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PubMed1986

On smokeless tobacco, addictive behavior and warning labels.

This article will offer three primary positions: First, it will support the use of a warning label on containers of smokeless tobacco and second, suggest that an alternative to the present warning statement be considered. The Massachusetts Department of Public Health--presently the first state to consider a warning label for smokeless tobacco--proposes a label that would read as follows: WARNING: Use of snuff is addictive and may cause mouth cancer and other mouth disorders. Third, this article will suggest that a warning label will not have any notable impact on the public health. In order to support these positions, the following discussion will briefly examine the relationship between chemical dependency, addictive behavior, tobacco smoking, and the use of warning labels as a deterrant to the use of smokeless tobacco.

Attitude to Health↗
PubMed2004

Domestic violence in Puerto Rican gay male couples: perceived prevalence, intergenerational violence, addictive behaviors, and conflict resolution skills.

Domestic violence (DV) is a pattern of behaviors in the context of an intimate relationship, which can be manifested in emotional, physical, or sexual abuse. DV currently represents a social and a public health issue. This study is an effort to foster a better understanding of DV among same-sex couples. In it, the authors included the participation of 199 Puerto Rican gay males to identify prevalence of DV, violence in their family of origin, participants' addictive behaviors and exposure to violence at childhood, and their conflict resolution skills. Participants were relatively young, highly educated Puerto Rican gay men who reported a high level of domestic violence in their relationships. This violence was identified as emotional violence by 48% of the participants. This sample reported high levels of violence among their families of origin and low conflict resolution skills.

Adaptation, Psychological↗
PubMed1994

[Addictive behavior in the elderly].

Alcohol and drug abuse are the two main addictions in the elderly subject. Prevalence of alcohol dependency is 14% in those over 65 years of age and 17% in elderly psychiatric patients. The distribution of alcoholism between the sexes becomes equal with age. After 65 years of age, the sex-ratio is 1 female to 1.3 male subjects. The elderly alcoholic population consists of both subjects having become alcoholics at a young age and those in whom alcoholic behaviour appeared at a late age. In one third of elderly alcoholics such dependency appeared after 60 years of age. The main risk factors for alcoholism in the elderly subject are lonliness, death of the spouse and the presence of an invalid or bedridden spouse. In the elderly, tolerance to and dependence on alcohol are rare and appear late. Somatic complications are particularly severe (cirrhosis, liver cancer, gastritis, acute pancreatitis and myocardial involvement). Psychiatric complications include anxiety, depression and especially suicide. Alcoholism is the third most frequent cause of organic cerebral dementia, following Alzheimer disease and vascular dementia. Drug dependency is very often linked to alcoholism and consists of tranquillizers and less often of antalgics.

Aged↗
PubMed2006

[Addictive behavior after starting buprenorphine maintenance treatment].

OBJECTIVE: This study of a cohort of drug addicts receiving buprenorphine maintenance treatment in a district in western France focused on changes in their drug use and their social and work lives. It also looked at the health consequences of their drug use before and after maintenance treatment (mean: four years). POPULATION AND METHODS: From the files of an agency providing services to drug addicts, we randomly selected 180 of the 236 patients receiving buprenorphine maintenance treatment (BMT). Usable questionnaires were returned by 118 subjects (66% response rate). This self-administered questionnaire included 32 items. RESULTS: The respondents accounted for half the population receiving drug maintenance treatment and were representative of the population for age and sex. The mean age was 30 +/- 5 years, mean BMT dose 6,5 mg/day, and mean duration of drug maintenance treatment 47 +/- 27 months. Other drug use diminished during the four years of maintenance treatment: three of every four heroin users had stopped, opiate users dropped from 31% to 5% of the population, and cocaine use followed a similar trend. Benzodiazepine use also fell, but remained relatively frequent (27%, compared with 68% four years earlier). Drinking patterns changed from strongly alcoholic beverages to lower-proof drinks. Arrest rates dropped from 70% to 25%. The percentage of persons seropositive for HIV (4%) and HCV (33%) remained low, but too many subjects had not been screened (35%). Roughly 10% of these subjects had returned to work, mainly those who had cut their drug use most. CONCLUSION: While our survey reveals some positive points, especially a reduction in illegal drug use, several negative observations appeared, including combined use of cannabis and benzodiazepines, inadequate screening, and misuse of BMD. These results underline how important it is for care providers to focus simultaneously on medical treatment and identification of co-morbidities and to provide social work when necessary. The employment rate remains too low.

Adult↗
PubMed1993

Genes, environment, and addictive behavior: etiology of individual differences and extreme cases.

