Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18

Addiction Related Abstracts

18 The Role of Androgens in Prediction of Success in Smoking Cessation in Women

Authors: Michaela Duskova, Martin Hill, Kateřina Šimůnková, Hana Hruškovičová, Hana Pospíšilová, Eva Králíková, Luboslav Stárka


Smoking represents the most widespread substance dependence in the world. Several studies show the nicotine's ability to alter women hormonal homeostasis. Women smokers have higher testosterone and lower estradiol levels throughout life compared to non-smoker women. We monitored the effect of smoking discontinuation on steroid spectrum with 40 premenopausal and 60 postmenopausal women smokers. These women had been examined before they discontinued smoking and also after 6, 12, 24, and 48 weeks of abstinence. At each examination, blood was collected to determine steroid spectrum (measured by GC-MS), LH, FSH, and SHBG (measured by IRMA). Repeated measures ANOVA model was used for evaluation of the data. The study has been approved by the local Ethics Committee. Given the small number of premenopausal women who endured not to smoke, only the first 6 week period data could be analyzed. A slight increase in androgens after the smoking discontinuation occurred. In postmenopausal women, an increase in testosterone, dihydrotestosterone, dehydroepiandrosterone, and other androgens occurred, too. Nicotine replacement therapy, weight changes, and age does not play any role in the androgen level increase. The higher androgens levels correlated with failure in smoking cessation. Women smokers have higher androgen levels, which might play a role in smoking dependence development. Women successful in smoking cessation, compared to the non-successful ones, have lower androgen levels initially and also after smoking discontinuation. The question is what androgen levels women have before they start smoking.

Keywords: Addiction, Smoking, cessation, androgens

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17 Parenting Styles and Their Relation to Videogame Addiction

Authors: Petr Kveton, Martin Jelinek


We try to identify the role of various aspects of parenting style in the phenomenon of videogame playing addiction. Relevant self-report questionnaires were part of a wider set of methods focused on the constructs related to videogame playing. The battery of methods was administered in school settings in paper and pencil form. The research sample consisted of 333 (166 males, 167 females) elementary and high school students at the age between 10 and 19 years (m=14.98, sd=1.77). Using stepwise regression analysis, we assessed the influence of demographic variables (gender and age) and parenting styles. Age and gender together explained 26.3% of game addiction variance (F(2,330)=58.81, p<.01). By adding four aspect of parenting styles (inconsistency, involvement, control, and warmth) another 10.2% of variance was explained (∆F(4,326)=13.09, p<.01). The significant predictor was gender of the respondent, where males scored higher on game addiction scale (B=0.70, p<.01), age (β=-0.18, p<.01), where younger children showed higher level of addiction, and parental inconsistency (β=0.30, p<.01), where the higher the inconsistency in upbringing, the more developed game playing addiction.

Keywords: Gender, Addiction, parenting styles, Video Games

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16 Motivation for Therapy in Clinical Social Work in Kuwait

Authors: Hend Almaseb


​The motivational model proposed by Self-Determination Theory provided an explanation for clients’ motivation for therapy. Among a sample of 78 inpatient residents in the Addiction Treatment Center, this study examined the relationship between three types of motivation (Autonomous, Controlled, and Amotivation) and each of the following variables: Age, Marital Status, Educational Level of Participant, and Number of Years of Addiction. In addition, the study investigated whether or not the participants are motivated to receive therapy. The results showed 1) a significant relationship between Controlled Motivation and the following variables: Age, Marital Status, and Number of Years of Addiction; 2) a significant relationship between Autonomous Motivation and Number of Years of Addiction; and a significant relationship between Educational Level and Amotivation. The results also illustrated that the participants of this study were not motivated to seek therapy.

Keywords: Addiction, Motivation, Clinical Social Work, Self-Determination

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15 The Effect of a Three-Month Training Program on the Back Kyphosis of Former Male Addicts

