Substance use and addiction

۞يَسۡـَٔلُونَكَ عَنِ ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِۖ قُلۡ فِيهِمَآ إِثۡمࣱ كَبِيرࣱ وَمَنَٰفِعُ لِلنَّاسِ وَإِثۡمُهُمَآ أَكۡبَرُ مِن نَّفۡعِهِمَاۗ وَيَسۡـَٔلُونَكَ مَاذَا يُنفِقُونَۖ قُلِ ٱلۡعَفۡوَۗ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَتَفَكَّرُونَ

They ask you [Prophet] about intoxicants and gambling: say, ‘There is great sin in both, and some benefit for people: the sin is greater than the benefit.’ They ask you what they should give: say, ‘Give what you can spare.’ In this way, God makes His messages clear to you, so that you may reflect

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِنَّمَا ٱلۡخَمۡرُ وَٱلۡمَيۡسِرُ وَٱلۡأَنصَابُ وَٱلۡأَزۡلَٰمُ رِجۡسࣱ مِّنۡ عَمَلِ ٱلشَّيۡطَٰنِ فَٱجۡتَنِبُوهُ لَعَلَّكُمۡ تُفۡلِحُونَ

You who believe, intoxicants and gambling, idolatrous practices, and [divining with] arrows are repugnant acts- Satan’s doing- shun them so that you may prosper

إِنَّمَا يُرِيدُ ٱلشَّيۡطَٰنُ أَن يُوقِعَ بَيۡنَكُمُ ٱلۡعَدَٰوَةَ وَٱلۡبَغۡضَآءَ فِي ٱلۡخَمۡرِ وَٱلۡمَيۡسِرِ وَيَصُدَّكُمۡ عَن ذِكۡرِ ٱللَّهِ وَعَنِ ٱلصَّلَوٰةِۖ فَهَلۡ أَنتُم مُّنتَهُونَ

With intoxicants and gambling, Satan seeks only to incite enmity and hatred among you, and to stop you remembering God and prayer. Will you not give them up

يَٰصَٰحِبَيِ ٱلسِّجۡنِ أَمَّآ أَحَدُكُمَا فَيَسۡقِي رَبَّهُۥ خَمۡرࣰ اۖ وَأَمَّا ٱلۡأٓخَرُ فَيُصۡلَبُ فَتَأۡكُلُ ٱلطَّيۡرُ مِن رَّأۡسِهِۦۚ قُضِيَ ٱلۡأَمۡرُ ٱلَّذِي فِيهِ تَسۡتَفۡتِيَانِ

Fellow prisoners, one of you will serve his master with wine; the other will be crucified and the birds will peck at his head. That is the end of the matter on which you asked my opinion.’

مَّثَلُ ٱلۡجَنَّةِ ٱلَّتِي وُعِدَ ٱلۡمُتَّقُونَۖ فِيهَآ أَنۡهَٰرࣱ مِّن مَّآءٍ غَيۡرِ ءَاسِنࣲ وَأَنۡهَٰرࣱ مِّن لَّبَنࣲ لَّمۡ يَتَغَيَّرۡ طَعۡمُهُۥ وَأَنۡهَٰرࣱ مِّنۡ خَمۡرࣲ لَّذَّةࣲ لِّلشَّٰرِبِينَ وَأَنۡهَٰرࣱ مِّنۡ عَسَلࣲ مُّصَفࣰّ ىۖ وَلَهُمۡ فِيهَا مِن كُلِّ ٱلثَّمَرَٰتِ وَمَغۡفِرَةࣱ مِّن رَّبِّهِمۡۖ كَمَنۡ هُوَ خَٰلِدࣱ فِي ٱلنَّارِ وَسُقُواْ مَآءً حَمِيمࣰ ا فَقَطَّعَ أَمۡعَآءَهُمۡ

Here is a picture of the Garden promised to the pious: rivers of water forever pure, rivers of milk forever fresh, rivers of wine, a delight for those who drink, rivers of honey clarified and pure, [all] flow in it; there they will find fruit of every kind; and they will find forgiveness from their Lord. How can this be compared to the fate of those stuck in the Fire, given boiling water to drink that tears their bowels

وَدَخَلَ مَعَهُ ٱلسِّجۡنَ فَتَيَانِۖ قَالَ أَحَدُهُمَآ إِنِّيٓ أَرَىٰنِيٓ أَعۡصِرُ خَمۡرࣰ اۖ وَقَالَ ٱلۡأٓخَرُ إِنِّيٓ أَرَىٰنِيٓ أَحۡمِلُ فَوۡقَ رَأۡسِي خُبۡزࣰ ا تَأۡكُلُ ٱلطَّيۡرُ مِنۡهُۖ نَبِّئۡنَا بِتَأۡوِيلِهِۦٓۖ إِنَّا نَرَىٰكَ مِنَ ٱلۡمُحۡسِنِينَ

Two young men went into prison alongside him. One of them said, ‘I dreamed that I was pressing grapes’; the other said, ‘I dreamed that I was carrying bread on my head and that the birds were eating it.’ [They said], ‘Tell us what this means- we can see that you are a knowledgeable man.’

