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Over the past three decades, gambling has been the nation's fastest growing industry. Although there is now some leveling off, states are still turning to legalized gambling to address financial problems without having to raise taxes. In addition, there is new technology that produces more rapidly addicting games. States are accepting some responsibility and, as of this writing, 12 of them have funded some programs in public education, research, training, and treatment. Although there are only a half dozen inpatient programs and very few qualified counselors and therapists, we can anticipate the development of clinics, residential programs, halfway houses, and alternative sentencing programs. The National Council on Problem Gambling has developed guidelines for the certification of gambling counselors. In addition to the training of mental health professionals, workshops are needed for attorneys, judges, probation and parole officers, and prison administrators. Initially, the task of assessing and diagnosing the pathological gambler was left to a small number of experts. Starting with DSM-IV, there will be clear and reliable criteria available to the professional community. These criteria, which are the product of thorough testing, should easily discriminate the pathological gambler from other types of gamblers. Most of what we have learned about pathological gambling has come in the last 5 years. A major impetus for research has been the Journal of Gambling Studies, which began publication in 1985. A review of the nature and course of the disorder, including the studies of criminal behavior, leads one to conclude that the majority of pathological gamblers (at least 70% to 80%) commit offenses late in the disorder and that these offenses are strictly gambling related. This is a population which is essentially nonviolent and which turns to property crimes out of desperation over gambling losses and their sequelae. The minority (in one study 14%) of gamblers with antisocial personality disorder--the group for whom treatment would be least likely to be effective--can be recognized easily both by the pattern of offenses and by diagnostic criteria for antisocial personality. Once this group is excluded, treatment for the others, in combination with restitution, community service, and some form of monitoring, would seem beneficial both for the individual and for society. Once they have stopped gambling, pathological gamblers are frequently hard-working people, whose mathematical skills and intelligence, high energy, and need to excel make them extremely valuable at their jobs. The alternative, imprisonment, may very well reinforce the disorder.(ABSTRACT TRUNCATED AT 400 WORDS)
Drug and alcohol seeking behaviour has become a great global problem affecting millions of inhabitants with a cost to society in the billions. Dopaminergic reward pathways have frequently been implicated in the etiology of addictive behaviour. While other neurotransmitters have also been implicated, to date the only molecular genetic defect which has been found to associate with alcoholism, drug dependency, obesity, smoking, pathological gambling, attention-deficit-hyperactivity disorder (ADHD), Tourette syndrome, as well as other related compulsive behaviours, are the variants of the dopamine D2 receptor gene (DRD2). In this review of the available data on the subject, we report a number of independent meta-analyses that confirm an association of DRD2 polymorphisms and impulsive-additive-compulsive behaviour (IACB), which we have termed "Reward Deficiency Syndrome". While we agree that Meta-analyses of all exant studies support an association of variants of DRD2 and IACB, correct negative findings with alcoholism may be due to differences in assessing controls and inclusion/exclusion criteria for selection of diseased probands.
Trends over the past decade have shown that online counseling has grown in terms of popularity among consumers and clinicians alike; however, little, if any empirical evidence exists that examines client attitudes towards online counseling as alternative to traditional face-to-face therapy. Therefore, this study investigated client attitudes towards online counseling. Data was collected from 48 e-clients who received online counseling at the Center for Online Addiction. Variables such as client perceptions and concerns about using online counseling, clients' reasons for seeking online counseling over in-office treatment, and demographic profiles of e-clients were assessed. Results suggested that Caucasian, middle-aged males, with at least a four-year bachelors degree were most likely to use online counseling and anonymity, convenience, and counselor credentials were the most cited reasons they sought online counseling over in-office treatment. The lack of perceived privacy and security during online chat sessions and the fear of being caught while conducting online sessions were the main concerns reported by e-clients. A better understanding of client motives and perceptions towards online counseling helps to guide treatment in using the Internet as a clinical tool, especially as the Internet becomes increasingly more available in previously remote markets and the field of online counseling continues to grow.
The additive drugs alcohol, morphine, cocaine, and amphetamine are each associated with the development of tolerance and physical dependence. Changes in gene expression occur in cell culture and in vivo with the administration of these centrally-acting drugs. This article reviews those experiments that have studied drug-induced alterations in gene transcription. Ethanol has diverse effects on the amounts of messenger RNA molecules within the central nervous system. Ion channels, neuropeptides, membrane receptors, and immediate early genes represent several regulated mRNAs. The effects are selective, however, as many other specific products are not altered. Evidence for a genetic predisposition to ethanol use reinforces the importance of the genotype. Opioids, cocaine, and amphetamine also affect gene transcription. Messenger RNAs studied have included many of those demonstrated to be altered by alcohol use. Interestingly, use of any of these drugs alters the expression of immediate early genes. These genes may represent an initial step in the pathway that leads to drug addiction. The composite of drug-induced changes in gene expression results in the cellular responses of tolerance and dependence. The characterization of these changes should provide a better understanding of the molecular mechanisms of drug addiction.
