Из Википедии, бесплатной энциклопедии
  (Перенаправлен из раздела " Наркотики" )
Перейти к навигации Перейти к поиску
«Злоупотребление наркотиками» перенаправляется сюда. Об альбоме см. « Злоупотребление наркотиками» (альбом) .
Злоупотребление алкоголем или наркотиками
Другие названияЗлоупотребление наркотиками, расстройство, связанное с употреблением психоактивных веществ, расстройство, связанное со злоупотреблением психоактивными веществами
Heroin drug kit.jpg
Банка, содержащая наркотики и принадлежности к наркотикам.
СпециальностьПсихиатрия
ОсложненияПередозировка наркотиками
Частота27 миллионов [1] [2]
Летальные исходы307 400 (2015) [3]
Человек нюхает ингалянт

Злоупотребление психоактивными веществами , также известное как злоупотребление наркотиками , - это употребление наркотиков в количествах или способами, которые вредны для человека или других. Это форма расстройства, связанного с употреблением психоактивных веществ . В контексте общественного здравоохранения, медицины и уголовного правосудия используются разные определения злоупотребления наркотиками. В некоторых случаях преступное или антиобщественное поведение возникает, когда человек находится под воздействием наркотика, а также могут происходить долгосрочные изменения личности у людей. [4] Помимо возможного физического, социального и психологического вреда, употребление некоторых наркотиков также может повлечь за собой уголовное наказание, хотя оно сильно различается в зависимости от местной юрисдикции. [5]

К наркотикам, наиболее часто связанным с этим термином, относятся: алкоголь , амфетамины , барбитураты , бензодиазепины , каннабис , кокаин , галлюциногены , метаквалон и опиоиды . Точная причина злоупотребления психоактивными веществами не ясна, но преобладают две теории: либо генетическая предрасположенность, полученная от других, либо привычка, которая в случае развития зависимости проявляется как хроническое изнурительное заболевание. [6]

В 2010 году около 5% людей (230 миллионов) употребляли запрещенные вещества. [1] Из этих 27 миллионов человек употребляют наркотики с высоким риском, иначе известное как периодическое употребление наркотиков, причиняющее вред их здоровью, психологические проблемы или социальные проблемы, которые подвергают их риску этих опасностей. [1] [2] В 2015 году расстройства, связанные с употреблением психоактивных веществ, привели к 307 400 смертельным случаям, по сравнению со 165 000 смертей в 1990 году. [3] [7] Из них наибольшее число - от расстройств, связанных с употреблением алкоголя - 137 500, расстройств, связанных с употреблением опиоидов, - 122 100 смертей, расстройства, связанные с употреблением амфетамина, у 12 200 случаев смерти и расстройства, связанные с употреблением кокаина, у 11 100 человек. [3]

Классификация [ править ]

Определения общественного здравоохранения [ править ]

Потребитель наркотиков, получающий инъекцию опиата героина

Практики общественного здравоохранения попытались взглянуть на употребление психоактивных веществ с более широкой точки зрения, чем личность, подчеркивая роль общества, культуры и доступности. Некоторые медицинские работники предпочитают избегать употребления терминов «злоупотребление алкоголем или наркотиками» в пользу более объективных формулировок, таких как «проблемы, связанные с психоактивными веществами и алкоголем» или «вредное / проблематичное употребление наркотиков». Совет медицинских работников Британской Колумбии - в своем документе для обсуждения политики 2005 года « Подход общественного здравоохранения к контролю над наркотиками в Канаде» - принял модель употребления психоактивных веществ в общественном здравоохранении, которая бросает вызов упрощенной черно-белой конструкции двоичного (или дополнительные) антонимы "использование" vs. "злоупотребление".[8]Эта модель явно признает спектр использования, от полезного использования до хронической зависимости .

Медицинские определения [ править ]

Исследование 2010 года, в котором различные незаконные и легальные наркотики ранжируются на основе заявлений экспертов по вредным веществам. Алкоголь оказался самым опасным наркотиком. [9]

«Не Наркомания» больше не является современной медицинской диагностики в одном из наиболее часто используемых диагностических инструментов в мире, Американской психиатрической ассоциации «s Диагностическое и статистическое руководство по психическим расстройствам (DSM) и Всемирной организации здравоохранения » s Международная статистическая классификация болезней (МКБ).

Ценностное суждение [ править ]

На этой диаграмме показана корреляция между употреблением 18 легальных и запрещенных наркотиков: алкоголь, амфетамины, амилнитрит, бензодиазепины, каннабис, шоколад, кокаин, кофеин, крэк, экстази, героин, кетамин, легальные наркотики, ЛСД, метадон, волшебные грибы ( Mushrooms), никотин и летучие вещества (VSA). Использование определяется как употребление препарата хотя бы один раз в 2005–2015 годах. Цветные связи между препаратами указывают на корреляцию с | r |> 0,4 , где | г | является абсолютным значением от коэффициента корреляции Пирсона . [10]

Филип Дженкинс предполагает, что есть две проблемы с термином «злоупотребление наркотиками». Во-первых, вопрос о том, что представляет собой «наркотик». Например, GHB , вещество, встречающееся в природе в центральной нервной системе, считается наркотиком и является незаконным во многих странах, в то время как никотин официально не считается наркотиком в большинстве стран.

Во-вторых, слово «злоупотребление» подразумевает признанный стандарт использования любого вещества. Время от времени выпивать бокал вина считается приемлемым в большинстве западных стран, в то время как выпивание нескольких бутылок считается злоупотреблением. Сторонники строгого воздержания, которые могут быть или не иметь религиозных мотивов, сочтут выпитое даже одного стакана оскорблением. Некоторые группы [ кто? ] даже осуждают употребление кофеина в любом количестве. Точно так же принятие мнения о том, что любое (рекреационное) употребление каннабиса или замещенных амфетаминов представляет собой злоупотребление наркотиками, подразумевает принятие решения о том, что это вещество является вредным даже в незначительных количествах. [11]В США лекарственные препараты были юридически разделены на пять категорий: Список I, II, III, IV или V в Законе о контролируемых веществах . Препараты классифицируются в зависимости от предполагаемой потенциальной злоупотребления ими. Использование некоторых лекарств сильно коррелировано. [12] Например, потребление семи запрещенных наркотиков (амфетамины, каннабис, кокаин, экстази, легальные наркотики, ЛСД и волшебные грибы) коррелировано, и коэффициент корреляции Пирсона r > 0,4 ​​в каждой паре из них; потребление каннабиса сильно коррелирует ( r > 0,5) с употреблением никотина (табак), героин коррелирует с кокаином ( r > 0,4) и метадоном ( r > 0,45) и сильно коррелирует с употреблением крэка ( r> 0,5) [12]

Злоупотребление наркотиками [ править ]

Злоупотребление лекарствами - это термин, обычно используемый, когда отпускаемые по рецепту лекарства с седативными , анксиолитическими , обезболивающими или стимулирующими свойствами используются для изменения настроения или интоксикации, игнорируя тот факт, что передозировка таких лекарств иногда может иметь серьезные побочные эффекты. Иногда это связано с утечкой лекарств у человека, которому они были прописаны.

