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The past thirty years have witnessed a revolution in the science of addiction, yet we still rely on outdated methods of treatment. Expensive new programs for managing addiction are also flourishing, but since they are not based in science, they offer little benefit to people who cannot afford to lose money or faith in their recovery. Clarifying the cutting-edge science of addiction for both practitioners and general readers, The Thirteenth Step pairs stories of real patients with explanations of key concepts relating to their illness. A police chief who disappears on the job illustrates the process through which a drug can trigger the brain circuits mediating relapse. One person's effort to find a burrito shack in a foreign city illuminates the reward prediction error signaled by the brain chemical dopamine. With these examples and more, this volume paints a vivid, readable portrait of drug seeking, escalation, and other aspects of addiction and suggests science-based treatments that promise to improve troubling relapse rates. Merging science and human experience, The Thirteenth Step offers compassionate, valuable answers to anyone who hopes for a better handle on a confounding disease.
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it's supposed to do-seek pleasure and relief-in a world that's not cooperating. As a result, most treatment based on the disease model fails. Lewis shows how treatment can be retooled to achieve lasting recovery. This is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.
Significant advances in brain research have been made, but investigators who face the resulting explosion of data need new methods to integrate the pieces of the "brain puzzle." Based on the expertise of more than 100 neuroscientists and computer specialists, this new volume examines how computer technology can meet that need. Featuring outstanding color photography, the book presents an overview of the complexity of brain research, which covers the spectrum from human behavior to genetic mechanisms. Advances in vision, substance abuse, pain, and schizophrenia are highlighted. The committee explores the potential benefits of computer graphics, database systems, and communications networks in neuroscience and reviews the available technology. Recommendations center on a proposed Brain Mapping Initiative, with an agenda for implementation and a look at issues such as privacy and accessibility.
Life scientists have declared the 1990s to be the "Decade of the Brain." Undoubtedly the most important organ, the brain is perhaps the least understood. Until recently, the proper methodology for exploring the basic functions of the brain were not available. However, the new era of computer technology brain imaging and molecular biology have given scientists the tools for studying previously hidden mechanisms of the brain which control thinking, emotions, and behavior. Along with this new knowledge, scientists have observed that drugs of abuse can alter these same brain functions in a profound and persistent manner. Drugs of abuse are widely used substances that differ in chemical nature but have a common property-creating dependence. Dependence is characterized by a stereotypical pattern of behavior oriented toward the search, acquisition, and ingestion of drugs of abuse with such frequency and in such quantity as to be harmful. This behavior is beyond the control of reason and will. Studies conducted during the "decade of the brain" or before, show that the clinically observed, dependent behavior induced by drugs of abuse result from neurophysiological and chemical alterations of complex brain mechanisms. These mechanisms involve the production and turnover of the brain neurotransmitters that carry information in the brain neurocircuitry, changes in brain metabolism and circulation, and alterations in the expression of DNA which programs the functions or the neuronal cell. This book describes a number of newly discovered basic brain mechanisms and the alterations caused by drugs of abuse. Contributions by top researchers in fields of radian biology, biochemistry, genetics, and pharmacology examine the new technological improvements for the measurement of brain function, metabolism, blood flow and drug elimination and report changes in brain biochemistry, including DNA expression, as they occur during drug abuse. Physicians and health professionals will benefit from a better understanding of the effects of drugs on the brain which will lead to more effective interventions for prevention and treatment. Highlights include: New knowledge about the brain New methods of investigation Opiates and the brain Marijuana and the brain Cocaine and the brain This book will be of interest to health professionals and program administrators involved in the education and treatment of substance abuse disorders, as well as physicians, nurses, psychiatric social workers, neuroscientists, and pharmacologists.
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.
Drugs and the Future presents 13 reviews collected to present the new advances in all areas of addiction research, including knowledge gained from mapping the human genome, the improved understanding of brain pathways and functions that are stimulated by addictive drugs, experimental and clinical psychology approaches to addiction and treatment, as well as both ethical considerations and social policy. The book also includes chapters on the history of addictive substances and some personal narratives of addiction. Introduced by Sir David King, Science Advisory to the UK Government and head of the Office of Science and Technology, and Nora Volkow, director of the National Institute on Drug Abuse in the USA, the book uniquely covers the full range of disciplines which can provide insight into the future of addiction, from genetics to the humanities. Written for a scientific audience, it is also applicable to non-specialists as well. - Provides an unique overview of what we know about addiction, and how scientific knowledge can and should be applied in the societal, ethical, and political context - Applies the state-of-the-art research in fields such as Genomics, Neuroscience, Pharmacology, Social Policy and Ethics to addiction research - Includes a preface by Sir David King, Science Advisory to the UK Government and head of the Office of Science and Technology, and in introduction by Nora Volkow, director of the National Institute on Drug Abuse in the USA
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.
Neuropsychedelia examines the revival of psychedelic science since the "Decade of the Brain." After the breakdown of this previously prospering area of psychopharmacology, and in the wake of clashes between counterculture and establishment in the late 1960s, a new generation of hallucinogen researchers used the hype around the neurosciences in the 1990s to bring psychedelics back into the mainstream of science and society. This book is based on anthropological fieldwork and philosophical reflections on life and work in two laboratories that have played key roles in this development: a human lab in Switzerland and an animal lab in California. It sheds light on the central transnational axis of the resurgence connecting American psychedelic culture with the home country of LSD. In the borderland of science and religion, Neuropsychedelia explores the tensions between the use of hallucinogens to model psychoses and to evoke spiritual experiences in laboratory settings. Its protagonists, including the anthropologist himself, struggle to find a place for the mystical under conditions of late-modern materialism.
Discovering Addiction brings the history of human and animal experimentation in addiction science into the present with a wealth of archival research and dozens of oral-history interviews with addiction researchers. Professor Campbell examines the birth of addiction science---the National Academy of Sciences's project to find a pharmacological fix for narcotics addiction in the late 1930s---and then explores the human and primate experimentation involved in the succeeding studies of the "opium problem," revealing how addiction science became "brain science" by the 1990s. Psychoactive drugs have always had multiple personalities---some cause social problems; others solve them---and the study of these drugs involves similar contradictions. Discovering Addiction enriches discussions of bioethics by exploring controversial topics, including the federal prison research that took place in the 1970s---a still unresolved debate that continues to divide the research community---and the effect of new rules regarding informed consent and the calculus of risk and benefit. This fascinating volume is both an informative history and a thought-provoking guide that asks whether it is possible to differentiate between ethical and unethical research by looking closely at how science is made. Nancy D. Campbell is Associate Professor of Science and Technology Studies at Rensselaer Polytechnic Institute and the author of Using Women: Gender, Drug Policy, and Social Justice. "Compelling and original, lively and engaging---Discovering Addiction opens up new ways of thinking about drug policy as well as the historical discourses of addiction." ---Carol Stabile, University of Wisconsin--Milwaukee Also available: Student Bodies: The Influence of Student Health Services in American Society and Medicine, by Heather Munro Prescott Illness and the Limits of Expression, by Kathlyn Conway White Coat, Clenched Fist: The Political Education of an American Physician, by Fitzhugh Mullan