Substitute addiction: a concern for researchers and practitioners

An understanding of the role of substitute addictions remains unclear. This article examines the range and possible reward functions of substitute addictions. We suggest that prevention education and treatment need to take into account substitute addictions as an influential aspect ofrecovery. Research is needed to better understand the prevalence and functions of, and solutions to substitute addictions.     

Charismatic/Pentecostal Christians,Spirituality, and Treatment: The Revival Phenomenon

ABSTRACT

This article examines the practice of revival as a means of “treating” people with addictions. Revival is practiced widely in Charismatic/Pentecostal circles and many people believe that that their recovery from addictions would not have been possible without it. The practice is reviewed and suggestions are made as to how to provide evidence-based practice while recognizing the contributions of revival practice.     

The Role of Social Workers in the Treatment of Addictions

Abstract

This article describes the history of social workers' involvement in the treatment of addictions in the United States. Beginning with Mary Richmond, the “mother of social casework,” social workers have played an increasingly important role in the treatment of individuals with alcohol and other drug problems and of their family members. Today, social workers are important players not only in program development, administration, and treatment of chemical addictions, but also in “process” addictions, such as eating disorders and gambling. Moreover, social workers are increasingly involved in addictions research and policy arenas.     

An exploratory study of gambling cross addictions

A growing body of empirical and theoretical research has concentrated on the overlaps and commonalities among chemical and non-chemical (behavioural) addictions. Pathological gambling has perhaps been the most widely researched behavioural addiction and some of this research has concerned the co-existing links between pathological gambling and alcohol/drug addiction in both the gambling substance abuser and the substance abusing gambler (i.e. cross addiction). This study was of an exploratory nature and attempted to gather information and data regarding gambling cross addictions in the UK. To achieve this, 456 letters were sent to all drug and alcohol helping agencies in England requesting such information. This yielded 210 returns (46% response rate). Results indicated that gambling cross addictions occur in both adults and adolescents and were almost exclusively a male condition. However, it must be noted only just over half of the responding agencies had encountered gambling cross addiction and reasons for this are speculated. Results also indicated the existence of various cross addicted subgroups including an adolescent subgroup who were addicted to fruit machines and abused solvents. Future research ideas are also discussed.A more detailed version of this paper is available from the author on request.     

Inpatient treatment of male pathological gamblers in Germany

Pathological gambling is viewed as a disease of unknown cause which requires treatment. Demographic and psychological traits of fifty-eight male patients are described. A control group of fifty-four patients with other addictions was used to determine the validity of a diagnostic test which aims to differentiate between harmless gambling behavior and addiction to gambling. This test is described along with the stages of pathological gambling and the process of treatment for the disorder. Most of the gamblers are young, often previously convicted of theft, highly indebted, in danger of committing suicide, and susceptible to other addictive substances, especially alcohol. Harmless, critical and chronic stages are described. Regarding in-patient treatment, it has proved to be useful to integrate individual members into groups of alcoholics as they are a therapeutic benefit to these groups. The pragmatic and symptom-oriented therapy proved to be good for gamblers as well. A follow-up with forty-nine patients for one year and twenty-five for two years found 71% abstinent after one year and 62% abstinent after two years of treatment. These results are similar to those obtained with alcoholics.     

A psychodynamic approach to the treatment of pathological gambling: Part I. Achieving abstinence

A psychodynamic approach emphasizes the meaning and consequences of one's behavior. After a brief review of the literature, the authors present the first of a two-part model for psychodynamic psychotherapy with pathological gamblers. In this first phase, the immediate goal is abstinence, and five strategies for obtaining it are discussed. These consist of 1.) breaking through the denial 2.) confronting omnipotent defenses 3.) interrupting the chasing cycle 4.) identifying reasons for gambling, and 5.) motivating the patient to become an active participant in treatment. An argument is made for integrating a traditional psychodynamic approach with an addictions model.     

Sex,Drugs, and Love Among the Middle Aged: A Case Study of a Serodiscordant Heterosexual Couple Coping with HIV

ABSTRACT

HIV infection attributable to injection is growing, as is the incidence among heterosexual persons. Some of the people affected are over 50, and we can anticipate a growing number of older people with substance use and HIV as primary concerns. Therefore, we need to know more about the intersections of age, addictions, and HIV. This article uses narrative analysis to examine a research interview with an African-American woman and her African-American HIV-infected male partner in order to gain insight about how a middle-aged serodiscordant drug-affected couple might struggle and succeed in the face of HIV. Implications for social work, policy and research are provided.     

The Search for Community Leaders: A Re-examination of the Reputational Technique*

A method similar to Bonjean's modification of the traditional reputational approach was applied to a study of two small communities within a Southern state. The relative absence of concealed and symbolic leaders suggests that leader visibility is a variable which varies systematically from community to community. Several community characteristics are posited as explanatory variables determining leader visibility.     

Behavioural Addictions in Adolescents and Young Adults: Results from a Prevalence Study

Our study aims to assess the prevalence of behavioural addictions in an adolescent population, evaluating the effects of gender and age, and to assess the correlations among different behavioural addictions. 2853 high school students were assessed in order to evaluate the prevalence of behavioural addictions such as Pathological Gambling (PG), Compulsive Buying (CB), Exercise Addiction (EA), Internet Addiction (IA), and Work Addiction (WA), in a population of Italian adolescents. The South Oaks Gambling Screen-Revised Adolescent (SOGS-RA), the Compulsive Buying Scale (CBS), the Exercise Addiction Inventory (EAI), the Internet Addiction Test (IAT), and the Work Addiction Risk Test (WART), were compiled anonymously by the students. Overall prevalence was 7.0% for PG, 11.3% for CB, 1.2% for IA, 7.6% for WA, 8.5% for EA. PG and EA were more common among boys, while gender had no effect on the other conditions. CB was more common among younger (<18 years old) students. The scores of all of these scales were significantly correlated. The strong correlation among different addictive behaviours is in line with the hypothesis of a common psychopathological dimension underlying these phenomena. Further studies are needed to assess personality traits and other clinical disorders associated with these problems behaviours.     