There is considerable interest in assessing the role of genetic factors in the aetiology of addiction. This paper reviews the possible contribution of a new quantitative technique, termed DF analysis after its originators DeFries & Fulker. DF analysis provides a way of examining whether aetiological factors relating to addiction as a discrete disorder (manifest as extreme scores on a diagnostic instrument) are similar to or different from those that relate to it as a continuum. For example, it is possible to estimate the contribution of familial factors to the development of a clinical condition defined in terms of an extreme score on an instrument by examining the extent of regression towards the unselected population mean of siblings' scores on that instrument. At the same time it is possible to estimate familial influences on the full range of values by examining the correlation between the scores of siblings. Insofar as the two methods produce different estimates, it is possible to infer different levels of involvement of familial factors for extreme cases than for the continuum as a whole. Information provided by such analyses could be critical when constructing models of addictive disorders and help direct more specific studies isolating particular mechanisms.

Behavior, Addictive↗
PubMed1995

[The addictive behavior of servicemen under combat conditions].

On the basis of the analysis of literature the authors make a correction in the significance of terms "addiction" and "addictive behaviour", making from them a single notion "additive disorders". The article analyses the problem of addictive disorders which occupied an important place among psychiatric casualties in the 40th Army during the war in Afghanistan. The comparison of this experience with the experience of the US Army in Korea and Vietnam gave the possibility to come to a conclusion that addictive disorders were an important medico-social problem for modern local wars. Its subdivision into addictive behaviour and narcomanic pathology lead to a necessity to revise some aspects in psychiatric care to servicemen in wartime period.

Adolescent↗
PubMed2006

[Addictive behaviors in a general hospital population from the viewpoint of consultation-liaison psychiatry].

AIM: Based on a comprehensive survey among patients of general hospital departments, the data relating to addictive behaviours were analyzed in this publication. METHOD: A questionnaire screening was performed involving general, demographic questions, and psychiatric rating scales in 9 Hungarian general hospitals. Data provided by 2485 patients were included in the analysis. Alcohol consumption was evaluated using the CAGE questionnaire. RESULTS: The prevalence of smoking was 28.5% in the total population, and ranged between 14.5% and 37.3% in the different hospital departments. 25.4% of the patients are at risk of developing alcoholism, and 4.4% can be regarded to be alcohol dependent. These data correspond well with former results obtained from the general Hungarian population. The highest prevalences measured with the CAGE questionnaire were found in the departments of pulmonology, surgery, traumatology, and orthopedics. CONCLUSIONS: The data obtained in this study help determine the segments of health care that are mostly affected by addictive disorders from the perspective of consultation-liaison psychiatry.

Adult↗
PubMed2002

Cannabinoid addiction: behavioral models and neural correlates.

The use of cannabis sativa preparations as recreational drugs can be traced back to the earliest civilizations. However, animal models of cannabinoid addiction allowing the exploration of neural correlates of cannabinoid abuse have been developed only recently. We review these models and the role of the CB1 cannabinoid receptor, the main target of natural cannabinoids, and its interaction with opioid and dopamine transmission in reward circuits. Extensive reviews on the molecular basis of cannabinoid action are available elsewhere (Piomelli et al., 2000; Schlicker and Kathmann, 2001).

Animals↗
PubMed2003

Hypothalamic digoxin, hemispheric chemical dominance, and addictive behavior.

The isoprenoid pathway produces an endogenous membrane sodium-potassium ATPase inhibitor, digoxin. Digoxin can regulate neurotransmitter transport in the brain with upregulation of tryptophan transport over tyrosine. The pathway was assessed in individuals with addiction, as well as in those with differing hemispheric dominance. The isoprenoid pathway was upregulated with increased digoxin synthesis in addiction. There was an increase in tryptophan catabolites--quinolinic acid, serotonin, nicotine, and strychnine--in patients with addiction, and a reduction in tyrosine catabolites--dopamine, noradrenatine, and morphine. The pattern seen in addiction individuals was similar to that in right hemispheric chemical dominance. Addiction represents a state of right hemispheric chemical dominance, hyperdigoxinemia, and endogenous morphine deficiency state.

Behavior, Addictive↗
PubMed2005

Personal factors influencing Korean American men's smoking behavior: addiction, health, and age.

The purpose of this qualitative study was to identify factors influencing Korean American men's smoking behavior. Focus-group research method was used, and participants were 22 Korean male smokers in New York City. They talked about their experiences of smoking and smoking cessation. Addiction, health, and age emerged as major personal factors affecting Korean men's smoking behavior. Their experiences in relation to addiction were similar to those reported in other racial/ethnic groups, whereas the dramatic change in the perception of smoking-related health risks coming with their forties, some cessation strategies used by former smokers, and preference for group meetings over individual counseling appeared to be specific to Korean men.

Acculturation↗
PubMed2002

Gambling: an addictive behavior with health and primary care implications.

