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Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation
The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a...
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| Published in: | JAMA : the journal of the American Medical Association 2000-10, Vol.284 (13), p.1689-1695 |
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| Format: | Article |
| Language: | English |
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| container_end_page | 1695 |
| container_issue | 13 |
| container_start_page | 1689 |
| container_title | JAMA : the journal of the American Medical Association |
| container_volume | 284 |
| creator | McLellan, A. Thomas Lewis, David C O'Brien, Charles P Kleber, Herbert D |
| description | The effects of drug dependence on social systems has helped shape the
generally held view that drug dependence is primarily a social problem, not
a health problem. In turn, medical approaches to prevention and treatment
are lacking. We examined evidence that drug (including alcohol) dependence
is a chronic medical illness. A literature review compared the diagnoses,
heritability, etiology (genetic and environmental factors), pathophysiology,
and response to treatments (adherence and relapse) of drug dependence vs type
2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal
choice, and environmental factors are comparably involved in the etiology
and course of all of these disorders. Drug dependence produces significant
and lasting changes in brain chemistry and function. Effective medications
are available for treating nicotine, alcohol, and opiate dependence but not
stimulant or marijuana dependence. Medication adherence and relapse rates
are similar across these illnesses. Drug dependence generally has been treated
as if it were an acute illness. Review results suggest that long-term care
strategies of medication management and continued monitoring produce lasting
benefits. Drug dependence should be insured, treated, and evaluated like other
chronic illnesses. |
| doi_str_mv | 10.1001/jama.284.13.1689 |
| format | article |
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generally held view that drug dependence is primarily a social problem, not
a health problem. In turn, medical approaches to prevention and treatment
are lacking. We examined evidence that drug (including alcohol) dependence
is a chronic medical illness. A literature review compared the diagnoses,
heritability, etiology (genetic and environmental factors), pathophysiology,
and response to treatments (adherence and relapse) of drug dependence vs type
2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal
choice, and environmental factors are comparably involved in the etiology
and course of all of these disorders. Drug dependence produces significant
and lasting changes in brain chemistry and function. Effective medications
are available for treating nicotine, alcohol, and opiate dependence but not
stimulant or marijuana dependence. Medication adherence and relapse rates
are similar across these illnesses. Drug dependence generally has been treated
as if it were an acute illness. Review results suggest that long-term care
strategies of medication management and continued monitoring produce lasting
benefits. Drug dependence should be insured, treated, and evaluated like other
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generally held view that drug dependence is primarily a social problem, not
a health problem. In turn, medical approaches to prevention and treatment
are lacking. We examined evidence that drug (including alcohol) dependence
is a chronic medical illness. A literature review compared the diagnoses,
heritability, etiology (genetic and environmental factors), pathophysiology,
and response to treatments (adherence and relapse) of drug dependence vs type
2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal
choice, and environmental factors are comparably involved in the etiology
and course of all of these disorders. Drug dependence produces significant
and lasting changes in brain chemistry and function. Effective medications
are available for treating nicotine, alcohol, and opiate dependence but not
stimulant or marijuana dependence. Medication adherence and relapse rates
are similar across these illnesses. Drug dependence generally has been treated
as if it were an acute illness. Review results suggest that long-term care
strategies of medication management and continued monitoring produce lasting
benefits. Drug dependence should be insured, treated, and evaluated like other
chronic illnesses.</description><subject>Addictions</subject><subject>Alcohol use</subject><subject>Asthma - diagnosis</subject><subject>Asthma - etiology</subject><subject>Asthma - physiopathology</subject><subject>Asthma - prevention & control</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Chronic illnesses</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - etiology</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - prevention & control</subject><subject>Drug use</subject><subject>Health care</subject><subject>Health Policy</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - etiology</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - prevention & control</subject><subject>Insurance coverage</subject><subject>Insurance, Health</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pharmacology. Drug treatments</subject><subject>Substance-Related Disorders - diagnosis</subject><subject>Substance-Related Disorders - etiology</subject><subject>Substance-Related Disorders - physiopathology</subject><subject>Substance-Related Disorders - prevention & control</subject><subject>Substance-Related Disorders - therapy</subject><subject>United States</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNpFkcFOwzAMhiMEYmNwhwuKEMe1xE3aJtzQNqDS0C7jXKVpCq3adCQtEm9PYEP4Ysv-_Fu2EboEEgIhcNfIToYRZyHQEBIujtAUYsoDGgt-jKaECB6kjLMJOnOuId6ApqdoAkAg5oRMUbO04xte6p02pTZKz7HEi3fbm1rhF13WSrY4a1ujnbvHWbdrfWaoe-Nw1Vu8tVoOnTbDHGfGjVbuFUyJN-Og-k47vPqU7fjbco5OKtk6fXHwM_T6uNounoP15ilbPKwDGXEYgiKVUmqRlkQqDtJ7zgslSkErljCaRlyUNCVFFHEKShc-pFpBAlyViQJKZ-hmr7uz_ceo3ZA3_WiNH5lHADRmMQcPXR-gseh0me9s3Un7lf9dxgO3B0A6f4TqZ7fa_XNMeC7x2NUe85_4LwoKjNFvhSN6Zg</recordid><startdate>20001004</startdate><enddate>20001004</enddate><creator>McLellan, A. 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generally held view that drug dependence is primarily a social problem, not
a health problem. In turn, medical approaches to prevention and treatment
are lacking. We examined evidence that drug (including alcohol) dependence
is a chronic medical illness. A literature review compared the diagnoses,
heritability, etiology (genetic and environmental factors), pathophysiology,
and response to treatments (adherence and relapse) of drug dependence vs type
2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal
choice, and environmental factors are comparably involved in the etiology
and course of all of these disorders. Drug dependence produces significant
and lasting changes in brain chemistry and function. Effective medications
are available for treating nicotine, alcohol, and opiate dependence but not
stimulant or marijuana dependence. Medication adherence and relapse rates
are similar across these illnesses. Drug dependence generally has been treated
as if it were an acute illness. Review results suggest that long-term care
strategies of medication management and continued monitoring produce lasting
benefits. Drug dependence should be insured, treated, and evaluated like other
chronic illnesses.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>11015800</pmid><doi>10.1001/jama.284.13.1689</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2000-10, Vol.284 (13), p.1689-1695 |
| issn | 0098-7484 1538-3598 |
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| source | AMA Current Titles |
| subjects | Addictions Alcohol use Asthma - diagnosis Asthma - etiology Asthma - physiopathology Asthma - prevention & control Biological and medical sciences Chronic Disease Chronic illnesses Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - etiology Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - prevention & control Drug use Health care Health Policy Humans Hypertension - diagnosis Hypertension - etiology Hypertension - physiopathology Hypertension - prevention & control Insurance coverage Insurance, Health Medical sciences Miscellaneous Outcome Assessment (Health Care) Pharmacology. Drug treatments Substance-Related Disorders - diagnosis Substance-Related Disorders - etiology Substance-Related Disorders - physiopathology Substance-Related Disorders - prevention & control Substance-Related Disorders - therapy United States |
| title | Drug Dependence, a Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation |
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