Authors: M. J. Pourvaghar, Sh. Khoshemehry


Adopting inappropriate body posture during addiction can cause muscular and skeletal deformities. This study is aimed at investigating the effects of a program of the selected corrective exercises on the kyphosis of addicted male patients. Materials and methods: This was a quasi-experimental study. This study has been carried out using the semi-experimental method. The subjects of the present study included 104 addicted men between 25 to 45 years of age. In 2014, these men were referred to one of the NA (Narcotic Anonymous) centres in Kashan in 2015. A total of 24 people suffering from drug withdrawal, who had abnormal kyphosis, were purposefully selected as a sample. The sample was randomly divided into two groups, experimental and control; each group consisted of 12 people. The experimental group participated in a training program for 12 weeks consisting of three 60 minute sessions per week. That includes strengthening, stretching and PNF exercises (deep stretching of the muscle). The control group did no exercise or corrective activity. The Kolmogorov-Smirnov test was used to assess normal distribution of data; and a paired t-test and covariance analysis test were used to assess the effectiveness of the exercises, with a significance level of P≤0.05 by using SPSS18. The results showed that three months of the selected corrective exercises had a significant effect (P≤ 0.005) on the correction of the kyphosis of the addicted male patients after three months of rehabilitation (drug withdrawal) in the experimental group, while there was no significant difference recorded in the control group (P≥0.05). The results show that exercise and corrective activities can be used as non-invasive and non-pharmacological methods to rehabilitate kyphosis abnormalities after drug withdrawal and treatment for addiction.

Keywords: Addiction, kyphosis, exercise-rehabilitation, addict

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14 Pathological Gambling and Impulsivity: Comparison of the Eight Laboratory Measures of Inhibition Capacities

Authors: Pinhas Dannon, Semion Kertzman


Impulsive behaviour and the underlying brain processes are hypothesized to be central in the development and maintenance of pathological gambling. Inhibition ability can be differentially impaired in pathological gamblers (PGs). Aims: This study aimed to compare the ability of eight widely used inhibition measures to discriminate between PGs and healthy controls (HCs). Methods: PGs (N=51) and demographically matched HCs (N=51) performed cognitive inhibition (the Stroop), motor inhibition (the Go/NoGo) and reflective inhibition (the Matching Familiar Figures (MFFT)) tasks. Results: An augmented total interference response time in the Stroop task (η² =0.054), a large number of commission errors (η² =0.053) in the Go/NoGo task, and the total number of errors in the MFFT (η² =0.05) can discriminate PGs from HCs. Other measures are unable to differentiate between PGs and HCs. No significant correlations were observed between inhibition measures. Conclusion: Inhibition measures varied in the ability to discriminate PGs from HCs. Most inhibition measures were not relevant to gambling behaviour. PGs do not express rash, impulsive behaviour, such as quickly choosing an answer without thinking. In contrast, in PGs, inhibition impairment was related to slow-inaccurate performance.

Keywords: Addiction, impulsivity, neurocognition, pathological gambling

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13 Heroic Villains: An Exploration of the Use of Narrative Plotlines and Emerging Identities within Recovery Stories of Former Substance Abusers

Authors: Tria Moore Aimee Walker-Clarke


The purpose of the study was to develop a deeper understanding of how self-identity is negotiated and reconstructed by people in recovery from substance abuse. The approach draws on the notion that self-identity is constructed through stories. Specifically, dominant narratives of substance abuse involve the 'addict identity' in which the meaning of being an addict is constructed though social interaction and informed by broader social meanings of substance misuse, which are considered deviant. The addict is typically understood as out of control, weak and feckless. Users may unconsciously embody this addict identity which makes recovery less likely. Typical approaches to treatment employ the notion that recovery is much more likely when users change the way they think and feel about themselves by assembling a new identity. Recovery, therefore, involves a reconstruction of the self in a new light, which may mean rejecting a part of the self (the addict identity). One limitation is that previous research on this topic has been quantitative which, while useful, tells us little about how this process is best managed. Should one, for example, reject the past addict identity completely and move on to the new identity, or, is it more effective to accept the past identity and use this in the formation of the new non-user identity? The purpose of this research, then, is to explore how addicts in recovery have managed the transition between their past and current selves and whether this may inform therapeutic practice. Using a narrative approach, data were analyzed from five in-depth interviews with former addicts who had been abstinent for at least a year, and who were in some form of volunteering role at substance treatment services in the UK. Although participants' identified with a previous ‘addict identity,’ and made efforts to disassociate themselves from this, they also recognized that acceptance was an important part of reconstructing their new identity. The participants' narratives used familiar plot lines to structure their stories, in which they positioned themselves as the heroes in their own stories, rather than as victim of circumstance. Instead of rejecting their former addict identity, which would mean rejecting a part of the self, participants used their experience in a reconstructive and restorative way. The findings suggest that encouraging people to tell their story and accept their addict identity are important factors in successful recovery.

