Running head: SUBSTANCE ADDICTION Substance Addiction LaMarcus Anderson HCS/542 June 19, 2017 Professor J. Wooley 1 SUBSTANCE ADDICTION 2 Introduction An analysis of the meaning, prevalence and the numerous effects of addiction revealed a lot of valuable information on it. Addiction can be defined as a disorder that is mainly characterized by excessive exposure to any substance which is in nature very addictive (Ressler, 2017). Most addictions have very adverse effects on the individual. In as much as the common addictions in today’s society are mainly negative, there are also other forms of addiction that are considered positive in nature. Such addictions include being addicted to reading to extents that one cannot go without reading something whether it’s a book, article or a magazine. The negative addiction practices include circumstances like constant drinking of alcohol and excessive use of cocaine, bhang, tobacco and other drugs. This form of addiction will have adverse effects on the user. Problem Statement In Relation To Healthcare From the research topic of addiction, this problem statement can be derived when relating it to health care. Does addiction have effects on health care? If so, then how can such effects be minimized or rather prevented so as to improve the health care of the general population? This statement invokes the thought of considering addiction as one of the primary factors contributing to the deteriorating health of the people of this generation. A majority of the population is addicted to alcohol and other alcoholic drinks. According to Kolodny et al. (2015), excessive consumption of such substances has resulted in many health defects to the consumers. The same effects such as brain damages, vomiting, and overall weight loss are common to people who are addicted to other drugs such as tobacco and cocaine. Moreover, addiction impacts negatively not only on the physical health of those addicted but also their emotional health and psychological SUBSTANCE ADDICTION 3 health. Drug addicts are likely to experience hallucinations, nightmares and other psychological problems. Research studies on Addiction Some institutions such as the National Institute on Drug Abuse (NIDA) and Gateway Treatment Center have completed some significant research on addiction and its effect on health care. A review of a recently completed research by NIDA on drug addiction reveals that early screening and intervention can be very fundamental in minimizing and in preventing addiction. Gateway Treatment Center also recognized the harmful effects of addiction such as injuries in its recently completed research on the topic. Conclusion Addiction is a critical area that requires immediate intervention from all health stakeholders since many forms of addiction have very negative impacts on the health of individuals. Cooperation and sensitization are some of the fundamental ways in which the addiction problem can be solved for the betterment of society. SUBSTANCE ADDICTION 4 References Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction. Annual review of public health, 36, 559-574. Ressler, K. (2017). Habitual behavior in addiction & stress: Neurogenetic approaches to PTSD comorbidity. Alcohol, 60, 203. Running head: LITERATURE REVIEW 1 Literature Review LaMarcus Anderson HCS/542 June 26, 2017 Professor J. Wooley LITERATURE REVIEW 2 Literature Review Shekarchizadeh, H., Khami, M. R., Mohebbi, S. Z., Ekhtiari, H., & Virtanen, J. I. (2013). Oral Health of Drug Abusers: A Review of Health Effects and Care. Iranian Journal of Public Health, 42(9), 929–940. This study reviews the effects of addiction on oral health. The study reviews the orals complications that are associated with drugs, the oral health acre in addiction rehabilitation, the available health services, and the existing barriers to the promotion of oral health among addicts. This study reveals that drug addiction is associated with various problems in oral health such generalized dental caries, mucosal dysplasia, periodontal diseases, tooth loss and wear among others. This study has validity because it uses both objective and subjective methods in evaluating the oral health status among drug addicts. In the objective evaluation, clinical examination is used to identify the patterns of drugs related oral conditions while subjective evaluation uses interview and questionnaires in data collection. The study also completely observes ethical issues including informed consent, data fabrication or falsification, misconduct, among others. The major strength of the study is that it reviews both the direct and indirect consequences of drug addiction and provides the interventions in oral health care for drug addicts. The study also reviews health services for drug addicts including the negative effects of treatment of oral health on drug addicts. The major weakness of the study includes the presence of barriers and challenges in the study which are critical in providing reliable evidence for further interventions. This includes assessing drug addicts as a target population as well as problems with long-term follow-up of drug addicts. Future research is needed on the appropriate LITERATURE REVIEW 3 policies which would improve the access to oral health care by drug addicts including how dental and general health care sectors can collaborate in improving the access to oral health care by drug addicts. Van der Stel, J. (2015). Precision in Addiction Care: Does It Make a Difference? The Yale Journal of Biology and Medicine, 88(4), 415–422. This study explores the possibilities of precision in the provision of addiction care whereby it examines the required changes in the realization of sensible progress in the epidemiological key figures. The study reviews the development of addiction care whereby it provides the current status of addiction care and the achievements in addiction science as well as the required attention in what lies ahead. The study also examines the ways in which addiction care can deal with the effects of the emerging paradigm of precision or personalized medicine. The study has validity because it examines the precision of addiction care from a global perspective because different countries handle the problem of addiction differently whereby it uses the scientific basis of addiction care in the European countries. The study also uses the existing knowledge about the neurocircuitry of addiction in examining the influence of addictive substances on the brain. The major strength of the study is that it elaborates the three major themes required in making progress in addiction science and practice which include the possibilities for improving precision in diagnosis and the existing opportunities, prognosis, and the treatment indications, especially at an early stage. The major weakness of this study is that the design and the organization of trials require an adjustment to generate clinically relevant knowledge for specific individuals who have complex problems. The knowledge about LITERATURE REVIEW 4 significant differences between the intervention types is also not sufficient to inform clinicians on require being done in specific cases. Future research is required on achievable targets for making progress in addiction care which require being divided into short-term, medium-term, and long-term goals. This would provide better results which are epidemiologically measurable indicating how specific addiction care contributes to the general health. Fleury, G., Milin, R., Crockford, D., Buckley, L., Charney, D., George, T. P., & ElGuebaly, N. (2015). Training in Substance-Related and Addictive Disorders, Part 1: Overviewof Clinical Practice and General Recommendations. