Treatment for Substance Use Disorder: Opportunities and Challenges Under the Affordable Care Act.

Treatment for Substance Use Disorder: Opportunities and Challenges under the Affordable Care Act.

Soc Work Public Health. 2013 May; 28(3-4): 165-74
Tai B, Volkow ND

Addiction is a chronic brain disease with consequences that remain problematic years after discontinuation of use. Despite this, treatment models focus on acute interventions and are carved out from the main health care system. The Patient Protection and Affordable Care Act (2010) brings the opportunity to change the way substance use disorder (SUD) is treated in the United States. The treatment of SUD must adapt to a chronic care model offered in an integrated care system that screens for at-risk patients and includes services needed to prevent relapses. The partnering of the health care system with substance abuse treatment programs could dramatically expand the benefits of prevention and treatment of SUD. Expanding roles of health information technology and nonphysician workforces, such as social workers, are essential to the success of a chronic care model. HubMed – addiction


The many roles of social workers in the prevention and treatment of alcohol and drug addiction: a major health and social problem affecting individuals, families, and society.

Soc Work Public Health. 2013 May; 28(3-4): 159-64
Daley DC, Feit MD

HubMed – addiction


Interoceptive conditioning with a nicotine stimulus is susceptible to reinforcer devaluation.

Behav Neurosci. 2013 Jun; 127(3): 465-73
Pittenger ST, Bevins RA

Pavlovian conditioning processes contribute to the etiology of nicotine dependence. Conditioning involving interoceptive stimuli is increasingly recognized as playing a role in many diseases and psychopathologies, including drug addiction. Previous animal research on diminishing the influence of interoceptive conditioning has been limited to antagonism and nonreinforced exposures to the drug stimulus. The goal of the present research was to determine whether interoceptive conditioning with a nicotine stimulus could be diminished through an unconditioned stimulus (US) devaluation procedure. In two separate experiments, male Sprague-Dawley rats received nicotine injections (0.4 mg base/kg) followed by intermittent sucrose (26%) access in a conditioning chamber. On intermixed saline sessions, sucrose was withheld. Conditioning was demonstrated by a reliable increase in head entries in the dipper receptacle on nicotine versus saline sessions. After conditioning, rats in a devaluation condition were given access to sucrose in their home cages immediately followed by a lithium chloride (LiCl) injection on 3 consecutive days. On subsequent test days, nicotine-evoked conditioned responding was significantly attenuated. Within-subject (Experiment 1) and between-subjects (Experiment 2) controls revealed that the diminished responding was not attributable to mere exposure to the sucrose US in the devaluation phase. Experiment 2 included a LiCl-alone control group. Repeated illness induced by LiCl did not reduce later nicotine-evoked responding. These findings suggest that there is a direct association between the interoceptive stimulus effects of nicotine and the appetitive sucrose US (i.e., stimulus-stimulus) rather than a stimulus-response association. (PsycINFO Database Record (c) 2013 APA, all rights reserved). HubMed – addiction


A cultural change in the management of mental illness.

Addiction. 2013 Jun 4;
Rashid MA

HubMed – addiction



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