Skip to main content
SpringerLink
Log in

Addictions

  • Chapter
Psychiatry for Neurologists

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Alcohol and drug dependence are two of the leading causes of disability and mortality worldwide; however, these problems are often not appreciated and are often unrecognized in primary and specialty medical settings (1). Past drug or alcohol use has also been recognized as important in the care of patients, as past periods of abuse or dependence can increase vulnerability to subsequent medical and neuropsychiatric problems. Perhaps more importantly, recent research has demonstrated the efficacy of both psychosocial and pharmacological treatments for substance dependence and there is evidence that treatment can lead, not only to reductions in substance use and associated social problems, but also to substantial improvements in the physical and mental health of patients. This chapter highlights some of the recent advances in understanding and treating substance use and abuse, with a particular emphasis on the identification of patients, consequences of use, and methods for motivating patients to engage in treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Murray C, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. In: Murray C, Lopez A, eds. The global burden of disease and injury series, Vol. 1. Boston: Harvard University Press; 1996.

    Google Scholar 

  2. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington DC: Amer Psychiatric Pub; 1994.

    Google Scholar 

  3. Blow F. Substance abuse among older Americans. In: C.f.S.A. Treatment, ed. Treatment Improvement Protocol. Washington DC: US Government Printing Office; 1998.

    Google Scholar 

  4. National Institute on Alcohol Abuse and Alcoholism. Diagnostic criteria for alcohol abuse. Alcohol Alert 1995;30(PH 359):1–6.

    Google Scholar 

  5. Chermack ST, Blow FC, Hill EM, Mudd SA. The relationship between alcohol symptoms and consumption among older drinkers. Alchohol Clin Exp Res 1996;20:1153–1158.

    Article  CAS  Google Scholar 

  6. Klatsky AL, Armstrong A. Alcohol use, other traits and risk of unnatural death: a prospective study. Alcohol Clin Exp Res 1993;17:1156–1162.

    Article  PubMed  CAS  Google Scholar 

  7. Poikolainen K. Epidemiologic assessment of population risks and benefits of alcohol use. Alcohol Alcohol 1991;1:27–34.

    CAS  Google Scholar 

  8. McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA 2000;284:1689–1695.

    Article  PubMed  CAS  Google Scholar 

  9. Dackis C, O’Brien C. The neurobiology of addiction. In: Asbury A, McDonald I, Goadsby PJ, McArthur JC, eds. Diseases of the Nervous System. Cambridge: Cambridge University Press; 2003:431–444.

    Google Scholar 

  10. Vanyukov MM, Tarter RE. Genetic studies of substance abuse. Drug Alcohol Depend 2000;59:101–123.

    Article  PubMed  CAS  Google Scholar 

  11. Dackis C, O’Brien C. Cocaine dependence: a disease of the brain’s reward centers. J Subst Abuse Treat 2001;21:111–117.

    Article  PubMed  CAS  Google Scholar 

  12. Beigel A, Ghertner S. Toward a social model: an assessment of social factors which influence problem drinking and its treatment. In: Kissin B, Begleiter H, eds. The Biology of Alcoholism: Vol. 5 Treatment and Rehabilitation of the Chronic Alcoholic. New York: Plenum Press; 1979.

    Google Scholar 

  13. Khantzian EJ. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatry 1985;142:1259–1264.

    PubMed  CAS  Google Scholar 

  14. Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP. The 12-month prevalence and trends in DSMIV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug Alcohol Depend 2004;74:223–234.

    Article  PubMed  Google Scholar 

  15. Substance Abuse and Mental Health Services Administration. Results from the 2002 National Survey on Drug Use and Health: National Findings In: NHSDA Series H-22, DHHS Publication No. SMA 03-3836, Rockville: Office of Applied Studies; 2003.

    Google Scholar 

  16. Moxey E, O’Connor JP, Novielli KD, Teutsch S, Nash DB. Prescription drug use in the elderly: a descriptive analysis. Health Care Financ Revi 2003;24:127–144.

