Drug abuse and addiction

Making Amends and Moving Forward by Hugo Schwyzer

by Feminism and Religion

cross published at Feminismandreligion.com

Since Clarisse Thorn’s interview with me appeared at Feministe about two weeks ago, there’s been a huge outpouring of... more Since Clarisse Thorn’s interview with me appeared at Feministe about two weeks ago, there’s been a huge outpouring of shock and anger surrounding revelations about my past. I’ve only read some of the posts and the comments at various sites, but I’ve seen enough to recognize that these revelations have understandably touched a deep nerve.

Exactly a year ago, I wrote a post about the last time I used drugs and alcohol, a binge episode that ended with my attempt to kill myself and my ex-girlfriend with gas. The post was written in haste as a response to a friend’s query about forgiving oneself for a terrible error. The example my buddy Bill offered was of neglecting a dog he’d been housesitting. Foolishly, I regrettably offered the most painful example from my own life of a dreadful action – the time I tried to kill another human being and myself. It was grotesquely insensitive of me to compare what Bill had done with a pet to what I did to my ex, and I deeply regret having framed the story in that way. I also am sorry that the post was written so as to frame my feelings alone in a way that eclipsed my ex, the victim of this episode.

I do want to clarify one point from that post for the sake of the record. I never lied to the sheriff’s deputies about a suicide pact, as some bloggers have alleged. I was barely coherent when they kicked down my apartment door, and made no statement to them about what was happening, other than to ask the deputies why they were handcuffing us. After I’d been placed on a hold in a mental hospital, it was a psychiatrist who told me that the deputies had told him that this had been a suicide pact. Filled with remorse, I immediately told him the truth. He then notified the sheriff’s department. My ex and her family declined to press charges, and so no case was filed.

CONTINUE READING: http://feminismandreligion.com/2012/01/11/making-amends-and-moving-forward-by-hugo-schwyzer/

TAGS: Ethics, Feminism, Gender and Power, Men and Feminism, Power relations, Sexual Ethics, drug and alcohol recovery, gender and power, Hugo Schwyzer, making amends, men and feminism, power relationships, professor student relationships

Anesthesia and Addiction, International Anesthesiology Clinics 49 (1), Winter 2011

by Ethan Bryson

By Ethan O. Bryson, M.D., and Elizabeth A. M. Frost, M.D.
Philadelphia, Lippincott Williams & Wilkins, 2011.
Pages: 176. Price: $176.00.

This is a review of the special issue of the International Anesthesiology Clinics book on Anesthesia and Addiction... more This is a review of the special issue of the International Anesthesiology Clinics book on Anesthesia and Addiction that Dr. Frost and I put together that was published in the January 2012 issue of Anesthesiology.

Novel Drugs, Novel Solutions: exploring the potentials of web-assistance and multimedia approaches for the prevention of drug abuse

by Manuela Pasinetti

Exposure of anesthesia providers in recovery from substance abuse to potential triggering agents

by Ethan Bryson

Hamza H, Bryson EO. Journal of Clinical Anesthesia, November 2011

Study Objective: To determine the experience, attitudes, and opinions of anesthesia providers in recovery from... more Study Objective: To determine the experience, attitudes, and opinions of anesthesia providers in recovery from addiction to anesthetic agents, who subsequently undergo surgery or who require opioid analgesics for injuries or other conditions.

Design: Survey instrument.

Setting: Academic medical center.

Subjects: Physicians and nurse-anesthetists in recovery in the United States.

Measurements: A link to a survey was posted on the Anesthetists in Recovery website on January 17, 2010 and allowed to remain active for a period of one week. The survey also was distributed via email to recovering anesthesiologists in a “snowball sampling” method. Completed surveys were reviewed, and data were compiled using Survey Monkey, with categorical variables described as frequencies and percentages.

