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Implications for Medical Professionals

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Taken as a whole, further refinement of combined medical/clinical interventions when patients are at the peak of dysregulation and their mood is in its most vulnerable state is needed. The following recommendations are proposed:

  • 1. Updating knowledge and intervention techniques aimed at improving immediate engagement when individuals are in their most vulnerable state. Without a strong connection, patients leave medical facilities before experiencing the benefits of abstinence. Focusing on techniques that assist in recognizing anxiety and improving emotional regulation even slightly could improve retention and recovery engagement.
  • 2. SUD training on developing brief clinical competencies related to the role of emotional regulation during a patient’s moment of clarity. Patients with SUD will experience a moment of clarity as one of extraordinary importance, but medical professionals must recognize this is also brief and fleeting. Symptom recognition and relief need to be combined with intervention techniques aimed at developing immediate rapport.
  • 3. Medical professionals can improve outcomes when they recognize the patient’s level of addiction severity. This will clarify itself further when professionals can identify early exposure and developmental readiness to receive assistance based on the age of first use.
  • 4. Medical professionals can pay close attention to the role that the moment of clarity plays in increasing patient motivation. The moment of clarity is a key experience for most SUD persons with extended periods of sobriety. After several attempts at sobriety, some are able to return to their moment of clarity and come to believe that achieving and maintaining sobriety is attainable. The importance of breaking the isolation cycle becomes crucial regardless of how uncomfortable socializing and problem solving with others make them feel. Reconnecting with others promotes value-driven decision-making which include a reliance on outside help to get through feelings of fear and pain.
  • 5. Medical professionals should be prepared and equipped with immediate strategies to adequately deal with the associated depressed feelings and intense moods, especially when dealing with the trauma associated with detoxification and withdrawal. Detoxification appears to be the most likely time at which patients begin to experience a severe wave of emotions embedded in what many will later describe as trauma. Patients will likely have deficiencies in their emotional development and turn toward learned coping strategies. An example of this is social isolation, which might have helped them in the past to immediately cope with feelings of shame and of emotional inadequacy. But this pattern is pervasive and harmful and in the long term will move them further away from the emotional growth and development required to sustain sobriety.


When patients experience a “miss” they are likely to become more frustrated and distrustful of medical professionals who do not “understand” or do not “really want to help.” Patients with multiple admissions for acute SUD symptoms are more likely to be combative, non-compliant, and dishonest regarding the nature of their use.

It’s probably not all that surprising that assisting patients with an SUD under current practices appears to the SUD patient as a set of fragmented services, and ineffective treatment recommendations resulting in repeat customers in emergency room settings.

Rather than implementing clear and regimented intervention protocols to stabilize patients and provide them with opportunities to recover, the current reactionary response to the SUD epidemic seems to be producing negative outcomes. There are significant consequences for the patient’s emotional and physical health when they do not receive adequate care at their first point of contact. Increased relapse incidents will likely advance the severity of emotional and physical consequences associated with addiction and invariably destroy the individual piece by piece with each relapse while valuable time is lost for a patient to successfully recover.

When full integration occurs—when healthcare systems, academic institutions, and public safety and behavioral health specialists embrace and recognize the value of adopting a reliable educational base of knowledge about SUD and the option of supporting consistent protocols at all levels of care—we then might see significant progress.