    Google Scholar 

  17. Hanlon JT, Filenbaum GG, Burchett B, et al. Drug-use patterns among black and nonblack community-dwelling elderly. Ann Pharmacother 1992;26:679–685.

    PubMed  CAS  Google Scholar 

  18. Scherr PA, LaCroix AZ, Wallace RB, et al. Light to moderate alcohol consumption and mortality in the elderly. J Am Geriatr Soc 1992;40:651–657.

    PubMed  CAS  Google Scholar 

  19. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly US adults. N Eng J Med 1997;337:1705–1714.

    Article  CAS  Google Scholar 

  20. Broe GA, Creasey H, Jorm AF, et al. Health habits and risk of cognitive impairment and dementia in old age: a prospective study on the effects of exercise, smoking and alcohol consumption. Aust N Z J Public Health 1998;22:621–623.

    Article  PubMed  CAS  Google Scholar 

  21. de Labry LO, Glynn RJ, Levenson MR, Hermos JA, LoCastro JS, Vokanas PS. Alcohol consumption and mortality in an American male population: Recovering the U-shaped curve—findings from the normative aging study. J Studies Alcohol 1992;53:25–32.

    Google Scholar 

  22. Klatsky AL, Armstrong MA, Friedman GD. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. Am J Cardiol 1990;66:1237–1242.

    Article  PubMed  CAS  Google Scholar 

  23. Orgogozo JM, Dartigues JF, Lafont S, et al. Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux area. Rev Neurol 1997;153:185–192.

    PubMed  CAS  Google Scholar 

  24. Shaper AG. Alcohol and mortality: a review of prospective studies. Br J Addict 1990;85:837–847.

    Article  PubMed  CAS  Google Scholar 

  25. Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 1988;319:267–273.

    Article  PubMed  CAS  Google Scholar 

  26. Gunzerath L, Faden V, Zakhan S, Warren K. National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. Alcohol Clin Exp Res 2004;28:829–847.

    PubMed  Google Scholar 

  27. Dufour MC, Archer L, Gordis E. Alcohol and the elderly. Clin Geriatr Med 1992;8:127–141.

    PubMed  CAS  Google Scholar 

  28. Saunders PA, Copeland JR, Dewey ME, et al. Heavy drinking as a risk factor for depression and dementia in elderly men. Br J Psychiatry 1991;159:213–216.

    PubMed  CAS  Google Scholar 

  29. Vaillant GE, Vaillant CO. Natural History of Male Psychological Health, XII: a 45 year study of predictors of successful aging at age 65. Am J Psychiatry 1990;147:31–37.

    PubMed  CAS  Google Scholar 

  30. Rodnitzky RL, Keyser DL. Neurologic complications of drugs. Tardive dyskinesias, neuroloeptic malignant syndrome, and cocaine-related syndromes. Psychiat Clin North Am 1992;15:491–510.

    CAS  Google Scholar 

  31. Gambert S, Katsoyannis K. Alcohol-related medical disorders of older heavy drinkers. In: Beresford T, Gomberg E, ed. Alcohol and Aging. New York: Oxford University Press; 1995:70–81.

    Google Scholar 

  32. Liberto JG, Oslin DW, Ruskin PE. Alcoholism in older persons: a review of the literature. Hosp Comm Psychiatry 1992;43:975–984.

    CAS  Google Scholar 

  33. Kivela SL, Nissinen A, Ketola A. Alcohol consumption and mortality in aging or aged Finnish men. J Clin Epidemiol 1989;42:61–68.

    Article  PubMed  CAS  Google Scholar 

  34. Onder G, Pedone C, Landi F, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). J Am Geriatr Society 2002;50:1962–1968.

    Article  Google Scholar 

  35. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79–90.

    PubMed  CAS  Google Scholar 

  36. Hylek EM, Heiman H, Skates SJ, Sheehan MA, Singer DE. Acetaminophen and other risk factors for excessive warfarin anticoagulation. JAMA 1998;279:657–662.

    Article  PubMed  CAS  Google Scholar 

  37. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse: results from the epidemiologic catchment area (ECA) study. JAMA 1990;264:2511–2518.