Clinical and behavioral evaluation of pathological gambling in Barcelona,Spain

This paper assesses both the clinical characteristics and gambling behavior of 45 pathological gamblers (40 male, 5 female, average age 41) in a psychiatric hospital in Barcelona, Spain. These pathological gamblers tend to have other addictions and psychiatric disorders in addition to their pathological gambling. Suicidal ideation and attempts were one of the most frequent complications with these patients. Slot and fruit machines were found to be the most preferred form of gambling. Loans and crime were frequently used by the gambler to finance his or her gambling. Nevertheless, the gambler is rarely aggessive, and legal problems resulting from serious crimes are the exception. The profile presentes is similar to that found among pathological gamblers in other countries.     

Attentional Bias in Problem Gambling: A Systematic Review

Attentional bias has been the subject of extensive empirical investigation in connection with chemical addictions, and it has been demonstrated in users of several different substances. The findings show that substance users seem to notice and attend to substance-related stimuli more readily than non-substance-related stimuli. Less is known, however, about attentional bias in pathological gambling. This systematic review investigates the existing empirical evidence on attentional bias in problem and pathological gamblers. Eleven studies were identified and evaluated following a literature search. Key findings are that problem and pathological gamblers seem to exhibit attentional bias toward gambling-related stimuli across different measuring paradigms, although some negative findings were reported. Recommendations aimed at improving research on this topic include better validation of measures, the inclusion of manipulations of craving level, and adding variations in gambling severity as a variable, as well as gambling preference. Research on therapeutic procedures aimed at reducing attentional bias is also recommended.     

Repeated suicide attempts

Attempted suicide is an act associated with childhood sexual abuse, depression, bipolar illness, substance abuse, and other diagnoses, as documented in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (American Psychiatric Association [APA], 1994). Three women, who attended a group to decrease their depression and increase their self-esteem and who had histories of multiple suicide attempts, agreed to participate in interviews designed to determine the common factors associated with their suicide attempts and to examine the assertion that their suicide attempts were an addiction, similar to their addictions to alcohol and drugs. The common factors found were depression, substance use disorders with early abuse and risky behaviors, history of sexual abuse, faulty relationships, alteration of mood with a suicide plan, and distorted and illogical thinking and motivation. The similarities to addiction also were described. Based on the complexity of factors that emerged and the addictive nature of the suicide attempts, treatment for similar patients needs to be multidimensional and ongoing to allow sufficient time to monitor progress and address the numerous factors involved.     

Addiction,Power and Gender

This paper examines addictive behaviour in relation to power and gender and introduces the notion of ‘addiction as a disordered power arrangement embedded in gender’ (Bepko, 1989). The notion of power in terms of relationship positions and their impact on addictions is discussed. The popular concepts of powerlessness and co-dependency are examined in terms of their clinical usefulness and compatibility within this framework.     

Mothers matter: A feminist perspective on child welfare-involved women

ABSTRACT

Mothers involved in child welfare services are often marginalized and misunderstood while the system focuses on protecting their children. These women are mothering within a context of poverty, violence, addictions, and racism, leaving them with minimal resources and supports. Using a feminist perspective, this article seeks to shift the common perception that children must always be regarded as needing to be protected from these mothers. Rather, a richer understanding of these women and more focus on attending to their needs may provide an added measure of safety and security for their children. An appreciation for the relationships central to these women’s experiences can provide child welfare workers with the ability to create strong working alliances and move families toward safe reunification.     

Couples treatment issues for recovering male compulsive gamblers and their partners

Until recently, the couple relationship has been relatively neglected in both clinical reports and systematic research in the compulsive gambling literature. This article suggests the need for family and intergenerational assessment as well as early interventions within the couple system. The following treatment issues are discussed: multiple addictions; finances; control and power; anger; sexuality; and emotional intimacy. Overcoming deficits in intimacy is viewed as central to couples recovery.     

Adoption of evidence-based practices among substance abuse treatment providers

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area.     

Pathological gambling and associated patterns of crime: Comparisons with alcohol and other drug addictions

The pattern of convictions for various categories of crime in the population of the United Kingdom was compared with the corresponding pattern in a sample of addictive gamblers drawn from Gamblers Anonymous in the U.K. A distinctive pattern of income-generating crime was found to be statistically associated with pathological gambling. This pattern was compared with other distinctive patterns associated with the intake of alcohol and with various other drugs and it was found to resemble most closely that of addiction to narcotic drugs.The possible role of gambling as a contributory cause of crime is discussed in the light of what is known of the issues surrounding other addictions as causes of their distinctive patterns of crime.The content and presentation of this paper benefited from the comments of J. Gillies and A.J. Weir, both of the Department of Psychology, University of Glasgow. The collection of the data would have been impossible without the active encouragement and assistance of the General Services Board of Gamblers Anonymous, U.K., its chairman G. Moody and the National Committee of Gamblers Anonymous, U.K.