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Substance use disorder

From Wikipedia, the free encyclopedia

Substance use disorder
Other namesDrug use disorder
A variety of drugs and drug paraphernalia
SpecialtyPsychiatry, clinical psychology
SymptomsExcessive use of drugs despite adverse consequences
ComplicationsDrug overdose;[1] general negative long-term effects on mental and physical health; acquiring infectious diseases;[2] in some cases criminal behaviour[3]
Risk factorsHaving parents or close family members with SUD; other mental health disorders; recreational use of drugs in adolescence and young adulthood[1][4][5][6][7]
Diagnostic methodSymptoms of drug addiction and dependence; inability to lower use; continued use despite awareness of negative consequences, and others
TreatmentDrug rehabilitation therapy

Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences to self and others.[8] Related terms include substance use problems[9] and problematic drug or alcohol use.[10][11]

Substance use disorders vary with regard to the average age of onset.[12] It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental, emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms.[8] Drug classes that are commonly involved in SUD include: alcohol (alcoholism); cannabis; opioids; stimulants such as nicotine (including tobacco), cocaine and amphetamines; benzodiazepines; barbiturates; and other substances.[8][13]

In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (2013), also known as DSM-5, the DSM-IV diagnoses of substance abuse and substance dependence were merged into the category of substance use disorders.[14][15] The severity of substance use disorders can vary widely; in the DSM-5 diagnosis of a SUD, the severity of an individual's SUD is qualified as mild, moderate, or severe on the basis of how many of the 11 diagnostic criteria are met. The International Classification of Diseases 11th revision (ICD-11) divides substance use disorders into two categories: (1) harmful pattern of substance use; and (2) substance dependence.[16]

In 2017, globally 271 million people (5.5% of adults) were estimated to have used one or more illicit drugs.[17] Of these, 35 million had a substance use disorder.[17] An additional 237 million men and 46 million women have alcohol use disorder as of 2016.[18] In 2017, substance use disorders from illicit substances directly resulted in 585,000 deaths.[17] Direct deaths from drug use, other than alcohol, have increased over 60 percent from 2000 to 2015.[19] Alcohol use resulted in an additional 3 million deaths in 2016.[18]

Causes

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Two women and a man smoking in an opium den, late 19th century

Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals' health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders.[20]

This section divides substance use disorder causes into categories consistent with the biopsychosocial model. However, it is important to bear in mind that these categories are used by scientists partly for convenience; the categories often overlap (for example, adolescents and adults whose parents had (or have) an alcohol use disorder display higher rates of alcohol problems, a phenomenon that can be due to genetic, observational learning, socioeconomic, and other causal factors); and these categories are not the only ways to classify substance use disorder etiology.

Similarly, most researchers in this and related areas (such as the etiology of psychopathology generally), emphasize that various causal factors interact and influence each other in complex and multifaceted ways.[21][22][23][24][25]

Social determinants

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Among older adults, being divorced, separated, or single; having more financial resources; lack of religious affiliation; bereavement; involuntary retirement; and homelessness are all associated with alcohol problems, including alcohol use disorder.[26] Many times, issues may be interconnected, people without jobs are most likely to abuse substances which then makes them unable to work. Not having a job leads to stress and sometimes depression which in turn can cause an individual to increase substance use. This leads to a cycle of substance abuse and unemployment.[27] The likelihood of substance abuse can increase during childhood. Through a study conducted in 2021 about the effect childhood experiences have on future substance use, researchers found that there is a direct connection between the two factors. Individuals that had experiences in their childhood which left them traumatized in some way had a much higher chance of substance abuse.[28]

Psychological determinants

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Psychological causal factors include cognitive, affective, and developmental determinants, among others. For example, individuals who begin using alcohol or other drugs in their teens are more likely to have a substance use disorder as adults.[1] Other common risk factors are being male, being under 25, having other mental health problems (with the latter two being related to symptomatic relapse, impaired clinical and psychosocial adjustment, reduced medication adherence, and lower response to treatment[29]), and lack of familial support and supervision.[1] (As mentioned above, some of these causal factors can also be categorized as social or biological). Other psychological risk factors include high impulsivity, sensation seeking, neuroticism and openness to experience in combination with low conscientiousness.[30][31]

Biological determinants

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Children born to parents with SUDs have roughly a two-fold increased risk in developing a SUD compared to children born to parents without any SUDs.[1] Other factors such as substance use during pregnancy, or the persistent inhalation of secondhand smoke can also influence a person's substance use behaviors in the future.[27]

Diagnosis

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Addiction and dependence glossary[32][33][34]
  • addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences
  • addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems
  • dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
  • drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose
  • drug withdrawal – symptoms that occur upon cessation of repeated drug use
  • physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)
  • psychological dependence – dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome)
  • reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them
  • rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach
  • sensitization – an amplified response to a stimulus resulting from repeated exposure to it
  • substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress
  • tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

