Causes Of Addiction Research Articles

UZALEŻNIENIE OD INTERNETU JAKO JEDNA Z PRZYCZYN ROZWODU

Addiction to Internet as a Possible Reason of DivorceSummaryThe article deals with problem of the addiction to the Internet as one of possible reasons of divorce. In the first part – theoretical – the Author tries to describe the phenomenon of addiction, its phases and consequences. In the second part there have been presented a results of the researches of the influence of addictions to the Internet on the quality of the relationshipbetween spouses. The conclusion is that the Internet can be the cause of addiction. Its influence on relationship between the spouses can be destructive, it can lead to conflicts and finally to divorce. The Author postulates of all-Polish researches on the scale of this phenomenon and its negative social effects.

The perception and attitudes of nursing staff in state psychiatric hospitals regarding the causes and treatment of substance abuse and effecting factors

ObjectiveThis study was performed with the aims of determining the perceptions of nursing staff in psychiatric hospitals regarding the causes and treatment of substance addiction as well as their attitudes towards people with substance abuse problems.MethodThis study was carried out with 389 nurses working at 5 state psychiatry hospitals in Turkey. In this study, demographic questionnaire, the causes of drug abuse scale (CADAS), drug abuse scale (CUDAS), attitudes scale (AS), and a demographic questionnaire were used. Independent sample t-test, variance, correlation, and linear regression analyses were used.ResultsIn this study, 82.8% of the nurses were female, and the mean age was 33.79 ± 7.58. We found that the demographic characteristics of the nurses did not affect their perception regarding the causes of addiction and treatment (P > 0.05); but it did have an effect upon their attitude towards people with substance use problem (P < 0.05). Also, it was established that there was a negative relationship between their perception regarding causes of substance misuse and their attitude towards a person with substance use problem; and a positive relationship between their perception regarding substance misuse treatment and their attitude towards the person with substance use problem (P < 0.05).ConclusionNursing staff working in psychiatric hospitals in Turkey have the perception that a person takes substances in order to “cope with problems”and for reasons pertaining to his/her “social environment”. Nursing staff tends to indicate a negative attitude towards persons with substance abuse problems, such distancing themselves socially from the patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A study of the connection between gambling and crime in Hungarian prisons

In the following study, we examine the connection between crime and gambling addictions. In addition to examining the playing habits of 140 detainees prior to their imprisonment, we also study their demographic characteristics, and their relations.222014 data recording took place in September–October, in Sándorháza, Mélykút and Baracska penitentiary institutions (Hungary). We previously studied these correlations as a part of a data recording in 2009 (Tessényi-Kovács, 2011).33The result of the first research is English appearance progress: Gaming Law Review and Economics Volume 19, Number 9, 2015.By the 10th of October 2012, the use of gaming machines was terminated in Hungary. Therefore, our survey has gained a repeated actuality, since a significant cause of addiction has disappeared from the market. We question whether this factor has had a measurable effect. Although the elapsed time is not necessarily enough to measure the presumed changes in crime due to gambling, we nevertheless make the comparison with the results from 2009.For the study of pathological problem gambling, we applied the original version of the SOGS-questionnaire, complemented with demographics and other relevant questions from the perspective of our survey.

Addiction and depression comorbidity approaches

Topic: Comorbidities, simultaneous occurrence of two or more disorders are common in psychiatry; therefore the concept of dual diagnosis was established due to new ethiopatogenetic dilemmas and principles of diagnosis and treatment of these conditions. The most common are comorbid affective disorders and comorbidity of drug addictions and affective disorders. Topic position in medical public: Epidemiological studies show a high percentage of comorbidity of drug addictions and depression. Various studies show that about one-third of individuals with depression have addiction, and often some other psychiatric disorders are present, such as personality disorder, anxiety, and bipolar affective disorder. Comorbid disorders exacerbate one another; have tendencies to chronicity and treatment resistance. The problem of adequate diagnosis is common; other diagnosis is neglected, leading to inadequate treatment and poor outcomes. Researches of possible causes of addiction and depression comorbidity follow different theoretical assumptions. One favor genetically determined vulnerability, the others are addressing to the impact of trauma in the formative stages of personality development. Widespread is the theoretical assumption on the deficit functioning of the same regions of the CNS and the same neurotransmitters system. In previous studies the preclinical ones dominate, which are theoretically placed in the context of the CNS of a man. Most of the research are related to dysfunction of the serotonergic and dopaminergic systems, whose influence on addiction and depression are clear, and recent studies show the importance of neuromodulators and their receptors, for example, the role of natural opioid dynorphin and 'kappa' receptors in the mesolimbic reward system. Further action: The better diagnosis would require proper screening of patients entering addiction treatments for affective disorders and vice versa. Treatment have to be combined; in addition to medications for addiction essential are antidepressants, atypical antipsychotics, and/or mood stabilizers, for better therapeutic results.

