In February 2014, the journal Nature published an editorial concerned primarily with the attempt by animal rights activists to close down addiction research labs that experimented on animals (Anima...
Welcome to the Clinician’s Corner and the first paper to be published as a part of this periodic, clinically focused section of Addiction Research and Theory. The Clinician’s Corner will present relatively brief, clinically-focused reviews of emerging and current empirically supported treatments for substance use disorders. These reviews are not intended to comprehensive reviews of the research, but rather brief introductions to the approach reviewed that sufficient information and references to be useful to clinicians who are interested in learning about the latest advances in techniques that may be helpful to substance users. The first two Clinician’s Corner papers are already in hand, but we are interested in having more of these clinically useful reviews written. I therefore invite you, the readers of this journal, to submit your ideas and manuscripts to me for consideration. Or, if you would like to write a Clinician’s Corner piece, and would like to know if your idea is one that would likely be included, please feel free to email me at psydoc1948@gmail.com. If you already have a Clinician’s Corner style manuscript and wish to submit it to me for review, please feel free to use our usual submission process at the Informa Manuscript Central site: https://mc.manuscriptcentral.com/gart. I hope you enjoy this and subsequent Clinician’s Corner papers, and sincerely hope you will consider submitting one yourself!
On March 14, 2011 the field of addiction research and theory lost one of its pioneers and giants, G. Alan Marlatt. This special section was commissioned by the journal with the assistance of Kim Fromme and Mary Larimer as action editors. It consists of review papers by Alan’s former students and colleagues that each address his contributions to the field within a specific area. In this introduction, Kim, Mary and I provide an overview of the papers you are about to read, as well as some personal recollections of Alan. This special section was a labor of love in honor of a man whose life touched others in immensely positive and influential ways. Alan Marlatt’s contributions to our understanding of the psychological processes involved in addiction and its treatment were immense. In addition to innovative and creative research into basic processes of addiction such as the notion of loss of control, Alan was a pioneer in the cognitive-behavioral treatment of addictions. He was the true father of the notion of relapse prevention as we now know it. He was instrumental in bringing the philosophy of harm reduction to the USA, and was a spur to the integration of harm reduction into the treatment interventions for addictions. He developed one of the first effective brief interventions for heavy drinking college students, and he was a major force in the development of programs specifically aimed at helping Native American youth reduce or eliminate the scourge of addiction in their lives. His last work, just coming into wide circulation only months before his death, grew from his own life experience as a mindfulness practitioner to bring the benefits of mindfulness practice to people attempting to maintain positive changes in substance use. In addition to being a creator of some of the most effective approaches to helping people resolve problems related to substance use, Alan was a mentor to some of the most prominent researchers and clinicians in the field today. As a teacher, he was tireless and generous in providing his insights and guidance to a generation of addiction researchers who completed doctoral and post-doctoral work with him at the Alcohol and Behavior Research Center at the University of Washington. Those of us who knew him have vivid memories of the impact he had upon us. In the following three sections, each of us (FR, KF, ML) provide a brief reflection on Alan’s influences on our lives and careers. I (FR) was fortunate enough to have encountered Alan early in my career. I will never forget hearing Alan speak about the new technology of relapse prevention that he and his former wife Judith Gordon developed in the 1980s as an approach to what is still one of the major obstacles to overcoming problems with substance use: maintaining changes made in treatment. Relapse prevention was the first comprehensive system to address that issue. The first time, I heard Alan speak about relapse prevention I was struck both by the eminent sense his ideas made from a scientific psychological perspective, and by the angry vehemence with which some people in the audience accused him of ‘‘killing alcoholics’’ because his system was not based upon, nor did it necessarily encourage, use of 12-step support groups as the only way to overcome alcohol problems. Alan’s response to this accusation was characteristic of his soft-spoken, gentle and warm style. He invited the audience to try out his approach for themselves, and let the proof of the pudding be in the eating. For many years, I only knew Alan from his work. Most striking to me of his ideas, after relapse prevention, was his introduction of the philosophy of harm reduction, an approach he had first learned of on a visit to the Jellinek Center in Amsterdam, The Netherlands. Alan made harm reduction the focus of his Presidential Address to the Association for Advancement of Behavior Therapy (since renamed as the Association for Behavioral and Cognitive Therapies). I sat enthralled as he recounted yet another eminently logical and humanistic approach to working with substance users who were not ready to submit to our societal mandate to become abstinent from all substances in order to be accorded full status as a member of the community. It was through harm reduction, and the subsequent development of harm reduction therapy, which I first met Alan and had the opportunity to work with him on the planning and execution of two international conferences on harm reduction therapy. Although I never had the honor of studying with Alan or working with him on research, I did hear him present his work many times, and he became a valued friend, as did many of his former students whose works of love and respect appear in this special section of Addiction Research and Theory assembled in Alan’s honor.
