Every year about half a million men, women, and children in the United States die from the effects of using nicotine, alcohol, and illegal drugs: one of every four American deaths. Yet research to solve this terrible problem is often perceived as less important than other types of biomedical investigation.
Focusing on four major classes of drugs with the greatest social and economic impact—nicotine, alcohol, opioids, and stimulants—Dispelling the Myths About Addiction examines what is known about addiction and what is needed to develop a talented cadre of investigators and to educate the public about addiction research. The committee explores these areas:
- Economic costs of addiction.
- What has been learned about addiction from research into basic neurobiology and the brain, psychosocial and behavioral factors, and epidemiology.
- Education and training of researchers and the research infrastructure.
- Public perceptions and their impact on public policy in this field.
This volume outlines the challenges and opportunities in addiction research today and makes recommendations to educators, treatment professionals, public and private institutions, and others for how to build support for addiction research and treatment.
- Dispelling the Myths about Addiction
- Copyright
- Preface
- Contents
- Acronyms
- Summary
- PREVALENCE, COSTS, AND RESEARCH INVESTMENTS
- NEUROBIOLOGY OF ADDICTION: AN OVERVIEW
- PSYCHOSOCIAL FACTORS AND PREVENTION
- TREATING ADDICTIVE DISORDERS
- RECOMMENDATIONS
- Education and Training
- Resources Needed for Young Investigators
- Public Perceptions and Public Policy
- NOTES
- 1 Introduction
- DEFINITIONS AND CONCEPTS
- CLASSIFICATION OF DRUGS
- ORGANIZATION OF THE REPORT
- REFERENCES
- 2 Prevalence, Costs, and Investments
- PREVALENCE
- Illicit Drugs
- Alcohol
- Nicotine
- Overall Trends in Illicit Drug, Alcohol, and Nicotine Use
- ECONOMIC COSTS OF ADDICTION
- Estimating the Cost of Drug Abuse in the United States
- Comparison of Drug Addiction Costs with Costs of Other Diseases
- INVESTMENTS
- CONCLUSION
- REFERENCES
- 3 Neurobiology of Addiction: An Overview
- THE BRAIN'S COMMON "REWARD" PATHWAY
- DRUG EFFECTS ON BRAIN REWARD SYSTEMS
- EMOTION, MEMORY, AND THE TRANSITION FROM USE TO ADDICTION
- VULNERABILITIES TO ADDICTION
- CONCLUSION
- REFERENCES
- 4 Psychosocial Factors and Prevention
- PSYCHOSOCIAL FACTORS
- PREVENTION
- Warning Labels on Alcoholic Beverages
- Warning Labels on Tobacco Products
- Advertising Bans
- Cigarette Promotions
- Alcohol Promotions
- Restrictions on Smoking in Specific Locations
- Prices and Use
- Access/Server Intervention
- The Role of Primary Care Physicians
- School-Based Prevention Programs
- Family-Based Interventions
- Media-Based Prevention Interventions
- Laws to Prevent Teen Alcohol Use and Smoking
- CONCLUSION
- REFERENCES
- 5 Treating Addictive Disorders
- TREATMENTS FOR ALCOHOL AND COCAINE ADDICTION
- Treatment Setting
- Psychosocial or Behavioral Therapies
- Pharmacotherapy
- Matching Studies
- TREATMENTS FOR OPIOID ADDICTION
- Methadone Maintenance Pharmacotherapy
- New Pharmacotherapies for Opioid Addiction
- SMOKING CESSATION PROGRAMS
- Nicotine Chewing Gum
- Nicotine Patches
- CONCLUSION
- REFERENCES
- 6 Education and Training
- CAREER PATHWAYS
- SECONDARY SCHOOL AND UNDERGRADUATE EDUCATION
- GRADUATE AND PROFESSIONAL EDUCATION
- Curricula
- Graduate School Programs
- Medical School Programs
- Strategies
- Recommendations
- THE IMPORTANCE OF MENTORS
- Strategies to Enhance the Role of Mentors
- Recommendations
- SPECIALIZATION AND CREDENTIALING ISSUES
- CONCLUSION
- REFERENCES
- 7 Resources Needed for Young Investigators
- FUNDING LEVELS
- THE PIPELINE
- Vulnerable Junctures and Lack of Research Training
- Alternatives to Federal Funding
- Competition with Senior Researchers
- Special Problems for Clinical Investigators
- Level Of Stipends
- Competing Demands
- Integration and Collaboration
- REFERENCES
- 8 Public Perceptions, Public Policies
- STIGMA
- Undervalued Area of Research
- ADVOCACY
- A MODEL FOR UNDERSTANDING THE EDUCATIONAL AND PUBLIC BARRIERS
- STRATEGIES
- Informing the Public
- The Role of Advocacy Groups
- REFERENCES
- Appendixes
- A Workshop Agenda
- INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES
- B Workshop Contributors and Participants
- INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES
- C Plenary Lecture I
- INTRODUCTION
- MULTIPLICITY OF DRUG EFFECTS
- Phase 1: Initiation of Drug Use—Prevention Research
- Phase 2: The Active Disease and Its Treatment
- Phase 3: Relapse and Its Prevention
- SUMMARY
- D Plenary Lecture II
- E History of Drug Addiction Research: Key Discoveries/Events, National Policies, and Funding
- F Recent Advances in Addiction Research
- MOLECULAR BIOLOGY, BIOCHEMISTRY, BRAIN IMAGING, AND ANATOMY
- General Issues
- Nicotine
- Opioids
- Stimulants
- Alcohol
- ANIMAL MODELS, EXPERIMENTAL THERAPEUTICS, AND GENETICS
- General Issues
- Nicotine
- Opioids
- Stimulants
- Alcohol
- G Recent Advances in Pharmacotherapy
- GENERAL ISSUES
- NICOTINE
- OPIOIDS
- STIMULANTS
- ALCOHOL
- H Recent Advances in Behavioral Sciences and Treatment
- GENERAL ISSUES
- NICOTINE
- STIMULANTS
- ALCOHOL
- I Key Barriers and Critical Strategies in the Research and Public Arenas
- RESEARCH ARENA
- Facilitating Integration and Collaboration
- Increasing Skilled Human Resources and Improving Quality
- Funding Stability and Adequacy
- PUBLIC ARENA
- Education and Training
- Tackling Stigma and Building Advocacy
- Index
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