Neurobiological research on addiction: What value has it added to the concept?

Kalant, H. (2015). Neurobiological research on addiction: What value has it added to the concept?. The International Journal Of Alcohol And Drug Research, 4(1), 53-59. doi:http://dx.doi.org/10.7895/ijadr.v4i1.196The initial goal of neurobiological research on addiction was to identify the neural mechanisms involved in the mediation and expression of addictive behavior. More recently, however, it has attributed causal roles to these mechanisms, as illustrated by the definition of addiction as a brain disease caused by chronic exposure to a drug. This concept carries a number of implications that can be assessed experimentally and clinically. None of these implications is borne out by the currently available evidence. The interactions of neuronal systems involved in addiction are also involved in adaptation to experience and environmental change. Much of the neurobiological research to date has not differentiated between causes of addiction, neuronal mechanisms that are activated by them, and risk factors that contribute to individual vulnerability. It has largely ignored the important experiential and environmental influences known to affect the prevalence of addiction in different populations or different times, and it has so far directed much less attention to other forms of addiction-like behavior that do not involve drugs. These failures are not inherent in neurobiological research but require reorientation of objectives, including more emphasis on the study of mechanisms by which environment and experience, including drug experience, can determine whether genetic risk factors are expressed or remain dormant and can direct neuroadaptive mechanisms toward alternative outcomes.

The most common reasons and incentives of tendency to addiction in prisons and rehabilitation centres of Zahedan (Iran).

In most European countries the ratio of addicts and normal people is 1 to 5,000, and in some third world countries such as Morocco, Egypt, and South Africa this figure is 1 to 1,000. In Iran, the situation is worse, and there is one drug addict per 100 people. The research method in this study is analytical descriptive. The study population consisted of all rehabilitated addicted men and women who were spending their time in prison. Total sample size were 134 people (99 men and 35 women).A special designed questionnaire used to collect data, which included socio-demographic characteristics. The validity of the questionnaire has content validity and for reliability, Cronbach α was used which was 0.78. The formal years of education was 4.3 year. The average age of the first drug use was 12 years for men and 22 years for women. Sixty-nine point seven percent of men used drugs with their friends and 31.4% of women used drug with their husbands. The men more than women, single men more than married women, and illiterates or poor literates were more at risk. Most men blamed bad friends and women blamed physical and psychological problems as the cause of addiction. The singles got addicted due to bad friends and married individuals were addicted due to emotional distress. The majority of age group (27-13 years), got addicted due to bad friends and older groups addicted due to emotional distress. In other words, the older the person gets, the influence of bad friends decreases, and the effect of psychological distress due to conflict and adversity increases.

How is acceptance of the brain disease model of addiction related to Australians’ attitudes towards addicted individuals and treatments for addiction?