Неправильное употребление по рецепту определяется по-разному и довольно непоследовательно в зависимости от статуса рецепта на лекарство, использования без рецепта, преднамеренного использования для достижения опьяняющих эффектов, способа введения, одновременного употребления с алкоголем и наличия или отсутствия симптомов зависимости. [13] [14] Хроническое употребление определенных веществ приводит к изменению в центральной нервной системе, известному как «толерантность» к лекарству, так что для достижения желаемого эффекта требуется больше вещества. Прекращение или сокращение употребления некоторых веществ может вызвать симптомы отмены [15], но это в значительной степени зависит от конкретного вещества, о котором идет речь.

Уровень употребления отпускаемых по рецепту лекарств быстро обгоняет употребление запрещенных наркотиков в Соединенных Штатах. По данным Национального института злоупотребления наркотиками, в 2010 году 7 миллионов человек принимали рецептурные лекарства для немедицинского использования. Среди 12-классников немедицинское употребление рецептурных наркотиков сейчас уступает только каннабису . [16] В 2011 году «почти каждый двенадцатый выпускник средней школы сообщил о немедицинском использовании викодина; каждый 20-й сообщил о таком применении оксиконтина». [17] Оба эти препарата содержат опиоиды . Опрос учащихся 12-х классов в США, проведенный в 2017 году, показал, что злоупотребление оксиконтином составляет 2,7 процента по сравнению с 5,5 процента на пике в 2005 году. [18] Неправильное использование комбинации гидрокодон / парацетамол.было самым низким с пика в 10,5 процента в 2003 году. [18] Это снижение может быть связано с инициативами в области общественного здравоохранения и снижением доступности. [18]

Проспекты получения лекарств по рецепту для злоупотребления разнообразны: обмен между семьей и друзьями, нелегально покупают лекарства в школе или на работе, и часто « врач покупка » , чтобы найти несколько врачей прописывать один и тот же препарат, без ведома других , кто выписывает.

Правоохранительные органы все чаще возлагают на врачей ответственность за прописывание контролируемых веществ без полного установления контроля над пациентами, такого как «контракт на наркотики» с пациентом. Обеспокоенные врачи учатся тому, как определять у своих пациентов поведение, связанное с поиском лекарств, и знакомятся с «красными флажками», которые могли бы предупредить их о возможном злоупотреблении лекарствами, отпускаемыми по рецепту. [19]

Признаки и симптомы [ править ]

Рациональная шкала оценки вреда рекреационного употребления наркотиков [20]
ЛекарствоКласс препаратаФизический
вред
Ответственность за зависимость		Социальный
вред		Средн.
вред
МетамфетаминЦНС стимулятор3,002,802,722,92
ГероинОпиоид2,783,002,542,77
КокаинЦНС стимулятор2.332.392,172.30
БарбитуратыЦНС депрессанты2,232,012,002,08
МетадонОпиоид1,862,081,871,94
АлкогольЦНС депрессанты1,401,932,211,85
КетаминДиссоциативный анестетик2,001,541,691,74
БензодиазепиныБензодиазепин1,631,831,651,70
АмфетаминЦНС стимулятор1,811,671,501,66
ТабакТабак1,242,211,421,62
БупренорфинОпиоид1,601,641,491,58
КаннабисКаннабиноид0,991,511,501,33
Растворители лекарствИнгалянт1,281.011,521,27
4-МТАДизайнер SSRA1,441,301.061,27
ЛСДПсиходелический1.131,231,321,23
МетилфенидатЦНС стимулятор1,321,250,971.18
Анаболические стероидыАнаболический стероид1,450,881.131,15
GHBНейротрансмиттер0,861.191,301,12
ЭкстазиЭмпатогенный стимулятор1.051.131.091.09
АлкилнитритыИнгалянт0,930,870,970,92
КатЦНС стимулятор0,501.040,850,80
Заметки о рейтингах вреда
The Physical harm, Dependence liability, and Social harm scores were each computed from the average of three distinct ratings.[20] The highest possible harm rating for each rating scale is 3.0.[20]
Physical harm is the average rating of the scores for acute binge use, chronic use, and intravenous use.[20]
Dependence liability is the average rating of the scores for intensity of pleasure, psychological dependence, and physical dependence.[20]
Social harm is the average rating of the scores for drug intoxication, health-care costs, and other social harms.[20]
Average harm was computed as the average of the Physical harm, Dependence liability, and Social harm scores.

Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.[21]

There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation.[22] Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse.[23] In the US, approximately 30% of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.[24]

Drug abuse, including alcohol and prescription drugs, can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during withdrawal. In some cases, substance-induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Both alcohol, barbiturate as well as benzodiazepine withdrawal can potentially be fatal. Abuse of hallucinogens can trigger delusional and other psychotic phenomena long after cessation of use.