It is important when diagnosing substance use disorder to define the difference between substance use and substance abuse. "Substance use pertains to using select substances such as alcohol, tobacco, illicit drugs, etc. that can cause dependence or harmful side effects."On the other hand, substance abuse is the use of drugs such as prescriptions, over-the-counter medications, or alcohol for purposes other than what they are intended for or using them in excessive amounts.[35] Individuals whose drug or alcohol use cause significant impairment or distress may have a substance use disorder (SUD).[8] Diagnosis usually involves an in-depth examination, typically by psychiatrist, psychologist, or drug and alcohol counselor.[36] The most commonly used guidelines are published in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).[36] There are 11 diagnostic criteria which can be broadly categorized into issues arising from substance use related to loss of control, strain to one's interpersonal life, hazardous use, and pharmacologic effects.[8]

There are additional qualifiers and exceptions outlined in the DSM. For instance, if an individual is taking opiates as prescribed, they may experience physiologic effects of tolerance and withdrawal, but this would not cause an individual to meet criteria for a SUD without additional symptoms also being present.[8] A physician trained to evaluate and treat substance use disorders will take these nuances into account during a diagnostic evaluation.

Signs and symptoms

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Symptoms for a substance use disorder include behavioral, physical and social changes. Changes in behavior include being absent from school or work; changes in appetite or sleep patterns; personality and attitude changes; mood swings, and anxiety. Signs include physical changes such as weight gain or loss; tremors, and bloodshot eyes.[37] Different substances used can give different signs and symptoms.[38]

Severity

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Substance use disorders can range widely in severity, and there are numerous methods to monitor and qualify the severity of an individual's SUD. The DSM-5 includes specifiers for severity of a SUD.[8] Individuals who meet only two or three criteria are often deemed to have mild SUD.[8] Substance users who meet four or five criteria may have their SUD described as moderate, and persons meeting six or more criteria as severe.[8] In the DSM-5, the term drug addiction is synonymous with severe substance use disorder.[34][39] The quantity of criteria met offer a rough gauge on the severity of illness, but licensed professionals will also take into account a more holistic view when assessing severity which includes specific consequences and behavioral patterns related to an individual's substance use.[8] They will also typically follow frequency of use over time, and assess for substance-specific consequences, such as the occurrence of blackouts, or arrests for driving under the influence of alcohol, when evaluating someone for an alcohol use disorder.[8] There are additional qualifiers for stages of remission that are based on the amount of time an individual with a diagnosis of a SUD has not met any of the 11 criteria except craving.[8] Some medical systems refer to an Addiction Severity Index to assess the severity of problems related to substance use.[40] The index assesses potential problems in seven categories: medical, employment/support, alcohol, other drug use, legal, family/social, and psychiatric.[41]

Screening tools

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There are several different screening tools that have been validated for use with adolescents, such as the CRAFFT, and with adults, such as CAGE, AUDIT and DALI.[42] Laboratory tests to detect alcohol and other drugs in urine and blood may be useful during the assessment process to confirm a diagnosis, to establish a baseline, and later, to monitor progress.[43] However, since these tests measure recent substance use rather than chronic use or dependence, they are not recommended as screening tools.[43]

Mechanisms

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Main articles: Addiction § Mechanisms, and Substance dependence § Biomolecular mechanisms

Rehabilitation

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There are many underlying mechanisms behind the rehabilitation of SUD. Some include coping, craving, motivation to change, self-efficacy, social support, motives and expectancies, behavioral economic indicators, and neurobiological, neurocognitive, and physiological factors. These can be treated in a variety of ways, such as by cognitive behavioral therapy (CBT), which is an intervention treatment that helps individuals identify and change harmful thought patterns that may influence their emotions and behaviors negatively.[44] As well as motivational interviewing (MI) that is a technique used to help motivate doubtful patients to change their behavior.[45] Lastly combined behavioral intervention (CBI), can be used which involves combining elements of alcohol interventions, motivational interviewing, and functional analysis to help the clinician identify skill deficits and high risk situations that are associated with drinking or drug use.[46][47]

Management

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Withdrawal management

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Withdrawal management is the medical and psychological care of patients who are experiencing withdrawal symptoms due to the ceasing of drug use.[48] Depending on the severity of use, and the given substance, early treatment of acute withdrawal may include medical detoxification. Of note, acute withdrawal from heavy alcohol use should be done under medical supervision to prevent a potentially deadly withdrawal syndrome known as delirium tremens. See also Alcohol detoxification.

Therapy

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Main article: Drug rehabilitation

Therapists often classify people with chemical dependencies as either interested or not interested in changing. About 11% of Americans with substance use disorder seek treatment, and 40–60% of those people relapse within a year.[49] Treatments usually involve planning for specific ways to avoid the addictive stimulus, and therapeutic interventions intended to help a client learn healthier ways to find satisfaction. Clinical leaders in recent years have attempted to tailor intervention approaches to specific influences that affect addictive behavior, using therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy, addictive sources of pleasure or relief from pain.