BackgroundWe investigated whether beliefs about addiction being a ‘disease’ or ‘brain disease’, and holding certain beliefs about addiction aetiology, are associated with public views about addicted persons and support for different types of treatment, coerced treatment and punishment for addiction.MethodsData were collected as part of the 2012 Queensland Social Survey, a computer assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted males, one who was addicted to heroin and the other addicted to alcohol. Participants were then asked a series of questions for both characters.ResultsThere was widespread support for all treatment modalities (alcohol: 80.8-98.0%, heroin: 89.9-97.2%). There was less support for coerced treatment for alcohol than heroin addiction (alcohol: 41%, heroin: 71%, χ2 = 273.90, p < 0.001). Being 35 years of age or older (alcohol: OR = 0.58 (0.37-0.91), heroin: OR = 0.49 (0.28-0.85)) and having 15 or more years of education (alcohol: OR = 0.60 (0.44-0.81), heroin: 0.55 (0.40-0.75)) predicted less support for coerced treatment. 31.7% of respondents agreed heroin use should be punished by imprisonment and being 35 years of age or older (OR = 0.51 (0.33-0.80)) predicted lack of support. The sample agreed that an alcohol or heroin dependent person would suffer career damage (alcohol: 96.2%, heroin: 98.9%), marriage breakdown (alcohol: 92.2%, heroin: 97.3%) and get in trouble with the law (alcohol: 92.3%, heroin: 98.9%). Respondents expressed more comfort with encountering alcohol rather than heroin addicted persons in the workplace or at a dinner party. Beliefs that addiction was a ‘brain disease’ or a ‘disease’ did not predict any of these attitudes. Beliefs about addiction aetiology were inconsistent predictors of outcomes measured.ConclusionsAge and educational attainment were the most consistent predictors of stigmatising beliefs and beliefs about coercion and punishment. Beliefs that addiction is a ‘disease’ or a ‘brain disease’ were not associated with an overall reduction in beliefs about stigma, coercion or punishment. Beliefs in different causes of addiction were not consistent predictors of beliefs about stigma, coercion or punishment.

Attachment, A Matter of Substance: The Potential of Attachment Theory in the Treatment of Addictions

In North America, substance abuse is a public health crisis with annual costs in the billions. Individuals suffer from substance use disorders for multiple years throughout their lifespan. This suggests that neither historical, community-based interventions, nor current, evidence-based behavioral modalities are successful in healing the causes of addiction. A growing corpus of research has established that traumatic early-childhood experiences and insecure attachments are both independent and interrelated risk factors for developing substance abuse disorders. An impressive literature is emerging exploring potential applications of attachment theory-informed intervention. There has yet to be widespread adoption of such techniques. By examining the scholarly literature, this paper synthesizes existing work on attachment theory in the treatment of substance use disorders. A clinical case application is provided to highlight the potential for attachment-informed therapy. Recommendations for using attachment-informed approaches in the treatment of substance use disorders with various groups are offered.

Public attitudes in Australia towards the claim that addiction is a (brain) disease

We investigated the Australian public's understandings of addiction to alcohol and heroin and the factors predicting support for the idea that these types of addiction are 'diseases' and specifically 'brain diseases'. Data were collected as part of the 2012 Queensland Social Survey, a computer-assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted persons, one who was addicted to heroin and the other addicted to alcohol. Participants were asked a series of questions about different definitions and causes of addiction for both characters. Over half of the respondents thought that addiction is a disease (alcohol: 67%, heroin: 53%), but fewer (alcohol: 34%, heroin: 33%) believed that addiction is a brain disease. Belief that addiction has biological causes predicted agreement that addiction is a disease [alcohol: odds ratio (OR) = 3.05 (2.15-4.31), heroin: OR = 3.99 (2.82-5.65)] and a brain disease [alcohol: OR = 4.97 (3.42-7.22), heroin: OR = 14.12 (9.23-21.61)]. Women were more likely than men to agree that addiction is a disease [alcohol: OR = 1.79 (1.35-2.38), heroin: OR = 1.40 (1.09-1.81)] as were those 35 years of age and older [alcohol: OR = 2.25 (1.50-3.40), heroin: OR = 1.50 (1.01-2.24)]. There is more public support for the idea that addiction is a 'disease' than for the more specific claim that it is a 'brain disease'. Support for a biological aetiology of addiction predicted higher levels of agreement with both disease concepts.

