Ellis, R. Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy. J Infect Dis 12 —, Fairbairn, N. Addict Beh 36 7 —, Additive effects of HIV and chronic methamphetamine use on brain metabolite abnormalities. Am J Psychiatry —, Rippeth, J. Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. J Int Neuropsychol Soc —14, Blackstone, K. Human immunodeficiency virus infection heightens concurrent risk of functional dependence in persons with long-term methamphetamine use.
Journal of Addiction Medicine 7 4 —, Rawson, R. A multi-site comparison of psychosocial approaches for the treatment of methamphetamine dependence. Addiction —, Huber, A. Integrating treatments for methamphetamine abuse: A psychosocial perspective.
J Addict Dis 16 4 —50, Petry, N. Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: A National Drug Abuse Treatment Clinical Trials Network study. Arch Gen Psychiatry 62 10 —, Chomchai C, Chomchai S. Global patterns of methamphetamine use.
Curr Opin Psychiatry ; Methamphetamine use: A comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend ; Moszczynska A. Neurobiology and clinical manifestations of methamphetamine neurotoxicity. Psychiatric Times Sept Kish SJ. Pharmacologic mechanisms of crystal meth. Canadian Medical Association Journal ; Artigiani EEH, M. Methamphetamine: A Regional Drug Crisis. Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature.
Mechanism of action of methamphetamine within the catecholamine and serotonin areas of the central nervous system. Curr Drug Abuse Rev ; Rusyniak DE. Neurologic manifestations of chronic methamphetamine abuse. Psychiatr Clin North Am ; Psychiatric disorders in individuals with methamphetamine dependence: prevalence and risk factors. Metab Brain Dis ; Methamphetamine psychosis: epidemiology and management. The strength of each of the editions of DSM has been "reliability" — each edition has ensured that clinicians use the same terms in the same ways.
The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. According to a review, "in order to be effective, all pharmacological or biologically based treatments for addiction need to be integrated into other established forms of addiction rehabilitation, such as cognitive behavioral therapy, individual and group psychotherapy, behavior-modification strategies, twelve-step programs , and residential treatment facilities.
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A meta-analytic review on the efficacy of various behavioral therapies for treating drug and behavioral addictions found that cognitive behavioral therapy e. Clinical and preclinical evidence indicate that consistent aerobic exercise, especially endurance exercise e. Alcohol, like opioids, can induce a severe state of physical dependence and produce withdrawal symptoms such as delirium tremens.
Because of this, treatment for alcohol addiction usually involves a combined approach dealing with dependence and addiction simultaneously. Pharmacological treatments for alcohol addiction include drugs like naltrexone opioid antagonist , disulfiram , acamprosate , and topiramate. These drugs can be effective if treatment is maintained, but compliance can be an issue as alcoholic patients often forget to take their medication, or discontinue use because of excessive side effects.
Behavioral addiction is a treatable condition. Treatment options include psychotherapy and psychopharmacotherapy i. Cognitive behavioral therapy CBT is the most common form of psychotherapy used in treating behavioral addictions; it focuses on identifying patterns that trigger compulsive behavior and making lifestyle changes to promote healthier behaviors. Currently, there are no medications approved for treatment of behavioral addictions in general, but some medications used for treatment of drug addiction may also be beneficial with specific behavioral addictions. As of [update] , there are no effective pharmacological interventions for cannabinoid addiction.
Another area in which drug treatment has been widely used is in the treatment of nicotine addiction, which usually involves the use of nicotine replacement therapy , nicotinic receptor antagonists , or nicotinic receptor partial agonists. Opioids cause physical dependence , and treatment typically addresses both dependence and addiction. Physical dependence is treated using replacement drugs such as suboxone or subutex both containing the active ingredients buprenorphine and methadone.