Treatments
Behavioral pattern Intervention Goals
Low self-esteem, anxiety, verbal hostility Relationship therapy, client centered approach Increase self-esteem, reduce hostility and anxiety
Defective personal constructs, ignorance of interpersonal means Cognitive restructuring including directive and group therapies Insight
Focal anxiety such as fear of crowds Desensitization Change response to same cue
Undesirable behaviors, lacking appropriate behaviors Aversive conditioning, operant conditioning, counter conditioning Eliminate or replace behavior
Lack of information Provide information Have client act on information
Difficult social circumstances Organizational intervention, environmental manipulation, family counseling Remove cause of social difficulty
Poor social performance, rigid interpersonal behavior Sensitivity training, communication training, group therapy Increase interpersonal repertoire, desensitization to group functioning
Grossly bizarre behavior Medical referral Protect from society, prepare for further treatment
Adapted from: Essentials of Clinical Dependency Counseling, Aspen Publishers

From the applied behavior analysis literature and the behavioral psychology literature, several evidence-based intervention programs have emerged, such as behavioral marital therapy, community reinforcement approach, cue exposure therapy, and contingency management strategies.[50][51] In addition, the same author suggests that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious.

Medication

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Medication-assisted treatment (MAT) refers to the combination of behavioral interventions and medications to treat substance use disorders.[52] Certain medications can be useful in treating severe substance use disorders. In the United States five medications are approved to treat alcohol and opioid use disorders.[53] There are no approved medications for cocaine, methamphetamine.[53][54]

Medications, such as methadone and disulfiram, can be used as part of broader treatment plans to help a patient function comfortably without illicit opioids or alcohol.[55] Medications can be used in treatment to lessen withdrawal symptoms. Evidence has demonstrated the efficacy of MAT at reducing illicit drug use and overdose deaths, improving retention in treatment, and reducing HIV transmission.[56][57][58]

Potential vaccines for addiction to substances

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Vaccines for addiction have been investigated as a possibility since the early 2000s.[59] The general theory of a vaccine intended to "immunize" against drug addiction or other substance abuse is that it would condition the immune system to attack and consume or otherwise disable the molecules of such substances that cause a reaction in the brain, thus preventing the addict from being able to realize the effect of the drug. Addictions that have been floated as targets for such treatment include nicotine, opioids, and fentanyl.[60][61][62][63] Vaccines have been identified as potentially being more effective than other anti-addiction treatments, due to "the long duration of action, the certainty of administration and a potential reduction of toxicity to important organs".[64]

Specific addiction vaccines in development include:

As of September 2023, it was further reported that a vaccine "has been tested against heroin and fentanyl and is on its way to being tested against oxycontin".[71]

Epidemiology

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The disability-adjusted life year, a measure of overall disease burden (number of years lost due to ill-health, disability or early death), from drug use disorders per 100,000 inhabitants in 2004
  no data
  <40
  40-80
  80-120
  120-160
  160-200
  200-240
  240-280
  280-320
  320-360
  360-400
  400–440
  >440

Rates of substance use disorders vary by nation and by substance, but the overall prevalence is high.[72] On a global level, men are affected at a much higher rate than women.[72] Younger individuals are also more likely to be affected than older adults.[72]

United States

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In 2020, 14.5% of Americans aged 12 or older had a SUD in the past year.[73] Rates of alcohol use disorder in the past year were just over 5%. Approximately 3% of people aged 12 or older had an illicit drug use disorder.[73] The highest rates of illicit drug use disorder were among those aged 18 to 25 years old, at roughly 7%.[73][72]

There were over 72,000 deaths from drug overdose in the United States in 2017,[74] which is a threefold increase from 2002.[74] However the CDC calculates alcohol overdose deaths separately; thus, this 72,000 number does not include the 2,366 alcohol overdose deaths in 2017.[75] Overdose fatalities from synthetic opioids, which typically involve fentanyl, have risen sharply in the past several years to contribute to nearly 30,000 deaths per year.[74] Death rates from synthetic opioids like fentanyl have increased 22-fold in the period from 2002 to 2017.[74] Heroin and other natural and semi-synthetic opioids combined to contribute to roughly 31,000 overdose fatalities.[74] Cocaine contributed to roughly 15,000 overdose deaths, while methamphetamine and benzodiazepines each contributed to roughly 11,000 deaths.[74] Of note, the mortality from each individual drug listed above cannot be summed because many of these deaths involved combinations of drugs, such as overdosing on a combination of cocaine and an opioid.[74]