The Addicted Human Brain: An Overview of Imaging Studies and Their Treatment Implications

Addiction is characterized by loss of control over substance use, often operationally defined as continued use of substances despite knowledge of adverse consequences. The exact cause of addiction is not known, but it’s hypothesized that both environmental and genetic factors play a crucial role in the predisposition of this disease. When an individual abruptly stops using a drug or an addictive substance, withdrawal symptoms often take place, which include vomiting, nausea, loss of appetite and depression. Not much is known about the neurobiology of addiction and treatment remains a huge challenge. Current research aims at identifying the neurological circuit of addiction as well as the key neurotransmitters and biological markers involved in this disease. In this paper, I will first begin by giving you an overview of the major substances that cause addiction as well as the most common addictive behavior patterns. Second, I will discuss the major findings that have been done using animal models of addiction, and describe in more details the role that brain imaging technology plays in improving our understanding of drug abuse. Finally, a closer look will be taken at the behavioral and pharmacological approaches frequently employed to treat addiction.

What do Differences in Emotional Regulation in Individuals Addicted to Different Substances Tell us About Addiction Treatment?

Dear Editor, Despite the high incidence of drug abuse, dependence and addiction worldwide, treatments for these conditions remain minimally effective. Among the reasons that might contribute to the limited efficacy of both pharmacological and behavioral/psychological treatments for addictions are symptomatic and etiologic heterogeneity. Although some addicts are predisposed to addiction toward multiple substances, many others appear to be more selectively disposed towards particular substances. This may reflect, to some degree, cultural biases that are unrelated to biological or psychological factors, resulting in limited access to certain drugs (such as alcohol in predominantly Moslem countries) or other aspects of drug availability, such as cost related to where drugs are produced. On the other hand, these differences may involve individual differences in psychological attributes that contribute to addiction and successful quitting. In a recent article in International Journal of High Risk Behaviors and Addiction by H. Mohajerin et al. (1) several interesting aspects of differences between individuals addicted to drugs of specific classes were examined. This study has implications for both the causes of addiction and its treatment. Mohajerin et al. examined styles of emotional regulation in individuals addicted to opiates or amphetamines. The idea behind this study was that differences in emotional regulation might differ in individuals addicted to different drugs. Using the Emotion Regulation Questionnaire (2), differences in emotional regulation style were examined in opiate-dependent and methamphetamine-dependent subjects. The results revealed that opiate-dependent subjects had higher scores on the emotional suppression scale, while methamphetamine-dependent subjects had higher scores on the reappraisal scale. The authors suggested that this may relate to differences in other psychiatric comorbidities among the subjects, including depression in opioid-dependent subjects. There are differences in psychiatric comorbidities in individuals based on different drug types, although this may more reflect the presentation of the disorder (3, 4). Mohajerin et al. emphasized types of cognitive-behavioral interventions involving active restructuring of interpretations of negative experiences for methamphetamine users, who tended to have this way of thinking to begin with. Although interesting, it does not necessarily follow that therapeutic approaches should follow such tendencies. Perhaps, despite the fact that opiate-dependent individuals have a tendency away from cognitive reappraisal towards suppressive strategies in emotional regulation, therapy should aim at ameliorating this weakness and improving cognitive reappraisal abilities. Two empirical questions arise which require further study: “Do different therapeutic approaches work better in individuals addicted to particular circumstances?”, and “Are such differences primarily premorbid in origin or partially the result of chronic drug exposure?” This “which came first” question becomes especially important in considering the etiology of addiction to opiates and stimulants. A substantial portion of the propensity to develop addiction is heritable and involves a large number of genes. However, whether this genetic basis is primarily polygenic or highly heterogeneous is a matter of some debate (5, 6). Based on genome-wide association studies, classes of genes other than drug targets appear to be primarily involved in addiction (6). This genetic variation could still alter sensitivity to addictive drugs in a less direct fashion, but these genes may also affect behavioral or psychological phenotypes such as those considered by Mohajerin et al. As Mohajerin et al. suggest, some portion of this predisposition might relate to attempts at self-treatment for co-morbid psychiatric conditions. Other genetically mediated behavioral or psychological characteristics might predispose individuals to addiction by affecting cognitive or behavioral traits that influence drug-taking behavior, such as impulsivity. Finally, an overlapping, but not entirely the same, set of genes may contribute to the ability to quit drugs or to the success of particular types of behavioral/psychological or pharmacological therapies, as initial studies of nicotine cessation have suggested (7, 8).

Public Understandings of Addiction: Where do Neurobiological Explanations Fit?

