Precision in Addiction Care: Does It Make a Difference?

Jaap van der Stel, Jaap van der Stel

Abstract

This perspective article explores the possibilities of precision in addiction care -- even better individually fitted or tailor-made care -- and examines what changes we need to make in order to realize sensible progress in epidemiological key figures. The first part gives a short review on the development of addiction care and tries to answer the question of where we stand now and what has been achieved in addiction science through the development and evaluation of interventions in the past decades. Following this analysis, attention will be paid to what lies ahead. This second part focuses on the question of how addiction care can deal with the consequences of the emerging paradigm of personalized or precision medicine, which is based on the fundamental assumption that individual differences matter. Finally, some limitations and conditions as well as tasks and goals for progress are raised. In conclusion, it is argued that integration of addiction care in (mental) health care in the future is desirable.

Keywords: addiction; addiction care; personalized medicine; precision.

References

    1. Rehm J, Marmet S, Anderson P, Gual A, Kraus L, Nutt DJ. et al. Defining substance use disorders: do we really need more than heavy use? Alcohol Alcohol. 2013;48(6):633–640.
    1. Schippers GM, Broekman TG. The course of alcohol dependence; the course of drug dependence. State of the art reports for ZonMw Program Addiction. Den Haag: ZonMw; 2006.
    1. Heyman GM. Quitting drugs: quantitative and qualitative features. Annu Rev Clin Psychol. 2013;9:29–59.
    1. Risks to mental health: an overview of vulnerabilities and risk factors. Background paper by WHO secretariat for the development of a comprehensive mental health action plan. World Health Organization [Internet] 2012. Aug 27, Available from: .
    1. Stone AL, Becker LG, Heyman AM, Catalano RF. Review of risk and protective factors of substance use and problem use in emerging adulthood. Addict Behav. 2012;37(7):747–775.
    1. Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse [Internet] 2014. Available from: .
    1. World Drug Report. United Nations Office on Drugs and Crime [Internet] 2015. Available from: .
    1. Comorbidity: Addiction and Other Mental Illnesses. Research Report Series. National Institute on Drug Abuse [Internet] 2010. Available from: .
    1. Smith DE. The evolution of addiction medicine as a medical specialty. Virtual Mentor. 2011;13(12):900–905.
    1. Jellinek EM. The disease concept of alcoholism. New Haven: Hillhouse; 1960.
    1. White WL. Slaying the dragon: the history of addiction treatment and recovery in America. Bloomington, IL: Chestnut Health Systems; 2014.
    1. Koob GF, Simon EJ. The Neurobiology of addiction: where we have been and where we are going. J Drug Issues. 2009;39(1):115–132.
    1. Wise RA, Koob GF. The development and maintenance of drug addiction. Neuropsychopharmacology. 2014;39(2):254–262.
    1. Volkow ND, Baler RD. Addiction science: uncovering neurobiological complexity. Neuropharmacology. 2014;76 Pt B:235–249.
    1. Olds J, Milner P. Positive reinforcement produced by electrical stimulation of septal area and other regions of rat brain. J Comp Physiol Psychol. 1954;47(6):419–427.
    1. Wise RA. Addictive drugs and brain stimulation reward. Annu Rev Neurosci. 1996;19:319–340.
    1. Robinson TE, Berridge KC. Review. The incentive sensitization theory of addiction: some current issues. Philos Trans R Soc Lond B Biol Sci. 2008;363(1507):3137–3146.
    1. Jentsch JD, Taylor JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology (Berl) 1999;146(4):373–390.
    1. Koob GF. Negative reinforcement in drug addiction: the darkness within. Curr Opin Neurobiol. 2013;23(4):559–563.
    1. George O, Koob GF. Individual differences in prefrontal cortex function and the transition from drug use to drug dependence. Neurosci Biobehav Rev. 2010;35(2):232–247.
    1. Marsch LA, Dallery J. Advances in the psychosocial treatment of addiction: the role of technology in the delivery of evidence-based psychosocial treatment. Psychiatr Clin North Am. 2012;35(2):481–493.
    1. Van den Brink W. Evidence-based pharmacological treatment of substance use disorders and pathological gambling. Curr Drug Abuse Rev. 2012;5(1):3–31.
    1. Pilowsky DJ, Wu LT. Screening instruments for substance use and brief interventions targeting adolescents in primary care: a literature review. Addict Behav. 2013;38(5):2146–2153.
    1. Harris SK, Louis-Jacques J, Knight JR. Screening and brief intervention for alcohol and other abuse. Adolesc Med State Art Rev. 2014;25(1):126–156.
    1. Borsari B. Universal prevention for alcohol use disorders: 1940-2014. J Stud Alcohol Drugs Suppl. 2014;75 Suppl 17:89–97.
    1. Faggiano F, Minozzi S, Versino E, Buscemi D. Universal school-based prevention for illicit drug use. Cochrane Database Syst Rev. 2014;12:CD003020.