Deaths from alcohol consumption account for the loss of over 88,000 lives per year.[76] Tobacco remains the leading cause of preventable death, responsible for greater than 480,000 deaths in the United States each year.[77] These harms are significant financially with total costs of more than $420 billion annually and more than $120 billion in healthcare.[78]

Canada

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According to Statistics Canada (2018), approximately one in five Canadians aged 15 years and older experience a substance use disorder in their lifetime.[79] In Ontario specifically, the disease burden of mental illness and addiction is 1.5 times higher than all cancers together and over 7 times that of all infectious diseases.[80] Across the country, the ethnic group that is statistically the most impacted by substance use disorders compared to the general population are the Indigenous peoples of Canada. In a 2019 Canadian study, it was found that Indigenous participants experienced greater substance-related problems than non-Indigenous participants.[81]

Statistics Canada's Canadian Community Health Survey (2012) shows that alcohol was the most common substance for which Canadians met the criteria for abuse or dependence.[79] Surveys on Indigenous people in British Columbia show that around 75% of residents on reserve feel alcohol use is a problem in their community and 25% report they have a problem with alcohol use themselves. However, only 66% of First Nations adults living on reserve drink alcohol compared to 76% of the general population.[82] Further, in an Ontario study on mental health and substance use among Indigenous people, 19% reported the use of cocaine and opiates, higher than the 13% of Canadians in the general population that reported using opioids.[83][84]

Australia

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Historical and ongoing colonial practices continue to impact the health of Indigenous Australians, with Indigenous populations being more susceptible to substance use and related harms.[85] For example, alcohol and tobacco are the predominant substances used in Australia.[86] Although tobacco smoking is declining in Australia, it remains disproportionately high in Indigenous Australians with 45% aged 18 and over being smokers, compared to 16% among non-Indigenous Australians in 2014–2015.[87] As for alcohol, while proportionately more Indigenous people refrain from drinking than non-Indigenous people, Indigenous people who do consume alcohol are more likely to do so at high-risk levels.[88] About 19% of Indigenous Australians qualified for risky alcohol consumption (defined as 11 or more standard drinks at least once a month), which is 2.8 times the rate that their non-Indigenous counterparts consumed the same level of alcohol.[87]

However, while alcohol and tobacco usage are declining, use of other substances, such as cannabis and opiates, is increasing in Australia.[85] Cannabis is the most widely used illicit drug in Australia, with cannabis usage being 1.9 times higher than non-Indigenous Australians.[87] Prescription opioids have seen the greatest increase in usage in Australia, although use is still lower than in the US.[89] In 2016, Indigenous persons were 2.3 times more likely to misuse pharmaceutical drugs than non-Indigenous people.[87]