Developments in the field of neuroscience, according to its proponents, offer the prospect of an enhanced understanding and treatment of addicted persons. Consequently, its advocates consider that improving public understanding of addiction neuroscience is a desirable aim. Those critical of neuroscientific approaches, however, charge that it is a totalising, reductive perspective–one that ignores other known causes in favour of neurobiological explanations. Sociologist Nikolas Rose has argued that neuroscience, and its associated technologies, are coming to dominate cultural models to the extent that 'we' increasingly understand ourselves as 'neurochemical selves'. Drawing on 55 qualitative interviews conducted with members of the Australian public residing in the Greater Brisbane area, we challenge both the 'expectational discourses' of neuroscientists and the criticisms of its detractors. Members of the public accepted multiple perspectives on the causes of addiction, including some elements of neurobiological explanations. Their discussions of addiction drew upon a broad range of philosophical, sociological, anthropological, psychological and neurobiological vocabularies, suggesting that they synthesised newer technical understandings, such as that offered by neuroscience, with older ones. Holding conceptual models that acknowledge the complexity of addiction aetiology into which new information is incorporated suggests that the impact of neuroscientific discourse in directing the public's beliefs about addiction is likely to be more limited than proponents or opponents of neuroscience expect.

The Shame of Addiction

Addiction is a person-level phenomenon that involves twin normative failures. A failure of normal rational effective agency or self-control with respect to the substance; and shame at both this failure, and the failure to live up to the standards for a good life that the addict himself acknowledges and aspires to. Feeling shame for addiction is not a mistake. It is part of the shape of addiction, part of the normal phenomenology of addiction, and often a source of motivation for the addict to heal. Like other recent attempts in the addiction literature to return normative concepts such as “choice” and “responsibility” to their rightful place in understanding and treating addiction, the twin normative failure model is fully compatible with investigation of genetic and neuroscientific causes of addiction. Furthermore, the model does not re-moralize addiction. There can be shame without blame.

Inference on finite population categorical response: nonparametric regression-based predictive approach

Suppose that a finite population consists of N distinct units. Associated with the ith unit is a polychotomous response vector, d i , and a vector of auxiliary variable x i . The values x i ’s are known for the entire population but d i ’s are known only for the units selected in the sample. The problem is to estimate the finite population proportion vector P. One of the fundamental questions in finite population sampling is how to make use of the complete auxiliary information effectively at the estimation stage. In this article a predictive estimator is proposed which incorporates the auxiliary information at the estimation stage by invoking a superpopulation model. However, the use of such estimators is often criticized since the working superpopulation model may not be correct. To protect the predictive estimator from the possible model failure, a nonparametric regression model is considered in the superpopulation. The asymptotic properties of the proposed estimator are derived and also a bootstrap-based hybrid re-sampling method for estimating the variance of the proposed estimator is developed. Results of a simulation study are reported on the performances of the predictive estimator and its re-sampling-based variance estimator from the model-based viewpoint. Finally, a data survey related to the opinions of 686 individuals on the cause of addiction is used for an empirical study to investigate the performance of the nonparametric predictive estimator from the design-based viewpoint.

Everybody Hurts: Addiction, Drama, and the Family in the Reality Television Show Intervention

This article employs the literature on reality television as well as empirical studies on addiction to analyze Intervention's narrative. We look at the narrative structure of the Intervention's first six seasons (2005–2009), its repeated emphases on the causes of addiction, and the show's purported success rate. Highlighting disturbing discrepancies between the show's representations and assertions versus empirical research, Intervention's notions of what constitutes effective remedies are those treatments generally available only to the financially affluent, and the program's depictions of addiction and intervention practices reinforce a popular culture, rather than a science-based understanding, of the family and of addiction itself.

P01-84 - Investigation the role of psychological, environmental and physical factors in tendency to addiction

Introduction &amp; objectivesFor better understanding of the effective factors in tendency to addiction, the research aimed to survey this question what is the first cause of addiction? Psychological, Environmental or Physical causes.Method80 addicted people were randomly selected and Abuse Drug Assessment Inventory (ADAI) was administered on them. Chi Square formula was used to analyze the results.ResultsFindings showed 55 percent of tendency to addiction was psychological. Also more analyzing showed 65 percent of continuing causes of addiction were psychological factors such as fear, anxiety, sorrow.ConclusionIn regard to results we should put more emphasis on psychological prevention and treatment methods so that both tendency to addiction and continuing causes of addiction decrease and control.

