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ADDICTION INVOLVING SUBSTANCES TOOLKIT


Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission.

Addiction can be, but is not always, associated with unhealthy substance use. Many substances associated with addiction, such as tobacco, marijuana, and other drugs, are regulated on the federal and state levels in different ways and to varying degrees. Below you will find resources to help you advocate for increased access to addiction treatment services as well as ASAM’s policy positions on current policy issues.

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OPIOIDS

Buprenorphine/naloxone, buprenorphine, methadone and extended-release injectable naltrexone are FDA-approved medications shown to be highly effective in the treatment of opioid addiction, a chronic, life-threatening disease that affects millions of Americans. As with most chronic diseases, opioid addiction often requires long-term medication maintenance to achieve optimal outcomes.

Relevant ASAM Policy Statements

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Regulation of Office-Based Opioid Treatment

OBOT promotes the treatment of addiction in the primary care setting, but ASAM understands that the use of controlled substances to treat addiction introduces the possibility of misuse and diversion of the very medications used for treatment.

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Substance Use, Misuse, and Use Disorders During and Following Pregnancy, with an Emphasis on Opioids

Learn more about ASAM's policy recommendations on substance use, misuse, and SUDs during and following pregnancy.

PDMP

Prescription Drug Monitoring Programs (PDMPs)

Find out more about PDMPs and ASAM's recommendations on how they should be regulated.

Resources

Facts and Figures on Opioid Use and Addiction

This fact sheet provides a two-page overview of the statistics and facts surrounding the opioid addiction and overdose epidemic.

Confronting an Epidemic: The Case for Eliminating Barriers to Medication Assisted Treatment of Heroin and Opioid Addiction

The Legal Action Center summarizes the clinical and cost-effectiveness of the three FDA-approved medications for opioid addiction and what insurance and legal barriers prevent doctors from prescribing them and patients from accessing them.

How States Handle Drug Use During Pregnancy

Created by ProPublica, this tool summarizes the legal issues facing pregnant women across the country who are engaged in drug use. Many women face charges of child abuse or other crimes when their newborns test positive for both illicit and licit drugs, resulting in mothers losing their children or being put behind bars. These laws have devastating effects on the health and well being of the child and the mother.

MARIJUANA

The evolving legal landscape and public perception surrounding cannabis regulation in the United States is giving rise to increased availability and use of cannabis and cannabis products. It is ASAM’s viewpoint that it is imperative that Americans promote and adopt public policies that protect public health and safety as well as protect the integrity of our nation’s pharmaceutical approval process, which is grounded in well-designed and executed clinical research. Currently, the legalization of cannabis in some states but not others provides a unique opportunity for a thorough investigation into the societal and public health impact of broader cannabis use. Use the resources below to advocate for how a jurisdiction can best protect and promote public health as they consider the legal status of marijuana use. 

Relevant ASAM Policy Statement

 
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Public Policy Statement on Marijuana, Cannabinoids and Legalization

In light of the evolving legal landscape surrounding cannabis in the United States, which is giving rise to increased availability and use of cannabis and cannabis products, it is imperative that Americans promote and adopt public policies that protect public health and safety as well as protect the integrity of our nation’s pharmaceutical approval process, which is grounded in well-designed and executed clinical research.  

 

Resources

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Marijuana Legalization: Protecting Public Health
and Safety in a Volatile Legal Landscape

Learn more about ASAM's position on marijuana decriminalization, and recreational and medical marijuana use.

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Marijuana and Cannabinoids Neuroscience Research Summit Summary

The National Institutes of Health held a two-day meeting in March to present the latest science and data on a wide range of topics related to marijuana use, such as addiction, PTSD, psychosis and driving, among others. This summary describes each presentation given and the issues that still need to be researched. 

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FDA Regulation of Cannabis and Cannabis-Derived Products Q&A

The Food and Drug Administration (FDA) released a frequently asked questions and answers document in response to growing interest in the development of therapies and other consumer products derived from cannabis and its components, including cannabidiol (CBD).

Marijuana Legislative Tracker

Find out more about each state's laws on legalization, medical marijuana and decriminalization. It also provides information on the specific states that are actively working to reform their laws, which is important for ASAM State Chapter organizations to monitor. Click on the map to learn more!
Marijuana Map

ALCOHOL

Alcohol and other drug addiction is a major public health problem, accounting for significant morbidity and mortality across all segments of the population. ASAM advocates for a wide range of policies that relate to alcohol including increasing education, especially for minors and vulnerable populations, on the negative health effects of alcohol use and increasing access to treatment for alcohol use disorder.

Relevant ASAM Policy Statement

 
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Pharmacological Therapy for Alcohol and Other Drug Addiction

Find out more about the negative public health effects of alcohol and other drug addiction as well as pharmacological options designed to treat alcohol addiction.

 

TOBACCO

According to a 2014 Surgeon General Report, cigarette smoking is the leading cause of preventable death and disability in the United States. More than 480,000 people die each year from smoking cigarettes, many of whom live with significant disability prior to death; it is reported that smoking cigarettes kills over time 50% of the people who use them.1

ASAM works closely with other organizations in coalitions to advance policies and regulations that protect public health and reduce the incidence of smoking, as well as other tobacco use, in the US.

Relevant ASAM Policy Statement

 
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E-Cigarettes

Learn more about ASAM's policy position on the use and regulation of e-cigarettes.

 

Sources
1 U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.