    1. Epidemiologic Trends in drug Abuse. Proceedings of the Community Epidemiology Work Group. Volume I Highlights and Executive Summary. U.S. Department of Health and Human Services National Institutes of Health. National Institute on Drug Abuse [Internet] 2009. Available from: .
    1. Merikangas KR, McClair VL. Epidemiology of substance use disorders. Hum Genet. 2012;131(6):779–789.
    1. Rehm J, Allamani A, Aubin HJ, Della Vedova R, Elekes Z, Frick U. et al. People with alcohol use disorders in specialized care in eight different European countries. Alcohol Alcohol. 2015;50(3):310–318.
    1. Liechti M. Novel psychoactive substances (designer drugs): overview and pharmacology of modulators of monoamine signaling. Swiss Med Wkly. 2015;145:w14043.
    1. Suh JJ, Pettinati HM, Kampman KM, O’Brien CP. The status of disulfiram: a half of a century later. J Clin Psychopharmacol. 2006;26(3):290–302.
    1. Lin SK. Pharmacological means of reducing human drug dependence: a selective and narrative review of the clinical literature. Br J Clin Pharmacol. 2014;77(2):242–252.
    1. Marazziti D, Presta S, Baroni S, Silvestri S, Dell’Osso L. Behavioral addictions: a novel challenge for psychopharmacology. CNS Spectr. 2014;19(6):486–495.
    1. Kreek KJ, Vocci FJ. History and current status of opioid maintenance treatments: blending conference session. J Subst Abuse Treat. 2002;23(2):93–105.
    1. Uchtenhagen AA. Heroin maintenance treatment: from idea to research to practice. Drug Alcohol Rev. 2011;30(2):130–137.
    1. Podymow T, Turnbull J, Coyle D, Yetisir E, Wells G. Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol. CMAJ. 2006;174(1):45–49.
    1. Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York: Guilford Press; 2013.
    1. Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM. et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295(17):2003–2017.
    1. Miller WR. Are alcoholism treatments effective? The Project MATCH data: response. BMC Public Health. 2005;5:76.
    1. Fischer T, Langanke M, Marschall P, Michl S, editors. Individualized medicine. Ethical, economical and historical perspectives. Springer; 2015.
    1. Jain KK. Textbook of personalized medicine. Dordrecht: Springer; 2009.
    1. Hendriks V, van der Schee E, Blanken P. Matching adolescents with a cannabis use disorder to multidimensional family therapy or cognitive behavioral therapy: treatment effect moderators in a randomized controlled trial. Drug Alcohol Depend. 2012;125(1-2):119–126.
    1. Karpyak VM, Biernacka JM, Geske JR, Jenkins GD, Cunningham JM, Rüegg J. et al. Genetic markers associated with abstinence length in alcohol-dependent subjects treated with acamprosate. Transl Psychiatry. 2014;4:e462.
    1. Batki SL, Pennington DL. Toward personalized medicine in the pharmacotherapy of alcohol use disorder: targeting patient genes and patient goals. Am J Psychiatry. 2014;171(4):391–394.
    1. Bierut LJ, Johnson EO, Saccone NL. A glimpse into the future: personalized medicine for smoking cessation. Neuropharmacology. 2014;76 Pt B:592–599.
    1. Lee HY, Li JH, Sheu YL, Tang HP, Chang WC, Tang TC. et al. Moving toward personalized medicine in the methadone maintenance treatment program: a pilot study on the evaluation of treatment responses in Taiwan. Biomed Res Int. 2013;2013:741403.
    1. Noël X, Brevers D, Bechara A. A triadic neurocognitive approach to addiction for clinical interventions. Front Psychiatry. 2013;4:179.
    1. Becker HC. Kindling in alcohol withdrawal. Alcohol Health Res World. 1998;22(1):25–33.
    1. Stephens DN, Duka T. Review. Cognitive and emotional consequences of binge drinking: role of amygdala and prefrontal cortex. Philos Trans R Soc Lond B Biol Sci. 2008;363(1507):3169–3179.
    1. Bewley-Taylor DR. International drug control: consensus fractured. Cambridge: Cambridge University Press; 2012.
    1. Uitermark J. The origins and future of the Dutch approach towards drugs. J Drug Issues. 2004;34:511–532.
    1. Leshner AI. Addiction is a brain disease, and it matters. Science. 1997;278(5335):45–47.
    1. Mueser KT, Gingerich S. Treatment of co-occurring psychotic and substance use disorders. Soc Work Public Health. 2013;28(3-4):424–439.
    1. Torrens M, Rossi PC, Martinez-Riera R, Martinez-Sanvisens D, Bulbena A. Psychiatric co-morbidity and substance use disorders: treatment in parallel systems or in one integrated system? Subst Use Misuse. 2012;47(8-9):1005–1014.
    1. Morisano D, Babor T, Robaina KA. Co-occurrence of substance use disorders with other psychiatric disorders: implications for treatment services. Nordic Studies on Alcohol and Drugs. 2014;31:5–25.
    1. Ehrlich C, Kendall E, Frey N, Kisely S, Crowe E, Crompton D. Improving the physical health of people with severe mental illness: boundaries of care provision. Int J Ment Health Nurs. 2014;23(3):243–251.
    1. Van der Stel J. In: Co-occurring addictive and psychiatric disorders. Dom G, Moggi F, editors. Heidelberg: Springer; 2015. Evolution of mental health and addiction care systems in Europe; pp. 13–26.

Source: PubMed

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