Use of replacement drugs increases the addicted individual's ability to function normally and eliminates the negative consequences of obtaining controlled substances illicitly. Once a prescribed dosage is stabilized, treatment enters maintenance or tapering phases. In the United States, opiate replacement therapy is tightly regulated in methadone clinics and under the DATA legislation. In some countries, other opioid derivatives such as levomethadyl acetate ,  dihydrocodeine ,  dihydroetorphine  and even heroin   are used as substitute drugs for illegal street opiates, with different prescriptions being given depending on the needs of the individual patient.
Baclofen has led to successful reductions of cravings for stimulants, alcohol, and opioids, and also alleviates alcohol withdrawal syndrome. Many patients have stated they "became indifferent to alcohol" or "indifferent to cocaine" overnight after starting baclofen therapy. As of May [update] , there is no effective pharmacotherapy for any form of psychostimulant addiction. Research indicates that vaccines which utilize anti-drug monoclonal antibodies can mitigate drug-induced positive reinforcement by preventing the drug from moving across the blood—brain barrier ;  however, current vaccine-based therapies are only effective in a relatively small subset of individuals.
The new study shows, that the vaccine may also save lives during a drug overdose. In this instance, the idea is that the body will respond to the vaccine by quickly producing antibodies to prevent the opioids from accessing the brain. Since addiction involves abnormalities in glutamate and GABAergic neurotransmission,   receptors associated with these neurotransmitters e. Gene therapy for addiction is an active area of research.
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One line of gene therapy research involves the use of viral vectors to increase the expression of dopamine D2 receptor proteins in the brain. Due to cultural variations, the proportion of individuals who develop a drug or behavioral addiction within a specified time period i. The prevalence of alcohol dependence is not as high as is seen in other regions.
In Asia, not only socioeconomic factors but also biological factors influence drinking behavior. The prevalence of substance abuse disorder among Australians was reported at 5. In , the estimated prevalence among the adult population was The mortality rates for alcohol and illicit drugs were highest in Eastern Europe. According to a poll conducted by the Pew Research Center , almost half of US adults know a family member or close friend who has struggled with a drug addiction at some point in their life.
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In , opioid addiction was acknowledged as a national crisis in the United States. The realities of opioid use and abuse in Latin America may be deceptive if observations are limited to epidemiological findings. Mexico, because of its border with the United States, has the highest incidence of use. Personality theories of addiction are psychological models that associate personality traits or modes of thinking i. Data analysis demonstrates that there is a significant difference in the psychological profiles of drug users and non-users and the psychological predisposition to using different drugs may be different.
From Wikipedia, the free encyclopedia. For other uses, see Addiction disambiguation and Addictive disambiguation. For the Lil Pump song, see Drug Addicts song. See also: Stimulus control. See also: Cognitive control. Main article: Behavioral addiction. Further information: Addiction vulnerability. See also: Transgenerational epigenetic inheritance. Signaling cascade in the nucleus accumbens that results in psychostimulant addiction v t e. Note: colored text contains article links. Nuclear pore. Nuclear membrane.
Plasma membrane. Main article: Reward system. This section needs expansion.
Tarter, Ralph E. [WorldCat Identities]
You can help by adding to it. August Top: this depicts the initial effects of high dose exposure to an addictive drug on gene expression in the nucleus accumbens for various Fos family proteins i. See also: Neuroepigenetics and Chromatin remodeling. June See also: Addiction recovery groups , Cognitive behavioral therapy , and Drug rehabilitation.
Further information: Alcoholism. This section is transcluded from Behavioral addiction. Further information: Smoking cessation. Further information: Opioid use disorder.
April Main article: Personality theories of addiction. Binge drinking Binge eating disorder Discrimination against drug addicts Pavlovian-instrumental transfer Philosophy of medicine Substance dependence. Most of the animal research with HDAC inhibitors has been conducted with four drugs: butyrate salts mainly sodium butyrate , trichostatin A , valproic acid , and SAHA ;   butyric acid is a naturally occurring short-chain fatty acid in humans, while the latter two compounds are FDA-approved drugs with medical indications unrelated to addiction.