Cannabis may trigger panic attacks during intoxication and with continued use, it may cause a state similar to dysthymia.[25] Researchers have found that daily cannabis use and the use of high-potency cannabis are independently associated with a higher chance of developing schizophrenia and other psychotic disorders.[26][27][28]

Severe anxiety and depression are commonly induced by sustained alcohol abuse. Even sustained moderate alcohol use may increase anxiety and depression levels in some individuals. In most cases, these drug-induced psychiatric disorders fade away with prolonged abstinence.[29] Similarly, although substance abuse induces many changes to the brain, there is evidence that many of these alterations are reversed following periods of prolonged abstinence.[30]

Impulsivity[edit]

Impulsivity is characterized by actions based on sudden desires, whims, or inclinations rather than careful thought.[31] Individuals with substance abuse have higher levels of impulsivity,[32] and individuals who use multiple drugs tend to be more impulsive.[32] A number of studies using the Iowa gambling task as a measure for impulsive behavior found that drug using populations made more risky choices compared to healthy controls.[33] There is a hypothesis that the loss of impulse control may be due to impaired inhibitory control resulting from drug induced changes that take place in the frontal cortex.[34] The neurodevelopmental and hormonal changes that happen during adolescence may modulate impulse control that could possibly lead to the experimentation with drugs and may lead to the road of addiction.[35] Impulsivity is thought to be a facet trait in the neuroticism personality domain (overindulgence/negative urgency) which is prospectively associated with the development of substance abuse.[36]

Screening and assessment[edit]

There are several different screening tools that have been validated for use with adolescents such as the CRAFFT Screening Test[37] and in adults the CAGE questionnaire.[38]

Some recommendations for screening tools for substance misuse in pregnancy include that they take less than 10 minutes, should be used routinely, include an educational component. Tools suitable for pregnant women include i.a. 4Ps, T-ACE, TWEAK, TQDH (Ten-Question Drinking History), and AUDIT.[39]

Given that addiction manifests in structural changes to the brain, it is possible that non-invasive magnetic resonance imaging could help diagnose addiction in the future.[30]

Treatment[edit]

Psychological[edit]

From the applied behavior analysis literature, behavioral psychology, and from randomized clinical trials, several evidenced based interventions have emerged: behavioral marital therapy, motivational Interviewing, community reinforcement approach, exposure therapy, contingency management[40][41] They help suppress cravings and mental anxiety, improve focus on treatment and new learning behavioral skills, ease withdrawal symptoms and reduce the chances of relapse.[42]

In children and adolescents, cognitive behavioral therapy (CBT)[43] and family therapy[44] currently has the most research evidence for the treatment of substance abuse problems. Well-established studies also include ecological family-based treatment and group CBT.[45] These treatments can be administered in a variety of different formats, each of which has varying levels of research support[46] Research has shown that what makes group CBT most effective is that it promotes the development of social skills, developmentally appropriate emotional regulatory skills and other interpersonal skills.[47] A few integrated[48] treatment models, which combines parts from various types of treatment, have also been seen as both well-established or probably effective.[45] A study on maternal alcohol and other drug use has shown that integrated treatment programs have produced significant results, resulting in higher negative results on toxicology screens.[48] Additionally, brief school-based interventions have been found to be effective in reducing adolescent alcohol and cannabis use and abuse.[49] Motivational interviewing can also be effective in treating substance use disorder in adolescents.[50][51]

Alcoholics Anonymous and Narcotics Anonymous are widely known self-help organizations in which members support each other abstain from substances.[52] Social skills are significantly impaired in people suffering from alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain.[53] It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious,[54] including managing the social environment.

Medication[edit]

A number of medications have been approved for the treatment of substance abuse.[55] These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form. Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion and modafinil. Methadone and buprenorphine are sometimes used to treat opiate addiction.[56] These drugs are used as substitutes for other opioids and still cause withdrawal symptoms but they facilitate the tapering off process in a controlled fashion.

Antipsychotic medications have not been found to be useful.[57] Acamprostate[58] is a glutamatergic NMDA antagonist, which helps with alcohol withdrawal symptoms because alcohol withdrawal is associated with a hyperglutamatergic system.

Heroin-assisted treatment[edit]

Three countries in Europe have active HAT programs, namely England, the Netherlands and Switzerland. Despite critical voices by conservative think-tanks with regard to these liberal approaches, significant progress in the reduction of drug-related deaths has been achieved in those countries. For example the US, devoid of such measures, have seen large increases in drug-related deaths since 2000 (mostly related to heroin use), while Switzerland has seen large decreases. In 2018, approximately 60,000 people have died of drug overdoses in America, while in the same time period, Switzerland's drug deaths were at 260. Relative to the population of these countries, the US has 10-times more drug-related deaths compared to the Swiss Confederation, which in effect illustrates the efficacy of HAT to reduce fatal outcomes in opiate/opioid addiction.[59][60]

Dual diagnosis[edit]

Main article: Dual diagnosis

It is common for individuals with drugs use disorder to have other psychological problems.[61] The terms “dual diagnosis” or “co-occurring disorders,” refer to having a mental health and substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), “symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol.”[62]

Individuals who have a comorbid psychological disorder often have a poor prognosis if either disorder is untreated.[61] Historically most individuals with dual diagnosis either received treatment only for one of their disorders or they didn't receive any treatment all. However, since the 1980s, there has been a push towards integrating mental health and addiction treatment. In this method, neither condition is considered primary and both are treated simultaneously by the same provider.[62]

Epidemiology[edit]

Disability-adjusted life year for drug use disorders per 100,000 inhabitants in 2004.
  no data
  <40
  40–80
  80–120
  120–160
  160–200
  200–240
  240–280
  280–320
  320–360
  360–400
  400–440
  >440

The initiation of drug use including alcohol is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.[63] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.[63] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.[64] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million with alcohol-related problems.[65]

Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%).[66] According to BBC, "Worldwide, the UN estimates there are more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."[67]

More than 70,200 Americans died from drug overdoses in 2017.[68] Among these, the sharpest increase occurred among deaths related to fentanyl and synthetic opioids (28,466 deaths).[68] See charts below.

  • Drug use is higher in countries with high economic inequality

  • Total recorded alcohol per capita consumption (15+), in litres of pure alcohol[69]

  • Total yearly U.S. drug deaths.[68]

  • US yearly overdose deaths, and the drugs involved.[68]

History[edit]

APA, AMA, and NCDA[edit]

In 1932, the American Psychiatric Association created a definition that used legality, social acceptability, and cultural familiarity as qualifying factors:

…as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien.[70]

In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision':

…'use' refers to the proper place of stimulants in medical practice; 'misuse' applies to the physician's role in initiating a potentially dangerous course of therapy; and 'abuse' refers to self-administration of these drugs without medical supervision and particularly in large doses that may lead to psychological dependency, tolerance and abnormal behavior.

