Handgun carrying among youth in the United States

Despite a wealth of research finding that adolescents who carry handguns are involved in risky behaviors, there has been little exploration into the heterogeneity of this behavior. Using a pooled sample of 12- to 17-year-olds from the National Study on Drug Use and Health who report past-year handgun carrying (N = 7,872), this study identified four subgroups of handgun carriers: low risk (n = 3,831; 47.93%), alcohol and marijuana users (n = 1,591; 20.16%), fighters (n = 1,430; 19.40%), and severe externalizers (n = 1,020, 12.51%). These subgroups differed on demographic, behavioral, and psychosocial characteristics. Findings are discussed in light of prevention and focused deterrence

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.National Institute of Health (NIH) award to ELG (R01DA042033

Addiction as Disease

The opioid addiction epidemic is the most overwhelming public health crisis our country has faced. It is now creating a legal crisis, as the its poisonous fruits spill over into the criminal, tort, and family courts. The epidemic costs the U.S. economy about $500 billion every year, and the pressure is crippling our legal systems. This Article is an attempt to relieve some of that pressure, by advocating for a comprehensive public health campaign based upon a new model of addiction. Research shows that the prevalent “moral choice” model of addiction has facilitated stigma and discouraged treatment, by viewing affected individuals as blameworthy, different in kind, and hopeless. Even when programs are accessible, which they often are not, individuals will not seek treatment because they fear adopting the label of “addict.” In this Article, I affirmatively reject the moral choice model, identifying it as an obstacle to mitigating the opioid epidemic. In its place, I offer a model of addiction that more closely tracks its complex disease etiology, while humanizing people with addiction, removing stigma, and encouraging treatment. I refer to this model as the “integrated disease model,” or IDM, as it explains addiction as a neuro-genetic phenomenon, but does not locate addiction entirely in the brain. Rather, it places addiction on equal footing with other chronic diseases, such as lung cancer or diabetes, each of which has significant genetic, behavioral, and environmental causes. This Article will explain 1) how the moral choice model leads to no treatment and poor treatment, 2) how the law has furthered stigma through the criminalization of addiction, 3) and why we need to fund a comprehensive public health campaign based upon findings from neuro-genetics and public health. The IDM emphasizes the biological continuum of genetic risk factors to which we are all susceptible, the neurological networks that are impaired once the addiction has taken hold, and finally, the incredible power of evidence-based treatments. Explaining addiction in this way – as a treatable, complex disease — has been shown to reduce stigma and encourage treatment

Recent Advances in Drug Addiction Research and Clinical Applications

Although it is well-accepted that drug addiction is a major public health concern, how we address it as a society continues to evolve as recent advances in the lab and clinic clarify the nature of the problem and influence our views. This unique collection of eight chapters reviews key findings on the neurobiology and therapeutics of addiction while capturing the diversity of perspectives that shape these concepts, which range from evolutionary biology to psychiatry to the legal system. This book discusses in depth how technological advances have led to important discoveries and how these discoveries, in turn, are increasingly being translated into clinical practice. It also presents avenues for future study that hold promise for the many affected by addiction

Human Connection as a Treatment for Addiction

Research supports that social connection is important in both humans and animals. In humans, having a cohesive support/social network system and healthy attachments in childhood predict low risk of later addiction (i.e. substance use disorder), as does perceived support from a religious or other cohesive community. Moreover, personal characteristics such as identifying as religious or spiritual can predict low risk for addiction, but little is known about the intersection of neuroscience and religion/spirituality in this regard. Conversely, adverse childhood experiences (ACEs) have repeatedly been shown to predict later addiction. However, the role of the body’s neuro-hormonal responses, such as the endogenous opioid and oxytocin systems in this process merits further exploration, such as how the production or deprivation of endogenous opioids impact later substance use patterns. Existing research also provides evidence that individuals decrease pursuit of interpersonal connections and social bonds when they use substances that activate opioid receptors. This has been found with both substances of abuse and medications used to treat addiction (e.g., methadone, buprenorphine, naltrexone). Research has also demonstrated that addiction often results in situations of social isolation. However, it remains to be elucidated whether the substances of abuse physiologically meet that need for connection. Importantly, research across numerous fields indicates that intentionally increasing interpersonal connection may be an effective treatment for addiction. However, less is known about how specific characteristics of communities impact the quantity, quality, or effectiveness of care and support for a person with addiction [...]https://dc.etsu.edu/etsu_books/1292/thumbnail.jp

Targeting cognitive-affective risk mechanisms in stress-precipitated alcohol dependence: An integrated, biopsychosocial model of automaticity, allostasis, and addiction

This paper proposes a novel hypothetical model integrating formerly discrete theories of stress appraisal, neurobiological allostasis, automatic cognitive processing, and addictive behavior to elucidate how alcohol misuse and dependence are maintained and re-activated by stress. We outline a risk chain in which psychosocial stress initiates physiological arousal, perseverative cognition, and negative affect that, in turn, triggers automatized schema to compel alcohol consumption. This implicit cognitive process then leads to attentional biases toward alcohol, subjective experiences of craving, paradoxical increases in arousal and alcohol-related cognitions due to urge suppression, and palliative coping through drinking. When palliative coping relieves distress, it results in negative reinforcement conditioning that perpetuates the cycle by further sensitizing the system to future stressful encounters. This model has implications for development and implementation of innovative behavioral interventions (such as mindfulness training) that disrupt cognitive-affective mechanisms underpinning stress-precipitated dependence on alcohol

Expanding the Theoretical Lenses of Addiction Treatment Through Art Therapy Practice

This research explores the connection and interaction between literature describing addiction theory and clinical art therapy practice. Literature spanning a wide variety of theoretical understandings of addiction and recovery was reviewed, as well as literature published on the use of art therapy with the substance abuse population. Using the review of the substance abuse literature as a base, key theoretical concepts were identified and formatted into a table that came to serve as a data coding system. Applying case study methodology, this coding system was then utilized as an analysis tool for the art therapy process and artwork of four clients in residential substance abuse treatment. Analysis of the data resulted in the emergence of five prominent themes amongst those listed in the coding system: 1) Intolerance of negative emotion 2) Problematic family dynamics 3) Traumatic experiences 4) Schemas and restructured cognitions and 5) Cultural issues. These findings were then examined in the context of the art therapy literature on substance abuse. The meanings derived from these findings make a case for greater integration between substance abuse literature and art therapy literature, illustrating the utility of clear and organized incorporation of theoretical ideas about addiction into art therapy with substance abuse clients