Alcoholics Anonymous-Related Helping and the Helper Therapy Principle

The helper therapy principle (HTP) observes the helper's health benefits derived from helping another with a shared malady. The HTP is embodied by the program of Alcoholics Anonymous as a method to diminish egocentrism as a root cause of addiction. This article reviews recent evidence of the HTP in alcohol populations, extends to populations with chronic conditions beyond addiction, and concludes with new directions of empirical inquiry.

WHAT INTEGRATED INTERDISCIPLINARY AND TRANSLATIONAL RESEARCH MAY TELL US ABOUT ADDICTION

In his article (1), Kalant raises important points regarding how addiction is conceptualized and researched. This topic seems particularly timely given current preparations for the next editions of the International Classification of Diseases and Diagnostic and Statistical Manual (DSM). At the article’s onset, Kalant provides a definition for addiction: “compulsive use of the drug despite the occurrence of adverse consequences.” Although this definition was widely agreed upon in prior iterations of the DSM including the current DSM-IV-TR (2), several DSM-V research workgroups (including those relating to substance use disorders and obsessive-compulsive spectrum disorders) have recently discussed at length the extent to which non-substance behaviors or disorders (e.g., related to gambling) should be considered addictions (3). Kalant cites the importance to studies of addiction of the decision to self-administer drug (or by extension engage in the potentially addictive behavior) by individuals who become addicted. Decision-making represents an important and arguably central component of addiction (4), and performance of individuals with addictions on neurocognitive tasks assessing decision-making has been associated with treatment outcome (5) and real-life measures such as the ability to maintain employment (6). Precisely how decision-making relates to addictions, however, is less clear. For example, individual differences in decision-making prior to substance exposure could lead to initial engagement in substance use and substance use may generate sub-optimal decision-making. Animal models seem particularly well suited to investigate such questions, and pre-clinical studies indicate that not only does substance-naive impulsive decision-making predict substance self-administration (7, 8), but also that substance intake, likely in a developmentally sensitive fashion, influences decision-making (9). Decision-making and related processes (e.g., impulsivity) represent complex, multi-faceted constructs (10), with their expression influenced by genetic and environmental factors in a dynamic and complicated fashion. Multiple individual differences, including those relating to gender, emotional reactivity, stress responsiveness, among others, represent important considerations with respect to addictions and frequently co-occurring disorders, and an improved understanding of how individual differences relate to decision-making and addiction will likely be facilitated by an integrative translational research approach involving multiple disciplines (11). Such approaches ideally might involve studying behaviors (e.g., through analogous tasks in pre-clinical and clinical settings) and using assessments (e.g., relating to brain imaging or genetics) across species such that findings from each study might be directly linked with one another while at the same time affording unique insight through the utilization of “species-specific” techniques (e.g., through self-report, diagnostic, and real-life measures in human studies and genetic manipulation and neurochemical measurements from brain tissues in pre-clinical studies) (12). I currently have the privilege of participating in an interdisciplinary research consortium on stress, self-control and addiction (http://stress.yale.edu/ and http://stress.yale.edu/projects.html). The consortium includes ten coordinated and integrated investigations that involve rats, non-human primates and humans and use molecular/cellular, genetic, brain imaging, behavioral, clinical and epidemiological approaches. While there exist organizational and logistical challenges in conducting interdisciplinary team science, such an approach holds significant promise for understanding complex neuropsychiatric conditions like addiction that are currently frequently refractory to existing treatments (13). Even if such studies do not identify the cause of addiction (14), they have tremendous potential for generating significant advances in prevention and treatment strategies and reducing the suffering and societal burden currently associated with addictions.

P03-240 - Psychological, environmental or physical factors, which is the first cause in tendency to addiction?

