All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

In the past, the prototypes for characterizing drug use were heroin and cocaine, so that research has focused on possible commonalities between any substance and these drugs. Addiction controversies explores the problems of the commonalities approach by looking at dissimilarities as well. The first chapters of Addiction Controversies trace the development of modern medical attitudes to drug use and the current controversy over its decriminalization. The second set of chapters examines the extent to which drugs have common biological and sociological mechanisms of action and contrasts these explanations. The final chapters consider the extent to which the desires for different substances are the same and the biological and social explanations of relapse. Clinicians, researchers and students in all areas of substance use will be stimulated by these challenges to current thinking and will enjoy the comparative approach that is taken by the contributors to Addiction Controversies.

Named a Best Book of the Year by The New Yorker and The Boston Globe An authoritative, illuminating, and deeply humane history of addiction—a phenomenon that remains baffling and deeply misunderstood despite having touched countless lives—by an addiction psychiatrist striving to understand his own family and himself “Carl Erik Fisher’s The Urge is the best-written and most incisive book I’ve read on the history of addiction. In the midst of an overdose crisis that grows worse by the hour and has vexed America for centuries, Fisher has given us the best prescription of all: understanding. He seamlessly blends a gripping historical narrative with memoir that doesn’t self-aggrandize; the result is a full-throated argument against blaming people with substance use disorder. The Urge is a propulsive tour de force that is as healing as it is enjoyable to read.” —Beth Macy, author of Dopesick Even after a decades-long opioid overdose crisis, intense controversy still rages over the fundamental nature of addiction and the best way to treat it. With uncommon empathy and erudition, Carl Erik Fisher draws on his own experience as a clinician, researcher, and alcoholic in recovery as he traces the history of a phenomenon that, centuries on, we hardly appear closer to understanding—let alone addressing effectively. As a psychiatrist-in-training fresh from medical school, Fisher was soon face-to-face with his own addiction crisis, one that nearly cost him everything. Desperate to make sense of the condition that had plagued his family for generations, he turned to the history of addiction, learning that the current quagmire is only the latest iteration of a centuries-old story: humans have struggled to define, treat, and control addictive behavior for most of recorded history, including well before the advent of modern science and medicine. A rich, sweeping account that probes not only medicine and science but also literature, religion, philosophy, and public policy, The Urge illuminates the extent to which the story of addiction has persistently reflected broader questions of what it means to be human and care for one another. Fisher introduces us to the people who have endeavored to address this complex condition through the ages: physicians and politicians, activists and artists, researchers and writers, and of course the legions of people who have struggled with their own addictions. He also examines the treatments and strategies that have produced hope and relief for many people with addiction, himself included. Only by reckoning with our history of addiction, he argues—our successes and our failures—can we light the way forward for those whose lives remain threatened by its hold. The Urge is at once an eye-opening history of ideas, a riveting personal story of addiction and recovery, and a clinician’s urgent call for a more expansive, nuanced, and compassionate view of one of society’s most intractable challenges.

This Special Issue presents some of the main emerging research on technological topics of health and education approaches to Internet use-related problems, before and during the beginning of coronavirus disease 2019 (COVID-19). The objective is to provide an overview to facilitate a comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. It contains 40 papers, four reviews and thirty-five empirical papers and an editorial introducing everything in a rapid review format. Overall, the empirical ones are of a relational type, associating specific behavioral addictive problems with individual factors, and a few with contextual factors, generally in adult populations. Many have adapted scales to measure these problems, and a few cover experiments and mixed methods studies. The reviews tend to be about the concepts and measures of these problems, intervention options, and prevention. In summary, it seems that these are a global culture trend impacting health and educational domains. Internet use-related addiction problems have emerged in almost all societies, and strategies to cope with them are under development to offer solutions to these contemporary challenges, especially during the pandemic situation that has highlighted the global health problems that we have, and how to holistically tackle them.

Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it's supposed to do-seek pleasure and relief-in a world that's not cooperating. As a result, most treatment based on the disease model fails. Lewis shows how treatment can be retooled to achieve lasting recovery. This is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.

DSM-V broke new ground in May of 2013, designating a new disorder called "behavioral addiction." Clinicians immediately wanted to know: how is a behavioral addiction different from an impulse control disorder? What are the criteria for determining that some behaviors are addictions rather than impulses? What, if anything, does this mean in terms of effective treatment?Behavioral Addictions is the first and most authoritative text ever written on the subject of behavioral addictions. This comprehensive work explains the criteria used to determine addiction, the evidence for identifying assorted behaviors as addictions, and the evidence-based treatment for each.With contributions from preeminent experts covering an exhaustive list of behavioral addictions, this book is unique in its coverage of behavioral addictions, their criteria, and treatment. It is a valuable and timely resource for any clinician treating addictions. - A guide to understanding the new DSM-V designation of behavioral addiction - Defines the criteria for behavior to be considered an addiction designation - Discusses the evidence for behaviors meeting addiction criteria - Identifies what is now, likely will be, and is not a behavioral addiction per evidence - Discusses behaviors formerly considered impulse control disorders - Presents evidence-based treatment for each behavioral addiction

Clinical Addiction Psychiatry is an anthology of essays that represent the most current and authoritative information now available on addiction theory, practice and research, covering dozens of provocative, fascinating and essential subdomains of the field. Each chapter is authored by a recognized authority in the field and detailed attention is paid to environment, genetics, culture and spirituality as well as treatment and pharmacology. History, street culture, and medical science are brought together in masterful discussions that encompass the full spectrum of addictive disorders, emphasizing assessment and clinical management. This unique resource gathers complex medical and scientific data in a way which is accessible to both health care professionals and readers without medical or psychology backgrounds. Essential reading for addiction counselors and other mental health professionals, this book will also be of interest to patients and their families, and residents and physicians in all fields of medicine.

A NEW YORK TIMES BESTSELLER More people than ever before see themselves as addicted to, or recovering from, addiction, whether it be alcohol or drugs, prescription meds, sex, gambling, porn, or the internet. But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment. Challenging both the idea of the addict's "broken brain" and the notion of a simple "addictive personality," The New York Times Bestseller, Unbroken Brain, offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum -- and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no "addictive personality" or single treatment that works for all. Combining Maia Szalavitz's personal story with a distillation of more than 25 years of science and research,Unbroken Brain provides a paradigm-shifting approach to thinking about addiction. Her writings on radical addiction therapies have been featured in The Washington Post, Vice Magazine, The Wall Street Journal, and The New York Times, in addition to multiple other publications. She has been interviewed about her book on many radio shows including Fresh Air with Terry Gross and The Brian Lehrer show.