The issue of chemical or substance addiction has long since become rampant all over the world, and the United States is no exception to it. Substance abuse includes the use of any substances such as alcohol, nicotine, medical prescription drugs, illegal drugs and many other subjects. Drug abuse can take a significant toll on any society at various levels. Drug and substance abuse has for a long time been a problem that apart from the health hazards for individuals affects social and economic domains as it places immense social and financial loads on the society, as well as unreasonable demands on the legal and the social service system. Drug abuse also poses risks to the safety of society as a whole. This paper researches the roots of the issue, its degree of impact, individual and system factors that have an influence on subjects, and seeks for the opportunities to better understanding and proposing solutions to the problem.
When the cases in hand are the definitions, it becomes apparent that dependency and addiction should be placed at different levels. According to the definitions provided by Malenka, Nestler and Hyman (2009) in “Molecular Neuropharmacology: A Foundation for Clinical Neuroscience”, the dependence is called:
An adaptive state that develops in response to repeated drug administration, and is unmasked during withdrawal, which occurs when drug taking stops … While physical dependence and withdrawal occur with some drugs of abuse … these phenomena are not useful in the diagnosis of addiction because they do not occur with other drugs of abuse … and can occur with many drugs that are not abused. (p. 365)
This definition implies that dependence mechanism can be a part of addiction phenomenon, for which “defining feature … is compulsive, out-of-control drug use, despite negative consequences” (Malenka et al. 2009, p. 364). However, these definitions are not completely clear, because the distinctions between the concepts of substance use, substance abuse, physical and psychological dependence and addiction, as well as their interdependence and interchangeability in the research literature are still determined quite poorly.
A general plan for investigating such deep and entrenched issue should involve a thorough background analysis and retrospective view of the problem, including the historic data collection and archive research. It might also be necessary to recourse to survey strategy and academic literature research and analysis. While investigating such vast topic as chemical dependency and addiction, in is extremely important to get distracted, but instead set a clear objective, develop argumentation and use an effective methodology to support these arguments. Although it is nearly impossible to cover the entire layer of the problem, the task at hand is to identify and conduct a thorough analysis of a specific aspect of the problem, and contribute to the quest for this problem’s solutions in whole.
One of the most important questions within the topic of drug abuse and addictions is the possibility of patient treatment and the guidelines to it. The issue itself is ample material for research, and numerous discussions and debates arise, concerning this material. Substance addiction and chemical dependence are considered to be severe, but curable conditions. However, there exists a wide variety of treatment options for addiction, which depend on the types and amount of substances used, addiction duration, health condition and medical complications of the patient. It can be difficult to choose specific recovery program because its options would also depend on various factors, which could be divided into two groups, patient related and system related. Patient factors include the individual’s personality, the substance of choice, one’s health condition, including the presence or lack of mental or physical illness, individual’s degree of spirituality and the choice of confession. The system factors would involve the local availability and affordability of recovery programs, the quality of patient-doctor relationship and the level of privacy for avoiding social stigmatization. According to research on treatment barriers for substance abusers, the main factors preventing the patients from taking a recovery program can be divided into three areas and are, as follows: “Absence of Problem (situational need); Negative Social Support, Fear of Treatment, and Privacy Concerns (enabling/inhibiting); and Time Conflict, Poor Treatment Availability, and Admission Difficulty (system)” (Rapp et al., 2006, p. 233). Following these arguments, it can be noted that depending on these factors and social needs of every patient, more or less favorable outcomes could be predicted for each individual case of treatment, varying from prolonged complete abstinence to the treatment of co-morbidities without stopping the drug use completely. Some patients may also decline the treatment, and such outcome complies with the abovementioned factors, although the ways of dissuading such individuals are now being studied.
