Drugs and the Future (eBook)

Front cover 1
DRUGS AND THE FUTURE 4
Copyright page 5
Table of contents 6
Contributors 8
Foreword Drugs and the Future 10
Introduction 12
Acknowledgements 14
Chapter 1. Drugs Futures 2025 16
Chapter 2. Foresight 22
1 INTRODUCTION 22
2 WHAT IS FORESIGHT? 22
3 WHAT APPROACH DID WE USE TO EXPLORE THE FUTURE OF DRUG USE? 23
4 WHAT HAPPENS NEXT? 25
Chapter 3. Neuroscience of Drugs and Addiction 26
1 EXECUTIVE SUMMARY 27
2 INTRODUCTION 28
3 NEUROPSYCHOLOGY OF REINFORCEMENT LEARNING AND ADDICTION 30
4 THE NEURAL SYSTEM BASIS OF REINFORCEMENT LEARNING: RELEVANCE TO NATURAL MOTIVATION AND DRUG ADDICTION 34
5 NEUROBIOLOGY OF RELAPSE 41
6 NEUROADAPTATIONS – INTRACELLULAR CASCADES 44
7 VULNERABILITY TO ADDICTION 47
8 HARMS CAUSED BY DRUGS OF ABUSE 55
9 DRUG ADDICTION: A SOCIAL COGNITIVE NEUROSCIENCE PERSPECTIVE 57
10 THE MIND/BRAIN INTERFACE: NEUROBEHAVIOURAL ECONOMICS OF ADDICTION 60
11 FUTURE IMPLICATIONS: NEW DRUGS, THEIR IMPACT AND MANAGEMENT 66
Chapter 4. Genomics 104
1 EXECUTIVE SUMMARY 104
2 GENES IN ACTION 106
3 GENETIC ANALYSIS 112
4 CURRENT STATE OF PLAY 120
5 FUTURE DIRECTIONS IN RESEARCH 129
6 THE IMPLICATIONS OF DEFINING GENETIC INFLUENCES IN DRUG USE FOR THE INDIVIDUAL AND SOCIETY 133
7 THE BRAIN SCIENCE, ADDICTION AND DRUGS PROJECT QUESTIONS 134
8 CONCLUSIONS 135
Chapter 5. Experimental Psychology and Research into Brain Science, Addiction and Drugs 148
1 EXECUTIVE SUMMARY 148
2 INTRODUCTION 149
3 SCIENTIFIC BASIS OF DRUG ADDICTION 152
4 CURRENT PSYCHOACTIVE SUBSTANCES – EFFECTS AND HARMS 160
5 INTERVENTIONS AND MANAGEMENT 164
6 VISIONS FOR THE FUTURE – FUTURE CAPABILITIES AND APPLICATIONS 167
7 CONCLUSIONS 173
Chapter 6. Pharmacology and Treatments 184
1 EXECUTIVE SUMMARY 184
2 DEFINITIONS AND SCOPE OF REVIEW 185
3 BACKGROUND 188
4 CURRENT PSYCHOACTIVE DRUGS 191
5 DRUG TREATMENTS FOR SUBSTANCE USE DISORDERS 198
6 FUTURE PSYCHOACTIVE SUBSTANCES 201
7 FUTURE THERAPEUTICS 203
8 CONTEXT OF FUTURE TREATMENTS 209
9 PROSPECTS 210
10 APPENDIX: ACRONYMS 223
Chapter 7. Psychological Treatments of Substance Misuse and Dependence 224
1 EXECUTIVE SUMMARY 225
2 INTRODUCTION 225
3 WHERE ARE WE NOW? THE CURRENT EVIDENCE BASE ON PSYCHOLOGICAL TREATMENTS 229
4 PSYCHOLOGICAL TREATMENTS OF SUBSTANCE MISUSE AND DEPENDENCE: THE FUTURE? 239
5 WHAT WILL BE THE DRUGS OF THE FUTURE? 242
6 PSYCHOSOCIAL TREATMENTS OF THE FUTURE 244
7 PREVENTION STRATEGIES IN THE FUTURE? 248
8 CONCLUSIONS 249
Chapter 8. Cognition Enhancers 256
1 EXECUTIVE SUMMARY 257
2 DEFINITIONS AND SCOPE OF REVIEW 257
3 BACKGROUND 258
4 BASIS OF LEARNING AND MEMORY 259
5 CURRENT COGNITION ENHANCERS 262
6 COGNITION ENHANCERS IN DEVELOPMENT 277
7 FUTURE COGNITION ENHANCERS 281
8 IMPLICATIONS 283
9 CONCLUSIONS 285
Chapter 9. Neuroimaging 300
1 EXECUTIVE SUMMARY 301
2 FUNCTIONAL NEUROIMAGING IN THE STUDY OF DRUG ADDICTION: DEFINING PHARMACOLOGY AND CRAVING 301
3 FUNCTIONAL NEUROIMAGING IN THE STUDY OF DRUG ADDICTION 307
4 FUNCTIONAL NEUROIMAGING IN PRECLINICAL MODELS OF ADDICTION 312
5 MOLECULAR IMAGING AND THE ROLE OF PET 315
6 ADVANCES IN MRI/S TECHNOLOGY 317
7 TRANSCRANIAL MAGNETIC STIMULATION 321