AimThe aim of the research is to test this question what is the first cause of addiction? Psychological, Environmental or Physical causes.Method80 addicted people were randomly selected and Abuse Drug Assessment Inventory (ADAI) was administered on them. Chi Square formula was used to analyze the results.ResultsFindings showed 55 percent of tendency to addiction was psychological. Also more analyzing showed 65 percent of continuing causes of addiction were psychological factors such as fear, anxiety, sorrow.ConclusionIn regard to results we should put more emphasis on psychological prevention and treatment methods so that both tendency to addiction and continuing causes of addiction decrease and control.

Datapoints: Iraqi Psychiatrists' Perceptions of Substance Use Disorders Among Patients

Back to table of contents Previous article Next article ColumnFull AccessDatapoints: Iraqi Psychiatrists' Perceptions of Substance Use Disorders Among PatientsSalih M. Al-Hasnawi M.D.Rawnak Aqrawi Pharm.D.Sabah Sadik F.R.C.Psych., D.P.M.Keith Humphreys Ph.D.Salih M. Al-Hasnawi M.D.Search for more papers by this authorRawnak Aqrawi Pharm.D.Search for more papers by this authorSabah Sadik F.R.C.Psych., D.P.M.Search for more papers by this authorKeith Humphreys Ph.D.Search for more papers by this authorPublished Online:1 Jun 2009https://doi.org/10.1176/ps.2009.60.6.728AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Numerous media stories have reported on rising substance use in post-U.S.-invasion Iraq ( 1 ). This study was intended to present a first profile of drug use in clinical populations. Psychiatrists were chosen as the best data source because they are the primary mental health professional in Iraq and are responsible for directing care for all psychiatric problems, including addiction. A brief questionnaire was completed by 83% (N=58) of the 70 psychiatrists working in Iraq in 2006. The questions referred to patients misusing substances whom the psychiatrists had encountered while working either for the Iraqi National Health Service or in their private practice (most Iraqi physicians work in both). The psychiatrists were asked to respond with regard to all patients who were having substance use problems, not just those seeking addiction treatment per se.Almost all (N=53, 91%) of the psychiatrists characterized the age of most patients with substance use problems as being between 18 and 40 years. There was also broad agreement (N=49, 84%) among respondents that most patients were unmarried. Respondents completed two forced-choice, six-item lists asking which drug was most commonly misused by patients and asking where patients would most often obtain these drugs. As shown in Table 1 , the results point strongly toward diverted pharmaceuticals as the leading drug problem among Iraqi patients. The prevalence of use of trihexyphenidyl and medications with anxiolytic effects may stem in part from the population's being under substantial stress in an environment where alcohol is both highly stigmatized and difficult to obtain ( 2 ). Table 1 Iraqi psychiatrists' (N=58) perceptions of the type of drugs most commonly abused by patients and the most common source of drugsTable 1 Iraqi psychiatrists' (N=58) perceptions of the type of drugs most commonly abused by patients and the most common source of drugsEnlarge tableFinally, respondents were asked a yes-no question, "Do you think the easy accessibility is the main cause of addiction in Iraq?" Almost all respondents (N=48, 83%) answered yes. Psychiatrists' perceptions of clinical populations will not likely represent the nature of drug use in the broader Iraqi population. Nor can the data here speak to the perceptions of the 17% of Iraq's psychiatrists who did not complete the survey, who may differ in some unknown respects from those who responded. But this study's results can reasonably be taken to show that it is legal rather than illegal substances that are generating significant misuse problems among most Iraqi patients. This is not surprising given the extensive looting of pharmacies, diversion of pharmaceuticals, and fraud in pharmacies ( 2 ). More stringent monitoring of the pharmaceutical system at all levels will be necessary to lower the population's exposure to potentially addictive drugs. Acknowledgments and disclosuresOpinions are those of the authors and do not necessarily represent official positions of the Iraqi or United States government.The authors report no competing interests.Dr. Al-Hasnawi and Dr. Aqrawi are affiliated with the Iraqi Ministry of Health, Baghdad. Dr. Sadik is with the International Medical Corps, Baghdad. Dr. Humphreys is with the Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto, California, and with the Department of Psychiatry, Stanford University Medical School of Medicine, Stanford, California. Send correspondence to Dr. Humphreys at the Department of Psychiatry, Stanford University School of Medicine, 401 N. Quarry Rd., Room C-305, Stanford, CA 94305-5717 (e-mail: [email protected]).