References

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  1. ^ a b c d e Thair T (2020). "Substance Use Disorder". In AAVV (ed.). Ferri's Clinical Advisor. Philadelphia: Elsevier. pp. 1321–2. ISBN 978-0-323-67254-2.
  2. ^ Wang SC, Maher B (December 2019). "Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review". Cell Transplantation. 28 (12). SAGE Journals: 1465–1471. doi:10.1177/0963689719878380. PMC 6923556. PMID 31547679. S2CID 202746148.
  3. ^ Skjærvø I, Clausen T, Skurtveit S, Bukten A (November 2021). "Desistance from crime following substance use treatment: the role of treatment retention, social network, and self-control". BMC Psychiatry. 21 (1). Springer Nature: 563. doi:10.1186/s12888-021-03518-2. ISSN 1471-244X. PMC 8588672. PMID 34772369. S2CID 243991019.
  4. ^ Hodder RK, Freund M, Bowman J, Wolfenden L, Campbell E, Dray J, et al. (August 2017). "Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: cluster-randomised controlled trial" (PDF). BMJ Open. 7 (8). BMJ Group: e016060. doi:10.1136/bmjopen-2017-016060. PMC 5629645. PMID 28821523. S2CID 1475517. Archived (PDF) from the original on 30 April 2019. Retrieved 1 October 2021.
  5. ^ Barry AE, King J, Sears C, Harville C, Bondoc I, Joseph K (January 2016). "Prioritizing Alcohol Prevention: Establishing Alcohol as the Gateway Drug and Linking Age of First Drink With Illicit Drug Use". The Journal of School Health. 86 (1). Wiley-Blackwell on behalf of the American School Health Association: 31–38. doi:10.1111/josh.12351. PMID 26645418. S2CID 8906331.
  6. ^ Parker EM, Bradshaw CP (October 2015). "Teen Dating Violence Victimization and Patterns of Substance Use Among High School Students". The Journal of Adolescent Health. 57 (4). Elsevier on behalf of the Society for Adolescent Health and Medicine: 441–447. doi:10.1016/j.jadohealth.2015.06.013. PMC 10041881. PMID 26271161. S2CID 40481423.
  7. ^ Moss HB, Chen CM, Yi HY (March 2014). "Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample". Drug and Alcohol Dependence. 136. Elsevier: 51–62. doi:10.1016/j.drugalcdep.2013.12.011. PMID 24434016. S2CID 13003820.
  8. ^ a b c d e f g h i j k l Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association. 2013. ISBN 978-0-89042-554-1. OCLC 830807378.
  9. ^ Paglia A, Room R (September 1999). "Preventing Substance Use Problems Among Youth: A Literature Review and Recommendations". Journal of Primary Prevention. 20 (1): 3–50. doi:10.1023/A:1021302302085. ISSN 1573-6547. S2CID 264261699.
  10. ^ Buchanan J (January 2006). "Understanding problematic drug use: A medical matter or a social issue". British Journal of Community Justice. 4 (2): 387–397 – via ResearchGate.
  11. ^ Mekonen T, Fekadu W, Chane T, Bitew S (2017). "Problematic Alcohol Use among University Students". Frontiers in Psychiatry. 8: 86. doi:10.3389/fpsyt.2017.00086. PMC 5437113. PMID 28579966.
  12. ^ Hassan MA, Abdelhameed MA, Abd El-Naem MM, Abdelhafeez MH (6 August 2021). "Does type and number of used substances affect the severity of illness in patients with substance use disorders?". The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 57 (1): 110. doi:10.1186/s41983-021-00361-w. ISSN 1687-8329. S2CID 236930825.
  13. ^ Substance Abuse and Mental Health Services Administration (June 2016). Substance Use Disorders. Substance Abuse and Mental Health Services Administration (US).
  14. ^ Guha M (11 March 2014). "Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th edition)". Reference Reviews. 28 (3): 36–37. doi:10.1108/RR-10-2013-0256. ISSN 0950-4125.
  15. ^ Hasin DS, O'Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, et al. (August 2013). "DSM-5 criteria for substance use disorders: recommendations and rationale". The American Journal of Psychiatry. 170 (8): 834–851. doi:10.1176/appi.ajp.2013.12060782. PMC 3767415. PMID 23903334.
  16. ^ World Health Organization, ICD-11 for Mortality and Morbidity Statistics (ICD-11 MMS), 2018 version for preparing implementation, rev. April 2019
  17. ^ a b c "World Drug Report 2019: 35 million people worldwide suffer from drug use disorders while only 1 in 7 people receive treatment". www.unodc.org. Retrieved 25 November 2019.
  18. ^ a b Global status report on alcohol and health 2018 (PDF). WHO. 2018. p. xvi. Retrieved 3 May 2020.
  19. ^ "Prelaunch". www.unodc.org. Retrieved 14 December 2018.
  20. ^ Wu LT, Blazer DG (April 2014). "Substance use disorders and psychiatric comorbidity in mid and later life: a review". International Journal of Epidemiology. 43 (2): 304–317. doi:10.1093/ije/dyt173. PMC 3997371. PMID 24163278.
  21. ^ Kendler KS (March 2005). "Toward a philosophical structure for psychiatry". The American Journal of Psychiatry. 162 (3): 433–440. doi:10.1176/appi.ajp.162.3.433. PMID 15741457. psychiatric disorders are etiologically complex ...
