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'''For patient information click [[Substance abuse (patient information)|here]]'''
'''For patient information click [[Substance abuse (patient information)|here]]'''


{{Infobox_Disease
{{CMG}}; {{AE}} {{Uma}}
| Name = Substance abuse
 
| DiseasesDB =
 
| BESNIK KALI = 
{{SK}}
| OMIM =
| MedlinePlus = 001945
| MeshID =
}}
{{SI}}
{{CMG}}


==Overview==
==Overview==
''Also see [[Alcoholism]] and [[Drug addiction]].
Definitions of substance abuse vary and have changed over time. However, this is the most well known definition and the definition for which the term should be used.


'''Substance abuse''' refers to the use of substances when said use is causing detriment to the individual's [[health|physical health]] or causes the user [[legal]], [[social]], [[financial]] or other problems including endangering their lives or the lives of others. Substance abuse is not specific to illegal substances but people can also abuse legal substances which are bought or prescribed. Substance abuse is an old fashioned term for which the term problematic substance use is now more widely used.
==Historical Perspective==
*Substance abuse has been around for centuries
*Dr. Benjamin Rush was one of the primary researchers in substance abuse
*The technology to tackle the "intricacies to tack the cellular response to the drugs"  were not present at the time.
 
==Classification==
 
Alcoholism may be classified according to its symptomatic expression into three distinguished types:<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
*episodic excessive drinking
*habitual excessive drinking
*dependency of alcohol.
 
 
==Pathophysiology==
*The pathogenesis of substance abuse is not definitive.<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
*Medical practitioners, instead, use symptoms to determine what the disease is
*This arises problems because clinicians are not able to diagnose the disorder as effectively as systematic clinical visits
*First et al. [citation] and other analysis provides evidence that clinicians
**"were most likely making DSM diagnoses using a method other than by evaluating each of the diagnostic criteria in sequence." [citation]
 
 
==Causes==
 
*Substance abuse can emerge later on in life, but can still be influenced by factors from one's childhood.<ref name="Scheller-GilkeyThomas2002">{{cite journal|last1=Scheller-Gilkey|first1=G.|last2=Thomas|first2=S. M.|last3=Woolwine|first3=B. J.|last4=Miller|first4=A. H.|title=Increased Early Life Stress and Depressive Symptoms in Patients With Comorbid Substance Abuse and Schizophrenia|journal=Schizophrenia Bulletin|volume=28|issue=2|year=2002|pages=223–231|issn=0586-7614|doi=10.1093/oxfordjournals.schbul.a006933}}</ref>
 
*Studies have found that early life stress and a tendency to have depression/ mental illnesses has proven to lead to substance abuse disorder later in life
 
==Differentiating Substance Abuse from other Diseases==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
 
OR
 
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
 
==Epidemiology and Demographics==
This table uses data from [citation]. When talking about any disease, there are many demographic characteristics that may affect the trends of the disorder.
 
 
{| border="3"
|+ Population Analysis of the Percentages of Unauthorized Drugs
! Population Composition !! Percent Total of Population
|-
! Row heading 1
| Cell 2 || Cell 3
|-
! Row heading A
|Cell B
|Cell C
|}
 
==Risk Factors==
 
*Alcohol is one of the oldest "psychoactive substances" that humankind has known.<ref name="RobinsonAdinoff2016">{{cite journal|last1=Robinson|first1=Sean|last2=Adinoff|first2=Bryon|title=The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations|journal=Behavioral Sciences|volume=6|issue=3|year=2016|pages=18|issn=2076-328X|doi=10.3390/bs6030018}}</ref>
*Excessive drinking is a problem in the United States
*It can lead to intoxication
*Is the "third preventable leading cause of death in the United States."
 
==Screening==
 
*It is essential that the screening process be structured an thorough, so the client is properly diagnosed
*Substance abuse cannot be detected with a simple X-ray machine
*The Alcohol Use Disorder Identification Test [citation] is a screening test for General Alcohol and Drug Abuse
**It is a ten-question survey that takes about two minutes to answer
*Substance abuse could be the result of/ can lead to mental disorders
*According to the U.S. Preventive Services Task Force 2002 [citation], screening for psychiatric diseases need to be thorough and follow these four steps:
**"comprehensive assessment, accurate diagnosis, effective treatment, and careful followup." [citation]
 