In 1973, the National Commission on Marijuana and Drug Abuse stated:

...drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions. It is an eclectic concept having only one uniform connotation: societal disapproval. ... The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong.[71]

DSM[edit]

The first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and other drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.[72] The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987, the DSM-IIIR category "psychoactive substance abuse," which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous." It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis. By 1988, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal." Substance abuse can be harmful to your health and may even be deadly in certain scenarios. By 1994, The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, the DSM-IV-TR, defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." along with criteria for the diagnosis.[73]

DSM-IV-TR defines substance abuse as:[74]

  • A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
  1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
  2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
  3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
  4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
  • B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

The fifth edition of the DSM (DSM-5), was released in 2013, and it revisited this terminology. The principal change was a transition from the abuse/dependence terminology. In the DSM-IV era, abuse was seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's 'dependence' term, as noted above, does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requested input as to how the terminology of this illness should be altered as it moves forward with DSM-5 discussion.[75] In the DSM-5, substance abuse and substance dependence have been merged into the category of substance use disorders and they now longer exist as individual concepts. While substance abuse and dependence were either present or not, substance use disorder has three levels of severity: mild, moderate and severe.[76]

Society and culture[edit]

Legal approaches[edit]

Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition, Harm reduction

Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what is illegal is their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all-time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health.[77][78] In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.[79]

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity.

Cost[edit]

Policymakers try to understand the relative costs of drug-related interventions. An appropriate drug policy relies on the assessment of drug-related public expenditure based on a classification system where costs are properly identified.

Labelled drug-related expenditures are defined as the direct planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. Direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. Unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. Starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (Unlabelled Drug-related Expenditure = Overall Expenditure × Attributable Proportion). For example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given period, and the attributable proportion of inmates due to drug-related issues. The product of the two will give a rough estimate that can be compared across different countries.[80]

Europe[edit]

As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction's network of national focal points set up in the 27 European Union (EU) Member States, Norway, and the candidates countries to the EU, were requested to identify labeled drug-related public expenditure, at the country level.[80]

This was reported by 10 countries categorized according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of Health (66%) (e.g. medical services), and Public Order and Safety (POS) (20%) (e.g. police services, law courts, prisons). By country, the average share of GDP was 0.023% for Health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of Health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for Health, and a 6-fold difference for POS. Why do Ireland and the UK spend so much in Health and POS, or Slovakia and Portugal so little, in GDP terms?

To respond to this question and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared Health and POS spending and GDP in the 10 reporting countries. Results found suggest GDP to be a major determinant of the Health and POS drug-related public expenditures of a country. Labelled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of Health, and r = 0.91 for POS. The percentage change in Health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively.

Being highly income elastic, Health and POS expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions.[80]

United Kingdom[edit]

The UK Home Office estimated that the social and economic cost of drug abuse[81] to the UK economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year.[82]However, the UK Home Office does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. Those aspects are necessary for a full analysis of the economics of prohibition.[83]

United States[edit]

YearCost
(billions of dollars)[84]
1992107
1993111
1994117
1995125
1996130
1997134
1998140
1999151
2000161
2001170
2002181

These figures represent overall economic costs, which can be divided in three major components: health costs, productivity losses and non-health direct expenditures.

  • Health-related costs were projected to total $16 billion in 2002.
  • Productivity losses were estimated at $128.6 billion. In contrast to the other costs of drug abuse (which involve direct expenditures for goods and services), this value reflects a loss of potential resources: work in the labor market and in household production that was never performed, but could reasonably be expected to have been performed absent the impact of drug abuse.
Included are estimated productivity losses due to premature death ($24.6 billion), drug abuse-related illness ($33.4 billion), incarceration ($39.0 billion), crime careers ($27.6 billion) and productivity losses of victims of crime ($1.8 billion).
  • The non-health direct expenditures primarily concern costs associated with the criminal justice system and crime victim costs, but also include a modest level of expenses for administration of the social welfare system. The total for 2002 was estimated at $36.4 billion. The largest detailed component of these costs is for state and federal corrections at $14.2 billion, which is primarily for the operation of prisons. Another $9.8 billion was spent on state and local police protection, followed by $6.2 billion for federal supply reduction initiatives.

According to a report from the Agency for Healthcare Research and Quality (AHRQ), Medicaid was billed for a significantly higher number of hospitals stays for Opioid drug overuse than Medicare or private insurance in 1993. By 2012, the differences were diminished. Over the same time, Medicare had the most rapid growth in number of hospital stays.[85]

Special populations[edit]

Immigrants and refugees[edit]

Immigrant and refugees have often been under great stress,[86] physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases, followed by "cultural dissonance," language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status and difficulty obtaining work and fears of deportation are common. Refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin.[87][88] For some, substance abuse functions as a coping mechanism to attempt to deal with these stressors.[88]

Immigrants and refugees may bring the substance use and abuse patterns and behaviors of their country of origin,[88] or adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering.[88][89]

Street children[edit]

Street children in many developing countries are a high risk group for substance misuse, in particular solvent abuse.[90] Drawing on research in Kenya, Cottrell-Boyce argues that "drug use amongst street children is primarily functional – dulling the senses against the hardships of life on the street – but can also provide a link to the support structure of the ‘street family’ peer group as a potent symbol of shared experience."[91]

Musicians[edit]

In order to maintain high-quality performance, some musicians take chemical substances.[92] Some musicians take drugs such as alcohol to deal with the stress of performing. As a group they have a higher rate of substance abuse.[92] The most common chemical substance which is abused by pop musicians is cocaine,[92] because of its neurological effects. Stimulants like cocaine increase alertness and cause feelings of euphoria, and can therefore make the performer feel as though they in some ways ‘own the stage’. One way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. The lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance.[92] Smoking harms the alveoli, which are responsible for absorbing oxygen.