Main Results: A total of 30 surveys were returned, with 27 (90%) reporting a history of abusing anesthetics or drugs commonly found in the work environment, and 19 (65.5%) reporting abuse of recreational drugs and drugs used during the administration of anesthesia. Twenty-eight (93%) respondents reported finding themselves in a situation that necessitated they receive their former drug of choice for legitimate medical reasons while in recovery.

Conclusions: Anesthesia care providers in recovery from addiction to anesthetic agents may undergo subsequent exposure to these agents due to medical necessity. Participation in a program of recovery with support from family members may decrease the risk of relapse but does not eliminate it.

Trends in Primary Methamphetamine-Related Admissions to Youth Residential Substance Abuse Treatment Facilities in Canada, 2005–2006 and 2009–2010

by Marina Verdichevski

Published in the Canadian Journal of Psychiatry

Authors:
Verdichevski M, Burns R, Cunningham JK, Tavares J, Callaghan RC.

Objective: During the last decade, methamphetamine use and issues surrounding its toxicity have triggered major... more Objective: During the last decade, methamphetamine use and issues surrounding its toxicity have triggered major concern in the Canadian government, leading to significant changes in drug policy and funding strategies to limit the societal impact of methamphetamine-related harms. This concern appears justified by research which found in 2005–2006 that 21% of all youth admissions to inpatient substance abuse treatment centres in Canada were due primarily to methamphetamine abuse. Given these patterns of treatment use and targeted governmental initiatives, an open question is whether the demand for methamphetamine treatment found in 2005–2006 has decreased. Our study aims to provide follow-up estimates of admissions for 2009–2010, as well as important trend information for these periods.
Method: We developed a comprehensive list of all Canadian residential youth substance abuse treatment facilities. The executive director of each facility was asked about the site’s annual caseload, and the proportion of cases primarily due to methamphetamine abuse within the past 12 months.
Results: Our survey data for the periods of 2005–2006 and 2009–2010 show marked reductions in admissions. In 2009–2010, we found that about 6% of all admissions were due primarily to methamphetamine abuse, a substantial drop from the 21% reported in our 2005–2006 study.
Conclusions: Our data show a significant national reduction in methamphetamine-related admissions. Other reports show that methamphetamine-related treatment admissions in the United States and Mexico declined sharply during 2005–2008, reportedly in association with Mexico’s methamphetamine precursor chemical controls, raising the possibility that the controls may also be associated with the declines reported here.

Apparent transient effects of recent" ecstasy" use on cognitive performance and extrapyramidal signs in human subjects

by Ryan Smith

OBJECTIVES:
Our purpose is to investigate cognitive performance and extrapyramidal function early after ecstasy... more OBJECTIVES:
Our purpose is to investigate cognitive performance and extrapyramidal function early after ecstasy use.

BACKGROUND:
Ecstasy, containing 3,4 methylenedioxymethamphetamine, has shown evidence of causing cognitive deficits and parkinsonian signs. Previous research has examined cognitive performance after a period of prolonged abstinence, but research assessing the early effects of ecstasy after recent use is limited despite temporal neurochemical differences demonstrated in nonhuman models.

METHODS:
This study compared task performance between 13 ecstasy users (10 to 15 h postdrug use) and a control group on a battery of neuropsychologic assessments while matching for education level, sleep deprivation, and premorbid IQ. The groups were also compared on measures relating to parkinsonian signs.

RESULTS:
The ecstasy subjects showed impairments on measures of executive function as evaluated by Raven's Standard Progressive Matrices (SPM) and the Wisconsin Card Sorting Task (WCST). Short-delay free recall memory was also impaired in ecstasy subjects on the California Verbal Learning Test (CVLT-II). No extrapyramidal motor impairments were detected.

CONCLUSIONS:
These deficits resemble deficits previously reported in chronic ecstasy use but also seem to reveal transient impairments in executive function. Future research is needed to better understand the neurologic and neuropsychologic implications of ecstasy use across time and extent of use.

