Starting Points

Points (n.) 1. marks of punctuation. 2. something that has position but not extension, as the intersection of two lines. 3. salient features of a story, epigram, joke, etc.:  he hit the high points. 4. (slang; U.S.) needles for intravenous drug use.

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Dissertation Compilation: Drugs and Health

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Understanding Associations of Alcoholic Beverage Consumption with Weight Status

Author: Butler, Jennie Lauren

Abstract: Contradictory findings exist on associations between alcoholic beverage consumption with Waist Circumference (WC) and Body Mass Index (BMI). Confounding by dietary intake and variation in associations by drinking level and/or alcoholic beverage type likely contribute to mixed literature. The overarching goal of this dissertation was to shed light on inconsistencies in the alcohol and obesity literature by investigating confounding by dietary intake and associations of changes in alcohol intake with WC and BMI change. A pooled cross-sectional analysis of data from 6,018 men and 5,885 women 20 – 79 years of age from the National Nutrition and Health Examination Survey (NHANES), 2003 – 2012 was conducted. Multivariable linear regression models were used to determine associations of alcohol intake with energy (kcal), macronutrient and sugar intakes (% kcal), WC and BMI. Associations of drinking with WC and BMI were examined with and without adjustment for dietary intake. Compared to non-drinkers, binge drinking men consumed less energy from food and heavy drinking women consumed less energy from non-alcoholic beverages. All drinking levels were inversely associated with carbohydrate and sugar intakes compared to non-drinking. Positive associations between binge drinking and WC in men were attenuated and no longer significant after adjustment for carbohydrate and sugar intakes. Negative associations between heavy drinking and WC and BMI in women were strengthened after adjustment for carbohydrate and sugar intakes. Next a prospective study of data from 1,894 men and 2,252 women utilizing 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data investigating associations of 5-yr changes in alcohol intake with 5-yr WC and BMI change was conducted. Random effects linear regression models were used to determine whether 5-yr changes in drinking were associated with 5-yr WC and BMI change. In men, decreasing drinking, particularly stopping excessive drinking, was associated with lower 5-yr WC gains. In women, increasing wine intake and decreasing liquor intake was associated with lower 5-yr WC and BMI gains. Our findings highlight dietary confounders of associations of alcohol intake with WC and BMI, and heterogeneity in associations by drinking level and beverage type in US adults.Read More »

Dissertation Research: Constructing the Addict, Addiction Models, and Drug Policy in the United States

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Piercing the Veil of Learned Helplessness: A Transpersonal Model of Addiction

Author: Eng, Peter Anthony

Abstract: This study expands the role of transpersonal psychology in the treatment of addiction and offers a revised theoretical model that is, in effect, a spiritual alternative to the Twelve-step approach. First, the current transpersonal model of addiction is deconstructed based on three of its core suppositions: (a) that Twelve-step programs are spiritual rather than religious, (b) that they are philosophically congruent with transpersonal theory, and (c) that they are the most effective treatment for addiction. Next, aspects of two major theoretical trends in transpersonal studies, the integral and the participatory perspectives, are then implemented as foundational supports for extending the traditional transpersonal model of addiction beyond its current boundaries. Addiction research from different fields and disciplines is also referenced to ensure that the model is effective, appropriate, and relevant.Read More »

Upcoming Witness Seminar: 50 Years of the MCA and Alcohol Treatment

anniversary_imageA WITNESS SEMINAR ON 50 YEARS OF THE MCA AND ALCOHOL TREATMENT

 To mark the 50th anniversary of the MCA, we are holding a Witness Seminar at BMA House, London on 14th November 2017. This will be a unique event in the history of alcohol and health.