Veterans[edit]

Substance abuse can be a factor that affects the physical and mental health of veterans. Substance abuse may also harm personal and familial relationships, leading to financial difficulty. There is evidence to suggest that substance abuse disproportionately affects the homeless veteran population. A 2015 Florida study, which compared causes of homelessness between veterans and non-veteran populations in a self-reporting questionnaire, found that 17.8% of the homeless veteran participants attributed their homelessness to alcohol and other drug-related problems compared to just 3.7% of the non-veteran homeless group.[93]

A 2003 study found that homelessness was correlated with access to support from family/friends and services. However, this correlation was not true when comparing homeless participants who had a current substance-use disorders.[94] The U.S. Department of Veterans Affairs provides a summary of treatment options for veterans with substance-use disorder. For treatments that do not involve medication, they offer therapeutic options that focus on finding outside support groups and “looking at how substance use problems may relate to other problems such as PTSD and depression”.[95]

Sex and gender[edit]

There are many sex differences in substance abuse.[96][97][98] Men and Women express differences in the short and long-term effects of substance abuse. These differences can be credited to sexual dimorphisms in brain, endocrine and metabolic systems. Social and environmental factors that tend to disproportionately effect women; such as child and elder care and the risk of exposure to violence are also factors in the gender differences in substance abuse.[96] Women report having greater impairment in areas such as employment, family and social functioning when abusing substances but have a similar response to treatment. Co-occurring psychiatric disorders are more common among women than men who abuse substances; women more frequently use substances to reduce the negative effects of these co-occurring disorders. Substance abuse puts both men and women at higher risk for perpetration and victimization of sexual violence.[96] Men tend to take drugs for the first time to be part of a group and fit in more so than women. At first interaction, women may experience more pleasure from drugs than men do. Women tend to progress more rapidly from first experience to addiction than men.[97] Physicians, psychiatrists and social workers have believed for decades that women escalate alcohol use more rapidly once they start. Once the addictive behavior is established for women they stabilize at higher doses of drugs than males do. When withdrawing from smoking women experience greater stress response. Males experience greater symptoms when withdrawing from alcohol.[97] There are even gender differences when it comes to rehabilitation and relapse rates. For alcohol, relapse rates were very similar for men and women. For women, marriage and marital stress were risk factors for alcohol relapse. For men, being married lowered the risk of relapse.[98] This difference may be a result of gendered differences in excessive drinking. Alcoholic women are much more likely to be married to partners that drink excessively than are alcoholic men. As a result of this, men may be protected from relapse by marriage while women are out at higher risk when married. However, women are less likely than men to experience relapse to substance use. When men experience a relapse to substance use, they more than likely had a positive experience prior to the relapse. On the other hand, when women relapse to substance use, they were more than likely affected by negative circumstances or interpersonal problems.[98]

See also[edit]

  • ΔFosB
  • Addictive personality
  • Alcohol abuse
  • Combined drug intoxication
  • Controlled Substances Act
  • Drug addiction
  • Drug overdose
  • List of controlled drugs in the United Kingdom
  • List of deaths from drug overdose and intoxication
  • Harm reduction
  • Low-threshold treatment programs
  • Needle-exchange programme
  • Poly drug use
  • Polysubstance abuse
  • Responsible drug use
  • Supervised injection site

References[edit]