==Natural History, Complications, and Prognosis==
*Cannabis use disorder is a type of substance abuse disorder that about 42.4% of the US population has developed in the past 3 years.<ref name="SarvetHasin2016">{{cite journal|last1=Sarvet|first1=Aaron L.|last2=Hasin|first2=Deborah|title=The natural history of substance use disorders|journal=Current Opinion in Psychiatry|volume=29|issue=4|year=2016|pages=250–257|issn=0951-7367|doi=10.1097/YCO.0000000000000257}}</ref>
*Although not conventional, warning signs include:
**Reduced frequency of use
**Abusing the substance when using it
**Developing other medical conditions
 
==Diagnosis==
===Diagnostic Study of Choice===
 
*It is common that people with substance abuse disorder also have a severe mental illness.<ref name="Santucci2012">{{cite journal|last1=Santucci|first1=Karen|title=Psychiatric disease and drug abuse|journal=Current Opinion in Pediatrics|volume=24|issue=2|year=2012|pages=233–237|issn=1040-8703|doi=10.1097/MOP.0b013e3283504fbf}}</ref>
*Mental illness can lead to a substance abuse disorder
*It has been recorded that about 7-10 million people in America possess at least one mental illness along with their substance abuse disorder.
 
===History and Symptoms===
*Since substance abuse disorder is the result of abusing virtually any drug, there are an array of symptoms depending on the substance
*This disorder can be common in people with other illnesses
*Researchers have seen a spike in the number of substance abuse cases among schizophrenia patients
*Many hold it to the "self-medication theory."
*Since schizophrenia can lead to "social withdrawal, apathy, dysphoria, and sleeping problems", many patients self-medicate to get rid of the negative feelings.
** Alcohol abuse among schizophrenic patients may lead to over-the-top hallucinations and delusions
** Cannabis abuse can lead to outrageous psychotic symptoms
** Cocaine abuse among schizophrenic patients, on the other hand, leads to a depressed mood.
 
===Physical Examination===
Some common symptoms that doctors look for are:
*poor personal hygiene
*significantly fluctuating weight
*marks on the skin that indicate injections,
*signs of withdrawal:
**slurred speech
**uneasy eyes
**euphoria
**sweating
**runny nose
**agitation
**sedation
 
===Laboratory Findings===
*Some lab tests that check for substance abuse include blood-alcohol content and urine Breathalyzers
**Although they are legal and effective, they only check for current use of the substance
*Urine tests are used across the spectrum of substance abuse, not just alcohol.
 
===Electrocardiogram===
There are no ECG findings associated with substance abuse.
 
===X-ray===
There are no x-ray findings associated with substance abuse.


== Other terms==
===Echocardiography or Ultrasound===
Other terms associated with substance abuse are substance use, substance misuse, problematic substance use, substance dependancy, substance [[addiction]], drug use, [[drug abuse]], drug dependancy, drug addiction, alcohol use, drinking, taking drugs, using drugs/substances, on a prescription, getting drunk, getting high, etc.  
There are no echocardiography/ultrasound findings associated with substance abuse.


"'''Substance use'''" basically means the use of any substance. This substance could be legal or illegal. The substance could be used in any manner of different ways such as sniffing, inhaling, swallowing, drinking, smoking or injecting. 
===CT scan===
There are no CT scan findings associated with substance abuse.


"'''Substance misuse'''" is a fairly modern term. It is used to mean the using of substances in a manner for which they were not intended. A good example of this would be using prescription medication differently to the way a doctor has directed. This could mean taking more tablets per hour than the doctor has directed or taking the substance into the body in a different way than directed by a doctor e.g injecting tablets rather than swallow as directed.
===MRI===
There are no MRI findings associated with substance abuse.


Substance use can become abuse or problematic use when it starts to cause the substance user medical, legal, social, economic etc. problems.
===Other Imaging Findings===
There are no other imaging findings associated with [disease name].


==Some definitions of substance abuse==  
===Other Diagnostic Studies===
The disorder is characterized by a pattern of continued pathological use of a medication, [[drug abuse|non-medically indicated drug or toxin]], that results in repeated adverse social consequences related to drug use, such as failure to meet work, family, or school obligations, interpersonal conflicts, or legal problems.  There are on-going debates as to the exact distinctions between substance abuse and [[substance dependence]], but current practice standard distinguishes between the two by defining substance dependence in terms of physiological and behavioral symptoms of substance use, and substance abuse in terms of the social consequences of substance use.<ref name="fn_2">Pham-Kanter, Genevieve. (2001). "Substance abuse and dependence." ''The Gale Encyclopedia of Medicine''. Second Edition. Jacqueline L. Longe, Ed. 5 vols. Farmington Hills, MI: Gale Group.</ref> 
There are no other diagnostic studies associated with [disease name].