The MCA was founded in 1967 by a group of doctors from a range of specialties, to improve the management of patients with alcohol related harm. There have been many changes during the last 50 years, ranging from the way the relationship between alcohol and health is conceived to the policy context in which alcohol treatment takes place.  The aim of this event is to capture this evolution, with the testimony of some of the early members of the MCA and others involved in the alcohol and health field over the last 50 years. Read More »

The Points Interview: Dan Malleck

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Dan Malleck

Dan Malleck is an Associate Professor of Health Sciences at Brock University in St. Catherines, Ontario. He is the author of Try to Control Yourself: The Regulation of Public Drinking in Post-Prohibition Ontario, 1927-1944 (University of British Colombia Press, 2012) and co-editor, with Cheryl Krasnick Warsh, of Consuming Modernity: Gendered Behaviour and Consumerism Before the Baby Boom (UBC Press, 2014). Try to Control Yourself won the Canadian Historical Association’s Clio Prize for Best Book in Ontario History in 2013, and Malleck’s writing has appeared in news outlets including the Globe and Mail and The National Post. He earned his PhD from Queen’s University in Kingston, ON. Malleck’s most recent book is When Good Drugs Go Bad: Opium, Medicine, and the Origins of Canada’s Drug Laws (UBC Press, 2015), which he discusses below.

Describe your book in terms your bartender could understand.

This book examines the social and cultural forces that combined to encourage the creation of Canada’s drug laws.  It argues that we need to get past the simplistic statement that drug laws were racist reactions to foreigners in our country, and have complex roots.

What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?

The book is not a political history, but it looks at how various cultural, economic, professional and social forces converged in the early 1900s to make it seem necessary to create federal laws restricting opiates and other mind altering drugs.  It takes long time-
line, following the threads of influence as they grew and expanded, gathering energy and cultural currency. I use the metaphor of streams converging into raging river.  

The main question driving the research was “why did we decide that addiction was a problem that needed federal intervention” and “when did it become okay for the government to severely restrict sales of certain substances that were previously generally unrestricted.”  I argue that Canada’s first drug laws were not laws against recreational use, but pharmacy laws that made it restricted certain substances determined to be dangerous. These laws, the results of political lobbying to deal with a social problem, made such restrictions acceptable.  From that point, the definition of “danger” expanded from the potential of death, to the potential for serious damage, to the potential for dependency.  The precedent for national drug regulation, then, was set in the pharmacy acts, which were a combination of professional pressure and social concern over access to poisonous substances.  

whengooddrugsI also challenge a dominant and reductionist narrative that the opium acts of the early 1900s were simply attacks on Chinese people in Canada.  This argument misses the power of the idea that drugs were a problem.  When William Lyon MacKenzie King argued, in his preamble to the 1908 report encouraging parliament to create the Opium Act, that opium’s “baneful influences” were “too well known to require comment” he was channeling that broader concern based upon the familiarity of most Canadians with the challenges of opium as a medicine and a habit-forming drug. He himself had experience of these baneful influences in his personal life, and most Canadians probably knew someone who had an opium habit. Most had probably consumed opium at some point.  To reduce this to an attack on the Chinese is simply a distortion of the past, often for current political reasons.  Moreover, the same session of parliament that passed the Opium Act also passed a Proprietary and Patent Medicines Act, dealing with another significant drug problem.  This book springs from that contention that reducing the drug laws to racist reactionism doesn’t do the story justice, nor does it help us understand the complexity of our drug laws in general, and the challenges of reforming them.

Now that the hard part is over, what is the thing YOU find most interesting about your book?

It’s the same page length as my first book even though it’s much longer, but took less time to write. Figure that out.

Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?

One thing I was never able to do due to the sheer volume of material and time it would take was track the changes in prescribing patterns as different laws came into effect. I have a database of probably hundreds of thousands of prescriptions from pharmacy records that span various provincial and federal law changes, and I wonder if those laws, restricting access to substances like opium, affected the way doctors prescribed, or the way customers purchased (or pharmacists dispensed). I suspect it did, but without a massive team, grant, and hiccup in space/time, I won’t be able to do that.

BONUS QUESTION: In an audio version of this book, who should provide the narration?