Substance misuse among offenders in a forensic intellectual disability service

by Verity Chester

Purpose – There have been few studies about the prevalence of substance abuse and links to offending behaviour among... more Purpose – There have been few studies about the prevalence of substance abuse and links to offending behaviour among those with intellectual disabilities. This paper aims to address this issue.

Design/methodology/approach – This baseline audit describes: the prevalence of alcohol and substance misuse in patients within a forensic intellectual disability service; and the introduction of a Drug and Alcohol Awareness Course. In total, 74 patients were included in the audit.

Findings – Roughly half of the patients audited had co-morbid harmful use or dependence with the problem being equally prevalent in men and women. Whilst alcohol and cannabis were the commonest drugs of abuse, cocaine, stimulants and opiates were abused by a small but significant number. Of those with harmful use or dependence, 35 per cent had used the drug in the immediate lead up to their index offence. A diagnosis of personality disorder and past history of convictions for violent offences was significantly more likely to be present in the group with harmful use or dependence. There were no differences on major mental illnesses or pervasive developmental disorders.

Practical implications – The high prevalence of substance abuse makes it an important risk factor that could determine treatment outcomes. Forensic intellectual disability units need replicable substance abuse targeted treatment programmes that can be formally audited and evaluated.

Originality/value – Findings are discussed in relation to service planning and treatment outcomes from forensic intellectual disability services.

Addiction, Narrative and Spirituality: Theoretical-Methodological Approaches and Overview

by Srdjan Sremac

Religija i tolerancija Vol.8/14, 2010, 255-273.

In the article the author presents different theoretical and methodological approaches to substance addiction:... more In the article the author presents different theoretical and methodological approaches to substance addiction: biological, socio-cultural, psychological, and narrative theories. The author argues that we have to develop a comprehensive theory of addiction that should include not only biomedical, psychological and socio-cultural factors but spiritual aspects of the individual as well. A more holistic and yet fully empirical model of research in addictiology as a human science must indeed include the spiritual dimension. Therefore, a comprehensive theory of addiction has to address all aspects: physical, psychological, social, and spiritual for effective treatment and recovery.

Key words: Addiction, spirituality, religiousness, narrative.

Addiction and Autonomy: are Addicts Autonomous?

by Srdjan Sremac

Nova Prisutnost 9(2011)1, 171-188. Co-authored with Frans Koopmans.

In the article, the authors deal with how addiction can be related to autonomy. First, they will provide a definition... more In the article, the authors deal with how addiction can be related to autonomy. First, they will provide a definition of substance addiction and the way various theories have interpreted this phenomenon. Further, they will give a general description of the concept of autonomy and relate this to the phenomenon of addiction. Subsequently, the authors will deal with the way some explanatory models of addiction (the disease model, disorder of choice model, and existential disorder model) see the relationship of autonomy and addiction and focus on the following questions: How does addiction relate to autonomy? Does addiction make volitional choice impossible, i.e. are addicts out of control? Is addictive behavior a rational activity?

Key words: Addiction, autonomy, disease model, disorder of choice model, existential disorder model, spirituality.

Prevalencia de trastorno por déficit de atención e hiperactividad (TDAH) en adictos a sustancias: del cribado al diagnóstico

by José María Ruiz Sánchez de León

Prevalence of attention-deficit hyperactivity disorder in substance addiction: from screening to diagnosis [In Spanish] Revista de Neurología 2011, 52(6), 331-340.

