Addiction

When seeking drug reform we should avoid the deeply entrenched anti-drug narratives that have dominated drug policy debate. These narratives are often rooted in fallacy, distortion and sweeping generalisations, whereas, reform must maintain integrity and stay firmly rooted in reason, rationale, science and evidence. We need to be clear, we don't have a global drug problem - we have a global drug policy problem, and the cause of the problem isn't gangsters - it's governments.

“Is marijuana a gateway drug?” – Any substance abuse counselor at this point is probably sick of hearing that redundant and often misleading question. The following explanation is time-tested, reasonable and easy to understand for just about everyone. See for yourself:

There is relatively little research considering motivations of passive Facebook use. However, research regarding motivations of general Facebook use indicates that people use Facebook to escapee and that escapism may motivate passive Facebook use. Research also suggests that using Facebook to escape is associated with Facebook addiction. Using an experimental vignette design, the present research investigated whether passive Facebook use is motivated by escapism and whether this escape motivation is associated with passive Facebook addiction. A within-participant experimental design using vignettes was used to explore the effect of positivity and, in addition, socialness on passive Facebook use. Addiction to passive Facebook use and perceived effect of passive Facebook use on mood were also assessed. Participants (n ¼ 69) responded to 16 vignettes describing daily life events, as well as responding to a question about passive Facebook use on mood and completing the Bergen Facebook Addiction Scale. Results suggested that individuals did not use Facebook to escape. There was no association between escapism in passive Facebook use and passive Facebook addiction. Social contact had a positive effect on passive Facebook use, and participants perceived passive Facebook use to have no effect on mood. Findings suggest that passive Facebook use is a less effective method of escape than general Facebook use, and reducing individuals' likelihood of experiencing Facebook addiction symptoms.

Acknowledgments This literature review was completed on behalf of circa (Cultural & Indigenous Research Centre Australia) to guide a Review of the In-Language Gambler's Help Services. Feedback and comments provided to guide the review from circa are greatly appreciated.
Funding for this study was provided by the Victorian Responsible Gambling Foundation: ‘Review of the In-Language Gambler’s Help Services’. The VRGF had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

ABSTRACT: Mental Disorders, Substance Use Disorders and Recidivism: Exploring Offence Trajectories in a Canadian Provincial Correctional Population Stefanie N. Rezansoff, Akm Moniruzzaman, Julian M. Somers Introduction Scholars have examined the relationship between mental illness and criminality from diverse traditions. Abundant research confirms a high prevalence of substance use and mental disorders in correctional samples. However, relatively little is known about the relationship between diagnostic status and the risk of recidivism. Existing literature is largely comprised of studies using varying operational definitions of “mental illness”, heterogeneous proxies for diagnostic status, and samples drawn from specific correctional settings. Emerging evidence suggests the importance of four major diagnostic groupings, those with: no diagnosis; non-substance related mental disorders (NSMD); substance use disorders (SUD); and dual diagnosis with both a substance use and another men...

Background/aims Contingency management (CM) interventions have gained considerable interest due to their success in the treatment of addiction. However, their implementation can be resource-intensive for clinical staff. Mobile telephonebased systems might offer a low-cost alternative. This approach could facilitate remote monitoring of behaviour and delivery of the reinforcer and minimize issues of staffing and resources. This systematic review and meta-analysis assessed the evidence for the effectiveness of mobile telephone-delivered CM interventions to promote abstinence (from drugs, alcohol and tobacco), medication adherence and treatment engagement among individuals with substance use disorders. Design A systematic search of databases (PsychINFO, CINAHL, MEDLINE PubMed, CENTRAL, Embase) for randomized controlled trials and within-subject design studies (1995-2019). The review was conducted in accordance with the PRISMA statement. The protocol was registered on PROSPERO. Setting All included studies originated in the United states. Participants Seven studies were found, including 222 participants; two targeted alcohol abstinence among frequent drinkers and four targeted smoking cessation (in homeless veterans and those with post-traumatic stress disorder). One targeted medication adherence. Measures The efficacy of CM to increase alcohol and nicotine abstinence was compared with control using several outcomes; percentage of negative samples (PNS), quit rate (QR) and longest duration abstinent (LDA) at the end of the intervention. Findings The random-effects meta-analyses produced pooled effect sizes of; PNS [d = 0.94, 95% confidence interval (CI) = 0.63-1.25], LDA (d = 1.08, 95% CI = 0.69-1.46) and QR (d = 0.46, 95% CI = 0.27-0.66), demonstrating better outcomes across the CM conditions. Most of the studies were rated as of moderate quality. 'Fail-safe N' computations for PNS indicated that 50 studies would be needed to produce a non-significant overall effect size. None could be calculated for QR and LDA due to insufficient number of studies. Conclusion Mobile telephonedelivered contingency management performs significantly better than control conditions in reducing tobacco and alcohol use among adults not in treatment for substance use disorders.

This downloadable PDF is designed to give to students or others being trained as counselors. There is a compehensive list of essential knowledge and skills for counselors focused on engagement with challenging clients with substance use and coexisting mental health issues.

