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Suggested Citation:"Index." 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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Index

A

Academic Career Award, 108

Academic Centers of Excellence, 6, 8, 135

Acamprosate, 81, 200

Access to substances, 62-63, 65-66

Accreditation and certification, 5, 106, 111

Acetylcholine, 40

Addiction

behavioral effects, 45

costs, 2, 11, 25-28

definition, 1, 13-14

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

recommendations for, 9, 146

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

prevalence, 21-22, 170

price effects, 61

psychosocial interventions, 79, 80

recent research advances, 195, 196-197, 199, 202-203

related morbidity/mortality, 22

server role, 62

social costs, 25, 27

tolerance, 170-171

treatment effectiveness, 73

Suggested Citation:"Index." 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.
×

treatment matching, 82

treatment setting, 75-78

use trends, 24, 25

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

Antabuse®, 79, 81

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

B/START, 7, 132

Behavioral sciences, 134, 201-203

Behavioral therapies, 79, 80

Board certification/examination, 5, 101, 104, 106, 110

Brief therapy, 79

Buprenorphine, 85, 200

C

Calcium channel regulation, 171-172

Career development awards, 7, 116, 120, 132

Career Teacher Training Program, 6, 108, 109, 120

Causes of addiction

conceptual model, 1, 9-10 n.1

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

disease comparison, 28, 30

of drug abuse and addiction, 2, 11, 25-28, 30, 32

health care, 2, 19

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

definition, 13, 14

neurobiology, 46

Depression, 57, 141-142

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

Disulfiram, 79, 81

Suggested Citation:"Index." 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.
×

Dopaminergic system

adaptive emotional circuit, 43-44, 46

brain reward system, 39, 40-41, 164

drug effects, 40, 41

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

typologies, 15, 162

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

role of mentors, 5-6, 106-109

secondary school level, 4, 97

for treatment professionals, 6, 109-111

Educational attainment, 21

alcohol use, 23

nicotine use, 24

Electroacupuncture analgesia, 166

Elementary schools, 4, 97

Emotional processes, in neurobiology of addiction, 42-44, 46

Employment status, 21

Endorphins, 40

Environmental risk factors, 48, 56

Ethnicity

alcohol use, 22-23

nicotine use, 23, 25

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

Fellowship awards, 116, 120

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

private sector, 32, 131

recommendations, 6, 7-9, 132-133, 134

system problems, 118

trends, 119-120, 121

vulnerable junctures in research careers, 120-121

G

GABA, 40, 81, 195

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

Graduate education, 5, 111

opportunities for abuse studies, 99-100

Suggested Citation:"Index." 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.
×

Grant funding

mechanisms, 116

system problems, 121

H

Harvard Medical School, 101

Health consequences of addiction, 30

costs, 2, 19

Health Research and Services Administration, 8, 134

Heroin detoxification, 74

High school, 19, 20

I

Illegal drugs

alcohol use and, 22

costs of addiction, 2, 11

prevalence of use, 20-21

social costs, 25, 27

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

research issues, 55, 163-165

Insurance, 3

Interdiction, 32, 33

L

LAAM, 85, 200

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

recommendations, 5, 106

Memory

addiction process, 46

neurobiology, 42

Mentors/mentoring

recommendations for, 6, 109

role of, 5-6, 106-107, 111

strategies for enhancing, 108-109, 206-207

Methadone, 83, 84, 200

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

recommendations for, 8, 132, 134, 135

research funding, 116, 119, 121

Suggested Citation:"Index." 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.
×

National Research Service Awards, 116, 120, 121

Neurobiology, 2, 16

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

access effects, 62-63, 66

advertising bans, 58-59

cessation programs, 85-86

demographic variation, 23-24

economic costs, 2

gums and patches, 86-87

intrauterine exposure, 164

legal restrictions, 65, 66

media portrayals, 65

neurobiology, 40, 41, 49

place-specific prohibitions, 60-61

prevalence, 23

price effects, 61-62

recent research advances, 194, 196, 199, 202

social costs, 25, 27

treatment effectiveness, 73

use trends, 24, 25

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

Orlaam®, 85, 200

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

cocaine use, 81-82, 164-165

education, substance abuse studies in, 100

opioid addiction, 83, 84-85

with psychosocial intervention, 80

recent research advances, 199-200

research challenges, 87

role of, 81

treatment matching, 82

Ph.D. programs, 133

recommendations for, 6, 109

Phoenix House, 78

Polysubstance abuse, 15

Posttraumatic stress disorder, 46

Pregnancy, 57-58, 164

Prevalence

age patterns, 20

alcohol use/abuse, 21-22, 170

ethnicity patterns, 21

trends, 20-21

of use by drug type, 15

Suggested Citation:"Index." 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.
×

Preventive interventions

advertising restrictions, 58-60

family-based, 65

federal funding, 30, 32-33

indicated, 3, 57

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

selective, 3, 57

target types, 3

universal, 3, 57

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

recommendations for, 7, 132

research careers in, 131

spending, 32

Professional societies

board certification/continuing education in abuse specialties, 5, 110-111

recommendations for, 4-5, 98

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

recommendations for, 9, 144

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

career pathways, 96, 115

clinical, 8, 133-134

collaborative interdisciplinary, 8-9, 134-136, 167, 205-206

competition among researchers, 131-132

federal funding, 30, 33, 116, 118, 119-121

funding trends, 119-120, 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

Suggested Citation:"Index." 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.
×

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

role models, 97, 107

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

recommendations for, 4, 97-98

Self-control training, 79

Self-esteem, 64

Self-medication, 56-57

Senior Scientist Award, 108

Serotonergic system, 40, 44

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

recommendations for, 8, 134

Support groups, 74

T

Therapeutic communities, 77-78

Tolerance

to alcohol effects, 170-171

definition, 13

neurobiology, 45-46

Treatment, 16

cue-dependent memory, 46, 56

detoxification, 74

effectiveness, 3-4, 32, 73-74, 79, 87

federal funding, 30, 32-33

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

pharmacotherapy, 80, 81-82

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

relapse prevention, 74, 80

research issues, 4, 87, 109-110, 165

settings, 75-78

social stigma as obstacle to, 140

stages of, 74

Suggested Citation:"Index." 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.
×

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

opioid, 83, 85

Workplace costs of substance abuse, 11

World Health Organization, 15

Suggested Citation:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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:"Index." 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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Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research Get This Book
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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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