Addiction Medicine
Encyclopedia
Addiction medicine is a medical specialty that deals with the treatment of addiction
. The specialty often crosses over into other areas, since various aspects of addiction fall within the fields of public health
, psychology
, social work
, psychiatry
, and internal medicine
, among others. Incorporated within the specialty are the processes of detoxification, rehabilitation
, harm reduction
, abstinence-based treatment, individual and group therapies, oversight of halfway house
s, treatment of withdrawal-related symptoms, acute intervention, and long term therapies designed to reduce likelihood of relapse . Some specialists, primarily those who also have expertise in family medicine
or internal medicine, also provide treatment for disease states commonly associated with substance use, such as hepatitis
and HIV infection.
Physicians specializing in the field are in general agreement concerning applicability of treatment to those with addiction to drugs, such as alcohol and heroin, and often also to gambling, which has similar characteristics and has been well described in the scientific literature. There is less agreement concerning definition or treatment of other so-called addictive behavior such as sexual addiction
and internet addiction, such behaviors not being marked generally by physiologic tolerance or withdrawal.
Doctors focusing on addiction medicine are medical specialists who focus on addictive disease and have had special study and training focusing on the prevention and treatment of such diseases. There are two routes to specialization in the addiction field: one via a psychiatric pathway and one via other fields of medicine. The American Society of Addiction Medicine
notes that approximately 40% of its members are psychiatrists while the remainder have received medical training in other fields.
In several countries around the world, specialist bodies have been set up to ensure high quality practice in addiction medicine. For example within the United States
, there are two accepted specialty examinations. One is a Certificate in Added Qualifications in Addiction Psychiatry from the American Board of Psychiatry and Neurology. The other is a certificate from the American Board of Addiction Medicine following a peer-reviewed Board-type examination. The latter approach is available to all physicians, while the former is available only to board-certified psychiatrists. The American Board of Addiction Medicine is not currently a member of the American Board of Medical Specialties. Osteopathic physicians may also seek board certification via the American Osteopathic Association (AOA). The Osteopathic physician must have a primary board certification in Family Practice, Psychiatry and Neurology or Internal Medicine from the American Osteopathic Association and complete an AOA approved addiction medicine fellowship. Successful completion of a board examination administered via the AOA will grant a certificate of added qualification (CAQ) in addiction medicine.
Within Australia, addiction medicine specialists are certified via the Chapter of Addiction Medicine, which is part of the Royal Australasian College of Physicians. They may alternatively be a member of the Section of Addiction Psychiatry, Royal Australian & New Zealand College of Psychiatrists.
The International Society of Addiction Medicine also can provide certification of expertise.
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
. The specialty often crosses over into other areas, since various aspects of addiction fall within the fields of public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
, psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
, social work
Social work
Social Work is a professional and academic discipline that seeks to improve the quality of life and wellbeing of an individual, group, or community by intervening through research, policy, community organizing, direct practice, and teaching on behalf of those afflicted with poverty or any real or...
, psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
, and internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
, among others. Incorporated within the specialty are the processes of detoxification, rehabilitation
Drug rehabilitation
Drug rehabilitation is a term for the processes of medical or psychotherapeutic treatment, for dependency on psychoactive substances such as alcohol, prescription drugs, and so-called street drugs such as cocaine, heroin or amphetamines...
, harm reduction
Harm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
, abstinence-based treatment, individual and group therapies, oversight of halfway house
Halfway house
The purpose of a halfway house, also called a recovery house or sober house, is generally to allow people to begin the process of reintegration with society, while still providing monitoring and support; this is generally believed to reduce the risk of recidivism or relapse when compared to a...
s, treatment of withdrawal-related symptoms, acute intervention, and long term therapies designed to reduce likelihood of relapse . Some specialists, primarily those who also have expertise in family medicine
Family medicine
Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...
or internal medicine, also provide treatment for disease states commonly associated with substance use, such as hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
and HIV infection.
