Showing papers on "Addiction published in 2015"
TL;DR: The scope of this public health crisis, its historical context, contributing factors, and lines of evidence indicating the role of addiction in exacerbating morbidity and mortality, are described, and a framework for interventions to address the epidemic of opioid addiction is provided.
Abstract: Public health authorities have described, with growing alarm, an unprecedented increase in morbidity and mortality associated with use of opioid pain relievers (OPRs). Efforts to address the opioid crisis have focused mainly on reducing nonmedical OPR use. Too often overlooked, however, is the need for preventing and treating opioid addiction, which occurs in both medical and nonmedical OPR users. Overprescribing of OPRs has led to a sharp increase in the prevalence of opioid addiction, which in turn has been associated with a rise in overdose deaths and heroin use. A multifaceted public health approach that utilizes primary, secondary, and tertiary opioid addiction prevention strategies is required to effectively reduce opioid-related morbidity and mortality. We describe the scope of this public health crisis, its historical context, contributing factors, and lines of evidence indicating the role of addiction in exacerbating morbidity and mortality, and we provide a framework for interventions to address the epidemic of opioid addiction.
1,150 citations
TL;DR: The circuit- and cell-level mechanisms of addiction are discussed and interventions designed to mitigate or even reverse them would be beneficial for the treatment of addiction.
926 citations
TL;DR: Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.
Abstract: Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain. Because previous reviews have indicated substantial variability in this literature, several steps were taken to enhance precision and utility. First, problematic use was coded using explicitly defined terms, referring to different patterns of use (ie, misuse, abuse, and addiction). Second, average prevalence rates were calculated and weighted by sample size and study quality. Third, the influence of differences in study methodology was examined. In total, data from 38 studies were included. Rates of problematic use were quite broad, ranging from <1% to 81% across studies. Across most calculations, rates of misuse averaged between 21% and 29% (range, 95% confidence interval [CI]: 13%-38%). Rates of addiction averaged between 8% and 12% (range, 95% CI: 3%-17%). Abuse was reported in only a single study. Only 1 difference emerged when study methods were examined, where rates of addiction were lower in studies that identified prevalence assessment as a primary, rather than secondary, objective. Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.
852 citations
TL;DR: In this paper, an integrative pathway model is proposed that aims to provide a theoretical framework to guide future research in the field of PMPU, highlighting that PMPU is a heterogeneous and multi-faceted condition.
Abstract: Despite the many positive outcomes, excessive mobile phone use is now often associated with potentially harmful and/or disturbing behaviors (e.g., symptoms of deregulated use, negative impact on various aspects of daily life such as relationship problems, and work intrusion). Problematic mobile phone use (PMPU) has generally been considered as a behavioral addiction that shares many features with more established drug addictions. In light of the most recent data, the current paper reviews the validity of the behavioral addiction model when applied to PMPU. On the whole, it is argued that the evidence supporting PMPU as an addictive behavior is scarce. In particular, it lacks studies that definitively show behavioral and neurobiological similarities between mobile phone addiction and other types of legitimate addictive behaviors. Given this context, an integrative pathway model is proposed that aims to provide a theoretical framework to guide future research in the field of PMPU. This model highlights that PMPU is a heterogeneous and multi-faceted condition.
615 citations
TL;DR: This article discussed how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions, and suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research.
Abstract: Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of "new" behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.
592 citations
TL;DR: A review of online social network site addiction can be found in this paper, which suggests that SNS addiction shares many similarities with those of other addictions, including tolerance, withdrawal, conflict, salience, relapse, and mood modification.