Resumen:
Introducción. Existe abundante bibliografía sobre la coexistencia de criterios diagnósticos para el... more Resumen:
Introducción. Existe abundante bibliografía sobre la coexistencia de criterios diagnósticos para el trastorno por déficit de atención/hiperactividad (TDAH) y el abuso/dependencia de sustancias. La prevalencia encontrada en diversos trabajos difiere considerablemente. Objetivo. Aplicar un algoritmo que considere todos los criterios necesarios para un adecuado diagnóstico y explorar las condiciones asociadas a los falsos positivos. Pacientes y métodos. Se aplicó el algoritmo diagnóstico, utilizando diversas pruebas en las distintas fases: la Attention Deficit Hyperactivity Disorder Self-Report Scale para el cribado, la Wender-Utah Rating Scale y la Parents’ Rating Scale para el diagnóstico retrospectivo, y la escala de comportamiento frontal, versión española autoadministrada, y la escala de estrés percibido para el estudio de verdaderos/falsos positivos. Se exploraron también síntomas de otros trastornos del eje I y se administró una batería de pruebas neuropsicológicas clásicas. Todo ello sobre una muestra de 696 sujetos que iniciaron tratamiento en un centro de atención a drogodependientes. Resultados. La prevalencia encontrada finalmente fue del 6,89%. Los falsos positivos en la prueba de cribado se asemejaban en su sintomatología previa al consumo a los verdaderos negativos, pero aquélla era similar en el momento actual a la de los verdaderos positivos, con quienes no mostraban diferencias en el rendimiento neuropsicológico. El trastorno de ansiedad generalizada fue el que mostró mayor relación con los falsos positivos. Conclusiones. La categoría diagnóstica de TDAH suele utilizarse indiscriminadamente para clasificar a sujetos con alteraciones neurológicas de aparición temprana y a quienes presentan similares manifestaciones tras la fase de adicción activa a sustancias. Se requiere un estudio neurológico y neuropsicológico que vaya más allá de los meros síntomas para caracterizar y tratar adecuadamente un conjunto de manifestaciones sintomatológicas similares, pero con componentes evolutivos y etiopatogénicos muy diversos.
Palabras clave:
Abuso/dependencia. Cribado. Diagnóstico. Drogodependientes. TDAH.

Abstract:
Introduction. There is a rich body of literature on the coexistence of diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and substance abuse/dependence. Prevalence, however, varies considerably from one work to another. Aims. To apply an algorithm that takes into account all the criteria needed to reach an adequate diagnosis and to explore the conditions associated with false positives. Patients and methods. The diagnostic algorithm was applied using several tests in the different phases, i.e. the Attention Deficit Hyperactivity Disorder Self-Report Scale was used for screening, the Wender-Utah Rating Scale and the Parents’ Rating Scale were administered for the retrospective diagnosis, and the self-administered Spanish version of the frontal behaviour scale and the perceived stress scale were used to study false positives. Symptoms of other axis I disorders were also explored and a battery of classic neuropsychological tests was administered. All this was carried out with a sample of 696 subjects whose treatment began in a care centre for drug addicts. Results. The final prevalence was found to be 6.89%. The symptoms of the false positives in the screening test prior to consumption were similar to those of the true negatives, but in that moment those symptoms were similar to those of the true positives, with whom no differences were found in the neuropsychological performance. Generalised anxiety disorder was the one that showed the highest relation with false positives. Conclusions. The diagnostic category of ADHD is usually utilised indiscriminately to classify subjects with early-onset neurological disorders and those who present similar manifestations following the phase of active addiction to substances. There is a need for a neurological and neuropsychological study that goes beyond the mere symptoms so as to be able to carry out a suitable characterisation and treatment of a set of similar symptomatic manifestations, but with a very wide range of developmental and aetiopathogenic components.
Key words:
Abuse/dependence. ADHD. Diagnosis. Drug addicts. Screening.

Smoking experience modulates the cortical integration of vision and haptics

by Yavor Yalachkov

published in Neuroimage

Reefer Madness: Cannabis, the Individual, and Public Policy

by Tuomas Tahko

In Dale Jaquette (ed.) Cannabis: What Were We Just Talking About? (Oxford: Wiley-Blackwell, 2010), pp. 149–161.

This paper is a survey of the positive and negative aspects of cannabis use from the point of view of the individual... more This paper is a survey of the positive and negative aspects of cannabis use from the point of view of the individual on the one hand and from the point of view of the society on the other hand. Health, social, and political motives are all discussed, and the best method of harm reduction is analysed. The upshot is that zero tolerance policy is obsolete, and that most individuals would be better off using cannabis rather than other drugs.