Text color Transcription factors. Office of the Surgeon General. November Retrieved 28 January Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5 referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug.
Tarter, Ralph E.
In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder. Dialogues Clin. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction.
Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict. Mount Sinai School of Medicine. Department of Neuroscience. Retrieved 9 February The defining feature of addiction is compulsive, out-of-control drug use, despite negative consequences. Abuse Rehabil. Initial drug use can be attributed to the ability of the drug to act as a reward ie, a pleasurable emotional state or positive reinforcer , which can lead to repeated drug use and dependence.
At present, no pharmacological therapy has been approved by the FDA to treat psychostimulant addiction. Many drugs have been tested, but none have shown conclusive efficacy with tolerable side effects in humans. A new emphasis on larger-scale biomarker, genetic, and epigenetic research focused on the molecular targets of mental disorders has been recently advocated.
Drug Alcohol Abuse. Moreover, many of these molecular changes identified are now directly linked to the structural, physiological and behavioral changes observed following chronic drug exposure 60,95,97, Some of these proposed interventions have limitations or are in their infancy However, it is hoped that some of these preliminary findings may lead to innovative treatments, which are much needed in addiction.
Functional neuroimaging studies in humans have shown that gambling Breiter et al, , shopping Knutson et al, , orgasm Komisaruk et al, , playing video games Koepp et al, ; Hoeft et al, and the sight of appetizing food Wang et al, a activate many of the same brain regions i. Cross-sensitization is also bidirectional, as a history of amphetamine administration facilitates sexual behavior and enhances the associated increase in NAc DA As described for food reward, sexual experience can also lead to activation of plasticity-related signaling cascades.
Further, viral overexpression of delta FosB enhances the conditioned place preference for an environment paired with sexual experience Hedges et al. In some people, there is a transition from "normal" to compulsive engagement in natural rewards such as food or sex , a condition that some have termed behavioral or non-drug addictions Holden, ; Grant et al. In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs.
This syndrome is characterized by a medication-induced increase in or compulsive engagement in non-drug rewards such as gambling, shopping, or sex Evans et al, ; Aiken, ; Lader, This is reflected in the increased, stable and long-lasting level of sensitivity to cocaine and other drugs, and tendency to relapse even after long periods of abstinence.
These newly constructed networks function very efficiently via new pathways as soon as drugs of abuse are further taken In this way, the induction of CDK5 gene expression occurs together with suppression of the G9A gene coding for dimethyltransferase acting on the histone H3.
A feedback mechanism can be observed in the regulation of these 2 crucial factors that determine the adaptive epigenetic response to cocaine. American Board of Addiction Medicine. Retrieved 3 April Sixteen percent of the non-institutionalized U. This is more than the number of Americans with cancer, diabetes or heart conditions. In , Of those who do receive treatment, few receive evidence-based care. There is no information available on how many individuals receive treatment for addiction involving nicotine.
Risky substance use and untreated addiction account for one-third of inpatient hospital costs and 20 percent of all deaths in the United States each year, and cause or contribute to more than other conditions requiring medical care, as well as vehicular crashes, other fatal and non-fatal injuries, overdose deaths, suicides, homicides, domestic discord, the highest incarceration rate in the world and many other costly social consequences. The economic cost to society is greater than the cost of diabetes and all cancers combined.
Despite these startling statistics on the prevalence and costs of addiction, few physicians have been trained to prevent or treat it. Retrieved 28 September Annu Rev Psychol. American Psychiatric Publishing. Archived from the original PDF on 15 August Retrieved 10 July Additionally, the diagnosis of dependence caused much confusion. Most people link dependence with "addiction" when in fact dependence can be a normal body response to a substance. The official diagnosis of drug addiction by the Diagnostic and Statistic Manual of Mental Disorders , which uses the term substance use disorder, is flawed.