They ask thee about wine and gambling.... And they ask thee what they should expend. God has servants on the earth who drink the wine of recognition and are drunk from the cup of love. There is no more than a whiff of this wine's reality in this world, and nothing but a show of that drunkenness, for this world is a prison, and what can a prison put up with? Today there is no more than that. Nonetheless, wait until tomorrow, the assembly of repose and ease [56:89], the arena of union with the Beloved, when the servants will be gazing on the Real. Hope for union with you has added to my life. What can union itself be, when hope does that!? A man in turmoil entered the shop of a wine merchant with one dirham. He said, “Give me wine for this dirham.” The merchant replied, “There's no wine left.” The man said, “I'm already in turmoil. I can't tolerate wine's reality. Show me a drop so I may s

O you who have faith! Wine, arrow-shuffling, idols, and divining arrows are a filth and of the deeds of Satan. The Prophet said, “Wine is the gatherer of sin and the mother of loathsome things”: Wine is the root of loathsome things and the key to great sins, the basis of misdeeds, the seed of misguided acts, and the source of discord. It dries up the springhead of obedience, holds back the water of remembrance, and opens the door to heedlessness. The soul becomes drunk from wine and is held back from the prayer. The heart becomes drunk from heedlessness and is held back from secret whispering. The Pir of the Tariqah spoke to these heedless people in the tongue of admonition: “O drunk- ards full of appetite! O sleepers in heedlessness! Have shame before that Lord who knows the treachery of the eyes and sees the inside of the hearts! He knows the treachery of the eyes and what the breasts

They ask you about wine and divinatory arrows gambling and what the ruling is regarding them. Say to them ‘In both that is in the partaking of both is great sin a variant reading for kabīr ‘great’ has kathīr ‘much’ because of the fighting cursing and swearing that ensue from it; and profit for men by way of delight and enjoyment in wine and acquiring money effortlessly from gambling; but the sin in them that is the degenerate behaviour in which they result is greater graver than the usefulness’. When this verse was revealed some gave up drinking while others persisted until the verse of sūrat al-Mā’ida Q. 590-91 finally made it illicit. And they will ask you what that is to say how much they should expend. Say expend ‘Comfortably’ al-‘afwa in the accusative is also read in the nominative al-‘afwu implying a preceding huwa that is the surplus of your need and do not expend what you need r

O you who believe verily wine that intoxicates and overcomes the mind and games of chance gambling and idols and divinatory arrows are an abomination an evil deemed vile of Satan’s work which he adorns; so avoid it this abomination consisting of the things mentioned do not do it; so that you might prosper.

Satan desires only to precipitate enmity and hatred between you through wine and games of chance when you partake of them because of the evil and discord that result therefrom; and to bar you by your being preoccupied with them from the remembrance of God and from prayer — He has specifically mentioned it prayer so as to magnify it. So will you then desist? from partaking of them? In other words Desist!

O you who believe! Khamr, Maysir, Ansab, and Azlam are a Rijs of Shaytan's handiwork. So avoid that in order that you may be successful (90)Shaytan wants only to excite enmity and hatred between you with Khamr and Maysir, and hinder you from the remembrance of Allah and from the Salah (the prayer). So, will you not then abstai (91)And obey Allah and obey the Messenger, and beware. Then if you turn away, you should know that it is Our Messenger's duty to convey in the clearest way (92)Those who believe and do righteous good deeds, there is no sin on them for what they ate, if they have Taqwa and believe and do righteous good deeds, and they (again) have Taqwa and believe, and then (once again) have Taqwa and perform good. And Allah loves the good-doers (93) Prohibiting Khamr (Intoxicants) and Maysir (Gambling) Allah forbids His believing servants from consuming Khamr and Maysir which is

