Substance Abuse and

Cowley DS Alcohol abuse, substance abuse, and panic disorder. Am J Med 92(suppl) 41S 8S, 1992... 

Substance Abuse and Mental Health Services Administration Results from the 2002 National Survey on Drug Use and Health National Findings (DHHS Publ No SMA 03-3836). Rockville, MD, Substance Abuse and Mental Health Services Administration, 2003. Available at http //oas.samhsa.gov/nhsda/2k2nsduh/ Results/2k2Results.htm chap3. Accessed November 5, 2004. 

Sullivan LE, O Connor PC Medical disorders in substance abuse patients, in Dual Diagnosis and Psychiatric Treatment Substance Abuse and Comorbid Disorders, 2nd Edition. Edited by Kranzler HR, Tinsley JA. New York, Marcel Dekker, 2004, pp 515-553... 

McNicholas L, Howell EF Buprenorphine Clinical Practice Guidelines, Field Review Draft November 17, 2000. Rockville, MD, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Office of Pharmacologic and Alternative Therapies, 2000... 

Source. From the results of the 2002 National Survey on Drug Use and Health (Substance Abuse and Mental Health Services Administration 2003). 

Substance Abuse and Mental Health Services Administration Treatment episode data set (TEDS), 1999. Available at http //www.icpsr.umich.edu/cocoon/ICPSR STUDY/03314.xml. Accessed Feburary 13, 2004... 

J Consult Clin Psychol 61 1100—1104, 1993 Stephens RS, Roffman RA, Simpson EE Treating adult marijuana dependence a test of the relapse prevention model. J Consult Clin Psychol 62 92—99, 1994 Stephens RS, Roffman RA, Curtin L Comparison of extended versus brief treatments for marijuana use. J Counsul Clin Psychol 68 898—908, 2000 Substance Abuse and Mental Health Services Administration The BASIS Report Marijuana Treatment Admissions Increase 1993-1999. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002a Substance Abuse and Mental Health Services Administration Results from the 2001 National Household Survey on Brug Abuse Vol I. Summary of National Findings. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2002b... 

Substance Abuse and Mental Health Services Administration The BASIS Report Marijuana Use Secondary to Other Substances of Abuse. Rockville, MB, Substance Abuse and Mental Health Services Administration, 2003 Tanda G, Munzar P, Goldberg SR Self-administration behaviour is maintained by the psychoactive ingredient of marijuana in squirrel monkeys. Nat Neurosci 3 1073— 1074, 2000... 

People who abuse inhalants are found in both urban and rural settings. Adverse socioeconomic conditions, rather than racial or cultural factors per se, account for most reported ethnic differences in rates of inhalant abuse. Native American youths living on reservations typically have higher rates of inhalant abuse than youths both in the general population and among Native Americans who do not live on reservations (Substance Abuse and Mental Health Services Administration 1996). 

Abused drugs generally produce pleasant effects that are desired by the user. However, while most individuals will experience these pleasant effects, not everyone abuses these drugs, and not everyone who abuses them becomes dependent on them. Why some persons abuse drugs while most people do not is a complex area of research. It appears that genetic, environmental, and cultural factors may all interact to predispose some individuals to substance abuse and subsequent dependence. The initial hedonic experiences secondary to use of drugs appear to be primarily due to their ability to activate the primary reward circuits in the brain. These same reward circuits operate under normal circumstances to reinforce certain activities that promote survival, such as food, social affiliation, or sexual activity. 

Overall, intoxication with any of the substances discussed above is evidence of substance abuse and is strongly suggestive of substance dependence. In all cases it is important to strongly emphasize to the patient that this is an issue that needs to be addressed, and that entry into a treatment program could be very beneficial. 

Important outcome indicators to evaluate postintoxication and/or postwithdrawal treatment of substance abuse and dependence can be divided into three major groups decreased consumption of substances, decreased problems associated with substance use, and increased psychosocial functioning. Although it is less commonly employed, a quality-of-life scale can help determine how substance abuse/dependence treatment has affected your patients lives. If you are involved in the cost-justification of services, a cost-benefit analysis could also become important, although this is more often used at the administrative level,... 

The mean age of onset of bipolar disorder is 20, although onset may occur in early childhood to the mid-40s.1 If the onset of symptoms occurs after 60 years of age, the condition is probably secondary to medical causes. Early onset of bipolar disorder is associated with greater comorbidities, more mood episodes, a greater proportion of days depressed, and greater lifetime risk of suicide attempts, compared to bipolar disorder with a later onset. Substance abuse and anxiety disorders are more common in patients with an early onset. Patients with bipolar disorder also have higher rates of suicidal thinking, suicidal attempts, and completed suicides. 

Bipolar I disorder affects men and women equally bipolar II seems to be more common in women. Rapid cycling and mixed mania occur more often in women. Individuals with bipolar disorder commonly have another psychiatric disease with 78% to 85% reporting another Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnosis during their lifetime. The most common comorbid conditions include anxiety, substance abuse, and eating disorders.2... 

Encourage a healthy lifestyle, including eliminating or stopping substance abuse and smoking, and encouraging proper nutrition and exercise. 

Controversy over substance abuse and growth delay with stimulant therapy. 

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