Addiction: Lifestyle Choice or Medical Diagnosis?

Addiction: lifestyle choice or medical diagnosis?

J Eval Clin Pract. 2013 Jun; 19(3): 493-6
Nutt D

The concept of addiction is under threat from the current UK government’s attempt to define it as a lifestyle choice rather than an illness. This overturns the previous government’s rational policy on drug treatment and is both dishonest and damaging. It is dishonest because addiction fulfils all the criteria for an illness. It is damaging because proven treatments for many addictions exist and the failure to optimize these means that more patients will die, get blood-borne viruses, and encourage others into drug use. In this paper, I detail these issues and suggest ways to avoid irreparable damage to the current care provisions that are proving effective. HubMed – addiction

Dose Patterns among Patients Using Low-Dose Buprenorphine Patches.

Pain Med. 2013 May 21;
Lesén E, Ericson L, Simonsberg C, Varelius R, Björholt I, Söderpalm B

OBJECTIVE: The objective of this study was to investigate the dose pattern of low-dose buprenorphine patches among patients in Swedish clinical practice. The clinical experts among the coauthors interpreted the results in relation to possible indications of development of tolerance and/or dependence/addiction. DESIGN AND SETTING: This was a nationwide, observational study using data from the Swedish Prescribed Drug Register. SUBJECTS: Individuals who were dispensed the low-dose buprenorphine patches continuously for more than 24 weeks during July 1, 2005 to February 28, 2011 were included. METHODS: The dose pattern was analyzed as the change in dose over time for each patient: 1) the dose at baseline compared with each of the following 8-week intervals, and 2) the dose at baseline compared with the dose during the patients’ last treatment period. RESULTS: The majority of the patients were female (74%), and most were 75 years and older (69%). The median treatment duration was 260 days, and 4% and 1% of patients remained on continuous treatment for 2 and 3 years, respectively. The mean dose was 11??g/h at baseline, and 15??g/h during the patients’ last treatment period. The average dose increased by 4??g/h during the patients’ entire treatment course. CONCLUSIONS: The average dose increased by 4??g/h during the patients’ treatment course, which lasted on an average of 260 days. From a clinical perspective, the dose increase of 4??g/h is low and does not suggest dependence/addiction, as also supported by the low proportion of patients remaining on continuous treatment. HubMed – addiction