Differences in the consumption of psychoactive substances and psychotropic drugs among Medical and Psychology students at exam time

by Jose A. Piqueras

Reference:
Carballo, J.L., Marín, M., Pons, C., Espada, J.P., Piqueras, J.A. y Orgiles, M. (2011). Diferencias en el consumo de sustancias psicoactivas y psicofármacos entre estudiantes de Medicina y Psicología en época de exámenes. Health and Addictions, 11(1), 19-30.

"In Spanish"

The increase in stress among university students at exam time has been associated with an increase in the consumption... more The increase in stress among university students at exam time has been associated with an increase in the consumption of psychoactive substances and psychotropic drugs. The aim of this paper was to describe and analyze the differences in the consumption of psychoactive substances and psychotropic drugs among Medical and Psychology students at exam time. A total of 257 students of Miguel Hernández University were involved in this study. The participants, aged between 17 and 25, were selected from different years of Psychology and Medicine degrees. Several questionnaires were used to assess the consumption of psychoactive substances and psychotropic drugs, as well as depression and anxiety levels. Regarding the results, Psychology students showed a higher consumption of recreational drugs, such as tobacco or cannabis. However, Medical students reported a higher consumption of psychotropic drugs, besides more depression and anxiety. The level of prior
information about the substances or the accessibility to them might have influenced the differences between both degrees, so that future papers should focus on the assessment of these risk factors.

Sensory and motor aspects of addiction

by Yavor Yalachkov

published in Behavioural Brain Research

Brain regions related to tool use and action knowledge reflect nicotine dependence

by Yavor Yalachkov

published in Journal of Neuroscience

Perception and action in nicotine addiction: fMRI and behavioral studies of sensorimotor and multisensory processes in smokers and non-smokers

by Yavor Yalachkov

PhD thesis

Involvement of action-related brain regions in nicotine addiction

by Yavor Yalachkov

published in Journal of Neurophysiology

One Strike, You're Out: One Size Fits None

by Ethan Bryson

reply to several letters to the editor of Anesthesiology regarding the article "Addiction and Substance Abuse in Anesthesiology" published in October 2008

Evidence for Habitual and Goal-Directed Behavior Following Devaluation of Cocaine: A Multifaceted Interpretation of Relapse

by David Barker

ENABLING DEPENDENT DRUG USERS: A COGNITIVE BEHAVIOURAL ASSESSMENT

by Julian Buchanan

Buchanan J (1991) ‘Enabling Dependent Drug Users - A Cognitive Behavioural Assessment.’ Practice Vol 5 No.1, 1991 BASW, London P34-46

if you like this paper there are more drugs articles by Julian Buchanan you can download for free from:
http://epubs.glyndwr.ac.uk/cgi/query.cgi?field_1=lname&value_1=Buchanan&field_2=fname&value_2=Julian&advanced=1

Any feedback or comments do email me: julian.buchanan@vuw.ac.nz

Based upon six years social work practice with dependent drug users in Merseyside, the author introduces the broad... more Based upon six years social work practice with dependent drug users in Merseyside, the author introduces the broad principles of a cognitive behavioural approach, and then integrates this theoretical understanding to a highly specific area of practice, - assessing dependent drug users. Assessment is discussed in detail and using examples the article provides a much needed model of good practice. The approach is based upon a risk reduction philosophy and is underpinned by cognitive behavioural principles. The article offers a comprehensive outline from which a practitioner could follow and conduct an assessment. Importantly, the process seeks to empower clients, redressing the balance by returning to them responsibility for their future, thus enabling them to set their own targets and plans without coercion from the worker.

This paper briefly outlines the emergence of cognitive behavioural therapy from within behaviourist theory and then, using examples, relates it to dependent behaviour. Based upon six years social work practice with dependent drug users, the paper provides a detailed framework of an established cognitive behavioural assessment which has been developed and refined through practice.