Abstract: Research into online social network site (SNS) addiction (i.e., excessive and compulsive online social networking) has expanded over the last years. This paper aims to give a review of this research. Although not formally recognized as a diagnosis, SNS addiction shares many similarities with those of other addictions, including tolerance, withdrawal, conflict, salience, relapse, and mood modification. Several screening instruments to identify SNS addicts have been developed—approaching the phenomenon in various ways, disclosing a conceptual and empirical obscurity in this field. Theoretical and empirical models suggest that SNS addiction is molded by several factors; including dispositional, sociocultural, and behavioral reinforcement. Also, empirical findings generally unveil that SNS addiction is related to impaired health and well-being. There has been little, if any, empirical testing of prevention or treatment for this behavioral addiction, although certain self-help strategies, therapies, and interventions have been proposed.
580 citations
TL;DR: This study provides the first insights into smartphone use, smartphone addiction, and predictors of smartphone addiction in young people from a European country and should be extended in further studies.
Abstract: Background and AimsSmartphone addiction, its association with smartphone use, and its predictors have not yet been studied in a European sample. This study investigated indicators of smartphone use, smartphone addiction, and their associations with demographic and health behaviour-related variables in young people.MethodsA convenience sample of 1,519 students from 127 Swiss vocational school classes participated in a survey assessing demographic and health-related characteristics as well as indicators of smartphone use and addiction. Smartphone addiction was assessed using a short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Logistic regression analyses were conducted to investigate demographic and health-related predictors of smartphone addiction.ResultsSmartphone addiction occurred in 256 (16.9%) of the 1,519 students. Longer duration of smartphone use on a typical day, a shorter time period until first smartphone use in the morning, and reporting that social networking was the mo...
562 citations
TL;DR: The NAc is a fascinating and potentially rich target for stereotactic neuros surgical intervention, and analysis of existing information regarding all aspects of this structure should help potentiate therapeutic advances and reduce complications from future studies of neurosurgical intervention in this region for a variety of disorders.
Abstract: There is increasing interest among functional neurosurgeons in the potential for novel therapies to impact upon diseases beyond movement disorders and pain. A target of increasing interest is the nucl
535 citations
TL;DR: There is good evidence that striatal dopamine receptor availability and dopamine release are diminished in individuals with stimulant or alcohol dependence but not in Individuals with opiate, nicotine or cannabis dependence, which has implications for understanding reward and treatment responses in various addictions.
Abstract: For several decades, addiction has come to be viewed as a disorder of the dopamine neurotransmitter system; however, this view has not led to new treatments. In this Opinion article, we review the origins of the dopamine theory of addiction and discuss the ability of addictive drugs to elicit the release of dopamine in the human striatum. There is robust evidence that stimulants increase striatal dopamine levels and some evidence that alcohol may have such an effect, but little evidence, if any, that cannabis and opiates increase dopamine levels. Moreover, there is good evidence that striatal dopamine receptor availability and dopamine release are diminished in individuals with stimulant or alcohol dependence but not in individuals with opiate, nicotine or cannabis dependence. These observations have implications for understanding reward and treatment responses in various addictions.
476 citations
TL;DR: Wang et al. as discussed by the authors explored the role of psychological attributes (such as shyness and loneliness) and smartphone usage patterns in predicting smartphone addiction symptoms and social capital and found that the most powerful predictor inversely affecting both bonding and bridging social capital was loneliness.
Abstract: The purpose of this study is to explore the roles of psychological attributes (such as shyness and loneliness) and smartphone usage patterns in predicting smartphone addiction symptoms and social capital. Data were gathered from a sample of 414 university students using online survey in Mainland China. Results from exploratory factor analysis identified five smartphone addiction symptoms: disregard of harmful consequences, preoccupation, inability to control craving, productivity loss, and feeling anxious and lost, which formed the Smartphone Addiction Scale. Results show that the higher one scored in loneliness and shyness, the higher the likelihood one would be addicted to smartphone. Furthermore, this study shows the most powerful predictor inversely affecting both bonding and bridging social capital was loneliness. Moreover, this study presents clear evidence that the use of smartphones for different purposes (especially for information seeking, sociability, and utility) and the exhibition of different addiction symptoms (such as preoccupation and feeling anxious and lost) significantly impacted social capital building. The significant links between smartphone addiction and smartphone usage, loneliness, and shyness have clear implications for treatment and intervention for parents, educators, and policy makers. Suggestions for future research are discussed.