    Article  PubMed  CAS  Google Scholar 

  38. Waern M. Alcohol dependence and misuse in elderly suicides. Alcohol Alcohol 2003;38:249–254.

    PubMed  Google Scholar 

  39. Cook B, Winokur G, Garvey MJ, Beach V. Depression and previous alcoholism in the elderly. Br J Psychiatry 1991;158:72–75.

    PubMed  CAS  Google Scholar 

  40. Conwell Y. Suicide in elderly patients. In: Schneider LS, Reynolds CF, Lebowitz BD, Friedhoff AJ, eds. Diagnosis and Treatment of Depression in Late Life. Washington DC: American Psychiatric Press Inc; 1991:397–418.

    Google Scholar 

  41. Oslin D, Atkinson RM, Smith DM, Hendrie H. Alcohol related dementia: proposed clinical criteria. Int J Geriatr Psychiatry 1998;13:203–212.

    Article  PubMed  CAS  Google Scholar 

  42. George LK, Landerman R, Blazer DG, Anthony JC. Cognitive impairment. In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: The Free Press; 1991:291–327.

    Google Scholar 

  43. Victor M. Persistent altered mentation due to ethanol. Neurolo Clin 1993;11:639–661.

    CAS  Google Scholar 

  44. Wagman AM, Allen RP, Upright D. Effects of alcohol consumption upon parameters of ultradian sleep rhythms in alcoholics. Adv Exp Med Biol 197;85A:601–616.

    Google Scholar 

  45. Moeller FG, Gillin JC, Irwin M, Golshan S, Kripke DF, Schuckit M. A comparison of sleep EEGs in patients with primary major depression and major depression secondary to alcoholism. J Affect Disord 1993;27:39–42.

    Article  PubMed  CAS  Google Scholar 

  46. Whitlock E, Polen MR, Green CA, et al. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2004;140:557–568.

    PubMed  Google Scholar 

  47. Barry K, Fleming M. Computerized administration of alcoholism screening tests in a primary care setting. J Am Board Fam Prac 1990;3:93–98.

    CAS  Google Scholar 

  48. Greist J, Klein MH, Erdman HP, et al. Comparison of computer-and interviewer-administered versions of the Diagnostic Interview Schedule. Hosp Community Psychiatry 1987;38:1304–1311.

    PubMed  CAS  Google Scholar 

  49. Barry KL, Oslin DW, Blow FC. Prevention and management of alcohol problems in older adults. New York: Springer Publishing; 2001.

    Google Scholar 

  50. Gomberg ESL, Nelson B, Hill EM. Treatment of Alcoholism in Elderly Persons: Preliminary Report. Marco Island, FL: Research Society of Alcoholism, 1991.

    Google Scholar 

  51. American Society of Addiction Medicine Patient Placement Criteria. Washington DC: Amer Psychiatric Pub; 1992.

    Google Scholar 

  52. Kampman KM, Volpicelli JR, Mulvaney F, et al. Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity. Drug Alcohol Depend 2001;63:69–78.

    Article  PubMed  CAS  Google Scholar 

  53. Center for Substance Abuse Treatment (SAMHSA). Brief interventions and therapies in substance abuse treatment. In: Barry K, ed. Treatment Improvement Protocol. Washington DC: US Government Printing Office, 2001.

    Google Scholar 

  54. Chick J, Lloyd G, Crombie E. Counseling problem drinkers in medical wards: a controlled study. Brit Med J Clin Res Ed 1985;290:965–967.

    CAS  Google Scholar 

  55. Persson J, Magnusson PH. Early intervention in patients with excessive consumption of alcohol: a controlled study. Alcohol 1989;6:403–408.

    Article  PubMed  CAS  Google Scholar 

  56. Fleming M, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry KL. Brief physician advice for problem alcohol drinkers: a randomized controlled trial in community-based primary care practices. JAMA 1997;277:1039–1045.

    Article  PubMed  CAS  Google Scholar 

  57. Booth RE, Crowley TJ, Zhang Y. Substance abuse treatment entry, retention and effectiveness: out-of-treatment opiate injection drug users. Drug Alcohol Depend 1996;42:11–20.