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 60(12), 1–9. This study aims at highlighting the key concepts which are relevant to substance-related and disorders that are addictive in the clinical psychiatry practice whereby it aims at providing recommendations regarding training and education of the professionals in the clinical practice of psychiatry. The study examines the matters pertinent to addiction such as screening and diagnosis, pharmacotherapy and psychosocial interventions and also their integration within the general psychiatry clinical settings. This validity of this study is achieved in the way the study aligns with the changes provided by the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Specialty Training Requirements (STR) in Psychiatry on addiction training psychiatry residents. The major strength of this study includes the provision of updated curriculum guidelines for psychiatry residents who are training on substance-related disorders. This includes reviewing in detail the appropriate preparation for those training to work with individuals suffering from addictive disorders. The study also reviews the effective treatment of LITERATURE REVIEW 5 the addicted individuals whereby it focuses on special populations such as adolescents, women and older populations. The major weakness of the study is the challenge of using new technologies in providing training on the competence and attitude required in substance addiction such as well-designed e-learning modules. Future studies are required on the assessment, diagnosis, and the management of substance-related and addictive disorders. Further studies are also required on the strategies of developing the appropriate attitudes and optimism in clinicians towards the treatment of the addicted populations with respect, compassion, and with a nonjudgmental attitude. Batra, A., Müller, C. A., Mann, K., & Heinz, A. (2016). Alcohol Dependence and Harmful Use of Alcohol: Diagnosis and Treatment Options. Deutsches Ärzteblatt International, 113(17), 301–310. http://doi.org/10.3238/arztebl.2016.0301 This study examines the impact of alcohol addiction on health and the strategies for diagnosing and addressing alcohol addiction. The study also provides measures for the acute and post-acute treatment of harmful consumption of alcohol and alcohol addiction. The study has validity because the provided measures conform to the current guidelines for alcohol and tobacco addiction. The validity of the study is also supported by its certification by the North Rhine Academy for Postgraduate and Continuing Medical Education. The major strength of this study is the way it addresses the extensively the concept of the impact of alcohol addiction in health whereby it addresses fully the addiction of alcohol and the health consequences including the psychological and neurobiological fundamentals. The study is also strong in addressing comprehensively the treatment of alcohol addiction including the diagnostic testing, psychometric evaluation instruments, laboratory findings, and the self-assessment scales. The LITERATURE REVIEW major weakness of the study is that it is a selective review of the pertinent literature and thus the proposed treatment of alcohol addiction has not been tested in human subjects. Further studies are thus required on the effectiveness of the proposed treatment approaches in alcohol addiction which should be conducted in a clinical setting. Fahimi, J., Aurrecoechea, A., Anderson, E., Herring, A., & Alter, H. (2015). Substance Abuse and Mental Health Visits among Adolescents Presenting to US Emergency Departments. Pediatric Emergency Care, 31(5), 331–338. http://doi.org/10.1097/PEC.0000000000000421 This study aims at identifying the factors that are associated with adolescent visits to the emergency department (ED) for substance abuse including the complications in mental health whereby it analyzes the effect of substance addiction on the length of stay in emergency department and disposition. This study has validity because it involved a secondary analysis of ED visits by addicted adolescents aged 11 to 24 years using the National Hospital Ambulatory Medical Care Survey which identifies the visits for substance abuse, mental health, and dual diagnosis. Among the major strengths of the study is the use of both univariate and multivariate statistics in the analysis of visit-level factors and demographic factors which are associated with substance addiction and mental health conditions on the length of stay in emergency department and disposition. The analysis of data is also a major strength of the study whereby it uses descriptive statistics in analyzing the regression models of the factors associated with substance addiction visits as well as the dual diagnosis visit. The statistical analysis that was performed in the study also accounts for the sampling methodology and hence the study was statistically significant. The major weakness of the study was misclassification bias in the data which 6 LITERATURE REVIEW 7 occurred when discharge diagnoses were applied for mental health conditions. Another weakness is the lack the statement of causation due to the cross-sectional analysis nature of the study. Future research is needed which should focus on both the novel findings of the study and the gaps it highlights especially identifying the highest group of the adolescent at risk of substance addiction. Special attention should address the classification of diagnosis and the utilization of routine toxicological screening. LITERATURE REVIEW 8 References Batra, A., Müller, C. A., Mann, K., & Heinz, A. (2016). Alcohol Dependence and Harmful Use of Alcohol: Diagnosis and Treatment Options. Deutsches Ärzteblatt International, 113(17), 301–310. http://doi.org/10.3238/arztebl.2016.0301 Fahimi, J., Aurrecoechea, A., Anderson, E., Herring, A., & Alter, H. (2015). Substance Abuse and Mental Health Visits Among Adolescents Presenting to US Emergency Departments. Pediatric Emergency Care, 31(5), 331–338. http://doi.org/10.1097/PEC.0000000000000421 Fleury, G., Milin, R., Crockford, D., Buckley, L., Charney, D., George, T. P., & El-Guebaly, N. (2015). Training in Substance-Related and Addictive Disorders, Part 1: Overview of Clinical Practice and General Recommendations. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 60(12), 1–9. Shekarchizadeh, H., Khami, M. R., Mohebbi, S. Z., Ekhtiari, H., & Virtanen, J. I. (2013). Oral Health of Drug Abusers: A Review of Health Effects and Care. Iranian Public Health, 42(9), 929–940. Journal of LITERATURE REVIEW Van der Stel, J. (2015). Precision in Addiction Care: Does It Make a Difference? The Yale Journal of Biology and Medicine, 88(4), 415–422. 9
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