Physicians specializing in the field are in general agreement concerning applicability of treatment to those with addiction to drugs, such as alcohol and heroin, and often also to gambling, which has similar characteristics and has been well described in the scientific literature. There is less agreement concerning definition or treatment of other so-called addictive behavior such as sexual addiction
Sexual addiction
Sexual addiction is a popular model to explain hypersexuality—sexual urges, behaviors, or thoughts that appear extreme in frequency or feel out of one's control...
and internet addiction, such behaviors not being marked generally by physiologic tolerance or withdrawal.
Doctors focusing on addiction medicine are medical specialists who focus on addictive disease and have had special study and training focusing on the prevention and treatment of such diseases. There are two routes to specialization in the addiction field: one via a psychiatric pathway and one via other fields of medicine. The American Society of Addiction Medicine
American Society of Addiction Medicine
The American Society of Addiction Medicine is a physician society with a focus on addiction and its treatment.- History :ASAM has its roots in research and clinical traditions that pre-date its founding in the early 1950s, when Ruth Fox, M.D. began regular meetings with other physicians interested...
notes that approximately 40% of its members are psychiatrists while the remainder have received medical training in other fields.
In several countries around the world, specialist bodies have been set up to ensure high quality practice in addiction medicine. For example within the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, there are two accepted specialty examinations. One is a Certificate in Added Qualifications in Addiction Psychiatry from the American Board of Psychiatry and Neurology. The other is a certificate from the American Board of Addiction Medicine following a peer-reviewed Board-type examination. The latter approach is available to all physicians, while the former is available only to board-certified psychiatrists. The American Board of Addiction Medicine is not currently a member of the American Board of Medical Specialties. Osteopathic physicians may also seek board certification via the American Osteopathic Association (AOA). The Osteopathic physician must have a primary board certification in Family Practice, Psychiatry and Neurology or Internal Medicine from the American Osteopathic Association and complete an AOA approved addiction medicine fellowship. Successful completion of a board examination administered via the AOA will grant a certificate of added qualification (CAQ) in addiction medicine.
Within Australia, addiction medicine specialists are certified via the Chapter of Addiction Medicine, which is part of the Royal Australasian College of Physicians. They may alternatively be a member of the Section of Addiction Psychiatry, Royal Australian & New Zealand College of Psychiatrists.
The International Society of Addiction Medicine also can provide certification of expertise.
See also
- American Society of Addiction MedicineAmerican Society of Addiction MedicineThe American Society of Addiction Medicine is a physician society with a focus on addiction and its treatment.- History :ASAM has its roots in research and clinical traditions that pre-date its founding in the early 1950s, when Ruth Fox, M.D. began regular meetings with other physicians interested...
- California Society of Addiction MedicineCalifornia Society of Addiction MedicineCalifornia Society of Addiction Medicine is the California organization of physicians who specialize in treating addiction. Addiction medicine is the medical specialty that provides care and treatment for people with substance use disorder...
Further reading
- Latt, Noeline; Katherine Conigrave, Jane Marshall, John Saunders, E. Jane Marshall, David Nutt (2009) Addiction medicine. Oxford: Oxford University Press.
- Psychedelic Medicine: New Evidence for Hallucinogens as Treatments Vol. 2. Michael J. Winkelman and Thomas B. Roberts (editors) (2007). Westport, CT: Praeger/Greenwood. Chapter 1, Halpern, John H. "Hallucinogens in the Treatment of Alcoholism and Other Addictions," Chapter 2, Yensen, Richard, and Dryer, Donna, "Addiction, Despair, and the Soul: Successful Psychedelic Psychotherapy: A Case Study," Chapter 3. Calabrese, Joseph D. "The Therapeutic Use of Peyote in the Native American Church," Chapter 4. Alper, R. Kenneth, and Lotsof, Howard S. "The Use of Ibogaine in the Treatment of Addictions," Chapter 5. Krupitsky, Evgeny, and Kolp, Eli. "Ketamine Psychedelic Psychotherapy." Chapter 6. Mabit, Jacques. "Ayahuasca in the Treatment of Addictions".