    Article  PubMed  CAS  Google Scholar 

  58. Fulco C, Liverman C, Earley, L. The development of medications for the treatment of opiate and cocaine addictions: issues for the government and private sector. Committee to Study Medication Development and Research at the National Institute on Drugs. Institute of Medicine, 1995.

    Google Scholar 

  59. Gossop M, Johns A, Green L. Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment. Br Med J (Clin Res Ed) 1986;293:103–104.

    Article  CAS  Google Scholar 

  60. Mattick RP, Hall, W. Are detoxification programmes effective? Lancet 1996;347:97–100.

    Article  PubMed  CAS  Google Scholar 

  61. National Consensus Development Panel on Effective Medical Treatment of Opiate Addsiction. Effective medical treatment of opiate addiction. JAMA 1998;280:1936–1943.

    Article  Google Scholar 

  62. Mattick RP, Ali R, White JM, O’Brien S, Wolk S, Danz C. Buprenorphine versus methadone maintenance therapy: a randomized double-blind trial with 405 opioid-dependent patients. Addiction 2003;98:441–452.

    Article  PubMed  Google Scholar 

  63. O’Connor PG, Oliveto AH, Shi JM, et al. A randomized trial of buprenorphine maintenance for heroin dependence in a primary care clinic for substance users versus a methadone clinic. Am J Med 1998;105:100–105.

    Article  PubMed  CAS  Google Scholar 

  64. Pettinati H, O’Brien CP, Wortman S, Oslin DW, Kampman KM, Lynch KG. The status of naltrexone in the treatment of alcohol dependence: specific effects on excessive drinking. under development.

    Google Scholar 

  65. Oslin DW, Berrettini W, Kranzler HR, et al. A functional polymorphism of the mu-opioid receptor gene is associated with naltrexone response in alcohol-dependent patients. Neuropsychopharmacology 2003;28:1546–1552.

    Article  PubMed  CAS  Google Scholar 

  66. Monterosso JR, Flannery BA, Pettinati HM, et al. Predicting treatment response to naltrexone: the influence of craving and family history. Am J Addiction 2001;10:258–268.

    Article  CAS  Google Scholar 

  67. Pelc I, Verbanck P, Le Bon O, Gavrilovic M, Lion K, Lehert P. Efficacy and safety of acamprosate in the treatment of detoxified alcohol-dependent patients. A 90-day placebo-controlled dose-finding study. Br J Psychiatry 1997;171:73–77.

    PubMed  CAS  Google Scholar 

  68. Sass H, Soyka M, Zieglgansberger W. Relapse prevention by acamprosate: results from a placebo-controlled study in alcohol dependence. Arch Gen Psychiatry 1996;53:673–680.

    PubMed  CAS  Google Scholar 

  69. Osterling A, Berglund M. Elderly first time admitted alcoholics: a descriptive study on gender differences in a clinical population. Alch Clin Exp Res 1994;18:1317–1321.

    Article  CAS  Google Scholar 

  70. Barry KL, Blow FC, Walton MA, et al. Elder-specific brief alcohol intervention: 3-month outcomes. Alch Clin Exp Res 1998; 22:32A.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Philadelphia VA Medical Center, University of Pennsylvania, Philadelphia, PA

    David W. Oslin MD

Authors
  1. David W. Oslin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Neurosciences, University of California, San Diego

    Dilip V. Jests MD

  2. Department of Psychiatry and Neurosciences, VA San Diego Healthcare System, San Diego, CA

    Dilip V. Jests MD

  3. Parkinson’s Disease and Movement Disorders Center, NeuroHealth, Warwick, RI

    Joseph H. Friedman MD

  4. University Medical School, Providence, RI

    Joseph H. Friedman MD

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Oslin, D.W. (2006). Addictions. In: Jests, D.V., Friedman, J.H. (eds) Psychiatry for Neurologists. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59259-960-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-960-8_9

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-483-8

  • Online ISBN: 978-1-59259-960-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation