Substance and Non-Substance Related Addictions: A Global Approach

238 Pages·2022·4.336 MB·English

by  Evaristo Akerele

Substance and Non-
Substance Related
Addictions
A Global Approach
Evaristo Akerele
Editor
123
Substance and Non-Substance Related
Addictions
Evaristo Akerele
Editor
Substance
and Non-Substance
Related Addictions
A Global Approach
Editor
Evaristo Akerele
Department of Psychiatry
New Jersey Medical School
Rutgers University
Newark, NJ, USA
ISBN 978-3-030-84833-0 ISBN 978-3-030-84834-7 (eBook)
https://doi.org/10.1007/978-3-030-84834-7
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I dedicate this book to my mother Elizabeth Folashade Akerele
(nee Daniel), SRN, SCM
Foreword
I was so happy to be asked by Dr. Akerele to write the foreword for this very
important book. The recognition and treatment of substance use disorders
(SUD) has never been more important. So many major developments are
underway that it is impossible to include mention of them all.
With regard to the opioid crisis, we are still losing the battle with more
than 93,000 drug overdoses in 2020, the highest number ever reported in US
history. The isolation and economic pressures of the COVID-19 pandemic
are certainly contributing to the increased numbers of not only opioid use but
also alcohol, tobacco, cocaine, and methamphetamine. Prescription opioid
misuse is still a major problem, in addition to the increased availability of
fentanyl and its derivatives in the illicit drug supply.
On other fronts, cannabis use is also climbing, with more daily users and
individuals with cannabis use disorder, as a result. Changing attitudes about
drug policy and legalization are creating a seismic shift in the culture and
resulting in new conversations about substance use and substance use disor-
ders. While some of this is undoubtably good and will help reduce stigma as
well as racial bias and decriminalization, changes are coming so fast that one
wonders how much the public really comprehends in these complex debates.
The rising use of psychostimulants, both recreationally and as possible thera-
peutic agents, is another rapidly developing area with many unknowns.
Medical decision-making by state ballot initiative is generally not prudent
and, in many cases, overreaches available evidence. Legalization and federal
drug classification are being considered seriously for the first time, and the
USA can look to its global partners for some implementation models.
Juxtaposed with these changing public attitudes and increased drug use
patterns is a dearth of education in substance use disorders, especially for
healthcare providers. Current training of physicians in the recognition and
treatment of SUD is felt by many to be inadequate to meet the needs of such
a diverse and growing population of patients. The scope of training on SUDs
is disproportionate to the population health need to address these problems,
and many with SUDs go undiagnosed and untreated. Despite marked
advances in the science of addiction, which includes an expanding range of
evidence-based pharmacologic and behavioral treatments, the educational
requirements in psychiatry and other medical training specialties have not
shifted, leaving many ill prepared to manage SUDs in practice. This book can
help to fill the gap by providing current evidence that is accessible to many
types of audiences.
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viii Foreword
In addition, too often materials are limited to only a US or Western per-
spective. Consideration of the global impact of substance abuse disorders is a
major achievement of this book. In addition to the designated chapters, a
global perspective is integrated throughout, with regard to regional, epide-
miological, cultural, and treatment issues, making this a unique and timely
resource.
The addition of a whole new set of behavioral addictions warrants addi-
tional attention as well. In addition to gambling, new neuroscience has
brought greater understanding and insights into how we view other compul-
sive behaviors including sex and food addiction. All clinicians need to recog-
nize Internet addiction and consider the influence of technology and social
media on clients they serve.
This book provides many clinical pearls and gives perspectives on an ever-
changing human problem of addiction. The experts who have contributed are
well regarded as thought leaders in the field. I hope you will find it as a great
resource as I have.
Jill M. Williams, MD
Professor of Psychiatry and Director of the Division
of Addiction Psychiatry
Rutgers University-Robert Wood Johnson Medical School
New Brunswick, NJ, USA
Preface
Substance use disorder is a significant public health issue. As a physician, I
have had the opportunity to work with individuals struggling with this dis-
ease. In this brief introduction, I highlight the social issues, my experience in
the field, and the global relevance of this disease.
The social, economic, and financial impact on lives of both patients and
their families have become evident to me. In most cases, substance use cul-
minates in loss of home, job, and relationships as well as significant medical
issues. Family members such as children and spouses are secondary victims
with significant trauma sequelae. In addition to these Herculean challenges,
individuals with substance use disorder have to confront the immense societal
stigma associated with drug use. The stigma exists in multiple strata which
include but are not limited to the general public and medical field and indi-
viduals with substance disorders. The public generally see individuals with
substance use disorders as being responsible for their own plight; therefore,
they have less empathy for such individuals. In the medical field, substance
use, until quite recently, was significantly marginalized. In psychiatry, treat-
ment and training in substance use disorders was not a top priority.
As a result, access to care is often much more challenging for individuals
with substance use disorders. Furthermore, social stigma is further aggra-
vated by the pecking order that exists among individuals with substance use
disorder. Individuals with alcohol use disorder are at the very top of the totem
pole. The situation has gradually improved in recent years.
I have been fortunate to work with this population from a variety of per-
spectives. Initially as a clinician, then as a researcher at Columbia University
working on pharmacological treatments for substance use. Later on, I contin-
ued to work with this patient population from various positions of leadership,
which included Vice President and Chair of Psychiatry and Behavioral
Health, Vice President of Medical Affairs at Phoenix House, United Nations
Consultant, and several national positions in the American Psychiatric
Association.
As professionals, we have focused on substance use disorders as they
affect primarily the United States of America. During my service as a consul-
tant for the United Nations, I became painfully aware of the global impact of
substance use disorders. Often these global perspectives are not shared with
our students, residents, and fellows. I felt a need to change this narrative. In
addition to the glaring absence of global substance use disorder, I became
aware that there is a dearth of literature on the identification and treatment of
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x Preface
behavioral disorders such compulsive sexual behavior (sex addiction), gam-
bling, and food and Internet addiction. As a researcher and educator, I real-
ized the need to fill this gap and provide a truly comprehensive education on
addiction to the next generation of leaders in this field.
In this book I have tried to address all the issues elucidated above. I have
brought non-substance behavioral disorders out of the shadows to be placed
vis-a-vis substance use disorders. I have attempted to introduce the concept
of substance use disorders as a global challenge. Finally, I have included both
established leaders and emerging future leaders of our field.
I wish to acknowledge all the contributors to this book for their time-
consuming effort and dedication. Special thanks to my past and present col-
leagues at Columbia, Rutgers, Interfaith, Harlem, and Mount Sinai, without
whom this book would not have been possible. There is an old African prov-
erb that states, “it takes a village to raise a child.” I would go one step further
by saying it takes the world to successfully address this public health chal-
lenge. Finally I want to thank my children, Andreea, Christa and Anna.
Newark, NJ, USA Evaristo Olanrewaju Akerele
Contents
Part I Comorbid and Age Related Drug Use
1 Drug Use and Mental Health: Comorbidity between
Substance Use and Psychiatric Disorders . . . . . . . . . . . . . . . . . . . 3
Maria A. Sullivan
2 ADHD and Co-Occurring Substance Use Disorders . . . . . . . . . . 19
Mariely Hernandez, Naomi Dambreville, and Frances
Rudnick Levin
3 Substance Use in Older Adults. . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Paroma Mitra
4 Child and Adolescent Substance Abuse Disorders . . . . . . . . . . . . 49
Jeffery J. Wilson and Michael Ferguson
Part II Nonsubstance Addictions
5 Compulsive Sexual Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Samantha Swetter, Ralph Fader, Tiffany Christian, and Brentt
Swetter
6 Food Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Oluwole Jegede and Tolu Olupona
7 Internet Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Geoffrey Talis
8 Gambling Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Evaristo Akerele
Part III M echanisms, Race and Gender
9 Neurobiological Process of Addiction . . . . . . . . . . . . . . . . . . . . . . 125
Khai Tran, Sasidhar Gunturu, and Panagiota Korenis
10 The Genetics of Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . 129
Olawale Ojo
11 Drug Abuse and Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Evaristo Akerele
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