حَدَّثَنَا أَبُو زَكَرِيَّا، يَحْيَى بْنُ دُرُسْتَ الْبَصْرِيُّ حَدَّثَنَا حَمَّادُ بْنُ زَيْدٍ، عَنْ أَيُّوبَ، عَنْ نَافِعٍ، عَنِ ابْنِ عُمَرَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ كُلُّ مُسْكِرٍ خَمْرٌ وَكُلُّ مُسْكِرٍ حَرَامٌ وَمَنْ شَرِبَ الْخَمْرَ فِي الدُّنْيَا فَمَاتَ وَهُوَ يُدْمِنُهَا لَمْ يَشْرَبْهَا فِي الآخِرَةِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَأَبِي سَعِيدٍ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ وَعُبَادَةَ وَأَبِي مَالِكٍ الأَشْعَرِيِّ ‏.‏ قَالَ أَبُو عِيسَى حَدِيثُ ابْنِ عُمَرَ حَدِيثٌ حَسَنٌ صَحِيحٌ وَقَدْ رُوِيَ مِنْ غَيْرِ وَجْهٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏ وَرَوَاهُ مَالِكُ بْنُ أَنَسٍ عَنْ نَافِعٍ عَنِ ابْنِ عُمَرَ مَوْقُوفًا فَلَمْ يَرْفَعْهُ ‏.‏

Narrated Ibn 'Umar: That the Messenger of Allah (ﷺ) said: "Every intoxicant is Khamr, and every intoxicant is unlawful. Whoever drinks Khamr in this world, and dies continuing it, he will not drink it in the Hereafter. He said: There are narrations on this topic from Abu Hurairah, Abu Sa'eed, 'Abdullah bin 'Amr, 'Ubadah, Abu Malik Al-Ash'ari, and Ibn 'Abbas. [Abu 'Eisa said:] The Hadith of Ibn 'Umar is a Hasan Sahih Hadith. It has been reported through other routes from Nafi', from Ibn 'Umar, from the Prophet (ﷺ). Malik bin Anas reported it from Nafi' from Ibn 'Umar in Mawquf - not Marfu' form

حَدَّثَنَا قُتَيْبَةُ، حَدَّثَنَا جَرِيرُ بْنُ عَبْدِ الْحَمِيدِ، عَنْ عَطَاءِ بْنِ السَّائِبِ، عَنْ عَبْدِ اللَّهِ بْنِ عُبَيْدِ بْنِ عُمَيْرٍ، عَنْ أَبِيهِ، قَالَ قَالَ عَبْدُ اللَّهِ بْنُ عُمَرَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ مَنْ شَرِبَ الْخَمْرَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ تَابَ اللَّهُ عَلَيْهِ فَإِنْ عَادَ الرَّابِعَةَ لَمْ يَقْبَلِ اللَّهُ لَهُ صَلاَةً أَرْبَعِينَ صَبَاحًا فَإِنْ تَابَ لَمْ يَتُبِ اللَّهُ عَلَيْهِ وَسَقَاهُ مِنْ نَهْرِ الْخَبَالِ ‏"‏ ‏.‏ قِيلَ يَا أَبَا عَبْدِ الرَّحْمَنِ وَمَا نَهْرُ الْخَبَالِ قَالَ نَهْرٌ مِنْ صَدِيدِ أَهْلِ النَّارِ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ وَقَدْ رُوِيَ نَحْوُ هَذَا عَنْ عَبْدِ اللَّهِ بْنِ عَمْرٍو وَابْنِ عَبَّاسٍ عَنِ النَّبِيِّ صلى الله عليه وسلم ‏.‏

Narrated 'Abdullah bin 'Umar: That the Messenger of Allah (ﷺ) said: "Whoever drinks Khamr, Salat is not accepted from him for forty days. If he repents, then Allah will accept his repentance. It he returns to it, then Allah will not accept his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it, then Allah will not accepts his Salat for forty days. If he repents, then Allah will accept his repentance. If he returns to it a fourth time, Allah will not accept his Salat for forty days, and if he were to repent, Allah would not accept his repentance, and he will be given to drink from the river of Al-Khabal." They said: "O Aby 'Abdur-Rahman! What is the river of Al-Khabal?" He said: "A river of the pus from the inhabitants of the Fire." [Abu 'Eisa said:] This Hadith is Hasan. Similar to this has been reported from 'Abdullah bin 'Amr and Ibn 'Abbas from the Prophet (ﷺ)