If you have visited our website at http://informahealthcare.com/art or have opened your latest issue of the print version of the journal, you will notice some significant changes. In our continuing efforts to bring you content of the highest possible scientific and professional quality, and with the shortest possible publication lag, we have decided to greatly expand our Editorial Board and to add a second Associate Editor for the America (the UK Editors will also be adding a second Associate Editor in the near future). The aim is not only to insure that we will be able to render more timely decisions on manuscripts that are submitted in light of vastly increased numbers of submissions, but also that we will have Editorial Board members whose expertise reflects the diversity of areas from which we have submissions. We are quite pleased that more authors are submitting manuscripts and that the quality of those manuscripts is steadily increasing. The field of addictive behaviors is ever growing, and as research and clinical work proceed into new and previously less prominent areas (e.g., gambling behavior, adolescent and developmental issues in addictive behaviors) Addiction Research and Theory will be well prepared to identify and publish the most outstanding of the many submissions we receive annually. Before introducing our new Associate Editors and reviewing our new Editorial Board members, we want to extend our thanks to Dr William Gottdiener who has shifted his role from American Associate Editor to Editorial Board member. Bill served admirably during the last couple of years and was a major part of the increase in the quality of papers published and in the number of manuscripts submitted during the past year. The editorial team as a whole, and one of us in particular (F. Rotgers) would like to personally thank Bill for his hard work and high editorial standards. We will miss him as a regular colleague on the American side, but are very glad that he will remain as an Editorial Board member, continuing his high level of scholarly and scientific contributions to the journal. Two outstanding American scholars and researchers, Paige Ouimette of Syracuse University and Jennifer P. Read from the State University of New York at Buffalo are replacing Bill. Both Paige and Jennifer bring outstanding credentials to their new positions as Associate Editors for the Americas. Both have outstanding records of scholarly publication and have been involved in editorial activities with other journals in the addictive behaviors field. They will be dividing the responsibilities of Associate Editor. This means they will be handling fewer manuscripts each than would have been the case previously, and this should lead to more rapid decisions and feedback to authors. To assist Paige and Jennifer in their duties, we have recruited a number of additional Editorial Board members from the most scholarly and productive researchers and clinicians
The proposed Common Standard for Conflict of Interest [1] raises a number of difficult practical and philosophical issues concerning how science progresses, and there is not space here to address them all. However, we wish to raise just three points. The views expressed are our own, reflecting previous discussions [2–4], and do not represent those of any group or organization. First, there are hidden value judgements in the argument. Secondly, while the enterprise is underlaid by the laudable desire to eliminate bias and misleading or fraudulent research from the scientific enterprise, the type of disclosure suggested actually endorses a particular source of bias while ignoring others. Thirdly, there are serious practical and ethical issues with the degree of disclosure suggested. Implicit in the approach advocated is an unacknowledged moral evaluation. Namely, research from certain sources is to be viewed a priori with scepticism. However, fraud is a property of certain research papers; it is not an inherent property of their points of origin. The history of fraudulent research shows that no one segment of the research community has a sinecure on fraud [5]. Yet here we find concealed encouragement to treat research differentially on the basis of its provenance. The fact that published work has been subsequently disqualified (i.e. ‘un-published’) in the past purely on that basis is worth reiterating and should serve as a warning [6,7]. The second issue is possibly the most important. Science has always progressed on the back of research funded by a wide variety of sources, and carried out by bodies of all types, in the ubiquitous presence of personal bias and motive on all sides. These influences can never be eliminated; but overall knowledge increases despite them. No particular segment of the research ‘market’ has a claim to purity [we use the word ‘market’ advisedly in these days of inter-institutional competition for grants, government health agendas, the research assessment exercise (RAE) and other ratings systems which