Over the past several decades, and particularly during the last 10 to 15 years, there has been a rapid increase in the accessibility of legalized gambling in the United States and other parts of the world. Few studies have systematically explored the relationships between patterns of gambling and health status. Existing data support the notion that some gambling behaviors, particularly problem and pathological gambling, are associated with nongambling health problems. The purpose of this article is to provide a perspective on the relationship between gambling behaviors and substance use disorders, review the data regarding health associations and screening and treatment options for problem and pathological gambling, and suggest a role for generalist physicians in assessing problem and pathological gambling. A rationale for conceptualization of pathological gambling as an addictive disorder and a model proposing stress as a possible mediating factor in the relationship between gambling and health status are presented. More research is needed to investigate directly the biological and health correlates associated with specific types of gambling behaviors and to define the role for generalist physicians in the prevention and treatment of problem and pathological gambling.

Behavior Therapy↗
PubMed1980

[Analysis of the ether addiction behavior of a schizophrenic patient].

We have studied the psychopathology of a young schizophrenic patient drug-addict exclusively to ether. The clinical evidence shows the acute ebriety as an experience lived in childist enjoyment, evoking mood of his infantile enfastening to the indifferent attitude of his parents. The obessive and impulsive intake of the drug, shows this behaviour as a defense process having the value of protection against dissociative anxiety. When addictive behaviour stopped, with interruption of the psychotic evolution, and return in family life, appears nevertheless hebephrenic impoverishment of feelings and personality structure, stabilished in his autistic way of life.

Adult↗
PubMed2003

Experiences with an outpatient relapse program (community reinforcement approach) combined with naltrexone in the treatment of opioid-dependence: effect on addictive behaviors and the predictive value of psychiatric comorbidity.

BACKGROUND: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. The effects of this compound are probably more favorable when combined with a psychosocial intervention such as the Community Reinforcement Approach (CRA). AIM: To explore the effects of a combination therapy (naltrexone plus CRA treatment) and the predictive value of sociodemographic and psychopathologic characteristics. METHOD: Using a before-and-after design, heroine addicts (n = 24) receiving a combined naltrexone plus CRA treatment are compared with a group (n = 20) on methadone maintenance therapy (reference group). RESULTS: Over a period of 6 months, 58% (14/24) did not relapse, after 1 year at least 55% (12/22) still met the initial goal of continuous abstinence. At baseline, the treatment group and the reference group were similar on nearly all variables except for the number of times clients were arrested. Within the treatment group, a comparison was made between the continuous abstinent and those who relapsed into frequent opioid use. Differences were significant in the cluster-B personality disorders and in polydrug users. CONCLUSION: The combination of naltrexone plus intensive CRA in an outpatient setting appears to be promising. A high score on cluster-B and polydrug use is associated with relapse.

Adult↗
PubMed1993

Combined dopamine and serotonin agonists: a synergistic approach to alcoholism and other addictive behaviors.

Successful phentermine and racemic fenfluramine treatment of 150 obese patients led to the use of this therapy in 12 alcoholic patients. Eleven of 12 consecutive patients, most within hours, reported a total loss or marked decrease in alcohol craving. Their reported consumption of alcohol ceased or decreased markedly. The hypothesis is proposed that this treatment is successful because of the dual and balanced increase in the bioavailability of the neurotransmitters, dopamine and serotonin, in the nucleus accumbens. The prospect is raised that cocaine, nicotine, narcotic, and amphetamine addiction, as well as various presentations of obsessive compulsive behavior, may also respond to dual aminergic agonists. The need for controlled studies to confirm these findings is clear.

Adult↗
PubMed2003

[Origins of addictive behavior: evidence from a study of stressful chilhood experiences].

A population-based analysis of over 17,000 middle-class American adults undergoing comprehensive, biopsychosocial medical evaluation indicates that three common categories of addiction are strongly related in a proportionate manner to several specific categories of adverse experiences during childhood. This, coupled with related information, suggests that the basic cause of addiction is predominantly experience-dependent during childhood and not substance-dependent. This challenge to the usual concept of the cause of addictions has significant implications for medical practice and for treatment programs.

Adolescent↗
PubMed2006

Should the scope of addictive behaviors be broadened to include pathological gambling?

AIMS: Pathological gambling is currently considered an impulse control disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This paper considers the prospect of reclassifying and broadening the substance use disorders to include non-pharmacological addictions such as pathological gambling. METHODS: Literature reviews were conducted on areas relevant to pathological gambling and its classification and similarities to substance use disorders. RESULTS: The diagnostic criteria for pathological gambling are outlined across the three versions of the DSM since its initial introduction. The paper also describes instruments that have been used to assess the disorder, basic epidemiology and some biological and genetic data, especially in terms of potential overlap with substance use disorders. Similarities and differences with respect to treatments are reviewed as well. CONCLUSIONS: Both advantages and disadvantages should be considered with respect to expanding the classification system to include pathological gambling within the context of addictive disorders.

Comorbidity↗