حَدَّثَنَا أَحْمَدُ بْنُ حَنْبَلٍ، حَدَّثَنَا إِسْمَاعِيلُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا أَبُو حَيَّانَ، حَدَّثَنِي الشَّعْبِيُّ، عَنِ ابْنِ عُمَرَ، عَنْ عُمَرَ، قَالَ نَزَلَ تَحْرِيمُ الْخَمْرِ يَوْمَ نَزَلَ وَهِيَ مِنْ خَمْسَةِ أَشْيَاءَ مِنَ الْعِنَبِ وَالتَّمْرِ وَالْعَسَلِ وَالْحِنْطَةِ وَالشَّعِيرِ وَالْخَمْرُ مَا خَامَرَ الْعَقْلَ وَثَلاَثٌ وَدِدْتُ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم لَمْ يُفَارِقْنَا حَتَّى يَعْهَدَ إِلَيْنَا فِيهِنَّ عَهْدًا نَنْتَهِي إِلَيْهِ الْجَدُّ وَالْكَلاَلَةُ وَأَبْوَابٌ مِنْ أَبْوَابِ الرِّبَا ‏.‏

’Umar said :The prohibition of wine came down when (the Quranic verse ) came down. It was made from five thing namely, grapes, dates, honey, wheat ,barley. Wine is what infects (khamara) the mind. There are three things I wished that the prophet (ﷺ) would not leave us until he explained them fully to our satisfaction: (share of) grandfather, one who leaves no descendants or ascendants as hairs, and the details of usury

حَدَّثَنَا عَبَّادُ بْنُ مُوسَى الْخُتَّلِيُّ، أَخْبَرَنَا إِسْمَاعِيلُ، - يَعْنِي ابْنَ جَعْفَرٍ - عَنْ إِسْرَائِيلَ، عَنْ أَبِي إِسْحَاقَ، عَنْ عَمْرٍو، عَنْ عُمَرَ بْنِ الْخَطَّابِ، قَالَ لَمَّا نَزَلَ تَحْرِيمُ الْخَمْرِ قَالَ عُمَرُ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي الْبَقَرَةِ ‏{‏ يَسْأَلُونَكَ عَنِ الْخَمْرِ وَالْمَيْسِرِ قُلْ فِيهِمَا إِثْمٌ كَبِيرٌ ‏}‏ الآيَةَ قَالَ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ قَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتِ الآيَةُ الَّتِي فِي النِّسَاءِ ‏{‏ يَا أَيُّهَا الَّذِينَ آمَنُوا لاَ تَقْرَبُوا الصَّلاَةَ وَأَنْتُمْ سُكَارَى ‏}‏ فَكَانَ مُنَادِي رَسُولِ اللَّهِ صلى الله عليه وسلم إِذَا أُقِيمَتِ الصَّلاَةُ يُنَادِي أَلاَ لاَ يَقْرَبَنَّ الصَّلاَةَ سَكْرَانُ فَدُعِيَ عُمَرُ فَقُرِئَتْ عَلَيْهِ فَقَالَ اللَّهُمَّ بَيِّنْ لَنَا فِي الْخَمْرِ بَيَانًا شِفَاءً فَنَزَلَتْ هَذِهِ الآيَةُ ‏{‏ فَهَلْ أَنْتُمْ مُنْتَهُونَ ‏}‏ قَالَ عُمَرُ انْتَهَيْنَا ‏.‏

Narrated Umar ibn al-Khattab: When the prohibition of wine (was yet to be) declared, Umar said: O Allah, give us a satisfactory explanation about wine. So the following verse of Surat al-Baqarah revealed; "They ask thee concerning wine and gambling. Say: In them is great sin...." Umar was then called and it was recited to him. He said: O Allah, give us a satisfactory explanation about wine. Then the following verse of Surat an-Nisa' was revealed: "O ye who believe! approach not prayers with a mind befogged...." Thereafter the herald of the Messenger of Allah (ﷺ) would call when the (congregational) prayer was performed: Beware, one who is drunk should not come to prayer. Umar was again called and it was recited to him). He said: O Allah, give us a satisfactory explanation about wine. This verse was revealed: "Will ye not then abstain?" Umar said: We abstained

وأما النبات فلا يحرم منه إلا ما يزيل العقل أو يزيل الحياة أو الصحة فمزيل العقل البنج و الخمر وسائر المسكرات ومزيل الحياة السموم ومزيل الصحة الأدوية في غير وقتها وكأن مجموع هذا يرجع إلى الضرر إلا الخمر و المسكرات فإن الذي لا يسكر منها أيضا حرام مع قلته لعينه ولصفته وهي الشدة المطربة

وقد يبيح هؤلاء شرب الخمر على وجه التداوي وحفظ الصحة إذا سلم من معرة السكر

وقال يزيد بن الوليد إياكم والغناء فإنه ينقص الحياء ويزيد الشهوة ويهدم المروءة وإنه لينوب عن الخمر ويفعل ما يفعله السكر فإن كنتم لا بد فاعلين فجنبوه النساء فإن الغناء داعية الزنا