create conflicts of interest for all of us]. Our fear is that underlying the paper is an implicit intention to encourage the belief that such a claim to purity can be made. However, nobody conducts value-free or disinterested research. We are human beings, like everyone else, with attitudes, beliefs and values that colour what we do, all the time and every time; and we use scientific rhetoric to advance those views at the expense of others. The scientist who has no strong opinions about what he/she does, advocates no viewpoints, establishes no alliances, friendships or rivalries, has no political beliefs or biases and has never held a grant from anybody is probably a disinterested junior research assistant and is likely to remain so. Finally, the degree of detail suggested as relevant for disclosure includes academic rivalries, relationships, religious and political beliefs, public statements, strongly held views and so on. This is absurd. Because these things apply to every one of us at some level, disclosures will become as long as the articles they accompany. It is also impossible to comply with any feeling of security, as the recommendations introduce vast and new areas of uncertainty as to where to stop; and at some level, given the degree of disclosure recommended, some sort of conflict or vested interest can be found in everybody's CV if we are so motivated. As far as the journal Addiction Research and Theory is concerned, we ask our authors to declare their affiliations, funding sources and any vested interests/conflicts as a matter of course, without prejudice. However, the level of disclosure being suggested in the discussion paper is, in our opinion, overly intrusive and seems to rest on an unconscious perception/assumption that some research (‘virtuous’ research) is value-free, uncompetitive and not conflicted, whereas ‘commercial’ research is uniquely plagued by those things. With that in mind, the level of disclosure recommended reminds us somewhat of the novel Nineteen Eighty-Four. If it were to become a new standard, we fear an increasing number of witch-hunts involving people whose research we do not like for ideological reasons that have nothing to do with their science. It goes way too far and conceals hidden weapons for the fighting of moral, as distinct from scientific, wars! John Davies is UK Editor in Chief of Addiction Research and Theory. He is a member of the special health board, National Health Service Quality Improvement Scotland. In the last 3 years he has been in receipt of a Scottish Government grant to measure the social and cultural impact of the Scottish Smokefree legislation, in collaboration with the Universities of Stirling and Central Lancashire. He is a non-executive director of the Glasgow Council on Alcohol. In April 2008 he gave a talk on the concept of addiction to a JTI scientific workshop, for which he was paid. He believes the concept of ‘addiction’ is confused and self-handicapping and has expressed that view in a variety of contexts. Frederick Rotgers is US Editor in Chief of Addiction Research and Theory. He is a member of the New Jersey State Division of Addiction Services Professional Advisory Committee. He has presented numerous workshops on treatment methods and has been paid for those presentations. He will present a workshop at the American Psychological Association Annual Convention in August, 2009, for which he will be paid. He is a strong proponent of harm reduction approaches toward the negative consequences of human substance use, and believes that substance use and misuse need to be addressed from the perspective of the whole person, not primarily as a ‘brain disease’ or other biological entity.
"Editorial Clinically-focused reviews of treatment research and empirically-supported treatments: Introduction to a new feature in Addiction Research and Theory." Addiction Research & Theory, 17(2), pp. 113–114
This paper introduces three articles focusing on clinical harm reduction
"BOOK REVIEW--Substance Abuse Treatment for Criminal Offenders: An Evidence-Based Guide for Practitioners" Journal of Studies on Alcohol, 65(2), p. 283
Advances in treatment approaches available for persons with alcohol problems, particularly the advent of cognitive behavioral and motivational approaches, have made systematic assessment of these problems more important than ever for clinicians. There is a plethora of assessment instruments available, and it is a difficult task for clinicians to conceptualize, select and use these instruments in a coherent fashion. Particularly important in this task is the identification of research validated instruments that provide both clinically useful and psychometrically sound data. This paper presents a model of alcohol assessment and reviews selected research validated instruments that can be assembled into an assessment battery that provides useful data to guide treatment of alcohol problems while also addressing practical concerns encountered by clinicians in practice.