A considerable amount of information and research regarding drug problems is available to modern researchers of this issue. Review of the literature promises to be a vast and complex operation because the accumulated data for academic research are complemented by large volumes of non-fiction literature and publications in newspapers and magazines. Almost every matter under discussion has been mentioned in the literature in one way or another, including the topics regarding the use of drugs in the various social strata, as well as drug treatment and the struggle against drug trafficking. One of the most reliable sources of information on the topic is the National Institute on Drug Abuse (NIDA), which accumulates and publishes recent research findings and traditional researches and articles on substance use and abuse. For example, one of the publications on the NIDA website, “Principles of Drug Addiction Treatment: A Research-Based Guide” has already been published in a third edition by 2012 and provide the basic guidelines for better understanding of addiction causes and treatment. In a preface to this guide, the Director of NIDA states:
This update of the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment is intended to address addiction to a wide variety of drugs, including nicotine, alcohol, and illicit and prescription drugs. It is designed to serve as a resource for healthcare providers, family members, and other stakeholders trying to address the myriad problems faced by patients in need of treatment for drug abuse or addiction. (2012, p. 5)
A few other authoritative sources include the publications of Substance Abuse and Mental Health Administration (2002), where most popular publications include, for example, “Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook”. National Institute on Alcohol Abuse and Alcoholism publishes its own peer-reviewed journal, named “Alcohol Research: Current Reviews”, the new issues and the archives of which are available online. However, despite the variety of publications concerning this urgent issue, there are still a few gaps where the essential parts of knowledge of drug abuse psychology, reasoning, and treatment, should be. For example, Matilda Hellman (2012), the author of an article “Mind the gap! Failure in understanding key dimensions of a drug user’s life” implies that the failure of treatment programs may be rooted in the lack of knowledge of users’ perspective of time, space, and body, or the so-called mental geography (p. 1651). Another psychological gap is pointed out in a book by Eric Wagner and Holly Waldron (2001), “Innovations in Adolescent Substance Abuse Interventions”, where a significant lack of information on drug abuse prevention among minority populations and on family work in the course of drug abuse treatment has been found. Some other publications on literature gaps address the questions of innovations in chemical dependency treatment, such as the article by Revitsky and Klein (2014) discussing the role of ghrelin hormone in drug abuse and reward-relevant behavior.
To conclude this research, it should be said that despite the significant amount of information regarding such the pressing problems as drug addiction and chemical dependency, there is a large gap not only in literature and academic research itself but also a gap between theory and practice. Many organizations that fight the drug abuse note that due to various factors, including the imperfection of legal and health systems, conventionality of academic circles and many other issues, the prevention and treatment of drug abuse is not as effective as it could have been. It means that to achieve greater success in the fight against drug addiction all parties involved should join forces and strive for greater cooperation and collaboration.
References
Hellman, M. (2012). Mind the gap! Failure in understanding key dimensions of a drug user’s life. Substance Use & Misuse 47(13-14): 1651-1657.
Malenka, R. C., Nestler, E. J., & Hyman, S. E. (2009). Chapter 15: Reinforcement and Addictive Disorders. In A. Sydor & R.Y. Brown (Eds.), Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.) (pp. 364–368). New York: McGraw-Hill Medical.
National Institute on Drug Abuse (2012). Principles of Drug Addiction Treatment: A Research-Based Guide. Web.
Rapp, R. C., Xu, J., Carr, C. A., Lane, D. T., Wang, J., & Carlson, R. (2006). Treatment barriers identified by substance abusers assessed at a centralized intake unit. Journal of Substance Abuse Treatment 30(3): 227-235. Web.
Revitsky, A.R., & Klein, L. C. (2014). Role of Ghrelin in Drug Abuse and Reward-Relevant Behaviors: A Burgeoning Field and Gaps in the Literature. Current Drug Abuse Reviews 6(3): 231-244.
Substance Abuse and Mental Health Administration (2002). Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook. Web.
Wagner, E. F. & Waldron, H. B. (2001). Innovations in Adolescent Substance Abuse Interventions. Oxford, UK: Elsevier Science, Ltd.