| Occupation | |
|---|---|
| Names | Addictionist/Addictionologist,[1][2]
|
Occupation type | Specialty |
Activity sectors | Medicine |
| Description | |
Education required |
|
Fields of employment | Hospitals,Clinics |
 | This articleneeds morereliable medical references forverification or relies too heavily onprimary sources. Please review the contents of the article andadd the appropriate references if you can. Unsourced or poorly sourced material may be challenged andremoved.Find sources: "Addiction medicine" – news ·newspapers ·books ·scholar ·JSTOR(March 2017) |
Addiction medicine is a medical subspecialty that deals with the diagnosis, prevention, evaluation, treatment, andrecovery of persons withaddiction, of those withsubstance-related andaddictive disorders, and of people who show unhealthy use of substances includingalcohol,nicotine,prescription medicine and other illicit and licit drugs.[3] The medical subspecialty often crosses over into other areas, since various aspects of addiction fall within the fields ofpublic health,psychology,social work,mental health counseling,psychiatry, andinternal medicine, among others. Incorporated within the specialty are the processes ofdetoxification,rehabilitation,harm reduction,abstinence-based treatment, individual and group therapies, oversight ofhalfway houses, treatment ofwithdrawal-related symptoms, acute intervention, and long term therapies designed to reduce likelihood of relapse. Some specialists, primarily those who also have expertise infamily medicine or internal medicine, also provide treatment for disease states commonly associated with substance use, such ashepatitis andHIV infection.[4]
Physicians specializing in the field are in general agreement concerning applicability of treatment to those with addiction to drugs, such asalcohol andheroin, and often also togambling, 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 assexual addiction andinternet addiction, such behaviors not being marked generally by physiologic tolerance or withdrawal.
Over centuries,addiction has been recognized as an issue to be treated, and has been addressed with the creation of a multitude of organizations, the passage of certain acts, and the development of various drugs in the medical field all to help those who struggle with addiction.[5]
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. TheAmerican Society of Addiction Medicine notes that approximately 40% of its members are psychiatrists (MD/DO) while the remainder have received primary medical training in other fields.[6][failed verification]
Addiction first became well known and seen as a major issue between the 1750s and early 1800s with alcoholism running rampant and being the main contributor to this.Dr. Benjamin Rush first began to discern alcoholism as an illness to be addressed when he published his writing “Inquiry into the Effects of Ardent Spirits on the Human Mind and Body” in 1784. Because of his writing of alcoholism, the beginnings of thetemperance movement came shortly after in the early 1800s.[7]
The first inebriate homes for alcoholics opened around the 1850s. These homes and asylums provided a segregated place for alcoholics to stay while they withdrew from the alcohol, along with integration into sobriety groups. In 1864, Dr. Joseph Edward Turner opened theNew York State Inebriate Asylum, which was the first rehabilitation center for alcoholism.[8] In the late 1800s, around 1890, alcoholics were sent tohospital wards anddrunk tanks, as inebriate homes began shutting down.
Throughout the first half of the 1900s, many hospitals and organizations opened to assist addicts, such as theCharles B. Towns substance abuse Hospital (1901), the Emmanuel Clinic/theEmmanuel movement (1906), morphine maintenance clinics (1919-1924),narcotics farms (1935),Alcoholics Anonymous (1935), etc.[9] In addition to this, certain state laws were passed to try to sterilize disabled people, addicts, and people with mental disorders (1910). During this time, various drugs also came out to attempt to curealcoholism likebarbiturates,amphetamines,LSD, anddisulfiram (1948-1950).
Within these years, multiple advancements were made, certain laws or acts were passed, and more organizations came about to help people with addiction. In 1957, treatment units for alcoholics were developed by theVeterans Administration. Shortly thereafter, a multitude of associations opened. These include but are not limited to theHalfway House Association (1958), theBetty Ford Clinic (1982),Cocaine Anonymous (1982), Secular Organizations for Sobriety and Rational Recovery (1985-1986), andSMART Recovery (1994). Along with that, drugs likemethadone (1964),Narcan (1971), andnaltrexone (1994), were developed to fight against opioid withdrawal and alcoholism. As for the legal side of things, theControlled Substances Act passed in 1970,[10] which classified all controlled substances into five classes, and theDrug Addiction Treatment Act passed in 1999, enforcing a stricter version of the Controlled Substances Act.
In the past 25 years, further developments have been made in the field of addiction medicine such as theFDA approval of a treatment calledbuprenorphine for opioid use disorder, along with The Mental Health Parity and Addiction Equity Act (2008) and theAffordable Care Act (2010) being passed. The MHPAEA of 2008 made it mandatory for insurance organizations to give people coverage for the cost of substance abuse related treatments,[11] while the ACA of 2010 further expanded the coverage offered for substance abuse related treatments through state health insurances.[12]
In October 2015, the American Board of Medical Specialties (ABMS) officially recognized addiction medicine as a subspecialty.[13] In several countries around the world, specialist bodies have been set up to ensure high quality practice in addiction medicine. For example, within theUnited States, there are two accepted specialty examinations.[14] One is a Board Certification in Addiction Psychiatry from the American Board of Psychiatry and Neurology.[15] The other is a Board Certification in Addiction Medicine from theAmerican Board of Preventive Medicine. The latter approach is available to all physicians with primary Board certification, while the former is available only to board-certified psychiatrists.
Doctors of Osteopathic Medicine may also seek board certification via theAmerican Osteopathic Association (AOA). The Doctor of Osteopathic Medicine must have a primary board certification inNeurology & Psychiatry,Internal Medicine, orFamily Practice[16] 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 theRoyal Australasian College of Physicians. They may alternatively be a member of the Section of Addiction Psychiatry, Royal Australian & New Zealand College of Psychiatrists.
TheInternational Society of Addiction Medicine also can provide certification of expertise.
