Addiction: A Runaway Phenomenon of Our Time?

Is addiction a runaway phenomenon of the 21st century? The answer depends on the definitions we use. Addiction is a common term referring to behaviors of a compulsive, consuming nature that an individual has difficulty relinquishing despite its adverse consequences to oneself and others. However, in the Diagnostic Statistical Manual- IV-TR, addiction is not a diagnostic category. Substance abuse and dependency are classified under Substance Abuse Disorders while other compulsive behaviors, such pathological gambling and kleptomania, are currently classified as Impulse Control Disorders. A Task Force is considering the addition of Addiction and Related Disorders to the DSM-V that will encompass both substance use disorders and non-substance addictions.

Running Over the Same Old Ground: What’s Missing in Cocaine Clinical Pharmacotherapy Trials?

In over two decades of cocaine treatment research, countless pharmacotherapies have been tested, without a single medication approved for the treatment of cocaine dependence. A short and entirely incomplete list of tested medications includes: olanzapine, valproate, coenzyme Q10, L-carnitine, cabergoline, reserpine, tiagabine, amantadine, propranolol, selegiline, modafinil, sertraline, disulfiram, baclofen, and citicoline. Setting aside the very real possibility that none of the medications tested to date is actually efficacious for treating cocaine dependence, there are three main issues that appear to have potentially hindered accurate findings in such studies.

Absence of Essential Integrated Services within Traditional Substance Abuse Treatment

Is the need for integrated services within traditional substance abuse treatment being ignored? Traditional substance abuse treatment lacks an integrated component in which a client would receive mental health counseling and vocational counseling in addition to substance abuse counseling. According to the Treatment Improvement Protocol (TIP) 38, developed by CSAT a part of the Mental Health Services Administration (SAMHSA), research has shown that predictors of substance abuse treatment completion include successful employment, family support, and lack of coexisting mental illness. Biegel, Beimers, Stevenson, and Boyle (2009) purport that people with co-occurring disorders experience higher rates of unemployment.

Now is the Time: Why Addiction Treatment Professionals and Researchers Can No Longer Continue to Ignore Issues Related to the Other “S” in the BPSS Model

For many years, addiction treatment professionals and researchers have stressed the importance of holistic approaches to both treatment for and recovery from any form of addiction. Based in the “disease concept,” as initially outlined by the Alcoholics Anonymous Big Book and then later by the Narcotics Anonymous Basic Text,this very important insight has forever changed the addiction treatment field (and indeed society as a whole) for the better by stressing the interconnectedness of the physical, mental and spiritual aspects of addiction and recovery. More recently, prominent researchers, such as Juhnke and Hagedorn, Oakley and Ksir, DiClemente, Lawson et al., and Perkinson and Jongsma, have promoted the expansion of the traditional disease conceptinto the now prevalent Biopsychosocial Spiritual Model or BPSS Model. It has been observed that some addiction treatment professionals and researchers (especially those who have been practicing for many years using the traditional disease concept model as the foundation of their life’s work) have hesitated to adopt the use of the BPSS Model.