Index
A
Academic Career Award, 108
Academic Centers of Excellence, 6, 8, 135
Access to substances, 62-63, 65-66
Accreditation and certification, 5, 106, 111
Acetylcholine, 40
Addiction
behavioral effects, 45
multifactorial model, 13, 37-39, 48, 162
neurobiology of transition to, 42-46
patterns of early substance use, 19-20
risk factors, 47-49
Addiction Severity Index, 76
Adenosine metabolism, 172-173
Advertising bans, 58-60
Advocacy and consumer groups, 208-209
competition among, 141-142
for needs of addicted persons, 141-142
role of, 144-146
Age variation
alcohol use, 22
alcohol use, risk of, 47
illicit drug use patterns, 20
nicotine use, 22
rationale for early intervention, 19
substance use trends, 25
Agency for Health Care Policy and Research, 8, 134
Alcohol use/abuse
access effects, 62
advertising bans, 58-60
age at onset, 47
aversive reaction, 47
costs, 2
demographic patterns, 22-23
detoxification, 74
fetal alcohol syndrome, 58
as gateway drug, 22
genetic risk factors, 47-48, 174-176
legal restrictions, 65-66
media portrayals, 65
neurochemistry, 40, 41, 45, 169, 171-176
pharmacotherapy, 81
price effects, 61
psychosocial interventions, 79, 80
recent research advances, 195, 196-197, 199, 202-203
related morbidity/mortality, 22
server role, 62
tolerance, 170-171
treatment effectiveness, 73
treatment matching, 82
treatment setting, 75-78
warning labels, 57-58
withdrawal effects, 171-172
Alcoholics Anonymous, 76-77
American Association for the Advancement of Science, 97
Amphetamine neurobiology, 41
Animal studies, 39
alcohol addiction risk, 47-48
recent research, 195-197
relapse processes, 165-166
research needs, 164
Antisocial personality, 57
Anxiety disorder, 57
Assessment and diagnosis
addiction severity measures, 76
in primary care settings, 63
treatment setting decisions, 76
Attention deficit disorder, 57
Attitudes and beliefs
moralistic view of addiction, 139-140
as risk/protective factors, 3, 55-56
B
Behavioral sciences, 134, 201-203
Board certification/examination, 5, 101, 104, 106, 110
Brief therapy, 79
C
Calcium channel regulation, 171-172
Career development awards, 7, 116, 120, 132
Career Teacher Training Program, 6, 108, 109, 120
Causes of addiction
See also Initiation
Center for Substance Abuse Prevention, 30
Center for Substance Abuse Treatment, 30
Chemical dependency programs, 77
Clinical practice guidelines, 76, 79
Cocaine use/abuse
crack/free base, 44-45
demographic patterns, 19
neurobiology of, 40, 41, 44-45, 49
pharmacotherapy, 81-82, 164-165
psychosocial interventions, 80
treatment effectiveness, 73
treatment matching, 82-83
treatment settings, 75-78
Community reinforcement, 79
Conduct disorder, 57
Costs, 16
of drug abuse and addiction, 2, 11, 25-28, 30, 32
indirect/related, 25
morbidity/mortality, 27
of treatment vs. interdiction, 32
of undiagnosed addictive disorders, 63
Credentialing and licensing, recommendations for, 6, 106, 111
Criminal justice funding, 30, 33
Cues, behavioral, 46, 56, 165-166
D
D.A.R.E., 64
Delivery mechanisms, 44-45
nicotine gums and patches, 86-87
Dependence
neurobiology, 46
in cocaine addiction, 83
Desipramine, 80
Detoxification, 74
in opioid addiction treatment, 83
Diagnostic and Statistical Manual of Mental Disorders-IV, 15
Disease model, 1, 9-10 n.1, 13, 37-38
pediatric onset, 19
personal agency and, 48
public education, 144
vs. moralistic view of addiction, 139-140
Dopaminergic system
adaptive emotional circuit, 43-44, 46
brain reward system, 39, 40-41, 164
recent research advances, 193
significance of, in addiction processes, 2, 37, 49
Drug classification
by neurobiological effects, 45
opioids, 10 n.2
rationale, 15
stimulants, 10 n.2
E
Education and training in addiction studies, 16
funding for researchers, 121, 132-133
in medical schools, 5, 100-101, 103-104
multidisciplinary approach, 104
obstacles to research careers, 95, 96-97, 115, 133-134, 206
recommendations, 4-7, 97-98, 111, 132-133
for treatment professionals, 6, 109-111
Educational attainment, 21
alcohol use, 23
nicotine use, 24
Electroacupuncture analgesia, 166
Emotional processes, in neurobiology of addiction, 42-44, 46
Employment status, 21
Endorphins, 40
Environmental risk factors, 48, 56
Ethnicity
alcohol use, 22-23
prevalence patterns, 21
psychosocial risk factors, 56
F
Faculty
expertise in substance abuse studies, 100, 101
recruiting, for addiction research, 5, 106
Faculty for Undergraduate Neuroscience, 97
Families
advocacy role, 145