Exceprt from Taking the Escalator Express (2016)

Motivation and Insight: These two factors, motivation and insight are crucial indicators with regard to defining what change process is all about and for learning about what is needed for this process to move forward and upward.

Successfully engaging difficult and resistant clients in substance abuse treatment is a frequent and prevalent obstacle for counselors particulalry when client's insight and motivation levels may be limited or questionable. Learning to utilize a Change Initiative is a critical guildeline for effectively managing these challenges

The book: Taking the Escalator: An Alternative to the 12 Steps explains the assessment of one's Change Initiative as a simple measure for insight and motivation. The following document explains how to use a Change Initiative measure in greater detail specifically for substance abuse counselors who are attempting to engage difficult clients in treatment

Brief Group Module and Icebreaker Collection 1  - Taking the Escalator releases brief icebreakers and group therapy modules about twice per week in the “Forum” section on the Taking the Escalator: Group Activities by Topic page of the website. This is a printable collection of these brief therapy modules and icebreakers released in that forum for the six-month period from October 2020 through March 2021

In todays changing world where treatment has become increasingly client-centered and accepting of incremental change, it makes to sense to re-examine how we view addiction, reccovery, abstinence and sobriety and the overall process of postive change

All counselors need to be prepared to appropriately address client setbacks in with engagement in view. The following is a guide for counselors when addressing setbacks with challenging clients, with a view toward maintaining rapport and positive engagement in treatment

The following is published on the www.takingtheescalator.com website but is also being made available on Academia.edu for review. It is designed for groups as an in-depth look at self esteem from a realistic perspective, with substance use issues in mind.

The vast majority of people in this world have heard about the idea of "hitting bottom" when it comes to addiction and making positve changes,  which can be a reality, but often can be a fallacy. "Topping Out" may be a more crucial consideration for young people who find themselves caught up in a lifestyle of drug and alcohol use, abuse and misuse

Quite often, when people hear the word “trigger” in a therapeutic context, one may immediately think of substance use and “relapse triggers”. Although substance use is part of this discussion for this exercise, it is important to consider that the idea of feeling “triggered” can also relate to many mental and emotional situations and disorders.

For some who have done previous Taking the Escalator worksheets focused on “Setbacks”, this may be a review. The Taking the Escalator methodology is a harm reduction-based, motivational and self- awareness focused philosophy. In the process of learning to recover and change from substance use disorders and other co-existing issues, it is not uncommon that there are many challenges along the way. Abstinence based models, such as the 12 Step Model, usually refer to these challenging periods in recovery as “Relapse”. By contrast, Taking the Escalator prefers the term “Setbacks”.

This is an insight and self-awareness building exercise specific to self-esteem and self-image. In this exercise everyone in the group will consider different descriptive words and then discuss how they feel personally about these word descriptions

This is an activity and discussion on how attitude can help us manage challenging emotional situations - If you read into second page you can see this is useful for groups focused on upcoming holiday season and its many challenges for clients with mental health and substance use issues

This activity is designed for active preparation for an upcoming event that may be challenging to deal with as related to substance use and co-occurring mental health issues. Often events can bring with them various triggers and other obstacles that can make it challenging to maintain a course of progress. It makes sense to plan ahead when a challenging event is on the horizon so as to prevent setbacks.

In recent years a number of studies have attempted to rank drugs by a single measure of harmfulness as the basis for decisions about scheduling and classification. These efforts are fundamentally flawed, both conceptually and methodologically. The effort to provide a single measure masks the variety of non-comparable dimensions that are relevant, the fact that benefits are ignored for most, but not all, drugs and that the harms of a drug are not invariant to the policy regime chosen. Methodologically, the most prominent recent effort ignores drug interactions and mixes aggregate and individual harms inappropriately. Instead we suggest that multiple dimensions of harm need to be displayed to inform human judgments of what drugs should be scheduled. Harm is not usefully reducible to a single dimension, and even perfect rankings would not constitute a 'sufficient statistic' for determining scheduling decisions.a dd_3461 1886..1890

We consider here the applications and limitations of urine testing schedules used in methadone maintenance treatment programs. We show that for patients attending clinic daily, any practical testing schedule will only reliably detect those who are using heroin or other illicit drugs very frequently (e.g., daily). For patients with take-home privileges no testing schedule can effectively detect either skipped doses or use of illicit drugs. Consequently, whether for patients attending clinic daily or for patients with take-home privileges, some programs, as measured by urine test results, may actually be less successful than they appear to be.