Aaron Paul.

 

Now Hiring: UF’s Center for Gender, Sexualities, and Women’s Studies Research

A message from Points Managing Editor Emeritus, Trysh Travis:

Longtime Points readers will know (and newcomers should find out about) my longstanding interest in feminist work on drug and alcohol issues. Now, at long last, I have the chance to hire someone to keep me company on that thankless research journey! The Center for Gender, Sexualities, and Women’s Studies Research at the University of Florida is hiring an entry-level assistant professor, and the field is WIDE OPEN! Now is the chance to build an absolute beach head of feminist substance abuse research in sunny (if slightly hurricane-ravaged) Florida. Points readers, come join me! And if you can’t join me yourself, please spread the word to those who might.  The incredibly non-specific job ad (application deadline 10 Nov.) is below; the full (yet still quite vague) position description with all the bells and whistles can be found in the UF Job Portal.

Tenure-track Assistant Professor in Gender, Sexualities, and Women’s Studies: The University of Florida College of Liberal Arts and Sciences invites applications for a tenure-track Assistant Professor position in the Center for Gender, Sexualities, and Women’s Studies Research (tenure home). We seek applicants with superior promise who combine rigorous scholarship with excellence in teaching and service. Applicants should be trained in and have a research program and teaching experience that centers feminist, women’s, gender, and/or sexualities studies. We are particularly interested in candidates whose research, teaching, and service takes a feminist intersectional approach to addressing disparities and/or (in)equities related to gender(s), gender identity and expression, sexualities, or women. The candidate is expected to contribute enthusiastically to the interdisciplinary research, teaching, and service mission of the unit by maintaining a productive program of scholarship, pursuing external funding, supervising undergraduate and graduate students, teaching both core required courses and needed electives in the women’s studies undergraduate and graduate curricula, and engaging actively in outreach, experiential learning, and the life and success of the Center and the College.

The Points Interview: William White

Bill White Casual
William White

Today’s Points interviewee is William White, author of such books as Slaying the Dragon:  The History of Addiction Treatment and Recovery in America; The History of Addiction Counseling in the United States; Drunkard’s Refuge:  The Lessons of the New York State Inebriate Asylum (with John Crowley); and Alcohol Problems in Native America: The Untold Story of Resistance and Recovery (with Don Coyhis). His latest book is Recovery Rising: A Retrospective of Addiction Treatment and Recovery Advocacy.

Describe your book in terms your bartender could understand.

Let me first say that readers who know me well will find this an amusing question. Recovery Rising is a collection of 350+ stories drawn from my nearly half-century of work in the addictions field. The vignettes honor my peers who have long worked in this special service ministry and mark the passing of a torch to a new generation of addiction professionals and recovery advocates. It is both a personalized history of the evolving world of addiction treatment over the closing decades of the 20th century and the opening decades of the 21st century and a collection of reflections about how to conduct oneself within this most unusual of occupations.Read More »

Social History of Alcohol and Drugs: Chief Editor Vacancy

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Social History of Alcohol and Drugs (SHAD) seeks a new chief editor to join Dr. James Kneale (editor), Dr. David Beckingham and Dr. Holly Karibo (reviews editors). The new chief editor will succeed Dr. Dan Malleck, who will stand down in 2017.

Social History of Alcohol and Drugs is a leading international journal and covers all social and cultural aspects of substance history. The journal is published twice a year on behalf of the Alcohol and Drugs History Society.

This is an exciting time for the journal as we are currently in discussion with a new academic publisher.  The new chief editor will oversee the move to more modern publication practices, including an online peer-review system and possible partnership with ProjectMUSE.

We are looking for an experienced scholar in the field who will ensure editorial cohesion and the delegation of tasks to other editors. Editorial experience is desirable. There will also be an opportunity to re-shape the editorial board.  Expertise in areas of alcohol or drug history is essential and all time-periods will be considered.

