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Substance use disorder is a legitimate medical disorder with its locus in the pleasure centers of the brain. People who have addictions frequently also have medical and psychiatric comorbidities that complicate their addictions. With perseverance, all of these challenging disorders can be prevented and treated. Prevention can be classified as primary, secondary, and tertiary. The sine qua non of treatment and prevention is the biopsychosocial model. Classification is crucial in science. As an example, the DSM-5 publication has been an important scientific achievement. In it, Substance- Related and Addictive Disorders can be diagnosed using the four Cs: craving, control (loss of), compulsion, and use despite negative consequences. Thanks to pharmacogenetics and epigenetics in the future, the high risk for different addictions can be clarified. Tragic cases of celebrities can be changed, and their triumphs celebrated instead of their deaths mourned from substance use disorders. Examples of tragic cases in the past are Ernest Hemingway, whose family also suffered five suicides (including Hemingway himself), and Eugene ONeill with three suicides in his family. On the other hand, Bob and Bill W., Betty Ford, and Robert Downey Jr. and Drew Barrymore all succeeded in their fights against addiction. As far as I know, Hemingway and ONeil were never told they had an alcohol use disorder and were never referred to AA. Although it is speculation, if both authors and their families were treated with lithium (used for mania first in Australia in 1949 and approved for the treatment of mood disorders in the United States in 1972) or, in the future, ketamine, their suicides could have been prevented. Bob Smith and Bill Watson, who experienced a spiritual transformation experience, were able to abstain from alcohol for the rest of their lives. Evidence-based studies can be used along with FDA-approved addiction medication as part of the biopsychosocial model. For alcohol use disorders, three medications are recommended: disulfiram, acamprosate, and naltrexone. The key is determining which medication is indicated for a specific patient. For cocaine and stimulant use disorders, FDA-approved medications for the treatment of ADHD are an alternative for patients trying to self-medicate with cocaine. For opiate use disorders, three other medications are also FDA-approved: naltrexone, methadone and buprenorphine. I favor buprenorphine due to the fact that is a partial mu blocker (the mu receptor is the most important analgesic opiate receptor)the risk of respiratory depression in cases of overdosing is low, and the success rate is high. Buprenorphine can be paired with naloxone, which is an opiate blocker, to prevent the illegal distribution. Kits with naloxone, Evzio (brand name of naloxone 0.4-milligram auto-injector), are being distributed to patients and family members, making it a life-saving medication similar to EpiPen for the treatment of anaphylactic shock. In order to diminish the risk of diversion, many deterrent techniques are being developed by manufactures of opiates. All these precautions will be almost superfluous if an implantable version of buprenorphine becomes available. Effective and updated medical education is the best antidote against stigma. Above all, all patients with substance use disorders should be treated with respect and humane care.
This book describes the importance of America being unitede pluribus unumaccording the original US motto. It contrasts what happened in the United States with the rest of the Americas. The United States, because of its manifest destiny or exceptionalism, one common language, and immigration assimilation, is a nation that, because of its union, should be emulated. Following geographical distribution, only three Americas should exist: North America (Canada, United States, and Mexico), Central America, and South America, which could be seen in figure 3. It starts with the United States of North America; the English colony; the American Revolution in 1776; its founding father, George Washington; and Abraham Lincoln. Then more recently, Barack Obama and Donald J. Trump are reviewed as well as their titanic efforts to maintain the union. This union was achieved after the original thirteen colonies were expanded with the Mexican-American war, the purchase of Louisiana and Florida, and the annexation of Alaska, Texas, and Hawaii. It triplicated its surface size. It is the third largest country in the world at 9,826,675 square kilometers. As a contrast in Latin America with rampant division, more than twenty countries were founded. Efforts to unite Central America, the Peru-Bolivian Confederation, and the South American Free Countries (Federal League of the Free Countries) have been unsuccessful with many caudillos and heroes like Marti, Bolivar, Artigas, Juana Azurduy de Padilla, OHiggins, and San Martin, whose efforts have unfortunately been a failure. Many revolutions, civil wars, and corruption among its presidents, such as Cristina Kirchner, Evo Morales, and Luiz Inacio Lula da Silva, have eroded the rest of the Americas. In the USA, the common language and the embrace of a multicultural nation with exceptionalism manifest destiny has been the formula of success. Two parties, Republicans and Democrats, vs. many parties in the rest of the Americas have contributed to the preservation of the union. This country has been successful in maintaining the union, but not without severe and sanguineous experiences such as the civil war and the abolition of slavery with 750, 000 deaths when the Confederate States of America existed from 1861 to 1865. Now the challenge remains. Will Donald J. Trump maintain the union and resolve the division that until now still exists? Time will tell.