To describe the frequency of alcohol consumption and beverage preferences in eight countries of the Commonwealth of Independent States (CIS). Design Cross-sectional. Setting Populations of Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation and Ukraine. Participants Representative samples of the adult population of each country (overall sample size 18,428; response rates: 71-88%). Measurements A standardised questionnaire was administered by trained interviewers to examine alcohol consumption frequency and usual intakes of beer, wine and strong spirits. Findings Between 11 and 34% of males and 26-71% of females reported never drinking alcohol. Abstention was lowest in the Russian Federation and Belarus, two traditional spirits-drinking countries. It was particularly high in Kyrgyzstan and Georgia, two countries with a relatively low frequency of alcohol consumption but large amounts consumed per occasion (particularly Georgia). On the contrary, Moldovan respondents drank frequently, but consumed smaller amounts per occasion. As expected, spirits were consumed in largest amounts in traditional spirits-drinking countries, as well as Armenia and wine in traditional wine-drinking countries. Beer consumption was relatively high in Russia, Belarus, Ukraine and Kazakhstan (males), particularly in young respondents. Conclusions Although cross-country comparisons of alcohol intake should be interpreted cautiously, this study suggested that drinking patterns in the countries examined are not entirely typical of usual dry/wet drinking cultures, and confirms that the CIS is very diverse in terms of drinking patterns and beverage preferences. The study provides an important baseline for future comparisons as markets open to new products, as has been the case elsewhere in Europe.

Aims This study compared 5-year treatment outcomes of older adults to thoseof middle-aged and younger adults in a large managed care chemical dependency program. We examined age group differences in individual, treatment and extra-treatment factors, which may influence long-term outcome. Design Seventy-seven per cent of original study participants completed a telephone interview 5 years after out-patient chemical dependency treatment at Kaiser Permanente. This sample (N = 925) included 65 patients aged 55-77, 296 patients aged 40-54 and 564 patients aged 18-39 (age at baseline). Measurements Measures at follow-up included alcohol and drug use, Addiction Severity Index (ASI), Alcoholics Anonymous Affiliation Scale, social resource and self-reported health questions. Mortality data were obtained from contact with family members of patients as well as automated health plan records. Findings Older adults were less likely to be drug-dependent at baseline than younger and middle-aged adults, and had longer retention in treatment than younger adults. At 5 years, older adults were less likely than younger adults to have close family or friends who encouraged alcohol or drug use. Fifty-two per cent of older adults reported total abstinence from alcohol and drugs in the previous 30 days versus 40% of younger adults. Older women had higher 30-day abstinence than older men or younger women. Among participants dependent only on alcohol, there were no significant age differences in 30-day abstinence. In logistic regression analysis, age group was not significant. Variables associated with greater age that independently predicted 30-day abstinence in the logistic regression model eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. included longer retention in treatment and having no close family or friends who encouraged alcohol or drug use at 5 years: female gender was also significant. Conclusions Results indicate that older adults have favorable long-term outcome following treatment relative to younger adults, but these differences may be accounted for by variables associated with age such as type of substance dependence, treatment retention, social networks and gender. Age differences in these characteristics inform intervention strategies to support long-term recovery of older adults and provide direction for investigation of how age affects outcome.

Through qualitative analysis of interviews conducted with men who have histories of gang affiliation and street crime, this article posits understanding these behaviors through the framework of addictions. The participants in this study describe themselves as being addicted to the action of the streets and their narratives fit with the evolving framework of a behavioral addiction. There is currently no formal diagnosis for understanding the draw of action to street crime and gang association as addiction. Through semi-structured interviews we examine the key constructs of cognition and behaviors relevant to understanding the cycle of gang involvement, crime, and violence under the rubric of behavioral addictions. Thematic elements of significance emerged which parallel the analytic framework of addictions and delineate ways that being addicted to the ''action of the streets'' is a substantive factor in recidivism with the criminal justice system. The construct of ''street addiction'' articulated by those who live it, makes important practical and theoretical contributions to the fields of addictions, criminal justice, public health, psychology, and sociology.

The practice of prescribing opioid drugs for opioid dependent patients in the U.S. has been subjected to special government scrutiny for almost 100 years. From 1920 until 1964, doctors who used opioids to treat addicts risked federal and/or state criminal prosecution. Although that period ended when oral methadone maintenance was established as legitimate medical practice, public concern about methadone diversion

Cohen Veterans Bioscience's AMP IT UP (Alliance for Modeling PTSD, Innovative Technologies, and Uniform Practices) Preclinical Program is pleased to announce the posting of the following RFA: Translational Preclinical Animal Model Systems of Post-Traumatic Stress Disorder. The purpose of this RFA is to further validate, characterize, and develop existing and novel animal models systems of PTSD that will be useful for screening novel therapeutics and/or elucidating mechanisms of disease.

Please click on the link below to find complete details for the RFA itself, the submission process, and our application portal. This opportunity is open to all and we invite you to forward the link to friends, colleagues, and other list serves.

AMP IT UP RFA: http://www.cohenveteransbioscience.org/RFA-PTSD-0002/

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Cohen Veterans Bioscience is the only 501(c)3 non-profit research organization with a singular focus on PTSD and TBI research. We are dedicated to fast-tracking the development of diagnostic tests and personalized therapeutics for the millions of veterans and civilians who suffer the devastating effects of trauma on the brain.
More information is available at www.cohenveteransbioscience.org.