preventive interventions in, 65
risk factor for drug use, 56
Fetal exposure
to alcohol, 58
to nicotine, 164
research needs, 164
First Independent Research Support and Transition, 120
Follow-up care, 74
Foundation awards, 131
Funding, 16
characteristics of individual awards, 116
for clinical investigators, 8, 133-134
federal, 30-33, 116, 118, 119-121
for interdisciplinary research, 8-9, 134-136
obstacles to research careers, 16, 115, 207
recommendations, 6, 7-9, 132-133, 134
system problems, 118
vulnerable junctures in research careers, 120-121
G
Gamma-hydroxybutyric acid, 81, 200
Gender differences, 21
alcohol use, 23
nicotine use, 23-24
Gene knockout research, 164, 193
Genetic predisposition, 47-48, 164, 174-176
Geographic variation, 21
alcohol use, 23
nicotine use, 24
opportunities for abuse studies, 99-100
Grant funding
mechanisms, 116
system problems, 121
H
Harvard Medical School, 101
Health consequences of addiction, 30
Health Research and Services Administration, 8, 134
Heroin detoxification, 74
I
Illegal drugs
alcohol use and, 22
prevalence of use, 20-21
terminology, 161-162
use trends, 24-25
Individual differences
beliefs and attitudes, 3
initiation of drug use, 162-163
Initiation
age patterns, 19
alcohol use risk factors, age-related, 47
drug delivery systems, 45
individual differences, 162-163
peer influences, 56
psychosocial factors, 2-3
Insurance, 3
L
Law enforcement, 32
Life Skills Training, 64
M
Media-based interventions, 65
Medical schools
education and training in addiction studies, 5, 100-101, 103-104
Memory
addiction process, 46
neurobiology, 42
Mentors/mentoring
strategies for enhancing, 108-109, 206-207
advocates for services, 141
detoxification role, 74
Midwestern Project, 64
Minnesota model of alcoholism treatment, 77
Morbidity, 11
Mortality, alcohol-related, 22
Motivation
moralistic view of addiction, 140
to use drugs, 45
N
Nalmefene, 49
Naloxone, 85
Naltrexone, 49, 81, 84, 164, 166, 200
National Alliance of Methadone Advocates, 141
National Cancer Institute, 118, 119
National Heart, Lung, and Blood Institute, 118, 121
National Institute of Mental Health
recommendations for, 7-8
research funding, 118
National Institute on Alcohol Abuse and Alcoholism
recommendations for, 6, 109, 132-133, 136
research funding, 116, 118, 119-120, 121
spending, 30
National Institute on Drug Abuse
recommendations for, 6, 7-8, 109, 132-133, 136
research budget, 30, 116, 118, 119-120, 121
National Institutes of Health
National Research Service Awards, 116, 120, 121
of alcohol effects, 40, 41, 45, 169, 171-176
current conceptualization of addiction, 37-39, 49
drug delivery systems and, 44-45
drug effects, 41, 44-46, 49, 162-163
drug-induced changes, 45-46
emotional circuitry, 42-44
model of addiction, 48
public education, 144
recent research advances, 193-194, 195-196
of relapse, 165-166
research questions, 49-50
reward pathways, 39-41, 45-46, 164
second messenger system, 40
transition to addiction, 42-46
vulnerability to addiction, 47
New York City, 28
NIAAA. See National Institute on Alcohol Abuse and Alcoholism
Nicotine use/abuse
advertising bans, 58-59
cessation programs, 85-86
demographic variation, 23-24
economic costs, 2
gums and patches, 86-87
intrauterine exposure, 164
media portrayals, 65
place-specific prohibitions, 60-61
prevalence, 23
price effects, 61-62
recent research advances, 194, 196, 199, 202
treatment effectiveness, 73
warning labels, 58
NIDA. See National Institute on Drug Abuse
Norepinephrine, 40
North Carolina Governor's Institute on Alcohol and Substance Abuse, Inc., 104
O
Opioids
addiction and relapse research issues, 166
detoxification, 83
methadone treatment for addiction, 83, 84
neurobiology, 40, 41, 44, 45, 49
recent research advances, 194, 196, 199
substances classed as, 10 n.2, 15 n.3
treatment strategies, 83
P
Parkinson's disease, 2
Patient-treatment matching, 4, 82-83
Peer relations, 56
preventive interventions based on, 64
Personality trait risk factors, 56
Pharmacotherapy
education, substance abuse studies in, 100
with psychosocial intervention, 80
recent research advances, 199-200
research challenges, 87
role of, 81
treatment matching, 82
Ph.D. programs, 133
Phoenix House, 78
Polysubstance abuse, 15
Posttraumatic stress disorder, 46
Prevalence
age patterns, 20
ethnicity patterns, 21
trends, 20-21
of use by drug type, 15
Preventive interventions
advertising restrictions, 58-60
family-based, 65
law-based, 65-66
media-based, 65