Keywords: Identity, Addiction, Substance abuse, Recovery, Narrative

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12 Quality of Life Measurements: Evaluation of Intervention Program of Persons with Addiction

Authors: Petr Seďa, Julie Wittmannová


Quality of life measurements (QLF) help to evaluate interventions programs in different groups of persons with special needs. Our presentation deals with QLF of persons with addiction in relation to the physical activity (PA), type of addiction, age, gender and other variables. The aim of presentation is to summarize the basic findings and offer thoughts for questions arose. Methods: SQUALA (Subjective Quality of Life Analysis); SEIQoL (Schedule for the Evaluation of Individual Quality of Life); questionnaire of own construction. The results are evaluated by Mann­Whitney U test and Kruskall­Wallis ANOVA test (p ≤ 0,05). Sample of 64 participants – clients of aftercare center, aged 18 plus. Findings: Application of the methods SQUALA and SEIQoL in the chosen population seems appropriate, the obtaining information regarding the QLF correlate to intervention program topics, the need of an activelifestyle and health related topics in persons with addiction is visible. Conclusions or Implications: The subjective evaluation of quality of life of Aftercare clients is an important part of evaluation process, especially used to evaluate satisfaction with offered services and programs. Techniques SQUALA and SEIQoL gave us the desired outcomes.

Keywords: Physical Activity, Addiction, Quality of Life, Adapted Physical Activity, aftercare

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11 Profile of Internet and Smartphone Overuse Based on Internet Usage Needs

Authors: Yeoju Chung


Adolescents internet and smartphone addiction are increasing in Korea. But differences between internet addiction and smartphone addiction have been researched in these days. The main objective of this article is to explore the presence of clusters within a sample of adolescents based on dimensions associated with addiction and internet usage needs. The sample consists of 617 adolescents in the 14-19 year age group who were recruited in Korea A cluster analysis identified four groups of participants: internet overuse(IO), smartphone overuse(SO), both overuse(B) and normal(N) use group. MANOVA analysis based on internet usage showed that there are differences among four groups in internet usage needs. IO has higher cyber self-seeking needs and emotion and thought expression needs than SO. SO has higher real relationship and life needs with cyberworld than IO, B, and N. B has the highest cyber self-seeking needs and emotion and thought expression needs, however, game fun seeking needs is the highest in IO. These results support that IO seeks game fun needs, SO seeks real relationship and life needs, and B seeks cyber self and expression in cyberworld.

Keywords: Internet, Addiction, Needs, smartphone

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10 The Effect of Dopamine D2 Receptor TAQ A1 Allele on Sprinter and Endurance Athlete

Authors: Oznur Ozge Ozcan, Canan Sercan, Hamza Kulaksız, Mesut Karahan, Korkut Ulucan


Genetic structure is very important to understand the brain dopamine system which is related to athletic performance. Hopefully, there will be enough studies about athletics performance in the terms of addiction-related genetic markers in the future. In the present study, we intended to investigate the Receptor-2 Gene (DRD2) rs1800497, which is related to brain dopaminergic system. 10 sprinter and 10 endurance athletes were enrolled in the study. Real-Time Polymerase Chain Reaction method was used for genotyping. According to results, A1A1, A1A2 and A2A2 genotypes in athletes were 0 (%0), 3 (%15) and 17 (%85). A1A1 genotype was not found and A2 allele was counted as the dominating allele in our cohort. These findings show that dopaminergic mechanism effects on sport genetic may be explained by the polygenic and multifactorial view.

Keywords: Addiction, genotype, Athletic Performance, sport genetics

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9 A Measurement Instrument to Determine Curricula Competency of Licensure Track Graduate Psychotherapy Programs in the United States

Authors: Laith F. Gulli, Nicole M. Mallory


We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: Psychotherapy, Addiction, Curriculum, Competency

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8 Self-Determination and Mental Disorders: Phenomenological Approach

