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Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
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H Recent Advances in Behavioral Sciences and Treatment

GENERAL ISSUES

  • Demonstration of the effectiveness of psychosocial interventions in conjunction with methadone treatment for narcotic addiction and naltrexone treatment for alcoholism.

  • Demonstration of efficacy of contingency voucher system as reinforcer for maintaining participation in drug treatment.

  • Investigations of the substrates of cue-dependent craving and clinical approaches to minimize the likelihood of relapse.

  • Identification of risk factors for using drugs (e.g., psychophathologies, personality disorders, difficulty in regulating emotions and behaviors).

  • Identification of protective factors for prevention and treatment of drug abuse disorders (e.g., high school achievement, peer and family relations, participation in religious or social events, social networks, community reinforcement approaches).

  • Identification of behavioral and social factors that serve as relapse determinants (e.g., psychological factors, drug availability and socializing with other abusers, emotional correlates and sequelae, craving, outcome expectancies).

  • Evaluation of contingency management incentives that promote drug abstinence.

  • Prevention strategies aimed at reducing the risk of needle sharing or unsafe sex to reduce risk of human immunodeficiency virus (HIV) transmission.

Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
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  • Evaluation of joint pharmacological and behavioral strategies for cocaine and opioid dependence.

  • Latent transition analysis (LTA) allows researchers to estimate and test models of stage-sequential development, such as the predictive effect of early caffeine use on subsequent drug use experience.

  • Prevention strategies for adolescents and older youth have shown the value of delaying early initiation of drug use through school-based education and resistance-skills training and with increased availability of social networks, athletic programs, and neighborhood support activities for older children.

NICOTINE

  • Characterization of the reinforcing aspects of nicotine in humans with appreciation of both positive reinforcers (e.g., cognitive effects, mood enhancement, weight control) and negative reinforcers (avoidance of nicotine withdrawal).

  • Establishment of environmental tobacco smoke as a health hazard, with implications for air quality control in the workplace and public places.

  • Successful patient-treatment matching studies (e.g., higher-dose nicotine replacement therapy for heavier smokers, supportive treatments for dysphoric smokers).

  • Demonstration of differential etiology of smoking for men and women and gender differences in smoking cessation.

STIMULANTS

  • Prenatal and other developmental exposure to cocaine may be influenced by both direct toxic effects and indirect effects of environment (e.g., parental functioning).

  • Cocaine appears to increase the vulnerability of the exposed child to effects of a poor caretaking environment.

ALCOHOL

  • Long-term follow-up study of behavioral effects of alcohol on young men with alcoholic fathers versus nonalcoholic fathers confirmed that a low-intensity response to alcohol at age 20 is associated with 4-times greater likelihood of future alcoholism.

  • Twin studies show that vulnerability to alcoholism is determined by a combination of genetic and environmental factors.

Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
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  • Mild cognitive impairments resulting from chronic alcohol abuse can affect an individual's ability to learn abstinence.

  • Lowering allowable blood alcohol concentrations for young drivers reduces fatal crashes and arrests for driving while intoxicated.

  • Training of alcohol servers in restaurants and bars reduces alcohol-related problems.

  • Use of patient-treatment matching (Project MATCH) to establish new standards for alcoholism treatment research.

Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
×

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Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
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Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
×
Page 202
Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
×
Page 203
Suggested Citation:"Appendix H." Institute of Medicine. 1997. Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research. Washington, DC: The National Academies Press. doi: 10.17226/5802.
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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.

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