Substance abuse may lead to addiction or substance dependence.  Medically, physiologic dependence requires the development of [[physiological tolerance|tolerance]] leading to [[withdrawal]] symptoms.  Both abuse and dependence are distinct from [[addiction]] which involves a [[compulsion]] to continue using the substance despite the negative consequences, and may or may not involve [[chemical dependency]]. Dependence almost always implies abuse, but abuse frequently occurs without dependence, particularly when an individual first begins to abuse a substance.  Dependence involves [[physiological]] processes while substance abuse reflects a complex interaction between the individual, the abused substance and society. Substance abuse is determined by the amount of pills,[http://www.mclean.harvard.edu/research/adarc/]
==Treatment==
===Medical Therapy===


==History==
*Substance abuse affects different circuits in the brain.<ref name="BariDiCesare2018">{{cite journal|last1=Bari|first1=Ausaf|last2=DiCesare|first2=Jasmine|last3=Babayan|first3=Diana|last4=Runcie|first4=Mariama|last5=Sparks|first5=Hiro|last6=Wilson|first6=Bayard|title=Neuromodulation for substance addiction in human subjects: A review|journal=Neuroscience & Biobehavioral Reviews|volume=95|year=2018|pages=33–43|issn=01497634|doi=10.1016/j.neubiorev.2018.09.013}}</ref>
In the early 1950s, the first edition of the [[American Psychiatric Association]]'s [[Diagnostic and Statistical Manual of Mental Disorders]] grouped alcohol and drug abuse under Sociopathic Personality Disturbances, which were thought to be symptoms of deeper psychological disorders or moral weakness.
**Standard medications and therapy, although helpful, cannot cure this disease
*People with this disorder have a tendency to relapse if treated with these types of medical therapies
*A field of medicine called neuromodulation has made advances in target and enhance treatment
**This method has proven effective for certain movement disorders such as epilepsy and OCD
**The data and interest in applying this to addiction is rapidly increasing


The third edition, in the 1980s, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.


In 1987 the [[DSM-III]]R category "psychoactive substance abuse", which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous". It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis.
===Surgery===
*Surgery is not recommended to prevent substance relapse
**this disorder can damage parts of the body that may require surgery to fix


By 1989, the DSM-IV defines substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal".
===Primary Prevention===


The fourth edition of the [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM) issued by the [[American Psychiatric Association]] defines substance abuse as:<ref name="fn_3">American Psychiatric Association (1994). ''Diagnostic and statistical manual of mental disorders'' (4th edition). Washington, DC.</ref>
*The first step to preventing this disease is an intervention.<ref name="DasSalam2016">{{cite journal|last1=Das|first1=Jai K.|last2=Salam|first2=Rehana A.|last3=Arshad|first3=Ahmed|last4=Finkelstein|first4=Yaron|last5=Bhutta|first5=Zulfiqar A.|title=Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews|journal=Journal of Adolescent Health|volume=59|issue=4|year=2016|pages=S61–S75|issn=1054139X|doi=10.1016/j.jadohealth.2016.06.021}}</ref>
*Interventions are not easy to complete successfully
** However, intensive family interventions and mass media campaigns are some methods that have proven to be effective.


:*A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
::#Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
::#Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
::#Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct
::#Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
:*B. The symptoms have never met the criteria for Substance Dependence for this class of substance.


The fifth edition of the DSM, planned for release in 2010, is likely to have this terminology revisited yet again. Under consideration is a transition from the abuse/dependence terminology. At the moment, abuse is seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's 'dependence' term, as noted above, does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requests input as to how the terminology of this illness should be altered as it moves forward with DSM-V discussion.
===Secondary Prevention===
*The next step after the intervention is providing intensive care:<ref name="FischerBlanken2015">{{cite journal|last1=Fischer|first1=Benedikt|last2=Blanken|first2=Peter|last3=Da Silveira|first3=Dartiu|last4=Gallassi|first4=Andrea|last5=Goldner|first5=Elliot M.|last6=Rehm|first6=Jürgen|last7=Tyndall|first7=Mark|last8=Wood|first8=Evan|title=Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies|journal=International Journal of Drug Policy|volume=26|issue=4|year=2015|pages=352–363|issn=09553959|doi=10.1016/j.drugpo.2015.01.002}}</ref>
**Therapy and another psycho/socio care
**Although these are valid tactics in the journey of recovery from substance abuse, they are understudied and require more research before they can be named "gold standard" treatment options


