The articles in this Special Report provide a broad, cross-cutting perspective on the current state of addiction psychiatry, insofar as it may pertain to your own clinical practice. 

Introduction: The State of Addiction Psychiatry

While opioid dependence is among the most severe and lethal of addictions, it also has the most effective medication treatments. The authors provide 2 case vignettes and a step-by-step process for clinical decision making.

Opioid Use Disorder: Update on Diagnosis and Treatment

The loss of control over urges and behaviors may be the central component of gambling disorders, but there is so much more to consider. Individuals with these problems have exponentially higher rates of suicide attempts and completions. 

A Brief Review of Gambling Disorder and Five Related Case Vignettes

A  review of the pharmacological and symptomatic effects of various classes of designer drugs, including stimulants, hallucinogens, and sedatives.

An Update on Street and Club Drugs: What Clinicians Need to Know

Current trends are toward relaxing laws on cannabis, but no one knows the likely outcome. Will legalization mean an increase in consumption? Psychiatrists will be on the front lines if and when problems arise.

Marijuana and Madness: Clinical Implications of Increased Availability and Potency

A discussion of treatment options to help foster the most effective psychosocial treatment for addiction.

The Therapeutic Alliance and Psychosocial Interventions for Successful Treatment of Addiction

Many people like to spend at least part of their free time playing video games. However, for some, what starts as innocent recreation becomes an addiction and, at times, tragedy ensues.

Video Games: Recreation or Addiction?

The authors provide information about the human-animal bond that may provide a starting point for understanding the development of animal-hoarding disorder.

The Hoarding of Animals: An Update

Watchman Nee’s suggestion of a potential link between spirituality and mental health is no longer foreign to the field of psychiatry. Recent studies indicate that spiritual beliefs may have a positive effect on mental health.

Reflecting on the Spiritual Man

This film is a must-see for psychiatrists, not because it adds new information about the course of Alzheimer disease or its impact on families, but because it forces us to rethink issues that can affect our clinical practice.

Still Alice

There are probably few health care professionals who are unaware of the concerns about the apparent overprescription of opioids. However, we have had only limited information on how good a job physicians may actually be doing in prescribing these medications.

Prescribing Opioid Analgesics: Are We Going in the Right Direction?

Professions, psychiatry included, do not have a stellar record of protecting those they serve. Do we have reason to believe that professional organizations or corporate entities can be trusted to protect their clientele?

Suicide, Violence, and Mental Illness

Lithium plays an important role in reducing morbidity and mortality associated with bipolar disorder. Psychiatrists can optimize the benefits of lithium by carefully choosing patients for long-term treatment and educating them about the risks and benefits.

Tips, Cautions, and Successes in Treating Bipolar Patients With Lithium

In his Editorial, Dr Allan Tasman reflects on a recent meeting he attended in Asia and considers the implications for psychiatric service planning in the US.

Too Few Psychiatrists for Too Many

The author applies psychodynamic psychology to understand and recognize so-called "homegrown" terrorists, individuals who are familiar with American culture and thus more difficult to detect.

The Making of a Homegrown Terrorist

That’s how he’d like to go, he tells me, not by this slow seeding of liver and spine, not with all the tears and long good-byes.

Hit by a Bus

Therapeutic lying, a concept that is currently seeping into the medical literature, is the practice of deliberately deceiving patients for reasons considered in their best interest.

Therapeutic Lying: A Contradiction in Terms

Was the business of the heart always so heartless?

“Romance”-It’s So Cold Out There

A recent report that argues against descriptive diagnosis in medicine is historically ill-informed and medically naive, in the opinion of this psychiatrist.

The War on Psychiatric Diagnosis

A blog on the cultural components of minority groups, mental illness, and stigma.

Reflections on Cultural Psychiatry and Society

Years ago I read somewhere that dying is easy-the hard part is being left behind. But I recently met an older woman who taught me otherwise.

Vol 32 No 4