  1. ^ a b c "World Drug Report 2012" (PDF). UNITED NATIONS. Retrieved 27 September 2016.
  2. ^ a b "EMCDDA | Information on the high-risk drug use (HRDU) (formerly 'problem drug use' (PDU)) key indicator". emcdda.europa.eu. Retrieved 2016-09-27.
  3. ^ a b c GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  4. ^ Ksir, Oakley Ray; Charles (2002). Drugs, society, and human behavior (9th ed.). Boston [u.a.]: McGraw-Hill. ISBN 978-0072319637.
  5. ^ (2002). Mosby's Medical, Nursing & Allied Health Dictionary. Sixth Edition. Drug abuse definition, p. 552. Nursing diagnoses, p. 2109. ISBN 0-323-01430-5.
  6. ^ "Addiction is a Chronic Disease". Archived from the original on 24 June 2014. Retrieved 2 July 2014.
  7. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  8. ^ "A Public Health Approach" (PDF). Retrieved 1 April 2017.
  9. ^ Nutt, David J; King, Leslie A; Phillips, Lawrence D (November 2010). "Drug harms in the UK: a multicriteria decision analysis". The Lancet. 376 (9752): 1558–1565. CiteSeerX 10.1.1.690.1283. doi:10.1016/S0140-6736(10)61462-6. PMID 21036393. S2CID 5667719.
  10. ^ E. Fehrman, A. K. Muhammad, E. M. Mirkes, V. Egan, A. N. Gorban,The Five Factor Model of personality and evaluation of drug consumption risk, arXiv:1506.06297 [stat.AP], 2015
  11. ^ Philip Jenkins, Synthetic panics: the symbolic politics of designer drugs, NYU Press, 1999, ISBN 0-8147-4244-0, pp. ix–x
  12. ^ a b Fehrman, Elaine; Egan, Vincent; Gorban, Alexander N.; Levesley, Jeremy; Mirkes, Evgeny M.; Muhammad, Awaz K. (2019). Personality Traits and Drug Consumption. A Story Told by Data. Springer, Cham. arXiv:2001.06520. doi:10.1007/978-3-030-10442-9. ISBN 978-3-030-10441-2. S2CID 151160405.
  13. ^ Barrett SP, Meisner JR, Stewart SH (November 2008). "What constitutes prescription drug misuse? Problems and pitfalls of current conceptualizations" (PDF). Curr Drug Abuse Rev. 1 (3): 255–62. doi:10.2174/1874473710801030255. PMID 19630724. Archived from the original (PDF) on 2010-06-15.
  14. ^ McCabe SE, Boyd CJ, Teter CJ (June 2009). "Subtypes of nonmedical prescription drug misuse". Drug Alcohol Depend. 102 (1–3): 63–70. doi:10.1016/j.drugalcdep.2009.01.007. PMC 2975029. PMID 19278795.
  15. ^ Antai-Otong, D. 2008. Psychiatric Nursing: Biological and Behavioral Concepts. 2nd edition. Canada: Thompson Delmar Learning
  16. ^ "The Prescription Drug Abuse Epidemic". PDMP Center of Excellence. 2010–2013.
  17. ^ "Topics in Brief: Prescription Drug Abuse" NIDA, December 2011.
  18. ^ a b c "Vaping popular among teens; opioid misuse at historic lows". National Institute on Drug Abuse. 14 December 2017. Retrieved 10 April 2019.
  19. ^ "Combating Prescription Drug Abuse in Your Practice" Archived 2012-06-18 at the Wayback Machine Aubrey Westgate, Physicians Practice, June 2012.
  20. ^ a b c d e f Nutt, D.; King, L. A.; Saulsbury, W.; Blakemore, C. (2007). "Development of a rational scale to assess the harm of drugs of potential misuse". The Lancet. 369 (9566): 1047–1053. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831. S2CID 5903121.
  21. ^ Burke PJ, O'Sullivan J, Vaughan BL (November 2005). "Adolescent substance use: brief interventions by emergency care providers". Pediatr Emerg Care. 21 (11): 770–6. doi:10.1097/01.pec.0000186435.66838.b3. PMID 16280955. S2CID 36410538.
  22. ^ Serafini G, Innamorati M, Dominici G, Ferracuti S, Kotzalidis GD, Serra G (April 2010). "Suicidal Behavior and Alcohol Abuse". International Journal of Environmental Research and Public Health. International Journal Environmental Research and Public Health. 7 (4): 1392–1431. doi:10.3390/ijerph7041392. PMC 2872355. PMID 20617037.
  23. ^ O'Connor, Rory; Sheehy, Noel (29 January 2000). Understanding suicidal behaviour. Leicester: BPS Books. pp. 33–36. ISBN 978-1-85433-290-5.
  24. ^ Isralowitz, Richard (2004). Drug use: a reference handbook. Santa Barbara, Calif.: ABC-CLIO. pp. 122–123. ISBN 978-1-57607-708-5.
  25. ^ University of Miami: Substance Abuse, Substance Abuse and Health Risks
  26. ^ "High-strength skunk 'now dominates' UK cannabis market". nhs.uk. 28 February 2018.
  27. ^ Di Forti M, Marconi A, Carra E, Fraietta S, Trotta A, Bonomo M, Bianconi F, Gardner-Sood P, O'Connor J, Russo M, Stilo SA, Marques TR, Mondelli V, Dazzan P, Pariante C, David AS, Gaughran F, Atakan Z, Iyegbe C, Powell J, Morgan C, Lynskey M, Murray RM (2015). "Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study" (PDF). Lancet Psychiatry. 2 (3): 233–8. doi:10.1016/S2215-0366(14)00117-5. PMID 26359901.
  28. ^ Marta Di Forti (17 December 2013). "Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users". Schizophrenia Bulletin. 40 (6): 1509–1517. doi:10.1093/schbul/sbt181. PMC 4193693. PMID 24345517.
  29. ^ Evans, Katie; Sullivan, Michael J. (1 March 2001). Dual Diagnosis: Counseling the Mentally Ill Substance Abuser (2nd ed.). Guilford Press. pp. 75–76. ISBN 978-1-57230-446-8.
  30. ^ a b Hampton WH, Hanik I, Olson IR (2019). "[Substance Abuse and White Matter: Findings, Limitations, and Future of Diffusion Tensor Imaging Research]". Drug and Alcohol Dependence. 197 (4): 288–298. doi:10.1016/j.drugalcdep.2019.02.005. PMC 6440853. PMID 30875650. Given that our the central nervous system is an intricately balanced, complex network of billions of neurons and supporting cells, some might imagine that extrinsic substances could cause irreversible brain damage. Our review paints a less gloomy picture of the substances reviewed, however. Following prolonged abstinence, abusers of alcohol (Pfefferbaum et al., 2014) or opiates (Wang et al., 2011) have white matter microstructure that is not significantly different from non-users. There was also no evidence that the white matter microstructural changes observed in longitudinal studies of cannabis, nicotine, or cocaine were completely irreparable. It is therefore possible that, at least to some degree, abstinence can reverse effects of substance abuse on white matter. The ability of white matter to “bounce back” very likely depends on the level and duration of abuse, as well as the substance being abused.
  31. ^ "Impulsivity". The Free Dictionary.
  32. ^ a b Gerard Moeller M.D., Barratt Ernest S., Ph, Dougherty Donald M., Ph, Schmitz Joy M., Ph, Swann Alan C. (2001). "Psychiatric Aspects of Impulsivity". The American Journal of Psychiatry. 158 (11): 1783–93. doi:10.1176/appi.ajp.158.11.1783. PMID 11691682. Archived from the original on April 15, 2013.CS1 maint: multiple names: authors list (link)