An updated and expanded edition on the roles that brain function and genetics play in addiction. Over the past 10 years, neurobiologic and genetic research has provided an increased understanding of what causes drug addiction in the brain’s reward pathway. Knowing this leads to a better understanding of how it may be treated and even reversed in those who successfully overcome the disease. This is especially true with addiction’s possible precursors of mild to moderate substance use disorders. These latter disorders can usually be treated more easily by less intensive models of “treatment” that do not require actual brain chemistry re-regulation over time. In this new edition, there are updated scientific references to support addiction as a medical brain disease, using the prevailing neurobiology, genetics, and psychological scientific literature. We now have more psychosocial and medicinal methods for reversing abnormal brain chemistry during drug addiction. There are also more effective intervention, counseling, and motivating methods (SBIRT, motivational interviewing) for overcoming resistance to treatment and resistance to change than were able to be discussed when the first edition was published over a decade ago. Here, readers will find a fully-updated glossary of terms, additional abbreviations, and updated appendices. These will aid in clarifying the somewhat lengthy and science-based upgrades in our knowledge of neuroscience and genetics research that are so critical in understanding why addiction is such a serious and tough-to-treat disease. Utilizing the same easy-to-read language that was a hallmark of the earlier edition, Erickson keeps the science understandable yet comprehensive—appropriate for health professionals as well as lay readers who need and want this critical information.
Neuroscience for Addiction Medicine: From Prevention to Rehabilitation - Methods and Interventions is the latest volume from Progress in Brain Research focusing on new trends and developments in addiction research. This established international series examines major areas of basic and clinical research within neuroscience, as well as popular emerging subfields such as addiction. This volume takes an integrated approach to review and summarize some of the most recent progress from the subfield of addiction research, with particular emphasis on potential applications in a clinical setting. - Explores new trends and developments in basic and clinical research in the addiction subfield of neuroscience - Uses an integrated approach to review and summarize recent progress - Emphasizes potential applications in a clinical setting - Enhances the literature of neuroscience by further expanding the established international series Progress in Brain Research
Mental illness stigma is rooted in a perceived lack of agency, but stigma itself undermines agency. While most philosophical accounts of the matter are concerned with the question of how much agency a person with mental illness has, this book asks how we can enhance the agency of people with mental illness. Humanizing Mental Illness explains and explores these connections, arguing that all of us can and should adjust our social practices to enhance the agency of people with mental illness. This agency is complicated and nuanced, as it is often directly constrained due to a person's symptoms and indirectly constrained due to stigma. Abigail Gosselin, both a scholar in the field of social philosophy and a person with a psychiatric disability, illustrates the importance of social interaction for developing and exercising agency. By overcoming mental illness stigma and by adopting certain epistemic and moral virtues, we can interact with people who have mental illness in ways that help enhance their agency and enable them to flourish. Humanizing Mental Illness demonstrates that we need to challenge our explicit and implicit biases and learn to interact with mental illness in more intentional, supportive, and inclusive ways.
A mother recounts her journey with her son through his trials of addiction and his long road to recovery in a memoir full of honesty, humor, and hope. The Weight of a Feather chronicles the relationship between a mother and her son from his journey into the dark world of addiction to his final recovery years later. In this raw and candid memoir, Lynda Hacker Araoz is ruthlessly honest about the deception, betrayal, and violence inherent in the world of addiction, as well as the many pitfalls one encounters on the pathway to recovery. However, she balances out the weight of her family’s struggles with lighter moments of connection with her son and the absurdities they encounter. Above all, The Weight of a Feather is a testimony to the enduring strength of family love. It brings comfort and hope to others who are going through a similar ordeal and provides insight for those who wonder why recovery can be so elusive. Lynda urges readers to take a fresh look at the world of addiction, calling for a new model for treatment in light of the opioid epidemic impacting families across the country.
This book explores the lived experiences of people who interact with needle and syringe program services in Western Sydney, Australia, including participants and industry workers. It locates the research within the wider context of harm reduction and drug policies. It addresses the question "what do needle and syringe programs do?" and seeks to unpack the agency of human and non-human factors to consider the ‘more than human’ effects of these programmes. Alongside a critical materialist perspective used to interpret the empirical findings, the book demonstrates that needle and syringe programs create new possibilities for engaging with the world by changing the material conditions of illicit drug consumption. It draws on the conceptual contributions of post-humanist thinking from assemblage theory, actor-network theory, and cognate scholarship. Consideration is given to transferable findings and insights for international contexts. The book speaks to scholars and postgraduate students in the areas such as sociology, criminology, social work, critical public health, cultural studies, and related fields.
The increasing number of individuals with co-existing substance misuse and psychiatric disorders presents a key challenge to mental health and addiction nurses. This practice-based text focuses on the management and intervention strategies to effectively meet the needs of this client group in both community and residential settings. Dual Diagnosis Nursing is a comprehensive text for practitioners on contemporary approaches to working with dual disorder and dual diagnosis patients. It explores both clinical and theoretical perspectives in a variety of different care and treatment settings, addressing key issues such as needs of special populations, multi-dimensional assessment, dealing with emergencies, prescribing and medication management, nursing and psychological interventions, spiritual needs, carers’ interventions and professional development.