Authors: Neringa Bagdonaitė


Background: The main focus of this paper is to explore how self-determination interplays in suicidal and addictive context leading one to autonomously choose self-destructive addictive behaviour or suicidal intentions. Methods: Phenomenological descriptions of the experiential structure of self-determination in addiction and suicidal mental life are used. The phenomenological method describes structures of mental life from the first-person-perspective, with a focus on how an experienced object is given in a subject’s conscious experience. Results: A sense of self-determination in the context of suicidal and addictive behaviour is possibly impaired. In the context of suicide, it's proposed that suicide is always experienced at least minimally self-determined, as it's the last freely discovered self-efficient behaviour, in terms of radically changing one's desperate mental state. Suicide can never be experienced as fully self-determined because no future retrospective re-evaluation of behaviour is possible. Understanding self-determination in addiction is challenging because addicts perceive themselves and experience situations differently depending on: (I) their level of intoxication; (II) whether the situation is in the moment or in retrospect; and (III) the goals set out in that situation. Furthermore, within phenomenology addiction is described as an embodied custom, which‘s acquired and established while performing 'psychotropic technique'. The main goal of performing such a technique is to continue 'floating in an indifference state' or being 'comfortably numb'. Conclusions: Based on rich phenomenological descriptions of the studied phenomenon, this paper draws on the premise that to experience self-determination in both suicide and addiction, underlying desperate or negative emotional states are needed. Such underlying desperate or negative mental life experiences are required for one to pre-reflectively evaluate suicide or addictive behaviours as positive, relieving or effective in terms of changing one's emotional states. Such pre-reflective positive evaluations serve as the base for the continuation of behaviour and later are identified reflectively.

Keywords: Addiction, phenomenology, Suicide, Self-Determination, self-effectivity

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7 Advocating in the Criminal Justice System for Individuals Who Use Drugs: Advice from Advocates in the Greater Vancouver Area

Authors: Haley Hrymak


For decades drug addiction has been understood to be a health problem and not a social problem. While research has advanced to allow for a more comprehensive understanding of the factors affecting addiction, the justice system has lagged behind. Given all that is known about addiction as a health issue and the need for effective rehabilitation to prevent further involvement with crime, there is a need for a dramatic shift in order to ensure individual's human right to health is being upheld within the Canadian criminal justice system. This research employs the qualitative methodology to interview advocates who work with substance users within the Greater Vancouver area to explore best practices for representing individuals with substance abuse issues within the Canadian justice system. The research shows that treatment, not punishment, is what is needed in order for recidivism to be reduced for individuals with substance abuse issues. The creative options that advocates employ to work within the current system are intended to provide a guide for lawyers working within the current criminal justice system.

Keywords: Rehabilitation, Criminal Law, Addiction, Right to Health

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6 Study of Mobile Game Addiction Using Electroencephalography Data Analysis

Authors: Muhammad Dawood Idrees, Arsalan Ansari, Maria Hafeez


Use of mobile phones has been increasing considerably over the past decade. Currently, it is one of the main sources of communication and information. Initially, mobile phones were limited to calls and messages, but with the advent of new technology smart phones were being used for many other purposes including video games. Despite of positive outcomes, addiction to video games on mobile phone has become a leading cause of psychological and physiological problems among many people. Several researchers examined the different aspects of behavior addiction with the use of different scales. Objective of this study is to examine any distinction between mobile game addicted and non-addicted players with the use of electroencephalography (EEG), based upon psycho-physiological indicators. The mobile players were asked to play a mobile game and EEG signals were recorded by BIOPAC equipment with AcqKnowledge as data acquisition software. Electrodes were places, following the 10-20 system. EEG was recorded at sampling rate of 200 samples/sec (12,000samples/min). EEG recordings were obtained from the frontal (Fp1, Fp2), parietal (P3, P4), and occipital (O1, O2) lobes of the brain. The frontal lobe is associated with behavioral control, personality, and emotions. The parietal lobe is involved in perception, understanding logic, and arithmetic. The occipital lobe plays a role in visual tasks. For this study, a 60 second time window was chosen for analysis. Preliminary analysis of the signals was carried out with Acqknowledge software of BIOPAC Systems. From the survey based on CGS manual study 2010, it was concluded that five participants out of fifteen were in addictive category. This was used as prior information to group the addicted and non-addicted by physiological analysis. Statistical analysis showed that by applying clustering analysis technique authors were able to categorize the addicted and non-addicted players specifically on theta frequency range of occipital area.