وأما حديث عبدالله بن عمرو فروى أحمد في مسنده وأبو داود عنه أن النبيقال : إن الله تعالى حرم على أمتي الخمر والميسر والكوبة والغبيراء وكل مسكر حرام

أما الجمادات فطاهرة كلها إلا الخمر وكل منتبذ مسكر والحيوانات طاهرة كلها إلا الكلب والخنزير وما تولد منهما أو من أحدهما

وأما حديث ابن عباس ففي المسند أيضا : عنه أن رسول اللهقال : إن الله حرم الخمر والميسر والكوبة وكل مسكر حرام والكوبة الطبل قاله سفيان وقيل : البربط والقنين هو الطنبور بالحبشية والتقنين : الضرب به قاله ابن الأعرابي

Effects of lofexidine on stress-induced and cue-induced opioid craving and opioid abstinence rates: preliminary findings.: Objective: A preliminary study examined whether lofexidine decreases stress-induced and cue-induced opioid craving and improves opioid abstinence in naltrexone-treated opioid-dependent individuals. Materials and methods: Eighteen opioid-dependent patients were stabilized for 4 weeks with naltrexone (50 mg daily) and lofexidine (2.4 mg bid) before entering a 4-week randomized, double-blind placebo-controlled discontinuation study where one group continued on lofexidine for an additional 4 weeks,

A randomized controlled trial of a gender-focused addiction model versus 12-step facilitation for women veterans.: Background and objectives: Substance use disorder (SUD) has increased among women, including military veterans, yet SUD treatment was historically designed for males. This randomized controlled trial compared 12 individual sessions of a gender-focused SUD recovery model, A Woman's Path to Recovery (WPR) to an evidence-based, non-gender-focused SUD model, 12-Step Facilitation (TSF) for 66 women veterans with current severe SUD. Methods: The primary outcome was substance use; secondary outcomes we

Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys.: Aims: This paper reviews evidence pertaining to the prevalence of common comorbid disorders, including alcohol use disorder, depression, substance use disorders, nicotine dependence, anxiety disorders and antisocial personality disorder, in population-representative samples of problem and pathological gamblers. Methods: A systematic search was conducted for peer-reviewed and unpublished articles reported between 1 January 1998 and 20 September 2010. Only studies which examined the prevalence of

Effortful Control - A Transdiagnostic Dimension Underlying Internalizing and Externalizing Psychopathology.: Effortful control (EC) or self-regulation refers to the ability to regulate behavior, emotion, and cognition. It has been identified as a contributor to both adaptive and adverse outcomes in children, adolescents, and adults and this across many domains. As such, it could be considered as a transdiagnostic dimension underlying internalizing (e.g., mood and anxiety disorders) and externalizing (e.g., substance use disorders, ADHD) psychopathology. We aimed to examine the role of EC throughout the

Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center.: Reincarceration rates are high among substance-involved criminal offenders. This study (conducted during 2010-2011 in an urban area and funded by a Washington State University-Vancouver mini-grant) used a randomized design to examine the effectiveness of mindfulness-based relapse prevention (MBRP) as compared to relapse prevention (RP), as part of a residential addictions treatment program for women referred by the criminal-justice system (N = 105). At 15-week follow up, regression analyses foun

Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis.: Objective: Although prior meta-analyses have significantly enriched the available literature on the comorbidity of substance use disorders (SUD) among individuals with eating disorders (ED), there have been few, recent, comprehensive reviews, and limited meta-analyses that include a range of SUDs. Method: In accordance with the PRISMA guidelines, six electronic databases were searched, and a total of 1013 articles were identified using a combination of search terms to identify relevant prevalenc

Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis.

Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5-93.9) and lifetime (75.5%, 95% CI 46.5-91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9-34.0), alcohol use disorders (21.2%, 95% CI 15.6-28.1), anxiety disorders (17.6%, 95% CI 10.8-27.3) an…

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Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies.

Background: Adolescence is a peak time for the onset of depression, but little is known about what adolescents can do to reduce their own level of risk. To fill this gap, a review was carried out to identify risk and protective factors for depression during adolescence that are modifiable by the young person. Methods: Employing the PRISMA method, we conducted a systematic review and meta-analysis of longitudinal studies to identify risk and protective factors during the adolescent period (aged 12-18 years) that are potentially modifiable by the young person without professional intervention or assistance. Stouffer׳s method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations. Results: We identified 113 publications which met the inclusion criteria. Putative risk…

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The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement.

