Addiction: Failure of Control Over Maladaptive Incentive Habits.
Addiction: failure of control over maladaptive incentive habits.
Curr Opin Neurobiol. 2013 Feb 26;
Belin D, Belin-Rauscent A, Murray JE, Everitt BJ
Drug addiction may be associated with a loss of executive control over maladaptive incentive habits. We hypothesize that these incentive habits result from a pathological coupling of drug-influenced motivational states and a rigid stimulus-response habit system by which drug-associated stimuli through automatic processes elicit and maintain drug seeking. Neurally, incentive habits may depend upon an interaction between the basolateral amygdala and nucleus accumbens core, together with the progressive development of a ventral-to-dorsolateral striatum functional coupling through the recruitment of striato-nigro-striatal dopamine-dependent loop circuitry. Recent evidence suggests that both ventral striatal and central nucleus pathways from the amygdala may be required for the recruitment of DLS-dependent control over habitual behavior. HubMed – addiction
The OxyContin crisis: Problematisation and responsibilisation strategies in addiction, pain, and general medicine journals.
Int J Drug Policy. 2013 Feb 26;
Whelan E, Asbridge M
BACKGROUND: OxyContin® (Purdue Pharma, L.P., Stamford, CT) is now widely regarded as a drug of abuse fueling a larger opioid health crisis. While coverage in the North American press about OxyContin overwhelmingly focused upon the problems of related crime and addiction/misuse and the perspectives of law enforcement officials and police, coverage in those fields of medicine most intimately concerned with OxyContin-pain medicine and addiction medicine-was more nuanced. METHODS: In this article, we draw upon the constructivist social problems tradition and Hunt’s theory of moral regulation in a qualitative analysis of 24 medical journal articles. We compare and contrast pain medicine and addiction medicine representations of the OxyContin problem, the agents responsible for it, and proposed solutions. RESULTS: While there are some significant differences, particularly concerning the nature of the problem and the agents responsible for it, both pain medicine and addiction medicine authors ‘take responsibility’ in ways that attempt to mitigate the potential appropriation of the issue by law enforcement and regulatory agencies. CONCLUSIONS: The responses of pain medicine and addiction medicine journal articles represent strategic moves to recapture lost credibility, to retain client populations and tools necessary to their jobs, and to claim a seat at the table in responding to the OxyContin crisis. HubMed – addiction
Perceived risks and benefits of cigarette smoking among Nepalese adolescents: a population-based cross-sectional study.
BMC Public Health. 2013 Mar 2; 13(1): 187
Aryal UR, Petzold M, Krettek A
BACKGROUND: The perceived risks and benefits of smoking may play an important role in determining adolescents’ susceptibility to initiating smoking. Our study examined the perceived risks and benefits of smoking among adolescents who demonstrated susceptibility or non susceptibility to smoking initiation. METHODS: In October–November 2011, we conducted a population-based cross-sectional study in Jhaukhel and Duwakot Villages in Nepal. Located in the mid-hills of Bhaktapur District, 13 kilometers east of Kathmandu, Jhaukhel and Duwakot represent the prototypical urbanizing villages that surround Nepal’s major urban centers, where young people have easy access to tobacco products and are influenced by advertising. Jhaukhel and Duwakot had a total population of 13,669, of which 15% were smokers. Trained enumerators used a semi-structured questionnaire to interview 352 randomly selected 14- to 16-year-old adolescents. The enumerators asked the adolescents to estimate their likelihood (0%–100%) of experiencing various smoking-related risks and benefits in a hypothetical scenario. RESULTS: Principal component analysis extracted four perceived risk and benefit components, excluding addiction risk: (i) physical risk I (lung cancer, heart disease, wrinkles, bad colds) ;(ii) physical risk II (bad cough, bad breath, trouble breathing);(iii) social risk (getting into trouble, smelling like an ashtray); and (iv) social benefit(looking cool, feeling relaxed, becoming popular, and feeling grown-up). The adjusted odds ratio of susceptibility increased 1.20-fold with each increased quartile in perception of physical Risk I. Susceptibility to smoking was 0.27- and 0.90-fold less among adolescents who provided the highest estimates of physical Risk II and social risk, respectively. Similarly, susceptibility was 2.16-fold greater among adolescents who provided the highest estimates of addiction risk. Physical risk I, addiction risk, and social benefits of cigarette smoking related positively, and physical risk II and social risk related negatively, with susceptibility to smoking. CONCLUSION: To discourage or prevent adolescents from initiating smoking, future intervention programs should focus on communicating not only the health risks but also the social and addiction risks as well as counteract the social benefits of smoking. HubMed – addiction
A survey of tobacco dependence treatment services in 121 countries.
Addiction. 2013 Mar 1;
Piné-Abata H, McNeill A, Murray R, Bitton A, Rigotti N, Raw M
AIMS: To report progress among Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in developing tobacco dependence treatment systems in accordance with FCTC Article 14 and the Article 14 guidelines recommendations. DESIGN: Cross-sectional study SETTING: Electronic survey from December 2011 to August 2012 PARTICIPANTS: One hundred and sixty-three of the 173 Parties to the FCTC at the time of our survey. MEASUREMENTS: The 51 item questionnaire contained 21 items specifically on treatment systems. Questions covered the availability of basic treatment infrastructure and national cessation support systems. FINDINGS: We received responses from 121 (73%) of the 166 countries surveyed. Fewer than half of the countries had national treatment guidelines (n=53, 44%), a government official responsible for tobacco dependence treatment (n=49, 41%), an official national treatment strategy (n=53, 44%), or provided tobacco cessation support for health workers (n=55, 46%). More than half encouraged brief advice in existing health care services (n=68, 56%), whilst only 44 (36%) had quitlines and only 20 (17%) had a network of treatment support covering the whole country. Low and middle-income countries had less tobacco dependence treatment provision than high-income countries. CONCLUSION: Most countries, especially low- and middle-income countries, have not yet implemented the recommendations of Framework Convention on Tobacco Control (FCTC) Article 14 or the FCTC Article 14 guidelines. HubMed – addiction
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