no-smoking areas, 60-61
peer-based, 64
price controls, 61-62
in primary care settings, 63
private spending, 32
psychosocial factors, 2-3
rationale for early intervention, 10-20, 163-164
restricting access for children, 62-63
in schools, 63-64
target types, 3
warning labels, 57-58
See also Relapse prevention
Primary care medicine, 63
education in substance abuse issues, 103-104, 110
nicotine cessation interventions, 85-86
recommendations for education and training, 8, 134
Private sector
research careers in, 131
spending, 32
Professional societies
board certification/continuing education in abuse specialties, 5, 110-111
Protective factors, 3
Protein kinases, 171-172, 173-174
Psychosocial functioning
alcohol server interactions, 62
co-occuring psychiatric disorders and substance use, 56-57
effects of advertising, 58-60
initiation of drug use, 2-3
peer relations, 56
personality traits as risk factors, 56
psychiatric/psychological practice specialization, 110
research challenges, 66
research issues, 55
treatment strategies, 79-80
Psychotropic drugs, 14
Public awareness and education, 16, 208
advertising bans, 58-60
advocacy for addiction services, 141-142, 208-209
barriers to research, 142
content, 9
importance of, for research efforts, 9, 139
media-based interventions, 65
moralistic view of addiction, 139-140
school-based interventions, 63-64
selective preventive interventions, 3, 57
trends in substance use and, 24
universal preventive interventions, 3, 57
warning labels, 57-58
R
Rehabilitation, 74
Reimbursement issues, 3
Relapse prevention, 74
opioid addiction treatment, 84
psychosocial interventions, 80
research issues, 165-166
Research
collaborative interdisciplinary, 8-9, 134-136, 167, 205-206
competition among researchers, 131-132
federal funding, 30, 33, 116, 118, 119-121
historical development, 178-192
in initiation processes, 163-165
issues in addiction, 11-12
mentors, 5-6, 106-109, 206-207
obstacles to career development, 16, 95, 115, 133-134, 206, 207
opportunities in neurobiology, 49-50, 167
private sector, 131
psychosocial, challenges in, 66
public awareness/support, 9, 139, 142
rationale, 28-30
recent advances in behavioral sciences, 201-203
recent advances in neurochemistry, 193-197
recent advances in pharmacotherapy, 199-200
recommendations for education and training, 5-7, 106, 132-133
recommendations for funding, 6-9, 132, 133, 134
in relapse processes, 165-166
shortcomings in education and training for, 95, 96-97, 206-207
social stigma as obstacle to, 140
treatment issues, 4, 87, 109-110, 165
vulnerable junctures in career development, 120-121
Risk of abuse/addiction
access, 62
current understanding, 47
environmental factors, 48
genetic predisposition, 47-48, 174-176
Robert Wood Johnson Foundation, 131
S
SAMHSA. See Substance Abuse and Mental Health Services Administration
Schools, public education campaigns in, 144
Secondary schools
addiction curricula, 97
Self-control training, 79
Self-esteem, 64
Self-medication, 56-57
Senior Scientist Award, 108
Smoking. See Nicotine use/abuse
Social skills training, 80
Stimulants
recent research advances, 194, 196, 199, 202
substances classed as, 10 n.2, 15 n.3
Stress and coping, 80
Substance Abuse and Mental Health Services Administration
programs, 30-32
purpose, 30
Support groups, 74
T
Therapeutic communities, 77-78
Tolerance
to alcohol effects, 170-171
definition, 13
neurobiology, 45-46
Treatment, 16
detoxification, 74
effectiveness, 3-4, 32, 73-74, 79, 87
follow-up, 74
historical development, 178-192
implications of model of addiction, 2, 48-49, 50, 75
length of, 76
nicotine cessation programs, 85-87
opioid addiction, 83-85
outcome determinants, 4, 74, 75
patient-treatment matching, 4, 82-83
private spending, 32
psychosocial, 79-80
recent advances in behavioral sciences research, 201-203
recent advances in pharmacotherapy research, 199-200
recommendations for professional education and certification, 6, 109-111
rehabilitation stage, 74
research issues, 4, 87, 109-110, 165
settings, 75-78
social stigma as obstacle to, 140
stages of, 74
support groups, 74
variation in services, 4, 74-75
U
Undergraduate education, 4-5, 98
University of Pennsylvania Medical School, 101
Use
definition, 13 n.1
neurobiology of transition to addiction, 42-46
W
Warning labels, 57-58
White House Office of National Drug Control Policy, 9, 136
Withdrawal, 45
alcohol, 171-172
Workplace costs of substance abuse, 11
World Health Organization, 15