Background: The World Health Organization's (WHO's) Health Promoting Schools (HPS) framework is an holistic, settings-based approach to promoting health and educational attainment in school. The effectiveness of this approach has not been previously rigorously reviewed. Objectives: To assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement. Search methods: We searched the following electronic databases in January 2011 and again in March and April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Campbell Library, ASSIA, BiblioMap, CAB Abstracts, IBSS, Social Science Citation Index, Sociological Abstracts, TRoPHI, Global Health Database, SIGLE, Australian Education Index, British Education Index, Education Resources Information Centre, Databas…

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Children's antisocial behavior, mental health, drug use, and educational performance after parental incarceration: a systematic review and meta-analysis.

Unprecedented numbers of children experience parental incarceration worldwide. Families and children of prisoners can experience multiple difficulties after parental incarceration, including traumatic separation, loneliness, stigma, confused explanations to children, unstable childcare arrangements, strained parenting, reduced income, and home, school, and neighborhood moves. Children of incarcerated parents often have multiple, stressful life events before parental incarceration. Theoretically, children with incarcerated parents may be at risk for a range of adverse behavioral outcomes. A systematic review was conducted to synthesize empirical evidence on associations between parental incarceration and children's later antisocial behavior, mental health problems, drug use, and educational performance. Results from 40 studies (including 7,374 children with incarcerated parents and 37,325…

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Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10-17.

Background: Multisystemic Therapy (MST) is an intensive, home-based intervention for families of youth with social, emotional, and behavioral problems. Masters-level therapists engage family members in identifying and changing individual, family, and environmental factors thought to contribute to problem behavior. Intervention may include efforts to improve communication, parenting skills, peer relations, school performance, and social networks. Most MST trials were conducted by program developers in the USA; results of one independent trial are available and others are in progress. Objectives: To provide unbiased estimates of the impacts of MST on restrictive out-of-home living arrangements, crime and delinquency, and other behavioral and psychosocial outcomes for youth and families. Search strategy: Electronic searches were made of bibliographic databases (including the Cochrane Librar…

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The role of the therapeutic alliance in the treatment of substance misuse: a critical review of the literature.

Background: In the past two decades, a number of studies investigating the role of the therapeutic alliance in drug treatment have been published and it is timely that their findings are brought together in a comprehensive review. Aims: This paper has two principal aims: (1) to assess the degree to which the relationship between drug user and counsellor predicts treatment outcome and (2) to examine critically the evidence on determinants of the quality of the alliance. Methods: Peer-reviewed research located through the literature databases Medline, PsycInfo and Ovid Full Text Mental Health Journals using predefined search-terms and published in the past 20 years is considered. Further papers were identified from the bibliographies of relevant publications. Findings: A key finding is that the early therapeutic alliance appears to be a consistent predictor of engagement and retention in d…

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Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving.

Drug-related cues induce craving, which may perpetuate drug use or trigger relapse in addicted individuals. Craving is also under the influence of other factors in daily life, such as drug availability and self-control. Neuroimaging studies using drug cue paradigms have shown frontal lobe involvement in this contextual influence on cue reactivity, but have not clarified how and which frontal area accounts for this phenomenon. We explored frontal lobe contributions to cue-induced drug craving under different intertemporal drug availability conditions by combining transcranial magnetic stimulation and functional magnetic resonance imaging in smokers. We hypothesized that the dorsolateral prefrontal cortex (DLPFC) regulates craving during changes in intertemporal availability. Subjective craving was greater when cigarettes were immediately available, and this effect was eliminated by transi…

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Smartphone Addiction among Adolescents in Southern Italy and Correlation with Other Risky Behaviors.

Background: Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic. Methods: A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-S…

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Compulsive overeating as an addiction disorder. A review of theory and evidence.

In this paper we argue that compulsive overeating has compelling similarities to conventional drug addiction. Our case is based on their comparable clinical features, the biological mechanisms they have in common, and on evidence that the two disorders have a shared diathesis. In making the argument for overeating as an addictive behaviour, it is clearly not appropriate to include all cases of excessive food consumption in this taxon. Nor are we claiming that obesity and addiction are one and the same. However, it is proposed that Binge Eating Disorder (BED) is a phenotype particularly well-suited to such a conceptualization, and that sound clinical and scientific evidence exists to support this viewpoint. We have provided some recommendations for treatment modifications that recognize the similarities between treating drug dependence and compulsive overeating.

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Psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients.

