Addiction & Substance Use

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The focus of this Special Report is on some future-oriented aspects of psychopharmacology. First, it is an eclectic set of articles that cover treating resistant depression, using currently illegal drugs to treat psychiatric problems, and finally the potential of using vaccines to treat substance use disorders.

I recently shared a research article on “no-suicide contracts” with a colleague who is very knowledgeable about suicide. That article concluded--as virtually all the previous literature had-that use of suicide prevention contracts (SPC) remains a questionable clinical practice intervention.

Expansion of age-appropriate developmental psycho-therapeutic services must become a top public health priority to make these treatments more widely available to young children and to capture the potential greater benefit of the earliest possible intervention for mental disorders.

Is violent behavior a proxy indicator for the relationship between severity of substance abuse and suicide risk? What has the strongest influence in promoting doubt about a delusion in a patient with schizophrenia? These questions and more.

What goes on in the minds of those who attempt suicide? Here: a psychologist who explores the myths that surround suicide notes "We need to get it in our heads that suicide is not easy, painless, cowardly, selfish, vengeful, self-masterful, nor rash."

Recently, the Substance Use Disorder Work group of the DSM-5 announced the inclusion of “craving” in the diagnostic criteria for all substance use disorders despite its lack of empirical support from the very analyses conducted by that Workgroup. In addition, no detailed literature review supports the decision to make “craving” a core symptom of Substance Use Disorder syndromes.

Sometimes, when I recommend an antidepressant, patients will ask if it will make them happy. No, I usually eventually answer. I try to gently and empathically point out that what we have are called antidepressants. They are not called happy pills for a good reason.

Many people associated with DSM-5 have privately expressed their serious doubts to me, but felt muzzled into public silence by constraining confidentiality agreements and loyalty to the process.