  22. ^ Borsboom D, Cramer AO, Kalis A (January 2018). "Brain disorders? Not really: Why network structures block reductionism in psychopathology research" (PDF). The Behavioral and Brain Sciences. 42 (e2): e2. doi:10.1017/S0140525X17002266. hdl:10468/7846. PMID 29361992. S2CID 13665601. Archived from the original (PDF) on 14 November 2020. Retrieved 13 November 2020. p. 1: mental disorders feature biological and psychological factors that are deeply intertwined in feedback loops. This suggests that neither psychological nor biological levels can claim causal or explanatory priority, and that a holistic research strategy is necessary for progress in the study of mental disorders.
  23. ^ Kendler KS, Ohlsson H, Edwards AC, Sundquist J, Sundquist K (October 2017). "A developmental etiological model for drug abuse in men". Drug and Alcohol Dependence. 179: 220–228. doi:10.1016/j.drugalcdep.2017.06.036. PMC 5623952. PMID 28806639. DA [drug abuse] in men is a highly multifactorial syndrome with risk arising from familial-genetic, psychosocial, behavioral and psychological factors acting and interacting over development.
  24. ^ MacKillop J, Ray LA (2017). "The Etiology of Addiction: a Contemporary Biopsychosocial Approach" (PDF). In MacKillop J, Kenna GA, Leggio L, Ray LA (eds.). Integrating Psychological and Pharmacological Treatments for Addictive Disorders: An Evidence-Based Guide. New York: Routledge. pp. 32–53. ISBN 978-1-138-91909-9. p. 32: The goal of the current chapter is to review contemporary perspectives on the etiology, or the causes, of addictive disorders. ... this is no small task because of the complexity of these conditions and because the study of addiction is the focus of multiple disciplines using highly divergent perspectives. Furthermore, these different perspectives have not generated a single accepted account for why a person develops an addiction, but a number of empirically-grounded theoretical approaches that broadly fall into three domains—biological determinants, psychological determinants, and social determinants. These are collectively referred to as the biopsychosocial model of addiction
  25. ^ Glackin SN, Roberts T, Krueger J (February 2021). "Out of our heads: Addiction and psychiatric externalism". Behavioural Brain Research. 398: 112936. doi:10.1016/j.bbr.2020.112936. hdl:10871/124796. PMID 33065141. S2CID 222317541.
  26. ^ Kuerbis A, Sacco P, Blazer DG, Moore AA (August 2014). "Substance abuse among older adults". Clinics in Geriatric Medicine. 30 (3): 629–654. doi:10.1016/j.cger.2014.04.008. PMC 4146436. PMID 25037298.
  27. ^ a b Spooner C, Hetherington K (2004). Social determinants of drug use (Technical report). NDARC. 35-184.
  28. ^ Davis JP, Tucker JS, Stein BD, D'Amico EJ (October 2021). "Longitudinal effects of adverse childhood experiences on substance use transition patterns during young adulthood". Child Abuse & Neglect. 120: 105201. doi:10.1016/j.chiabu.2021.105201. PMC 8384697. PMID 34245974.
  29. ^ Bartoli F, Cavaleri D, Moretti F, Bachi B, Calabrese A, Callovini T, et al. (November 2020). "Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study". Medicina. 56 (11): 613. doi:10.3390/medicina56110613. PMC 7696058. PMID 33203127.
  30. ^ Belcher AM, Volkow ND, Moeller FG, Ferré S (April 2014). "Personality traits and vulnerability or resilience to substance use disorders". Trends in Cognitive Sciences. 18 (4): 211–217. doi:10.1016/j.tics.2014.01.010. PMC 3972619. PMID 24612993.
  31. ^ Fehrman E, Egan V, Gorban AN, Levesley J, Mirkes EM, Muhammad AK (2019). Personality Traits and Drug Consumption. A Story Told by Data. Springer, Cham. arXiv:2001.06520. doi:10.1007/978-3-030-10442-9. ISBN 978-3-030-10441-2. S2CID 151160405.
  32. ^ Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues in Clinical Neuroscience. 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.41 ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.
  33. ^ Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 978-0-07-148127-4.
  34. ^ a b Volkow ND, Koob GF, McLellan AT (January 2016). "Neurobiologic Advances from the Brain Disease Model of Addiction". New England Journal of Medicine. 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMC 6135257. PMID 26816013. Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
    Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
  35. ^ "National Cancer Institute".
  36. ^ a b "Drug addiction (substance use disorder) – Symptoms and causes". Mayo Clinic. Retrieved 7 December 2018.
  37. ^ "Mental Health and Substance Use Co-Occurring Disorders". www.samhsa.gov. 7 February 2023. Retrieved 20 December 2023.
  38. ^ "Drug addiction (substance use disorder) – Symptoms and causes". Mayo Clinic. Retrieved 6 April 2023.
  39. ^ "Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health" (PDF). Office of the Surgeon General. US Department of Health and Human Services. November 2016. pp. 35–37, 45, 63, 155, 317, 338. Retrieved 28 January 2017.