Keywords: Addiction, mobile game, psycho-physiology, EEG analysis

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5 Current Judicial Discourse Regarding the Impact of Alcohol Use Disorders on Crime in Canada

Authors: Ellen McClure


It is generally well-known that a number of inmates suffer from some form of substance or alcohol use disorder. This study identifies, analyses, classifies and codifies the most recent Canadian criminal judgments involving an accused diagnosed with an alcohol use disorder specifically. From this research, patterns in judicial discourse and sentencing norms can be established, and these findings can be juxtaposed with existing relevant academic literature, particular attention will be given to this discussion at the sentencing stage, and the subsequent incarceration of those with alcohol use disorders. This topic will be explored with an overarching emphasis on the effects that a lack of conversation regarding a possible correlation between alcohol consumption and crime may have. Although comparisons may be made in order to clarify or highlight certain issues, particular attention will be paid to jurisdictions within Canada. This paper explores the existing judicial discourse in sentencing regarding the relationship between alcohol and crime, and how this might explain the higher incarceration rates of those suffering from alcohol use disorders in Canada. The research questions are as follows: (1) What are the existing judicial discourses in sentencing around the relationship between alcohol and crime? (2) To what extent has the current discourse on alcohol addiction among judges and legal academics contributed to the incarceration of alcoholics?The major findings of this research indicate a strong correlation between a lack of judicial discussion regarding the accused’s alcohol use disorder and an increased tendency to consider an alcohol use disorder as an aggravating factor. Furthermore, it was found that an 82% of judges who discussed the alcohol use disorder meaningfully referred to the disorder as a mitigating factor. This can be compared with 6.7% of judges who referred to the alcohol use disorder as a mitigating factor in cases where the disorder was not meaningfully discussed.

Keywords: Criminal Justice, Addiction, alcohol use disorder, judicial discourse

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4 Non-Time and Non-Sense: Temporalities of Addiction for Heroin Users in Scotland

Authors: Laura Roe


This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.

Keywords: Addiction, temporality, poly-substance use, timelessness

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3 An Engineered Epidemic: Big Pharma's Role in the Opioid Crisis

Authors: Donna L. Roberts


2019 marked 23 years since Purdue Pharma launched its flagship drug, OxyContin, that unleashed an unprecedented epidemic touching both celebrities and common citizens, metropolitan, suburbia and rural areas and all levels of socioeconomic status. From rural Appalachia to East LA individuals, families and communities have been devastated by a trajectory of addiction that often began with the legitimate prescription of a pain killer for anything from a tooth extraction to a sports injury to recovery from surgery or chronic arthritis. Far from being a serendipitous progression of events, the proliferation of this new breed of 'miracle drug' was instead a carefully crafted marketing program aimed at both the medical community and common citizens. This research represents and in-depth investigation of the evolution of the marketing, distribution and promotion of prescription opioids by pharmaceutical companies and its relationship to the propagation of the opioid crisis. Specifically, key components of Purdue Pharma’s aggressive marketing campaign, including its bonus system and sales incentives, were analyzed in the context of the sociopolitical environment that essential created the proverbial 'perfect storm' for the changing manner in which pain is treated in the U.S. The analyses of these series of events clearly indicate their role in first, the increase in prescription of opioids for non-terminal pain relief and subsequently, the incidence of related addiction, overdose, and death. Through this examination of the conditions that facilitated and maintained this drug crisis, perhaps we can begin to chart a course toward its resolution.

Keywords: Addiction, opioid, opioid crisis, Purdue Pharma

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2 How the Current Opioid Crisis Differs from the Heroin Epidemic of the 1960s-1970s: An Analysis of Drugs and Demographics

Authors: Donna L. Roberts


Heroin has appeared on the drug scene before. Yet the current opioid crisis differs in significant ways. In order to address the grave challenges, this epidemic poses, the unique precipitating and sustaining conditions must be thoroughly examined. This research explored the various aspects of the political, economic, and social conditions that created a 'perfect storm' for the evolution and maintenance of the current opioid crisis. Specifically, the epidemiology, demographics, and progression of addiction inherent in the current crisis were compared to the patterns of past opioid use. Additionally, the role of pharmaceutical companies and prescribing physicians, the nature and pharmaceutical properties of the available substances and the changing socioeconomic climate were considered. Results indicated that the current crisis differs significantly with respect to its evolution, magnitude, prevalence, and widespread societal effects. Precipitated by a proliferation of prescription medication and sustained by the availability of cheaper, more potent street drugs, including new versions of synthetic opioids, the current crisis presents unprecedented challenges affecting a wider and more diverse segment of society. The unique aspects of this epidemic demand unique approaches to addressing the problem. Understanding these differences is a key step in working toward a practical and enduring solution.

Keywords: Addiction, Opioids, Drug abuse, opioid crisis

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1 Feasibility and Efficacy of Matrix Model in Arabic Countries

Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawkat, Mohammed Abdelfattah, Nesif Alhemiary


Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: Addiction, developing countries, Arabic countries, matrix model

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