TL;DR: Understanding the contributions of eCB disruptions to behavioural and physiological traits provides insight into the eCB influence on addiction vulnerability.
Abstract: Brain endocannabinoid (eCB) signalling influences the motivation for natural rewards (such as palatable food, sexual activity and social interaction) and modulates the rewarding effects of addictive drugs. Pathological forms of natural and drug-induced reward are associated with dysregulated eCB signalling that may derive from pre-existing genetic factors or from prolonged drug exposure. Impaired eCB signalling contributes to dysregulated synaptic plasticity, increased stress responsivity, negative emotional states and cravings that propel addiction. Understanding the contributions of eCB disruptions to behavioural and physiological traits provides insight into the eCB influence on addiction vulnerability.
TL;DR: The thesis argued here is that the brain has specific neurochemical neurocircuitry coded by the hedonic extremes of pleasant and unpleasant emotions that have been identified through the study of opponent processes in the domain of addiction.
TL;DR: The use of new technologies, including optogenetics and DREADDs (Designer Receptors Exclusively Activated by Designer Drugs), are reviewed in unraveling the role of the striatum in addiction, focusing on the roles of striatal cell populations and dopaminergic and glutamatergic afferents in addiction-related plasticity and behaviors.
TL;DR: The findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction.
Abstract: Background and AimsSmartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction.MethodsCollege students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young’s Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State–Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor–Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses.ResultsThe risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor ...
TL;DR: Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions, suggesting a mediating role of Mystical experience in psychedelic-facilitated addiction treatment.
Abstract: Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.
TL;DR: It is clear that subsets of VTA neurons have different pharmacological properties and participate in separate circuits, and the degree to which MOP receptor agonists act on different VTA circuits depends upon the behavioral state of the animal, which can be altered by manipulations such as food deprivation or prior exposure to MOPceptor agonists.
TL;DR: The study suggests the identification of smartphone addiction by diagnostic interview and via the App-generated parameters with EMD analysis, which suggests excessive use by daily use duration and frequency is associated with smartphone addiction.
TL;DR: This work has hypothesized that two distinctive forms of Internet addiction exist, and generalized Internet addiction refers to the problematic use of the Internet covering a broad range of Internet‐related activities.
Abstract: Introduction
It has been hypothesized that two distinctive forms of Internet addiction exist. Here, generalized Internet addiction refers to the problematic use of the Internet covering a broad range of Internet-related activities. In contrast, specific forms of Internet addiction target the problematic use of distinct online activities such as excessive online video gaming or activities in social networks.
Methods
The present study investigates the relationship between generalized and specific Internet addiction in a cross-cultural study encompassing data from China, Taiwan, Sweden and Germany in n = 636 participants. In this study, we assessed – besides generalized Internet addiction – addictive behavior in the domains of online video gaming, online shopping, online social networks and online pornography.
Results
The results confirm the existence of distinct forms of specific Internet addiction. One exception, however, was established in five of the six samples under investigation: online social network addiction correlates in large amounts with generalized Internet addiction.
Discussion
In general, it is of importance to distinguish between generalized and specific Internet addiction.
TL;DR: This review integrates theoretical models with experimental findings on the activity of DA systems, and on the causal role of specific neuronal projections and cell types, to provide a circuit-based framework for probing DA-RPE function in addiction.
TL;DR: A new trajectory by which serotonergic neuroadaptations induced by first drug exposure pave the way for the establishment of addiction is suggested.
TL;DR: The possible roles of the insula in addiction are examined, open questions are identified, and ways to address them are explored.
TL;DR: Optogenetic self-stimulation of DA neurons of the ventral tegmental area of the VTA induces behavioral and cellular hallmarks of addiction, indicating sufficiency for the induction and progression of the disease.