8 FURTHER DEVELOPMENTS 323
Chapter 10. Drug Testing 330
1 EXECUTIVE SUMMARY 330
2 INTRODUCTION 331
3 TEST MATRICES 332
4 ANALYTICAL METHODS 337
5 EMERGING TECHNOLOGIES 346
6 THE FUTURE OF DRUG TESTING 349
7 CONCLUSIONS 350
Chapter 11. Social Policy and Psychoactive Substances 352
1 EXECUTIVE SUMMARY 352
2 OPTIONS FOR CONTROLLING PSYCHOACTIVE SUBSTANCES 353
3 INSTRUMENTS AND MEANS OF GOVERNANCE AND CHANGE 363
4 POLICY IMPACT STUDIES 363
5 SCENARIOS FOR THE FUTURE 366
6 AN OPPORTUNITY FOR RESEARCH – AND FOR EVIDENCE-BASED POLICIES 369
Chapter 12. Sociology and Substance Use 374
1 EXECUTIVE SUMMARY 374
2 INTRODUCTION 377
3 SOCIOLOGICAL RESEARCH IN THE SUBSTANCE USE/MISUSE FIELD 377
4 DEVELOPMENTS IN THE PREVALENCE OF SUBSTANCE USE AND MISUSE 380
5 INDIVIDUAL SOCIAL AND CULTURAL FACTORS INFLUENCING DRUG USE 389
6 TREATMENT 392
7 CONCLUSIONS 395
Chapter 13. Economics of Addiction and Drugs 404
1 EXECUTIVE SUMMARY 404
2 INTRODUCTION 406
3 THE ROLE OF ECONOMIC THEORY 406
4 THE EMPIRICAL PICTURE 412
5 COST-EFFECTIVE MANAGEMENT OF SUBSTANCE MISUSE 417
6 PATTERNS OF DRUG ADOPTION 419
Chapter 14. Problem Gambling and Other Behavioural Addictions 432
1 EXECUTIVE SUMMARY 432
2 INTRODUCTION TO THE CONCEPT OF BEHAVIOURAL ADDICTION 434
3 GAMBLING ADDICTION 436
4 ACCOUNTING FOR THE DEVELOPMENT OF A BEHAVIOURAL ADDICTION SUCH AS GAMBLING 439
5 AVAILABILITY OF TREATMENTS FOR BEHAVIOURAL ADDICTIONS 445
6 CONCLUSION: CURRENT SCIENCE CAPABILITY AND DEVELOPMENTS IN THE NEXT 10 YEARS 447
Chapter 15. Ethical Aspects of Developments in Neuroscience and Drug Addiction 454
1 EXECUTIVE SUMMARY 454
2 ETHICAL ISSUES OF POTENTIAL CLINICAL APPLICATIONS: THE NEXT 20 YEARS? 455
3 VACCINATIONS AND DRUG MISUSE 456
4 GENETICS AND INDIVIDUALISED INFORMATION 463
5 NEURAL IMAGING 468
6 PERFORMANCE, COGNITIVE ENHANCEMENTS AND DRUG ADDICTION 469
7 CONCLUSIONS 472
Chapter 16. History and the Future of Psychoactive Substances 482
1 EXECUTIVE SUMMARY 482
2 INTRODUCTION 483
3 WHAT WILL BE THE PSYCHOACTIVE SUBSTANCES OF THE FUTURE? 483
4 WHAT ARE THE EFFECTS OF USING PSYCHOACTIVE SUBSTANCES? 490
5 WHAT MECHANISMS DO WE HAVE TO MANAGE THE USE OF PSYCHOACTIVE SUBSTANCES? 492
6 CONCLUSIONS 496
Chapter 17. Life Histories and Narratives of Addiction 500
1 EXECUTIVE SUMMARY 500
2 INTRODUCTION 502
3 NARRATIVE THEORY 503
4 CONCEPT OF ADDICTION 505
5 ADDICTION – ITS LITERARY DEPICTION IN THE NINETEENTH CENTURY 506
6 ILLNESS NARRATIVES 507
7 ADDICTIONS OF THE PAST, PRESENT AND FUTURE 512
8 WHAT KINDS OF INTERVENTION MIGHT BE SUCCESSFUL IN PREVENTING ADDICTION? 516
9 CONCLUSIONS 516
10 APPENDIX: SUMMARIES OF POST-1950S ADDICTION NARRATIVES CONSIDERED 519
Chapter 18. Drugs Futures 2025? Perspective of the Pharmaceutical Industry 522
1 EXECUTIVE SUMMARY 522
2 INTRODUCTION 524
3 SURVEY RESULTS 529
4 APPENDIX: SURVEY MATERIAL 543
Chapter 19. The Scenarios 550
1 INTRODUCTION 551
2 SCENARIO PLANNING 551
3 OVERVIEW OF THE SCENARIOS 552
4 HIGH PERFORMANCE 555
5 NEIGHBOURHOOD WATCH 561
6 DISPENSE WITH CARE 566
7 TREATED POSITIVELY 570
8 WORKING WITH THE SCENARIOS 575
9 APPENDIX: METHODOLOGY 577
Author Index 582
Subject Index 612