==References==
==References==
{{reflist|2}}
{{reflist|2}}


==See also==
{{WikiDoc Help Menu}}
*[[Addiction]]
{{WikiDoc Sources}}
*[[Addiction recovery groups]]
*[[Behavioural sciences]]
*[[Chemical dependency]]
*[[Shared Care]]
*[[Substance-abuse rehabilitation]]
*[[Treatment Improvement Protocols]]
[[fr:Toxicomanie]]
{{WH}}
{{WS}}
 
[[Category:Disease]]
[[Category:Disease]]
[[Category:Psychiatry]]
[[Category:Psychiatry]]

Latest revision as of 14:59, 3 November 2020

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For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Uma Maveli[2]


Synonyms and keywords:

Overview

Historical Perspective

  • Substance abuse has been around for centuries
  • Dr. Benjamin Rush was one of the primary researchers in substance abuse
  • The technology to tackle the "intricacies to tack the cellular response to the drugs" were not present at the time.

Classification

Alcoholism may be classified according to its symptomatic expression into three distinguished types:[1]

  • episodic excessive drinking
  • habitual excessive drinking
  • dependency of alcohol.


Pathophysiology

  • The pathogenesis of substance abuse is not definitive.[1]
  • Medical practitioners, instead, use symptoms to determine what the disease is
  • This arises problems because clinicians are not able to diagnose the disorder as effectively as systematic clinical visits
  • First et al. [citation] and other analysis provides evidence that clinicians
    • "were most likely making DSM diagnoses using a method other than by evaluating each of the diagnostic criteria in sequence." [citation]


Causes

  • Substance abuse can emerge later on in life, but can still be influenced by factors from one's childhood.[2]
  • Studies have found that early life stress and a tendency to have depression/ mental illnesses has proven to lead to substance abuse disorder later in life

Differentiating Substance Abuse from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

This table uses data from [citation]. When talking about any disease, there are many demographic characteristics that may affect the trends of the disorder.


Population Analysis of the Percentages of Unauthorized Drugs
Population Composition Percent Total of Population
Row heading 1 Cell 2 Cell 3
Row heading A Cell B Cell C

Risk Factors

  • Alcohol is one of the oldest "psychoactive substances" that humankind has known.[1]
  • Excessive drinking is a problem in the United States
  • It can lead to intoxication
  • Is the "third preventable leading cause of death in the United States."

Screening

  • It is essential that the screening process be structured an thorough, so the client is properly diagnosed
  • Substance abuse cannot be detected with a simple X-ray machine
  • The Alcohol Use Disorder Identification Test [citation] is a screening test for General Alcohol and Drug Abuse
    • It is a ten-question survey that takes about two minutes to answer
  • Substance abuse could be the result of/ can lead to mental disorders
  • According to the U.S. Preventive Services Task Force 2002 [citation], screening for psychiatric diseases need to be thorough and follow these four steps:
    • "comprehensive assessment, accurate diagnosis, effective treatment, and careful followup." [citation]

Natural History, Complications, and Prognosis

  • Cannabis use disorder is a type of substance abuse disorder that about 42.4% of the US population has developed in the past 3 years.[3]
  • Although not conventional, warning signs include:
    • Reduced frequency of use
    • Abusing the substance when using it
    • Developing other medical conditions

Diagnosis

Diagnostic Study of Choice

  • It is common that people with substance abuse disorder also have a severe mental illness.[4]
  • Mental illness can lead to a substance abuse disorder
  • It has been recorded that about 7-10 million people in America possess at least one mental illness along with their substance abuse disorder.

History and Symptoms

  • Since substance abuse disorder is the result of abusing virtually any drug, there are an array of symptoms depending on the substance
  • This disorder can be common in people with other illnesses
  • Researchers have seen a spike in the number of substance abuse cases among schizophrenia patients
  • Many hold it to the "self-medication theory."
  • Since schizophrenia can lead to "social withdrawal, apathy, dysphoria, and sleeping problems", many patients self-medicate to get rid of the negative feelings.
    • Alcohol abuse among schizophrenic patients may lead to over-the-top hallucinations and delusions
    • Cannabis abuse can lead to outrageous psychotic symptoms
    • Cocaine abuse among schizophrenic patients, on the other hand, leads to a depressed mood.

