The Addiction Psychologist

Addiction is among the most stigmatized of all social/health problems. Language surrounding clinical care in addiction is unlike any other area of medicine in that it often uses terms that are pejorative and lack specificity. In this episode, Dr. John Kelly talks about why we need to “stop talking dirty” in addiction research and treatment. He also discussed the results of the National Recovery Study – the only epidemiological of people in recovery ever conducted. Ever wonder how many serious attempts it takes to resolve an alcohol or drug problem, on average? He will cover that and more in this cannot-miss episode. Dr. Kelly is an endowed Professor of Psychiatry in Addiction Medicine at Harvard Medical School, the Founder and Director of the Recovery Research Institute at the Massachusetts General Hospital (MGH), the Program Director of the Addiction Recovery Management Service (ARMS) and Associate Director of the Center for Addiction Medicine (CAM) at MGH. Follow this link to sign the Action Network petition to remove the word "abuse" from national institutes: https://actionnetwork.org/petitions/change-the-name-end-the-stigma

Across substances, rates of use are high in indigenous populations across North America. Melissa Schick discusses the historical and ongoing trauma experienced by these populations and why it might be related to higher rates of substance use. Melissa also discusses combining strength-based approaches, from the perspective of positive psychology with community participatory research to provide culturally humble treatment and interventions. Melissa Schick is a Doctoral candidate in Clinical Psychology at the University of Rhode Island and the Senior Student Representative to the executive committee for the Society for Addiction Psychology.

Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) often co-occur. A great deal of research has attempted to understand the nature of this relationship. Is PTSD a risk factor for AUD? Is high risk drinking a risk factor for PTSD? These questions can help us understand which of the two disorders to target first. Dr. Debra Kaysen talks about her research on treatments for co-occurring PTSD and AUD, focusing special attention toward state of the art science on ordering effects. Dr. Debra Kaysen is a clinical psychologist and Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University. Dr. Kaysen’s area of specialty both in research and clinical work is in treatment of those who have experienced traumatic events including PTSD, mood and substance-use disorders. Debra is one of the leading researchers in adaptation of evidence-based PTSD treatments to increase access to evidence based treatments for diverse populations (Iraq, Democratic Republic of Congo, Native Americans), comorbidities (alcohol use disorders, HIV risk behavior), and for use in non-specialty care settings (digital health, telepsychology and primary care settings). Debra is currently the Immediate Past President of the International Society for Traumatic Stress Studies (ISTSS).

Biomarkers are objective signs or indications of a clinical state which can be measured reliably and accurately. Biomarkers are important because they can reveal mechanisms of behavior and help inform treatments. Laura Lesnewich talks about Biomarkers for Alcohol Use Disorder and her work identifying Biomarkers related to executive functioning deficits. Laura is a Doctoral candidate in Clinical Psychology at Rutgers and a Predoctoral intern at the Coatesville VA Medical Center. 

Listen to the future voices of addiction research. Seven students/ECRs discuss their excellent work which will also be presented live, during CPA 2021 from March 17-19. All interviewees were winners of the CPA registration award. Primary presenters, poster titles, and timestamps for posters below. Registration is still open: https://addictionpsychology.org/cpa Neo Gebru (1:48-10:20) - “That’s Pot Culture Right There”: Purchasing Behaviors of Recreational Marijuana Users Hallie Jordan: (10:20-18:55) - Psychometric Validation of the Protective Drinking Practices Scale in a National Sample of Students Dr. Jenni Teeters (18:55-26:24) - A Mobile-phone Based Intervention Is Associated With Reductions In Driving After Cannabis Use Among Near Daily Cannabis Users Dr. Emily Hennessy (26:24-36:59) - Parents and Family Mechanisms of Social Recovery Capital for Youth Recovery Marie O'Hanrahan (36:49-42:10) - Factors Predicting Substance Use Relapse: Service-Providers Perceptions Dr. Frank Schwabel (42:10-48:32) - Budding Recursive Partitioning Tress to Identify Predictors of Cannabis-related Outcomes (http://mateolab.yolasite.com/openscience.php) Thalia Sullivan (48:32-55:03) - Validation of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory Among an Illicit Cannabis Using Population

A great deal of the literature delineating the experience of addiction uses cross-sectional survey data or longitudinal data separated by wide gaps of time. Although this research is critical and is useful for answer certain questions, these research designs are unable to answer certain questions, such as about proximal contextual factors associated with within-person differences in substance use, or about psychological processes that shift moment to moment that may increase risk of substance engagement. Dr. Lorraine Collins talks about her seminal work applying ecological momentary assessment methodologies to alcohol and cannabis. Dr. Lorraine Collins is the Associate Dean for Research in the School of Public Health and Health Professions, and a Professor in the Department of Community Health and Health Behavior at the University at Buffalo.

Alleviation of pain, whether emotional or physical, is among the most common reasons for substance use. Despite this, very little experimental work has been done to delineate a causal effect of pain. Dezarie Moskal talks about her experimental work on the effect of pain on substance use and a recent meta-analysis on the effect of endocannabinoids on the alleviation of pain. Finally, she discusses the role of psychotherapy in alleviating pain. Dez is a doctoral candidate in clinical psychology at Syracuse University and a predoctoral internship at the VA Maryland Health Care System/University of Maryland School of Medicine Psychology Internship Consortium. Dez is also a proud Division 50 student member. 

In December of 2020, the US House of Representatives passed the Marijuana Opportunities Reinvestment and Expungement (MORE) act, which removes marijuana from the list of scheduled substances under the Controlled Substances Act and eliminates criminal penalties for an individual who manufactures, distributes, or possesses marijuana. Although the bill is unlikely to survive the Senate, it seems to be a matter of time before some version of this bill does pass. There has been growing interest in decriminalizing and legalizing cannabis in on the state level in the United States and in many countries around the world, and many around the country support the action. It is increasingly important to understand the impact of cannabis legalization. How will the impact of federal legislation be different from that of state legislation? How will cannabis legislation impact the epidemiological harm of cannabis use? How can psychologists contribute to this legislation to minimize costs and maximize benefits oft he legislation? Dr. Alan Budney discusses the likely effects of cannabis legislation and outlines what we still do not know about cannabis. Dr. Alan Budney is a Professor of Psychiatry in the Geisel School of Medicine at Dartmouth College.

Self control is thought to be closely associated with the ability to abstain or regulate substance use and is just one aspect of self-regulation, or the ability to organize behavior toward a goal. Many have suggested that self-regulation is damaged in those with chronic patterns of harmful substance use. However, it has also been noted that substance use itself is a highly goal directed behavior and requires self-regulation. Kyle Walters discusses his work on the interaction between self-regulation and the environment and suggests that this relationship may not be as simple as we once thought. Kyle also briefly discusses his forays into Network Analysis as an alternative approach to traditional conceptualizations of psychopathology.  Kyle Walters is a doctoral candidate in the Department of Psychology at the University of South Dakota.

There are two competing paradigms attempting to explain the phenomena of addiction: Addiction as compulsion and addiction as choice.  The compulsion model describes addiction as a brain disease in which alcohol and drug use cause neuroadaptations, resulting in uncontrolled drug seeking behavior. The choice model describes addiction as pathology of reinforcement that is contextually dependent upon the availability of meaningful and rewarding alternatives in the choice environment. Dr. Matt Field describes each model and their respective bodies of research.  Dr. Matt Field is a Professor in the Department of Psychology at University of Sheffield.