Background: Psychopathology (depression, anxiety, somatization disorder) and substance abuse (opioid misuse and illicit drug use) are common in patients with chronic pain and present problems for public health and clinical management. Despite a body of literature describing various methods for identifying psychopathology, opioid misuse, and illicit drug use in chronic pain patients, the relationship between psychopathologies, substance abuse, and chronic pain has not been well characterized. Methods: This report describes a total of 500 consecutive pain patients prescribed and receiving stable doses of opioids. The patients were evaluated for psychopathology, opioid abuse, and illicit drug use during the course of regular pain management treatment. The relationships between psychopathology and drug abuse and/or illicit drug use in chronic pain patients were examined, and psychological ev…

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Assessment of spirituality and its relevance to addiction treatment.

The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders. We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers. This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs. Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspec…

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Pre/early adolescent onset of gambling and psychosocial problems in treatment-seeking pathological gamblers.

This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent years (mean age of 10.5 years; 1st quartile) were compared to gamblers who began gambling later in life (mean age of 23.0 years; 2nd to 4th quartiles). Compared to later onset gamblers, pre/early adolescent onset gamblers reported increased severity of psychiatric, family/social, and substance abuse problems on the ASI. They were more likely to report cognitive problems (trouble understanding, concentrating, or remembering), suicidal ideation, and a his…

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Personality and problem gambling: a prospective study of a birth cohort of young adults.

Context: Individual differences in dimensions of personality may play an important role in explaining risk for disordered gambling behavior as well as the comorbidity between disordered gambling behavior and other substance-related addictive disorders. Objectives: To identify the personality correlates of problem gambling in a representative non-treatment-seeking sample, as well as to determine whether these are similar to the personality correlates of other substance-related addictive disorders and whether individual differences in personality might account for the comorbidity between disordered gambling behavior and other substance-related addictive disorders. Design: Longitudinal population-based study. Participants: A complete birth cohort of young adults born in Dunedin, New Zealand, between April 1, 1972, and March 31, 1973 (N = 939; 475 men, 464 women). Main outcome measures: Mult…

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The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial.

Aims: To compare outcomes for a behavioral activation group treatment for substance use [life enhancement treatment for substance use (LETS ACT)] versus a time and group size-matched control condition delivered in a residential treatment setting. Design: Single-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment. Setting: Residential substance use treatment facility in the United States. Participants: Participants were 263 adults [mean age 42.7 (11.8); 29.5% female; 95.4% African American; 73.2% court mandated] whose insurance dictated 30-day (65.9%) or 90-day (34.1%) treatment duration. Intervention and comparator: LETS ACT (n = 142) is a treatment developed originally for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depres…

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Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study.

We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011). All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months after the original study's final MDMA session (mean = 45.4; SD = 17.3). Our primary outcome measure used was the Clinician-Administered PTSD Scale (CAPS). Secondary outcome measures were the Impact of Events Scale-Revised (IES-R) and the Neuroticism Extroversion Oppenness Personality Inventory-Revised (NEO PI-R) Personality Inventory. We also collected a long-term follow-up questionnaire. Results for …

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Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial.

Importance: People with substance dependence have health consequences, high health care utilization, and frequent comorbidity but often receive poor-quality care. Chronic care management (CCM) has been proposed as an approach to improve care and outcomes. Objective: To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care. Design, setting, and participants: The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up. Interventions: Participants were randomized to receive CCM (n=282) or no CCM (n=281…

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Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial.

Objectives: To evaluate the effectiveness of integrated motivational interviewing and cognitive behavioural therapy in addition to standard care for patients with psychosis and a comorbid substance use problem. Design: Two centre, open, rater blind randomised controlled trial. Setting: Secondary care in the United Kingdom. Participants: 327 patients with a clinical diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a diagnosis of dependence on or misuse of drugs, alcohol, or both according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Intervention: The intervention was integrated motivational interviewing and cognitive behavioural therapy plus standard care, which was compared with standard care alone. Phase one of therapy-"motivation building"-concerns engaging the patient, then exploring and resolving ambivalence for c…

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The effect of Johrei healing on substance abuse recovery: a pilot study.

Objective: The purpose of the present study was to determine the effectiveness of Johrei healing, a form of energy healing, on substance use and psychologic symptoms in a sample of clients receiving substance abuse treatment. Methods: Twenty-one (21) persons in residential substance-abuse treatment participated in a randomized, wait-list control pilot study of Johrei healing. Twelve (12) of the participants received three 20-minute Johrei sessions for 5 weeks in addition to their regular treatment. Results: The results are from the first treatment wave. Individual healing sessions were evaluated pre-post with the Johrei Experience Scale. Participants showed significant decreases in stress/depression and physical pain and increases in positive emotional/spiritual state, energy, and overall well-being after an individual Johrei healing session. The Global Assessment of Individual Need (GAI…

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Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial.