Physical Examination

Some common symptoms that doctors look for are:

  • poor personal hygiene
  • significantly fluctuating weight
  • marks on the skin that indicate injections,
  • signs of withdrawal:
    • slurred speech
    • uneasy eyes
    • euphoria
    • sweating
    • runny nose
    • agitation
    • sedation

Laboratory Findings

  • Some lab tests that check for substance abuse include blood-alcohol content and urine Breathalyzers
    • Although they are legal and effective, they only check for current use of the substance
  • Urine tests are used across the spectrum of substance abuse, not just alcohol.

Electrocardiogram

There are no ECG findings associated with substance abuse.

X-ray

There are no x-ray findings associated with substance abuse.

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with substance abuse.

CT scan

There are no CT scan findings associated with substance abuse.

MRI

There are no MRI findings associated with substance abuse.

Other Imaging Findings

There are no other imaging findings associated with [disease name].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

Treatment

Medical Therapy

  • Substance abuse affects different circuits in the brain.[5]
    • Standard medications and therapy, although helpful, cannot cure this disease
  • People with this disorder have a tendency to relapse if treated with these types of medical therapies
  • A field of medicine called neuromodulation has made advances in target and enhance treatment
    • This method has proven effective for certain movement disorders such as epilepsy and OCD
    • The data and interest in applying this to addiction is rapidly increasing


Surgery

  • Surgery is not recommended to prevent substance relapse
    • this disorder can damage parts of the body that may require surgery to fix

Primary Prevention

  • The first step to preventing this disease is an intervention.[6]
  • Interventions are not easy to complete successfully
    • However, intensive family interventions and mass media campaigns are some methods that have proven to be effective.


Secondary Prevention

  • The next step after the intervention is providing intensive care:[7]
    • Therapy and another psycho/socio care
    • Although these are valid tactics in the journey of recovery from substance abuse, they are understudied and require more research before they can be named "gold standard" treatment options

References

  1. ↑ 1.0 1.1 1.2 Robinson, Sean; Adinoff, Bryon (2016). "The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations". Behavioral Sciences. 6 (3): 18. doi:10.3390/bs6030018. ISSN 2076-328X.
  2. ↑ Scheller-Gilkey, G.; Thomas, S. M.; Woolwine, B. J.; Miller, A. H. (2002). "Increased Early Life Stress and Depressive Symptoms in Patients With Comorbid Substance Abuse and Schizophrenia". Schizophrenia Bulletin. 28 (2): 223–231. doi:10.1093/oxfordjournals.schbul.a006933. ISSN 0586-7614.
  3. ↑ Sarvet, Aaron L.; Hasin, Deborah (2016). "The natural history of substance use disorders". Current Opinion in Psychiatry. 29 (4): 250–257. doi:10.1097/YCO.0000000000000257. ISSN 0951-7367.
  4. ↑ Santucci, Karen (2012). "Psychiatric disease and drug abuse". Current Opinion in Pediatrics. 24 (2): 233–237. doi:10.1097/MOP.0b013e3283504fbf. ISSN 1040-8703.
  5. ↑ Bari, Ausaf; DiCesare, Jasmine; Babayan, Diana; Runcie, Mariama; Sparks, Hiro; Wilson, Bayard (2018). "Neuromodulation for substance addiction in human subjects: A review". Neuroscience & Biobehavioral Reviews. 95: 33–43. doi:10.1016/j.neubiorev.2018.09.013. ISSN 0149-7634.
  6. ↑ Das, Jai K.; Salam, Rehana A.; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A. (2016). "Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews". Journal of Adolescent Health. 59 (4): S61–S75. doi:10.1016/j.jadohealth.2016.06.021. ISSN 1054-139X.
  7. ↑ Fischer, Benedikt; Blanken, Peter; Da Silveira, Dartiu; Gallassi, Andrea; Goldner, Elliot M.; Rehm, Jürgen; Tyndall, Mark; Wood, Evan (2015). "Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies". International Journal of Drug Policy. 26 (4): 352–363. doi:10.1016/j.drugpo.2015.01.002. ISSN 0955-3959.


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