Addiction
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This paper reviews international issues in the supply of tobacco and tobacco products, including trade liberalization and globalization. The paper begins with a brief discussion of the theoretical foundations for trade and trade restrictions. ⋯ The implications of two recently proposed international agreements--the Multilateral Agreement on Investments and the Framework Convention for Tobacco Control--are then discussed. The paper concludes by summarizing the theoretical and empirical evidence that shows clearly that trade liberalization has significantly increased tobacco use, particularly in low and middle-income countries, and follows this with a discussion of the lessons learned from tobacco for controlling alcohol supply.
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To examine rates and patterns of marijuana and other illicit drug use among different types of students and colleges in 1999, and changes in use since 1993. ⋯ Use of marijuana and other illicit drugs has increased on campuses across the United States in most student subgroups and all types of colleges. This may reflect earlier increases in middle schools and secondary schools among this cohort. However, nearly one-third of students initiated marijuana use in college and one of three began to use it regularly. Intervention efforts should be directed at college students, as well as secondary school students.
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Comparative Study
The characteristics of 'new users' of cocaine and heroin unknown to treatment agencies: results from the Swiss Hidden Population Study.
To examine the characteristics of 'new users' (i.e. first use not more than 5 years before interview) of heroin or cocaine currently unknown to treatment agencies in Switzerland, compared to 'new users' who are in treatment, as well as to 'experienced users' (i.e. first use more than 5 years before interview). ⋯ Some of the 'new users' unknown to treatment agencies can be considered as being in need of assistance. Efforts to enhance the treatment on offer should be continued. Drug users should be provided with better knowledge of how to identify signs for problem drug use and need for assistance.
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The question of addiction specifically concerns (1), the process by which drug-taking behavior, in certain individuals, evolves into compulsive patterns of drug-seeking and drug-taking behavior that take place at the expense of most other activities and (2), the inability to cease drug-taking; the problem of relapse. In this paper current biopsychological views of addiction are critically evaluated in light of the "incentive-sensitization theory of addiction", which we first proposed in 1993, and new developments in research are incorporated. ⋯ These are: (1) Potentially addictive drugs share the ability to produce long-lasting adaptations in neural systems. (2) The brain systems that are changed include those normally involved in the process of incentive motivation and reward. (3) The critical neuroadaptations for addiction render these brain reward systems hypersensitive ("sensitized") to drugs and drug-associated stimuli. (4) The brain systems that are sensitized do not mediate the pleasurable or euphoric effects of drugs (drug "liking"), but instead they mediate a subcomponent of reward we have termed incentive salience (drug "wanting"). We also discuss the role that mesolimbic dopamine systems play in reward, evidence that neural sensitization happens in humans, and the implications of incentive-sensitization for the development of therapies in the treatment of addiction.