Various dopaminergic drugs have been studied for their efficacy in the treatment of cocaine addiction. Pretreatment with either selective dopamine D1 receptor agonists or selective dopamine D2 receptor antagonists prevents reinstatement of cocaine-seeking in animal models of drug craving and relapse. We tested a novel ergoline derivative with combined D1 agonistic and D2 antagonistic effects, 9,10-didehydro- N-methyl- N-(2-propynyl)-6-methyl-8beta-aminomethylergoline bimaleate (LEK-8829), for its effects on cocaine-seeking in the intravenous cocaine self-administration model in rats. Pretreatment with systemic injections of LEK-8829 attenuated reinstatement of cocaine-seeking induced by cocaine priming injections and diminished cocaine intake in cocaine self-administration sessions. LEK-8829 itself did not induce reinstatement of cocaine-seeking and did not maintain intravenous self-administration. The results of our study indicate that LEK-8829 is a candidate medication for the treatment of cocaine craving in cocaine addiction.
The Internet Addiction Scale (IAS) is a self-report instrument based on the 7 Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) substance dependence criteria and 2 additional criteria recommended by Griffiths (1998). The IAS was administered to 233 undergraduates along with 4 measures pertaining to loneliness and boredom proneness. An item reliability analysis reduced the initial scale from 36 to 31 items (with a Cronbach's alpha of .95). A principal-components analysis indicated that the IAS consisted mainly of one factor. Multiple regression analyses revealed that Family and Social Loneliness and Boredom Proneness were significantly correlated with the IAS; Family and Social Loneliness uniquely predicted IAS scores. No evidence for widespread Internet addiction was found.
Extraversion has been suggested as a factor associated with addiction. This claim was tested in relation to exercise addiction. Twelve exercise addicts were compared with 12 nonaddicted individuals who were committed to regular exercise and with 12 nonexercising individuals drawn from the same student population. Addicted exercisers did not differ from nonaddicted exercisers in extraversion, although exercisers as a group were more extraverted than nonexercisers. The results are interpreted as evidence against the claim that extraversion is a component of the addictive personality profile.
AIMS: The purpose of the present study was to examine differences between frequent, infrequent and non-gamblers in autonomic arousal, as indexed by heart rate, while playing a fruit machine and controlling for the confounding effect of movement. DESIGN: The experiment employed a between-subjects design, with a total of three groups being investigated-two experimental groups (frequent and infrequent gamblers) and a control group (non-gamblers). SETTING: To enhance ecological validity the study took place within an actual gambling setting, in Glasgow city centre. PARTICIPANTS: A total of 63 participants, 21 for each of the three groups, who were matched for age and gender, took part in the study. MEASUREMENTS: In terms of autonomic arousal, measurements were taken using a Pulse Oximeter (Pulsox-3I-Minolta Company Limited Milton Keynes, UK). In addition, a questionnaire was employed to measure levels of gambling severity (SOGS). FINDINGS: Frequent gamblers were found to have significantly higher levels of autonomic arousal than infrequent and non-gamblers, with the frequent gamblers arousal levels continuing to rise after play, unlike the other two groups. Interestingly, novel findings to arise from this research involved the fact that the specialist play characteristics of the fruit machine, such as bonuses, nudges and features, were found to be as arousing as wins. CONCLUSIONS: The main hypothesis was supported, suggesting that arousal is indeed a key factor in fruit machine gambling. The research has value, as few studies have examined specifically the differences between frequent, infrequent and non-gamblers, and no studies have investigated the arousal associated with the actual dynamics of fruit machine play (i.e. bonuses, nudges, features, wins). The arousal associated with modern British fruit machines suggests a high potential for addiction.
BACKGROUND: Exercise addiction is not routinely screened for probably because available instruments take a long time to administer, their scoring may be complicated, and their interpretation is not always obvious. A new psychometric instrument has been developed that is capable of identifying people affected by, or at risk of, exercise addiction: the exercise addiction inventory (EAI). A preliminary report showed the EAI had good reliability and validity. OBJECTIVES: To test further the EAI's psychometric properties and show that it would be quick and simple to administer by general practitioners. METHODS: A sample of 200 habitual exercisers were given the EAI and two existing exercise addiction scales (obligatory exercise questionnaire; exercise dependence scale). Two weeks later, another sample of 79 exercisers were administered the EAI to determine the test-retest reliability of the questionnaire. RESULTS: The original data from the preliminary report were reanalysed to determine the split half correlation of the EAI. This was found to be 0.84 (Guttman split-half coefficient). A correlation between weekly frequency of exercising and EAI scores was also determined, and it was found that the two variables shared 29% of the variance (r2 = 0.29). The test-retest reliability of the scale was found to be very good (0.85). CONCLUSIONS: The EAI is a valid and reliable tool which would be capable of helping general practitioners to quickly and easily identify people affected by, or at risk of, exercise addiction.
In 1986, the Surgeon General concluded that smokeless tobacco is an addictive drug sharing many qualities with other drugs of abuse such as morphine and cocaine. Smokeless tobacco can be used to deliver psycho-active and dependence-producing levels of nicotine. Tolerance develops with repeated use, causing the user to increase nicotine dosing through increased use and/or switching to products with higher nicotine yields. Clinical signs of nicotine withdrawal develop upon cessation of use. Recent data show that smokeless tobacco products vary widely in their nicotine dosing capabilities. Low-dose products tend to be those commonly marketed toward, and used by, young people without previous smokeless tobacco experience. Many of these people develop dependence and switch to high-dose products. The present article discusses each of these qualities of smokeless tobacco in greater detail. The article also discusses qualities of smokeless tobacco that make it an effective nicotine delivery device that leads to addiction.