Applicants are asked to send a C.V. and statement of interest to the current President of the Alcohol and Drugs History Society, Dr Tim Hickman, Lancaster Universrity (email: t.a.hickman@lancaster.ac.uk) by 1 November 2017.

The application should provide a brief statement of why the candidate is attracted to the post, an outline of what they would contribute to SHAD, and a synopsis of their relevant experience (1000 word maximum).

Further details about the journal and the Alcohol and Drugs History Society can be found at https://alcoholanddrugshistorysociety.org

Collection Exhibition: “Altered States: Sex, Drugs, and Transcendence” at Harvard’s Houghton Library

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The search for something beyond the limits of ordinary experience—for transcendence—has preoccupied humankind for millennia. Religion, the occult, philosophy, music, endorphins, sex, Ecstasy: various paths have been taken in the hope of achieving it. In Altered States: Sex, Drugs, and Transcendence in the Ludlow-Santo Domingo Library, on view at Houghton Library September 5 – December 16, one collector’s quest to document the history of this search through rare books, manuscripts, photographs, posters, prints, comics, and ephemera is celebrated.Read More »

Hot Take: Dr. Oz Defends Medical Marijuana on “Fox & Friends”

Anyone tuning in to Fox & Friends this week was treated to an awkward moment courtesy of Dr. Oz, when he went off-script after plugging his upcoming interview with Ivanka Trump and launched into an impassioned defense of medical marijuana.

“Can I ask you one thing? I talked about the opioid epidemic, but the real story is the hypocrisy around medical marijuana. And just really quickly, medical marijuana – people think it’s a gateway drug to narcotics but it may be the exit drug to get us out of the narcotic epidemic. But we’re not allowed, we’re not allowed to study it, because it’s a schedule I drug. And personally, I believe it could help.”

“Wow,” co-host Steve Doocy intoned, visibly tense. “Hadn’t heard that before.” He reminded viewers to watch Oz’s show and cut to commercial break, clearly wishing the cardiologist had taken co-host Brian Kilmeade’s cue to end the segment twenty seconds prior.Read More »

Recent Addiction Debates: Opiate Substitution, Behavioral Addictions, and AA’s “Higher Power”

Editor’s Note: The journal Addiction occasionally features critical perspectives on debates in addiction studies. Below is a selection of recent publications dealing with topical issues in the field.

Ed DaLuke Mitcheson

Abstract

Background and Aims: Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond ‘routine counselling’.

Analysis: We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice.

Conclusion: The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions.


Dan
iel Kardefelt-Winther et al.

Abstract

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.

Abstract

Background: Alcoholics Anonymous (AA) is a world-wide recovery mutual-help organization that continues to arouse controversy. In large part, concerns persist because of AA’s ostensibly quasi-religious/spiritual orientation and emphasis. In 1990 the United States’ Institute of Medicine called for more studies on AA’s effectiveness and its mechanisms of behavior change (MOBC) stimulating a flurry of federally funded research. This paper reviews the religious/spiritual origins of AA and its program and contrasts its theory with findings from this latest research.

Method: Literature review, summary and synthesis of studies examining AA’s MOBC.

Results: While AA’s original main text (‘the Big Book’, 1939) purports that recovery is achieved through quasi-religious/spiritual means (‘spiritual awakening’), findings from studies on MOBC suggest this may be true only for a minority of participants with high addiction severity. AA’s beneficial effects seem to be carried predominantly by social, cognitive and affective mechanisms. These mechanisms are more aligned with the experiences reported by AA’s own larger and more diverse membership as detailed in its later social, cognitive and behaviorally oriented publications (e.g. Living Sober, 1975) written when AA membership numbered more than a million men and women.

Conclusions: Alcoholics Anonymous appears to be an effective clinical and public health ally that aids addiction recovery through its ability to mobilize therapeutic mechanisms similar to those mobilized in formal treatment, but is able to do this for free over the long term in the communities in which people live.