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Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.
“Hart’s argument that we need to drastically revise our current view of illegal drugs is both powerful and timely . . . when it comes to the legacy of this country’s war on drugs, we should all share his outrage.” —The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy life Dr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a researcher and professor, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism. Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars. Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.
Drug abuse and addiction are common in clinical practice. Often they interfere with patient treatment or require an alternative approach. Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment is a major contribution to the literature, a gold standard title offering a comprehensive range of topics for those who care for patients with addiction, conduct research in this area, or simply have an interest in the field. Offering state-of-the-art information for all those working with drug abusing or addicted patients, or for those interested in this topic from other research perspectives, the volume is a first of its kind book -- rich, comprehensive, yet focused, addressing the needs of the very active theoretical, basic, and clinical research in the field. Comprised of 46 chapters organized in four sections and developed by the leading international experts, Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment covers virtually every core, as well as contemporary, topic on addiction, from the established theories to the most modern research and development in the field. Enhancing the educational value of the volume, every chapter includes an abstract and two boxes summarizing learning objectives and directions for future research. Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment discusses the topic in a authoritative, systematic manner and is an indispensable reference for all clinicians and researchers interested in this rapidly changing field.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.
Focusing on two central themes--the psychobiological evolution from youth to adult and the effects of drugs on the developing central nervous system--this important reference elucidates the mechanisms of chemical dependency in adolescents. Its multidisciplinary coverage analyzes addiction across major domains of human functioning against the backdrop of hormonal, cognitive, and other changes that accompany the transition to adulthood. Chapters discuss legal as well as illicit drugs, examine age-related social contexts, and present the latest findings on links between drug use and mental disorders. Throughout, the contributors make clear that education is more valuable to understanding--and preventing--substance abuse than are prohibition and zero-tolerance thinking. Included among the topics: Cognitive development, learning, and drug use. Neurobiology of the action of drugs of abuse. Findings in adolescents with substance dependence based on neuroimaging tests. Alcohol abuse in adolescents: relevance of animal models. Effects of chronic drug abuse on the chronobiology of sleep in adolescents. Neurological and cognitive disorders arising from the chronic use of drugs of abuse. The multiple lenses for understanding its subject and the sensitivity with which causal nuances are treated make Neuroscience of Drug Abuse in Adolescence an invaluable resource for clinical and child psychologists, psychiatrists, social workers, and addiction counselors.
This book is the culmination of five years of debate among distinguished scholars in law, public policy, medicine, and biopsychology, about the most difficult questions in drug policy and the study of addictions. Do drug addicts have an illness, or is the addiction under their control? Should they be treated as patients or as criminals? Challenging the conventional wisdom, the authors show that these standard dichotomies are false.
Drug addiction is a chronically relapsing mental illness involving severe motivational disturbances and loss of behavioral control leading to personal dev- tation. The disorder af?icts millions of people, often co-occurring with other mental illnesses with enormous social and economic costs to society. Several decades of research have established that drugs of abuse hijack the brain’s natural reward substrates, and that chronic drug use causes aberrant alterations in these rewa- processing systems. Such aberrations may be demonstrated at the cellular, neu- transmitter, and regional levels of information processing using either animal models or neuroimaging in humans following chronic drug exposure. Behaviorally, these neural aberrations manifest as exaggerated, altered or dysfunctional expr- sion of learned behavioral responses related to the pursuit of drug rewards, or to environmental factors that precipitate craving and relapse during periods of drug withdrawal. Current research efforts are aimed at understanding the associative and causal relationships between these neurobiological and behavioral events, such that treatment options will ultimately employ therapeutic amelioration of neural de?cits and restoration of normal brain processing to promote efforts to abstain from further drug use. The Behavioral Neuroscience of Drug Addiction, part of the Springer series on Current Topics in Behavioral Neurosciences, contains scholarly reviews by noted experts on multiple topics from both basic and clinical neuroscience ?elds.
Drugs, Addiction, and the Brain explores the molecular, cellular, and neurocircuitry systems in the brain that are responsible for drug addiction. Common neurobiological elements are emphasized that provide novel insights into how the brain mediates the acute rewarding effects of drugs of abuse and how it changes during the transition from initial drug use to compulsive drug use and addiction. The book provides a detailed overview of the pathophysiology of the disease. The information provided will be useful for neuroscientists in the field of addiction, drug abuse treatment providers, and undergraduate and postgraduate students who are interested in learning the diverse effects of drugs of abuse on the brain. - Full-color circuitry diagrams of brain regions implicated in each stage of the addiction cycle - Actual data figures from original sources illustrating key concepts and findings - Introduction to basic neuropharmacology terms and concepts - Introduction to numerous animal models used to study diverse aspects of drug use. - Thorough review of extant work on the neurobiology of addiction