This study evaluated the psychiatric symptoms, psychosocial problems, and treatment response of personality-disordered substance abusers receiving services within a homeless drop-in center. Fifty-two homeless clients were assessed after program admission and randomly assigned to receive either individual psychotherapy focused on personality disorder and substance abuse relapse prevention (dual-focus schema therapy [DFST]) or standard group substance abuse counseling (SAC). Client functioning was assessed using measures of personality disorder, psychiatric symptoms, early maladaptive schemas, interpersonal problems, and addiction-related psychosocial impairment. Therapy retention (total weeks in treatment) and utilization (number of weeks in which sessions were attended) were the primary outcomes. Although rates of cluster B personality disorders were comparable to other substance depende…

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Efficacy of Invasive and Non-Invasive Brain Modulation Interventions for Addiction.

It is important to find new treatments for addiction due to high relapse rates despite current interventions and due to expansion of the field with non-substance related addictive behaviors. Neuromodulation may provide a new type of treatment for addiction since it can directly target abnormalities in neurocircuits. We review literature on five neuromodulation techniques investigated for efficacy in substance related and behavioral addictions: transcranial direct current stimulation (tDCS), (repetitive) transcranial magnetic stimulation (rTMS), EEG, fMRI neurofeedback and deep brain stimulation (DBS) and additionally report on effects of these interventions on addiction-related cognitive processes. While rTMS and tDCS, mostly applied at the dorsolateral prefrontal cortex, show reductions in immediate craving for various addictive substances, placebo-responses are high and long-term outco…

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Realising the technological promise of smartphones in addiction research and treatment: An ethical review.

Background: Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. Aims: This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. Methods: A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. Results: Smartphones are being used to collect large amounts of sensi…

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Neuroscience of learning and memory for addiction medicine: from habit formation to memory reconsolidation.

Identifying effective pharmacological treatments for addictive disorders has remained an elusive goal. Many different classes of drugs have shown some efficacy in preclinical models, but the number of effective clinical therapeutics has remained stubbornly low. The persistence of drug use and the high frequency of relapse is at least partly attributable to the enduring ability of environmental stimuli associated with drug use to maintain behavioral patterns of drug use and induce craving during abstinence. We propose that stimuli associated with drug use exert such powerful control over behavior through the development of abnormally strong memories, and their ability to initiate subconscious sequences of motor actions (habits) that promote uncontrolled drug use. In this chapter, we will review the evidence suggesting that drugs of abuse strengthen associations with cues in the environmen…

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Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention.

Addiction has generally been characterized as a chronic relapsing condition (Leshner, 1999). Several laboratory, preclinical, and clinical studies have provided evidence that craving and negative affect are strong predictors of the relapse process. These states, as well as the desire to avoid them, have been described as primary motives for substance use. A recently developed behavioral treatment, mindfulness-based relapse prevention (MBRP), was designed to target experiences of craving and negative affect and their roles in the relapse process. MBRP offers skills in cognitive-behavioral relapse prevention integrated with mindfulness meditation. The mindfulness practices in MBRP are intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting "automatically." A recent efficacy trial found that those …

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A review of addiction.

Addiction to drugs and alcohol is often undiagnosed and untreated. Physicians are often unaware or have negative attitudes regarding these patients, such as the perception that treatment is ineffective. Addiction--psychological dependence with or without tolerance and withdrawal--is essentially compulsive uncontrolled substance use despite physical, psychological, or social consequences. We now have an understanding of the 2 major neurological pathways involved in addiction. First, the mesolimbic dopamine reward pathway, which is essential for survival, can be physically altered by drug abuse to result in uncontrolled cravings. Second, the decision-making prefrontal cortex, which suppresses inappropriate reward response, can also be altered by drug abuse. Thus, accelerated "go" signals and impaired "stop" signals result in uncontrolled use despite severe consequences. Further, addicts ca…

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Anticraving medications for relapse prevention: a possible new class of psychoactive medications.

Psychiatrists have gradually developed a list of medications that are effective in the treatment of addictive disorders. Although alcoholism has received the most attention, nicotine, heroin, and cocaine have all been shown to be influenced by heredity. Of course, the immediate goal is the reduction of drug craving and the prevention of relapse to compulsive drug taking. A medication that can aid in the maintenance of the opiate-free state is naltrexone, a specific opiate antagonist. Naltrexone is also a good example of an anticraving medication used in the treatment of alcoholism. Clinicians currently have two types of medication to aid in the treatment of tobacco use disorder, arguably the most important addiction. Bupropion and nicotine replacement can be given in a coordinated fashion to provide the best available results. At present, no medication is approved by the Food and Drug Ad…

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