  40. ^ Butler SF, Budman SH, Goldman RJ, Newman FL, Beckley KE, Trottier D. Initial Validation of a Computer-Administered Addiction Severity Index: The ASI-MV Psychology of Addictive Behaviors 2001 March
  41. ^ "DARA Thailand". Archived from the original on 3 June 2017. Retrieved 4 June 2017.
  42. ^ Antony MM, Barlow DH (18 August 2020). Handbook of Assessment and Treatment Planning for Psychological Disorders (Third = ed.). Guilford Publications. pp. 32, 490, 521. ISBN 978-1-4625-4488-2.
  43. ^ a b Center for Substance Abuse Treatment (1997). Chapter 2—Screening for Substance Use Disorders. Substance Abuse and Mental Health Services Administration (US).
  44. ^ Nakao M, Shirotsuki K, Sugaya N (2021). "Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies". Biopsychosocial Medicine. 15 (1): 16. doi:10.1186/s13030-021-00219-w. PMC 8489050. PMID 34602086.
  45. ^ Bischof G, Bischof A, Rumpf HJ (2021). "Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice". Deutsches Ärzteblatt International. 118 (7): 109–115. doi:10.3238/arztebl.m2021.0014. PMC 8200683. PMID 33835006.
  46. ^ Witkiewitz K, Pfund RA, Tucker JA (May 2022). "Mechanisms of Behavior Change in Substance Use Disorder With and Without Formal Treatment". Annual Review of Clinical Psychology. 18 (1): 497–525. doi:10.1146/annurev-clinpsy-072720-014802. PMID 35138868.
  47. ^ Moyers TB, Houck J, Rice SL, Longabaugh R, Miller WR (2016). "Therapist empathy, combined behavioral intervention, and alcohol outcomes in the COMBINE research project". Journal of Consulting and Clinical Psychology. 84 (3): 221–229. doi:10.1037/ccp0000074. PMC 4760890. PMID 26795938.
  48. ^ Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. World Health Organization. 2009. ISBN 978-92-9061-430-2.
  49. ^ McLellan AT, Lewis DC, O'Brien CP, Kleber HD (October 2000). "Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation". JAMA. 284 (13): 1689–1695. doi:10.1001/jama.284.13.1689. PMID 11015800. S2CID 2086869.
  50. ^ O'Donohue W, Ferguson KE (2006). "Evidence-Based Practice in Psychology and Behavior Analysis". The Behavior Analyst Today. 7 (3): 335–350. doi:10.1037/h0100155. Retrieved 24 March 2008.
  51. ^ Chambless DL, et al. (1998). "An update on empirically validated therapies" (PDF). Clinical Psychology. 49. American Psychological Association: 5–14. Retrieved 24 March 2008.
  52. ^ Bonhomme J, Shim RS, Gooden R, Tyus D, Rust G (July 2012). "Opioid addiction and abuse in primary care practice: a comparison of methadone and buprenorphine as treatment options". Journal of the National Medical Association. 104 (7–8): 342–350. doi:10.1016/s0027-9684(15)30175-9. PMC 4039205. PMID 23092049.
  53. ^ a b American Psychiatric Association. (2002). American Psychiatric Association practice guidelines for the treatment of psychiatric disorders. The Association. ISBN 0-89042-320-2. OCLC 48656105.
  54. ^ Cheron J, Kerchove d'Exaerde A (August 2021). "Drug addiction: from bench to bedside". Translational Psychiatry. 11 (1): 424. doi:10.1038/s41398-021-01542-0. PMC 8361217. PMID 34385417.
  55. ^ Access to substance use disorder treatment in Massachusetts. Massachusetts: Center for Health Information and Analysis, issuing body. OCLC 911187572.
  56. ^ Holt H (15 July 2019). "Stigma Associated with Opioid Use Disorder and Medication Assisted Treatment". Advance. doi:10.31124/advance.8866331. S2CID 241858682.
  57. ^ Schwartz RP, Gryczynski J, O'Grady KE, Sharfstein JM, Warren G, Olsen Y, et al. (May 2013). "Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009". American Journal of Public Health. 103 (5): 917–922. doi:10.2105/ajph.2012.301049. PMC 3670653. PMID 23488511.
  58. ^ Substance Abuse and Mental Health Services Administration (US), Office of the Surgeon General (US) (November 2016). "Early intervention, treatment, and management of substance use disorders". Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet]. US Department of Health and Human Services.
  59. ^ Harwood HJ, Myers TG, Addiction NR, et al. (National Research Council (US) and Institute of Medicine (US) Committee on Immunotherapies and Sustained-Release Formulations for Treating Drug Addiction) (23 July 2004). Vaccines and Immunotherapies to Control Addiction in Minors: The Legal Framework. National Academies Press (US) – via www.ncbi.nlm.nih.gov.
  60. ^ "'Heavy' heroin vaccine provides hope for addiction treatment". Scripps Research. 30 July 2020.
  61. ^ "Experimental Opioid Vaccine Being Tested at Columbia". Columbia University Irving Medical Center. 1 July 2021.
  62. ^ Furfaro H (5 January 2022). "To fight opioid crisis, UW researchers take new shot at developing vaccine against addictive drugs". The Seattle Times.
  63. ^ "A Vaccine Against Addiction". Addiction Center. 12 January 2022.
  64. ^ American Addiction Centers Editorial Staff (4 January 2022) [December 29, 2016]. "Why Don't We Have Addiction Vaccines?". DrugAbuse.com.