  33. ^ Bishara AJ, Pleskac TJ, Fridberg DJ, Yechiam E, Lucas J, Busemeyer JR, Finn PR, Stout JC (2009). "Similar Processes Despite Divergent Behavior in Two Commonly Used Measures of Risky Decision Making". J Behav Decis Mak. 22 (4): 435–454. doi:10.1002/bdm.641. PMC 3152830. PMID 21836771.
  34. ^ Kreek, Mary Jeanne; Nielsen, David A; Butelman, Eduardo R; LaForge, K Steven (26 October 2005). "Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction". Nature Neuroscience. 8 (11): 1450–1457. doi:10.1038/nn1583. PMID 16251987. S2CID 12589277.
  35. ^ Chambers RA, Taylor JR, Potenza MN (2003). "Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability". Am J Psychiatry. 160 (6): 1041–52. doi:10.1176/appi.ajp.160.6.1041. PMC 2919168. PMID 12777258.
  36. ^ Jeronimus B.F.; Kotov, R.; Riese, H.; Ormel, J. (2016). "Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants". Psychological Medicine. 46 (14): 2883–2906. doi:10.1017/S0033291716001653. PMID 27523506.
  37. ^ Knight JR, Shrier LA, Harris SK, Chang G (2002). "Validity of the CRAFFT substance abuse screening test among adolescent clinic patients". JAMA Pediatrics. 156 (6): 607–614. doi:10.1001/archpedi.156.6.607.
  38. ^ Dhalla S, Kopec JA (2007). "The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies". Clinical and Investigative Medicine: 33–41. doi:10.25011/cim.v30i1.447.
  39. ^ Morse, Barbara (1997). Screening for Substance Abuse During Pregnancy: Improving Care, Improving Health (PDF). pp. 4–5. ISBN 978-1-57285-042-2.
  40. ^ O'Donohue, W; K.E. Ferguson (2006). "Evidence-Based Practice in Psychology and Behavior Analysis". The Behavior Analyst Today. 7 (3): 335–350. doi:10.1037/h0100155. Retrieved 2008-03-24.
  41. ^ Chambless, D.L.; et al. (1998). "An update on empirically validated therapies" (PDF). Clinical Psychology. 49: 5–14. Retrieved 2008-03-24.
  42. ^ "NIH Senior Health "Build With You in Mind": Survey". nihseniorhealth.gov. Archived from the original on 2015-08-11. Retrieved 29 July 2015.
  43. ^ "Association for Behavioral and Cognitive Therapies – What is CBT?". Archived from the original on 2010-04-21.
  44. ^ "Association for Behavioral and Cognitive Therapies – What is Family Therapy?". Archived from the original on 2010-06-13.
  45. ^ a b Hogue, A; Henderson, CE; Ozechowski, TJ; Robbins, MS (2014). "Evidence base on outpatient behavioral treatments for adolescent substance use: updates and recommendations 2007–2013". Journal of Clinical Child and Adolescent Psychology. 43 (5): 695–720. doi:10.1080/15374416.2014.915550. PMID 24926870. S2CID 10036629.
  46. ^ "Association for Behavioral and Cognitive Therapies – Treatment for Substance Use Disorders". Archived from the original on 2010-04-21.
  47. ^ Engle, Bretton; Macgowan, Mark J. (2009-08-05). "A Critical Review of Adolescent Substance Abuse Group Treatments". Journal of Evidence-Based Social Work. 6 (3): 217–243. doi:10.1080/15433710802686971. ISSN 1543-3714. PMID 20183675. S2CID 3293758.
  48. ^ a b "Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis". crd.york.ac.uk. Retrieved 2016-03-09.
  49. ^ Carney, Tara; Myers, Bronwyn J; Louw, Johann; Okwundu, Charles I (2016-01-20). "Brief school-based interventions and behavioural outcomes for substance-using adolescents". Cochrane Database of Systematic Reviews (1): CD008969. doi:10.1002/14651858.cd008969.pub3. hdl:10019.1/104381. PMC 7119449. PMID 26787125.
  50. ^ Jensen, Chad D.; Cushing, Christopher C.; Aylward, Brandon S.; Craig, James T.; Sorell, Danielle M.; Steele, Ric G. (2011). "Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review". Journal of Consulting and Clinical Psychology. 79 (4): 433–440. doi:10.1037/a0023992. PMID 21728400. S2CID 19892519.
  51. ^ Barnett, Elizabeth; Sussman, Steve; Smith, Caitlin; Rohrbach, Louise A.; Spruijt-Metz, Donna (2012). "Motivational Interviewing for adolescent substance use: A review of the literature". Addictive Behaviors. 37 (12): 1325–1334. doi:10.1016/j.addbeh.2012.07.001. PMC 3496394. PMID 22958865.
  52. ^ "Self-Help Groups Article". Retrieved May 27, 2015.
  53. ^ Uekermann J, Daum I (May 2008). "Social cognition in alcoholism: a link to prefrontal cortex dysfunction?". Addiction. 103 (5): 726–35. doi:10.1111/j.1360-0443.2008.02157.x. PMID 18412750.
  54. ^ Purvis G.; MacInnis D. M. (2009). "Implementation of the Community Reinforcement Approach (CRA) in a Long-Standing Addictions Outpatient Clinic" (PDF). Journal of Behavior Analysis of Sports, Health, Fitness and Behavioral Medicine. 2: 133–44. Archived from the original (PDF) on 2010-12-29.
  55. ^ "Current Pharmacological Treatment Available for Alchhol Abuse". The California Evidence-Based Clearinghouse. 2006–2013.
  56. ^ James W. Kalat Biological psychology 11th edition pg.78
  57. ^ Maglione, M; Maher, AR; Hu, J; Wang, Z; Shanman, R; Shekelle, PG; Roth, B; Hilton, L; Suttorp, MJ; Ewing, BA; Motala, A; Perry, T (September 2011). "Off-Label Use of Atypical Antipsychotics: An Update [Internet]". Agency for Healthcare Research and Quality (US). PMID 22132426. Report No.: 11-EHC087-EF.
  58. ^ Lingford-Hughes AR, Welch S, Peters L, Nutt DJ, British Association for Psychopharmacology, Expert Reviewers Group (2012-07-01). "BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP". Journal of Psychopharmacology. 26 (7): 899–952. doi:10.1177/0269881112444324. ISSN 0269-8811. PMID 22628390.
  59. ^ "Drogentote" Swiss Health Observatory. obsan.admin.ch. Retrieved 23 December 2020.
  60. ^ "Overdose Death Rates". drugabuse.gov. Retrieved 23 December 2020.
  61. ^ a b Lingford-Hughes A. R.; Welch S.; Peters L.; Nutt D. J. (2012). "BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP" (PDF). Journal of Psychopharmacology. 26 (7): 899–952. doi:10.1177/0269881112444324. PMID 22628390. S2CID 30030790. Archived from the original (PDF) on 2012-12-03.
  62. ^ a b Peterson Ashley L (2013). "Integrating Mental Health and Addictions Services to Improve Client Outcomes". Issues in Mental Health Nursing. 34 (10): 752–756. doi:10.3109/01612840.2013.809830. PMID 24066651. S2CID 11537206.
  63. ^ a b Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2010. Ann Arbor: Institute for Social Research, The University of Michigan.
  64. ^ "CDC Newsroom Press Release June 3, 2010".
  65. ^ Barker, P. ed. 2003. Psychiatric and mental health nursing: the craft and caring. London: Arnold. pp297
