This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

Addiction Dilemmas “Professor Orford is one of the most distinguished researchers of addictions today. In this book he aims to counter the neglect and misunderstanding faced by families affected by addiction – an estimated one hundred million worldwide – and to highlight the personal, professional and public policy dilemmas. By drawing on personal accounts from fiction, autobiography and Professor Orford and his colleagues’ own international research ­programme, the voices of children, wives, grandparents and friends spring to life. The penetrating and sensitive commentary, and thought-provoking questions and exercises make this book invaluable for practitioners, ­researchers and family members. It demonstrates the many shared ­experiences of family members across continents and over time, whether alcohol, drug misuse or gambling is involved.” Judith Harwin, Professor of Social Work, Brunel University, UK Addiction Dilemmas explores the impact of addiction on those closest to the individuals affected – their families. Many barriers can stand in the way of family members receiving help, not least a lack of available services and a failure on the part of professionals and their organisations to fully ­appreciate the nature of the dilemmas which they face. This book is based on a combination of personal interviews from scientific research, accounts from biography and autobiography (featuring well-known names both past and present) and excerpts from well-informed works of literature. The book’s core theme is the stress faced by family members when a close relative has an addiction problem, and the struggles they experience in deciding how to cope. By tracing the same dilemmas through a range of contexts, Jim Orford offers unique insights to professionals who deal with people with addictions and their families, researchers, policy makers and ultimately family members themselves. Sources include The Tenant of Wildfell Hall by Anne Brontë, A Chancer by James Kelman, Long Day’s Journey into Night by Eugene O’Neill, and biographies of close relatives of Dylan Thomas and Samuel Taylor Coleridge.

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.

Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.

Meth, crank, ice, glass, fire, tina, chalk, crystal or crystal meth. Whatever you call it, it's the same thing. Addictive. Drugs ruin people's lives. I should know, they destroyed mine. I'm Hannah and I got hooked on ice. What started as a trickle, ended with a tsunami washing everything away; my family, my life. I'm not sure you're ready to read my story; it's real and confronting. Open the book, read the pages and see how easy it is for anyone to get addicted. Ice affects all types of people. It doesn't discriminate. It will SCREW. YOU. UP.

Drawing on two centuries of important literary and historical writings, Rebecca Shannonhouse has shaped a remarkable collection of works that are, in turn, tragic, compelling, hilarious, and enlightening. Together, these selections comprise a profound and truthful portrait of the life experience known as addiction. Under the Influence offers classic selections from fiction, memoirs, and essays by authors such as Tolstoy, Cheever, Parker, and Poe. Also included are topical gems by writers who illuminate the causes, dangers, pleasures, and public perceptions surrounding people consumed by excessive use of drugs, alcohol, and tobacco. Recent provocative works by Abraham Verghese, the Barthelme brothers, Margaret Bullitt-Jonas, and others expand and modernize the definition of addiction to include sex, gambling, and food. Together, these incomparable writings give shape and meaning to the raw experience of uncontrollable urges. Shannonhouse’s recent anthology, Out of Her Mind: Women Writing on Madness, is also available as a Modern Library Paperback.

This book explores the rise of the aesthetic category of addiction in the nineteenth century, a century that saw the development of an established medical sense of drug addiction. Drugs and the Addiction Aesthetic in Nineteenth-Century Literature focuses especially on formal invention—on the uses of literary patterns for intensified, exploratory engagement with unattained possibility—resulting from literary intersections with addiction discourse. Early chapters consider how Romantics such as Thomas De Quincey created, with regard to drug habit, an idea of habitual craving that related to self-experimenting science and literary exploration; later chapters look at Victorians who drew from similar understandings while devising narratives of repetitive investigation. The authors considered include De Quincey, Percy Shelley, Alfred Tennyson, Christina Rossetti, Charles Dickens, Robert Louis Stevenson, and Marie Corelli.

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.

"Gustave Flaubert's Madame Bovary takes up the problems of drugs and addiction in numerous ways, which Ronell unpacks and presents as exemplary of the contemporary fascination with extreme danger. For Ronnell, Emma Bovary represents the first addict, embodying a yearning that calls from the bottom of her depleted soul, and which places her in a chronic state of dissatisfaction."--BOOK JACKET.