  65. ^ Barbara Shine (October 2000). "Nicotine Vaccine Moves Toward Clinical Trials". National Institute on Drug Abuse. Archived from the original on 10 August 2006. Retrieved 19 September 2006.
  66. ^ "Nabi Biopharmaceuticals Website".
  67. ^ Hatsukami DK, Rennard S, Jorenby D, Fiore M, Koopmeiners J, de Vos A, et al. (November 2005). "Safety and immunogenicity of a nicotine conjugate vaccine in current smokers". Clinical Pharmacology and Therapeutics. 78 (5): 456–467. doi:10.1016/j.clpt.2005.08.007. PMID 16321612. S2CID 1218556.
  68. ^ Martell BA, Mitchell E, Poling J, Gonsai K, Kosten TR (July 2005). "Vaccine pharmacotherapy for the treatment of cocaine dependence". Biological Psychiatry. 58 (2): 158–164. doi:10.1016/j.biopsych.2005.04.032. PMID 16038686. S2CID 22415520.
  69. ^ "Cocaine vaccine 'stops addiction'". BBC News. 14 June 2004. Retrieved 7 October 2009.
  70. ^ "CelticPharma: TA-NIC Nicotine Dependence". Archived from the original on 6 December 2009. Retrieved 27 October 2009.
  71. ^ KIRO 7 News Staff (19 September 2023). "UW researcher explains new vaccine in the works to prevent opioid overdoses". KIRO 7.
  72. ^ a b c d Galanter M, Kleber HD, Brady KT (17 December 2014). The American Psychiatric Publishing Textbook of Substance Abuse Treatment. doi:10.1176/appi.books.9781615370030. ISBN 978-1-58562-472-0.
  73. ^ a b c "Reports and Detailed Tables From the 2020 National Survey on Drug Use and Health (NSDUH) | CBHSQ". www.samhsa.gov. 11 September 2020. Retrieved 11 February 2022.
  74. ^ a b c d e f g "Overdose Death Rates". National Institute on Drug Abuse. U.S. National Institutes of Health. 9 August 2018. Retrieved 6 December 2018.
  75. ^ Centers for Disease Control and Prevention, National Center for Health Statistics. Substance-induced cause, 2017, percent total, with standard error from the Underlying Cause of Death 1999–2018 CDC WONDER Online Database. Accessed at http://wonder.cdc.gov/ucd-icd10.html on 18 March 2020 at 18:06 UTC.
  76. ^ Centers for Disease Control and Prevention (2013). "Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI)". Centers for Disease Control and Prevention (CDC). Retrieved 6 December 2018.
  77. ^ "Smoking and Tobacco Use; Fact Sheet; Fast Facts". Centers for Disease Control and Prevention (CDC). 9 May 2018. Retrieved 6 December 2018.
  78. ^ Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD (November 2015). "2010 National and State Costs of Excessive Alcohol Consumption". American Journal of Preventive Medicine. 49 (5): e73–e79. doi:10.1016/j.amepre.2015.05.031. PMID 26477807.
  79. ^ a b "Strengthening Canada's Approach to Substance Use Issues". Health Canada. 5 September 2018. Retrieved 1 November 2019.
  80. ^ "Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions Report". Public Health Ontario. Retrieved 1 November 2019.
  81. ^ Bingham B, Moniruzzaman A, Patterson M, Distasio J, Sareen J, O'Neil J, et al. (April 2019). "Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action". BMJ Open. 9 (4): e024748. doi:10.1136/bmjopen-2018-024748. PMC 6500294. PMID 30962229.
  82. ^ "Aboriginal Mental Health: The statistical reality | Here to Help". www.heretohelp.bc.ca. Archived from the original on 27 August 2021. Retrieved 1 November 2019.
  83. ^ "Prescription Opioids (Canadian Drug Summary) | Canadian Centre on Substance Use and Addiction". www.ccsa.ca. Retrieved 1 November 2019.
  84. ^ Firestone M, Smylie J, Maracle S, McKnight C, Spiller M, O'Campo P (June 2015). "Mental health and substance use in an urban First Nations population in Hamilton, Ontario". Canadian Journal of Public Health. 106 (6): e375–e381. doi:10.17269/CJPH.106.4923. JSTOR 90005913. PMC 6972211. PMID 26680428.
  85. ^ a b Berry SL, Crowe TP (January 2009). "A review of engagement of Indigenous Australians within mental health and substance abuse services". Australian e-Journal for the Advancement of Mental Health. 8 (1): 16–27. doi:10.5172/jamh.8.1.16. ISSN 1446-7984. S2CID 26033698.
  86. ^ Haber PS, Day CA (2014). "Overview of substance use and treatment from Australia". Substance Abuse. 35 (3): 304–308. doi:10.1080/08897077.2014.924466. PMID 24853496. S2CID 36761260.
  87. ^ a b c d "Alcohol, tobacco & other drugs in Australia, Aboriginal and Torres Strait Islander people". Australian Institute of Health and Welfare. Retrieved 24 November 2019.
  88. ^ Sanson-Fisher RW, Campbell EM, Perkins JJ, Blunden SV, Davis BB (May 2006). "Indigenous health research: a critical review of outputs over time". The Medical Journal of Australia. 184 (10): 502–505. doi:10.5694/j.1326-5377.2006.tb00343.x. PMID 16719748. S2CID 43868317.
  89. ^ Leong M, Murnion B, Haber PS (October 2009). "Examination of opioid prescribing in Australia from 1992 to 2007". Internal Medicine Journal. 39 (10): 676–681. doi:10.1111/j.1445-5994.2009.01982.x. PMID 19460051. S2CID 205503169.

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