  66. ^ Effective Child Therapy: Substance Abuse and Dependence. Copyright 2012 Archived 2013-05-03 at the Wayback Machine
  67. ^ "Drug Trade". BBC News.
  68. ^ a b c d Overdose Death Rates. By National Institute on Drug Abuse (NIDA).
  69. ^ Global Status Report on Alcohol 2004
  70. ^ Glasscote, R.M., Sussex, J.N., Jaffe, J.H., Ball, J., Brill, L. (1932). The Treatment of Drug Abuse for people like you...: Programs, Problems, Prospects. Washington, D.C.: Joint Information Service of the American Psychiatric Association and the National Association for Mental Health.
  71. ^ Second Report of the National Commission on Marihuana and Drug Abuse; Drug Use In America: Problem In Perspective (March 1973), p.13
  72. ^ Transformations: Substance Drug Abuse
  73. ^ DSM-IV & DSM-IV-TR:Substance Dependence Archived 2011-09-27 at the Wayback Machine
  74. ^ American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC.
  75. ^ Hasin, Deborah S.; O’Brien, Charles P.; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M.; Crowley, Thomas; Ling, Walter (2013-08-01). "DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale". American Journal of Psychiatry. 170 (8): 834–851. doi:10.1176/appi.ajp.2013.12060782. ISSN 0002-953X. PMC 3767415. PMID 23903334.
  76. ^ "Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (5th edition)2014 102 Washington, DC American Psychiatric Association 2013 xliv+947 pp. 9780890425541(hbck);9780890425558(pbck) £175 $199 (hbcchvk); £45 $69 (pbck)". Reference Reviews. 28 (3): 36–37. 11 March 2014. doi:10.1108/rr-10-2013-0256.
  77. ^ Copeman M (April 2003). "Drug supply and drug abuse". CMAJ. 168 (9): 1113, author reply 1113. PMC 153673. PMID 12719309. Archived from the original on 2009-09-06.
  78. ^ Wood E, Tyndall MW, Spittal PM, et al. (January 2003). "Impact of supply-side policies for control of illicit drugs in the face of the AIDS and overdose epidemics: investigation of a massive heroin seizure". CMAJ. 168 (2): 165–9. PMC 140425. PMID 12538544.
  79. ^ Bewley-Taylor, Dave, Hallam, Chris, Allen Rob. The Beckley Foundation Drug Policy Programme: The Incarceration of Drug Offenders: An Overview. March 2009.
  80. ^ a b c Prieto L (2010). "Labelled drug-related public expenditure in relation to gross domestic product (gdp) in Europe: A luxury good?". Substance Abuse Treatment, Prevention, and Policy. 5: 9. doi:10.1186/1747-597x-5-9. PMC 2881082. PMID 20478069.
  81. ^ "NHS and Drug Abuse". National Health Service (NHS). March 22, 2010. Retrieved March 22, 2010.
  82. ^ "Home Office | Tackling Drugs Changing Lives | Drugs in the workplace". 2007-06-09. Archived from the original on 2007-06-09. Retrieved 2016-09-19.
  83. ^ Thornton, Mark. "The Economics of Prohibition".
  84. ^ The economic costs of drug abuse in the United States
  85. ^ Owens PL, Barrett ML, Weiss AJ, Washington RE, Kronick R (August 2014). "Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993–2012". HCUP Statistical Brief #177. Rockville, MD: Agency for Healthcare Research and Quality.
  86. ^ Drachman, D. (1992). "A stage-of-migration framework for service to immigrant populations". Social Work. 37 (1): 68–72. doi:10.1093/sw/37.1.68.
  87. ^ Pumariega A. J.; Rothe E.; Pumariega J. B. (2005). "Mental health of immigrants and refugees". Community Mental Health Journal. 41 (5): 581–597. CiteSeerX 10.1.1.468.6034. doi:10.1007/s10597-005-6363-1. PMID 16142540. S2CID 7326036.
  88. ^ a b c d National Institute on Alcohol Abuse and Alcoholism. (2005). Module 10F: Immigrants, refugees, and alcohol. In NIAAA: Social work education for the prevention and treatment of alcohol use disorders (NIH publication). Washington, D.C.
  89. ^ Caetano R.; Clark C. L.; Tam T. (1998). "Alcohol consumption among racial/ethnic minorities: Theory and research". Journal of Alcohol, Health, and Research. 22 (4): 233–241.
  90. ^ UNODC. "Understanding Substance Use Among Street Children" (PDF). Retrieved 30 January 2014.
  91. ^ Cottrell-Boyce, Joe (2010). "The role of solvents in the lives of Kenyan street children: An ethnographic perspective" (PDF). African Journal of Drug & Alcohol Studies. 9 (2): 93–102. doi:10.4314/ajdas.v9i2.64142. Retrieved 28 January 2014.
  92. ^ a b c d Breitenfeld D.; Thaller V.; Perić B.; Jagetic N.; Hadžić D.; Breitenfeld T. (2008). "Substance abuse in performing musicians". Alcoholism: Journal on Alcoholism and Related Addictions. 44 (1): 37–42. ProQuest 622145760.
  93. ^ Dunne, E. M., Burrell, L. I., Diggins, A. D., Whitehead, N. E., & Latimer, W. W. (2015). "Increased risk for substance use and health‐related problems among homeless veterans". The American Journal on Addictions. 24 (7): 676–680. doi:10.1111/ajad.12289. PMC 6941432. PMID 26359444.CS1 maint: multiple names: authors list (link)
  94. ^ Zlotnick, C., Tam, T., & Robertson, M. J. (2003). "Disaffiliation, substance use, and exiting homelessness". Substance Use & Misuse. 38 (3–6): 577–599. doi:10.1081/ja-120017386. PMID 12747398. S2CID 31815225.CS1 maint: multiple names: authors list (link)
  95. ^ "Treatment Programs for Substance Use Problems – Mental Health". mentalhealth.va.gov. Retrieved 2016-12-17.
  96. ^ a b c McHugh, R. Kathryn; Votaw, Victoria R.; Sugarman, Dawn E.; Greenfield, Shelly F. (2018-12-01). "Sex and gender differences in substance use disorders". Clinical Psychology Review. Gender and Mental Health. 66: 12–23. doi:10.1016/j.cpr.2017.10.012. ISSN 0272-7358. PMC 5945349. PMID 29174306.
  97. ^ a b c Becker, Jill B.; McClellan, Michele L.; Reed, Beth Glover (2016-11-07). "Sex differences, gender and addiction". Journal of Neuroscience Research. 95 (1–2): 136–147. doi:10.1002/jnr.23963. ISSN 0360-4012. PMC 5120656. PMID 27870394.
  98. ^ a b c Walitzer, Kimberly S.; Dearing, Ronda L. (2006-03-01). "Gender differences in alcohol and substance use relapse". Clinical Psychology Review. Relapse in the addictive behaviors. 26 (2): 128–148. doi:10.1016/j.cpr.2005.11.003. ISSN 0272-7358. PMID 16412541.

External links[edit]

Classification
D
  • ICD-10: F10.1-F19
  • ICD-9-CM: 305
  • MeSH: D019966
  • DiseasesDB: 3961
External resources
  • MedlinePlus: 001945
  • Substance abuse at Curlie
  • Adverse Childhood Experiences: Risk Factors for Substance Misuse and Mental Health Dr. Robert Anda of the U.S. Centers for Disease Control describes the relation between childhood adversity and later ill-health, including substance abuse (video)
  • The National Institute on Drug Abuse