  • 1. Volkow, N.D., Frieden, T.R., Hyde, P.S., & Cha, S.S. (2014). Medication-assisted therapies — tackling the opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.
  • 2. Hawkins, J.D., Catalano, R.F.. & Miller, J.Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychological Bulletin. 112(1). 64-105.
  • 3. Stice, E., & Gonzales, N. (1998). Adolescent temperament moderates the relation of parenting to antisocial behavior and substance use. Journal of Adolescent Research, 13(1), 5-31.
  • 4. Wills, T., McNamara, G., Vaccaro, D., & Hirky, A. (1996). Escalated substance use: a longitudinal grouping analysis from early to middle adolescence. Journal of Abnormal Psychology, 105(2), 166-180.
  • 5. Wills, T.A., & Dishion, T.J. (2004). Temperament and adolescent substance use: a transactional analysis of emerging self-control. Journal of Clinical Child and Adolescent Psychology, 33(1), 69-81.
  • 6. Rinaldi, R.C., Steindler. E.M., Wilford, B.B., & Goodwin. D. (1988). Clarification and standardization of substance abuse terminology. JAMA, 259(4), 555-557.
  • 7. Baldacchino, A., Balfour, D.J., Passetti, F., Humphris, G., & Matthews, K. (2012). Neuropsychological consequences of chronic opioid use: a quantitative review and meta-analysis. Neuroscience and Biobehavioral Reviews, 36(9), 2056-2068.
  • 8. McLellan, A.T., Luborsky, L., Woody, G.E., & O'Brien, C.P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: the addiction severity index. Journal of Nervous and Mental Disease, 168(1), 26-33.
  • 9. Tice, D., Bratslavsky, E., & Baumeister, R. (2001). Emotional distress regulation takes precedence over impulse control: if you feel bad, do it! Journal of Personality and Social Psychology, 80(1), 53-67.
  • 10. Campbell, W.G. (2003). Addiction: a disease of volition caused by a cognitive impairment. The Canadian Journal of Psychiatry, 4,669-674.
  • 11. Spitsbergen, B. (2017). Drugs of choice and other explanatory factors in young adults understandings of adolescent addiction and recovery experiences. PhD Dissertation. Oakland University.
  • 12. Davis, L., Uezato, A., Newell, J.M., & Frazier, E. (2008). Major depression and comorbid substance use disorders. Current Opinion in Psychiatry, 21(1), 14-18.
  • 13. Driessen, M„ Meier, S., Hill, A., Wetterling, T., Lange, W„ & Junghanns, K. (2001). The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders. Alcohol and Alcoholism, 36(3), 249-255.
  • 14. Anda. R.F., Whitfield, C.L., Felitti, V.J., Chapman. D., Edwards, V.J., Dube, S.R., & Williamson. D.F. (2002). Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 53(8), 1001-1009.
  • 15. Blumenthal. H.. Blanchard. L., Feldner, M.T.. Babson, K.A., Leen-Feldner. E.W., & Dixon, L. (2008). Traumatic event exposure, posttraumatic stress, and substance use among youth: a critical review of the empirical literature. Current Psychiatry Reviews, 4(4), 228-254.
  • 16. Chilcoat, H.D., & Breslau, N. (1998a). Investigations of causal pathways between PTSD and drug use disorders. Addictive Behaviors, 23(6), 827-840.
  • 17. Chilcoat, H.D., & Breslau, N. (1998b). Posttraumatic stress disorder and drug disorders: testing causal pathways. Archives of General Psychiatry, 55(10), 913-917.
  • 18. Dube, S.R.. Anda, R.F., Felitti, V.j., Edwards. V.J., & Croft, J.B. (2002). Adverse childhood experiences and patiental alcohol abuse as an adult. Addictive Behaviors, 27(5), 713-725.
  • 19. Dube, S.R., Felitti, V.J., Dong, M., Chapman, D.P, Giles, W.H., & Anda, R.F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111(3), 564-572.
  • 20. Bukstein, O.G., & Horner, M.S. (2010). Management of the adolescent with substance use disorders and comorbid psychopathology. Child and Adolescent Psychiatric Clinics of North America, 19(3), 609-623.
  • 21. Anda. R.F., Dong, M., Brown, D.W., Felitti, V.J.. Giles. W.H.. Perry, G.S., et al. (2009). The relationship of adverse childhood experiences to history of premature death of family members. BMC Public Health, 9, 106.
  • 22. Brown. D.W.. Anda, R.F.. Tiemeier, H.. Felitti, V.J.. Edwards, V.J., Croft, J.B., & Giles, W.H. (2009). Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine, 37(5), 389-396.
  • 23. Dube, S.R., Fairweather. D.. Pearson, W.S., Felitti, V.J.. Anda. R.F.. & Croft, J.B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine, 71(2), 243-250.
  • 24. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
  • 25. American Society of Addiction Medicine. (2018). American society of addiction medicine, ASAM placement criteria. Retrieved March 2019, from
  • 26. Baler, R.D., & Volkow, N.D. (2006). Drug addiction: the neurobiology of disrupted self-control. Trends in Molecular Medicine, 12(12), 559-566.
  • 27. Kollins, S.H., Barkley, R.A., & DuPaul, G.J. (2001). Use and management of medications for children diagnosed with attention deficit hyperactivity disorder (ADHD). Focus on Exceptional Children, 33(5), 1-24.
  • 28. Poulin, C. (2001). Medical and nonmedical stimulant use among adolescents: from sanctioned to unsanctioned use. Canadian Medical Association Journal, 165(8), 1039-1044.
  • 29. United States Department of Health and Human Services. (SAMHSA). (2012). Substance abuse and mental health services administration. Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set-Admissions(TEDS-A), ICPSR35037-vl. Ann Arbor, MI: Inter-University Consortium for Political and Social Research [distributor] (2014-05-07).
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