TL;DR: The results demonstrated a significant difference in personality traits for addictive behaviors related to different online activities and may provide a better understanding of the etiopathology of internet-related addictive behaviors and have implications for psychoeducation and psychotherapy programs.
TL;DR: Internet addiction by adolescents was associated with cyberbullying, substance use and depression, while parental restrictive mediation wasassociated with reductions in adolescent Internet addiction and cyberbullies.
TL;DR: The current state of knowledge of reward processing in addictive disorders from a widely used and validated task: the monetary incentive delay task is discussed and a focus on anticipatory processing and striatal regions activated during task performance as well as the relationship of these regions with individual difference and treatment outcome variables is reviewed.
TL;DR: In the case depicted here, the addiction model was shown to lead to standardized and non-relevant treatment, whereas the clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific, empirically based psychological interventions.
Abstract: Dysfunctional use of the mobile phone has often been conceptualized as a‘behavioural addiction’that shares most features with drug addictions In the current article, we challenge the clinical utility of the addiction model as applied to mobile phone overuse We describe the case of a woman who overuses her mobile phone fromtwodistinct approaches:(1) asymptom-basedcategorical approachinspiredfromtheaddiction model of dysfunctional mobile phone use and (2) aprocess-based approach resulting froman idiosyncratic clinical case conceptualization In the case depicted here, the addiction model was shown to lead to standardized and nonrelevanttreatment,whereastheclinicalcaseconceptualizationallowedidentificationof specific psychological processes that can be targeted with specific, empirically based psychological interventions This finding highlights that conceptualizing excessive behaviours (eg, gambling and sex) within the addiction model can be as implification of an individual’s psychological functioning, offering only limited clinical relevance Copyright © 2014 John Wiley & Sons, Ltd Key Practitioner Message: The addiction model, applied to excessive behaviours (eg, gambling, sex and Internet-related activities) may lead to non-relevant standardized treatments Clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific empirically based psychological interventions The biomedical model might lead to the simplification of an individual’s psychological functioning with limited clinical relevance
TL;DR: Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence, and recent advances in pharmacological treatment options include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.
Abstract: Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.
TL;DR: In this paper, the authors examined the relationship between a full range of personality traits and cell phone addiction using a comprehensive personality model and found that emotional instability and materialism were positively associated with addiction.
TL;DR: The present review will focus on the role of serotonin (5-HT; 5-hydroxytryptamine) neurotransmission in the neuropharmacology of cocaine and related abused stimulants and proposes new approaches to guide targeted development of serotonergic ligands for the treatment of cocaine use disorder.
Abstract: Cocaine exhibits prominent abuse liability, and chronic abuse can result in cocaine use disorder with significant morbidity. Major advances have been made in delineating neurobiological mechanisms of cocaine abuse; however, effective medications to treat cocaine use disorder remain to be discovered. The present review will focus on the role of serotonin (5-HT; 5-hydroxytryptamine) neurotransmission in the neuropharmacology of cocaine and related abused stimulants. Extensive research suggests that the primary contribution of 5-HT to cocaine addiction is a consequence of interactions with dopamine (DA) neurotransmission. The literature on the neurobiological and behavioral effects of cocaine is well developed, so the focus of the review will be on cocaine with inferences made about other monoamine uptake inhibitors and releasers based on mechanistic considerations. 5-HT receptors are widely expressed throughout the brain, and several different 5-HT receptor subtypes have been implicated in mediating the effects of endogenous 5-HT on DA. However, the 5-HT2A and 5-HT2C receptors in particular have been implicated as likely candidates for mediating the influence of 5-HT in cocaine abuse as well as to traits (e.g., impulsivity) that contribute to the development of cocaine use disorder and relapse in humans. Lastly, new approaches are proposed to guide targeted development of serotonergic ligands for the treatment of cocaine use disorder.