It is ironic and unfortunate that the manual still avoids use of the term addiction as an official diagnosis, even though addiction provides the best description of the clinical syndrome. J Exp Anal Behav. Today, arguably more than at any time in history, the constructs of attention, executive functioning, and cognitive control seem to be pervasive and preeminent in research and theory. Even within the cognitive framework, however, there has long been an understanding that behavior is multiply determined, and that many responses are relatively automatic, unattended, contention-scheduled, and habitual.
Indeed, the cognitive flexibility, response inhibition, and self-regulation that appear to be hallmarks of cognitive control are noteworthy only in contrast to responses that are relatively rigid, associative, and involuntary. EFs and prefrontal cortex are the first to suffer, and suffer disproportionately, if something is not right in your life.
They suffer first, and most, if you are stressed Arnsten , Liston et al. You can see the deleterious effects of stress, sadness, loneliness, and lack of physical health or fitness at the physiological and neuroanatomical level in prefrontal cortex and at the behavioral level in worse EFs poorer reasoning and problem solving, forgetting things, and impaired ability to exercise discipline and self-control. At any age across the life cycle EFs can be improved, including in the elderly and in infants. Thus, inhibitory control makes it possible for us to change and for us to choose how we react and how we behave rather than being unthinking creatures of habit.
Indeed, we usually are creatures of habit and our behavior is under the control of environmental stimuli far more than we usually realize, but having the ability to exercise inhibitory control creates the possibility of change and choice. The subthalamic nucleus appears to play a critical role in preventing such impulsive or premature responding Frank These diverse inputs and back projections to both cortical and subcortical structures put the prefrontal cortex in a position to exert what is often called "top-down" control or cognitive control of behavior.
The prefrontal cortex receives inputs not only from other cortical regions, including association cortex, but also, via the thalamus, inputs from subcortical structures subserving emotion and motivation, such as the amygdala Chapter 14 and ventral striatum or nucleus accumbens; Chapter In conditions in which prepotent responses tend to dominate behavior, such as in drug addiction, where drug cues can elicit drug seeking Chapter 15 , or in attention deficit hyperactivity disorder ADHD; described below , significant negative consequences can result.
ADHD can be conceptualized as a disorder of executive function; specifically, ADHD is characterized by reduced ability to exert and maintain cognitive control of behavior. Compared with healthy individuals, those with ADHD have diminished ability to suppress inappropriate prepotent responses to stimuli impaired response inhibition and diminished ability to inhibit responses to irrelevant stimuli impaired interference suppression.
Functional neuroimaging in humans demonstrates activation of the prefrontal cortex and caudate nucleus part of the striatum in tasks that demand inhibitory control of behavior. Subjects with ADHD exhibit less activation of the medial prefrontal cortex than healthy controls even when they succeed in such tasks and utilize different circuits.
Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention. A review of the literature". Sexual addiction, which is also known as hypersexual disorder, has largely been ignored by psychiatrists, even though the condition causes serious psychosocial problems for many people.
A lack of empirical evidence on sexual addiction is the result of the disease's complete absence from versions of the Diagnostic and Statistical Manual of Mental Disorders. The adverse consequences of sexual addiction are similar to the consequences of other addictive disorders. Addictive, somatic and psychiatric disorders coexist with sexual addiction.
In recent years, research on sexual addiction has proliferated, and screening instruments have increasingly been developed to diagnose or quantify sexual addiction disorders. In our systematic review of the existing measures, 22 questionnaires were identified. As with other behavioral addictions, the appropriate treatment of sexual addiction should combine pharmacological and psychological approaches.
The Journal of Neuroscience. Drugs of abuse induce neuroplasticity in the natural reward pathway, specifically the nucleus accumbens NAc , thereby causing development and expression of addictive behavior. Sexual behavior is highly rewarding Tenk et al. Moreover, sexual experience induces neural plasticity in the NAc similar to that induced by psychostimulant exposure, including increased dendritic spine density Meisel and Mullins, ; Pitchers et al.
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