest drug', looms large in the popular consciousness. Heroin addiction in Britain first began to cause concern during the 1920s, yet while one group of doctors regarded the addiction as a disease which required treatment, other physicians viewed it as a vice which demanded strict control. The medical community and the government have debated both the definition of addiction - medical condition, moral failing or social problem - and the method of dealing with addiction - medical treatment vs. legal controls.In "Heroin", Alex Mold examines the interaction of the different approaches to heroin addiction and argues that the treatment of the addiction as a disease and the control of heroin as a social problem could, in practice, rarely be separated. Treatment became a way of controlling the addiction and the addicts themselves, but debates about the nature of addiction treatment and the methods used resulted in politicisation of the topic. During the late 1960s Drug Dependence Units (DDUs) were established as a means to combine both medical treatment and social control.The 'British System' essentially treated addiction as a disease and offered maintenance - the administering of heroin or an opioid substitute on a long-term basis - as treatment. Maintenance proved to be a source of tension between psychiatrists specialising in addiction treatment and private and general practitioners who operated outside the DDUs. This conflict manifested itself in heated disputes on the pages of medical journals, in government committees and in disciplinary hearings before the General Medical Council.The same debates, conflicts and tensions which have beset drug addiction treatment since the beginning of the 20th century persist today. Despite international laws and codes concerning addiction and treatment, there is much that is peculiar and significant about the British case. Drawing on government papers, private archival collections, medical journals, oral history sources and official reports, Mold presents the first detailed historical analysis on the subject. Historians, sociologists, addiction specialists and contemporary policy-makers can look to this groundbreaking study to learn from the past and shape the future response to heroin addiction.

The Addiction Recovery Clinic: A Novel, Primary-Care-Based Approach to Teaching Addiction Medicine.

Abstract: ProblemSubstance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine.ApproachIn 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also

Parity and the Medicalization of Addiction Treatment

Abstract: Parity, the idea that insurance coverage for the treatment of addiction should be on a par with insurance coverage for the treatment of other medical illnesses, is not a new idea, but the path to achieving "real parity" has been a long, hard and complex journey. Action by Congress to pass major parity legislation in 2008 was a huge step forward, but does not mean that parity has been achieved. Parity has required a paradigm shift in the understanding of addiction as a biological illness: many developments of science and policy changes by professional organizations and governmental entities have contributed to that paradigm shift. Access to adequate treatment for patients must acknowledge the paradigm shift reflected in parity as it has evolved to the current point: that this biological illness is widespread, that it is important that it be treated effectively, that appropriate third party payment for physician-provided or physician-supervised addiction treatment is critical for addiction medicine to become a part of the mainstream of our nation's healthcare delivery system, and that medical specialty care provides the most effective and cost effective benefit to patients and therefore to our society.

What place for prolonged-release buprenorphine depot-formulation Buvidal® in the treatment arsenal of opioid dependence? Insights from the French experience on buprenorphine.

Abstract: Introduction: Since the 1990s, opioid maintenance treatments (OMTs), i.e. mostly methadone and buprenorphine, have represented the therapeutic cornerstone of opioid dependence. In France, the public health strategy on opioid dependence, identified here as the 'French model', has consisted of offering a facilitated access to buprenorphine, to reach a large treatment coverage and reduce opioid-related mortality. Areas covered: Recently, a new formulation of subcutaneous buprenorphine depot (Buvidal®) has been approved in Europe for treatment of opioid dependence. The place of Buvidal® among the pre-existing arsenal of OMTs is discussed in the light of the pharmacological specificities of this new formulation, and with the particular standpoint of the French model on opioid dependence. Expert opinion: Buvidal® could constitute a promising treatment option mainly in case of: 1) OMT initiation, including in non-specialized addiction medicine care; 2) Discharge from prison or hospital; Diversion/misuse of 3) buprenorphine or 4) methadone; 5) Clinically stabilized patients wishing to avoid daily oral taking of the medication. As such, this new formulation should be highly accessible, which will require specific pathways through care as the product is intended to be administered by a healthcare professional.

An integration of three approaches to addiction and methadone maintenance treatment: the self-medication hypothesis, the disease model and social criticism.

Abstract: The two models which have most affected theory and practice of addiction medicine have been the disease model and the self-medication hypothesis. The disease model's fundamental concept is that the addicted individual is sick and suffers from a disease. The self-medication hypothesis proposes that drug and alcohol users are attempting to cope with an underlying psychological or social disorder by means of self-medication. These two viewpoints are presented in the light of a number of specific methadone maintenance treatment and drug abuse related issues such as the question whether drug abuse is an illness of the body, the mind or society; whether the disease model really de-stigmatized drug abuse; what the correct methadone dosing policy should be; the place of psychotherapy in methadone maintenance treatment and drug abuse and how polydrug abuse should be treated. These issues are discussed and an integrated approach is suggested stressing the need for social criticism and a renewed social policy towards drug abuse in general and its treatment in particular.