These readings in the scientific and popular literature about addiction and related topics were suggested by readers of unhooked.com. See Note, below. To suggest additional readings, please e-mail webmaster@unhooked.com

People with specific questions about scientific, medical and pharmacologic topics in recovery may have their inquiries researched by William McCloskey, PGHnews@aol.com . Contact him directly.

Topic Index: Genetics and Addiction | Brain Physiology | 'Controlled Drinking' | Effects of Alcohol | Alcoholism as Disease | Women | Youth, Students | Tobacco | Advocacy, Law & Policy | Dual Diagnosis | For the Professional | Secular Options | Drug Treatments | Alcohol Industry | Other Cultures | Treatment | Stress | Ethics 

Ethics

• Religion, Spirituality and Medicine. By Richard P. Sloan.  Does religious activity promote positive health outcomes? A small group of well funded medical researchers would have us believe that is the case and they have been successful in promulgating what turns out to be at best an unsubstantiated assertion. This critical examination of the professional literature on this topic forms the solid background for answering the question:  Can physicians ethically prescribe religion for their patients (e.g. AA for alcoholism)?

• THE MORALITY OF ALCOHOLISM by Gary S. Stofle. The morality of alcoholism is a topic seldom on the agenda of workshops concerning alcoholism, or dealt with as a topic by itself in the literature. And yet moral issues regarding alcoholism are often talked about among professionals and this is a topic in many counseling sessions....Morality in the context of alcoholism can be viewed as a moral/physical dualism where alcoholics are not morally responsible for their behavior during the active alcoholism, but they are always physically responsible for their behavior. Each piece of the moral/physical dualism is explained ...  Part Two of Article here.

Genetics and Addiction

• Cellular Biology of Addiction.  A course given Aug. 17-31 2001 at the Cold Spring Harbor Laboratory; funding support by NIDA.  Series of video lectures.  Requires sound card and Real Player.  Best with high-speed Internet connection.  (Steve Snyder 7/21/02)
   

• From the Lab to the Clinic: Group Works to Understand Alcoholism.  Researchers at the Bowles Center at the University of North Carolina, Chapel Hill, are on the track of genetic and biological differences that appear to define some types of alcoholism.  (Scott N., 6/23/02)
   
• Neurogenetics Lab Scan Suggests Genetic Linkage on Chromosomes 4 and 11 Genetic links to alcoholism and drug addition as well as resistance to same are being identified in specific areas of chromosomes.  (Marty N. and Scott N. 2/28/99)

• Kenneth Blum and others, Reward Deficiency Syndrome,  [See note]  The American Scientist, March-April 1996. Alcoholism and some other addictions and compulsions have in common the inability to achieve satisfaction from limited quantities of a pleasure stimulus. This inability, "reward deficiency syndrome," is hard-wired into the brain and appears to be linked to a genetic variation in the D2 receptor of chromosome 11. (Steve Gardner, 10/9/96)  [Note: the original link to The American Scientist is temporarily unavailable while the journal rebuilds its web site.  In the interim, please use this substitute source.  -- MN 5/30/03]

Brain Physiology and Addiction

• The Addicted Brain.  Drug abuse produces long-term changes in the reward circuitry of the brain. Knowledge of the cellular and molecular details of these adaptations could lead to new treatments for the compulsive behaviors that underlie addiction.  By Eric J. Nestler and Robert C. Malenka, Scientific American, March 2004.  (Dan K. 7/24/04)

• Cellular Biology of Addiction.  A course given Aug. 17-31 2001 at the Cold Spring Harbor Laboratory; funding support by NIDA.  Series of video lectures.  Requires sound card and Real Player.  Best with high-speed Internet connection.  (Steve Snyder 7/21/02)
   

• Neurobiology of Addiction.  A Spring semester 2000 course at the University of California San Francisco -- Wheeler Center for the Neurobiology of Addiction.  Online materials include course outline and reading materials from the professional literature, including full text PDFs of journal articles not readily available elsewhere.  [MN 6/14/00)
  
  

• Scientists Identify Brain Systems Involved in Drug Craving. National Institute on Drug Abuse research summary. (Marty N., 10/16/96)
  
  
• Scientists discover new brain system that counters effects of opioid drugs. National Institute on Drug Abuse research summary. (Marty N., 10/11/96)
  
  
• Chronic morphine use produces visible changes in brain cells. National Institute on Drug Abuse research summary. (Marty N., 10/11/96)

• ANIMAL MODELS IN ALCOHOL RESEARCH, from: ALCOHOL ALERT (National Institute on Alcohol Abuse and Alcoholism) April 1994, pp. 1-4. Studies with mice and other animals shed light on physiological and biochemical factors in alcohol addiction. (Tom S., 10/22/96)*

"Controlled Drinking"

• Founder of Moderation Management sentenced to 4 1/2 years for fatal drunk driving crash (MN 2/11/01)
  
  
• The Winter of Scholarly Science Journals, by Irving Maltzman, Ph.D., Professional Counselor, Oct. 1992. Maltzman uncovers a scholarly fraud: the Sobell studies purporting to prove that 'controlled drinking' is a viable option. (Mike B., 9/1/96)*

Effects of Alcohol

• Alcohol and Violent Crime, National Council on Alcohol and Drug Abuse fact sheet, Spring 1995. (Mike B., 9/1/96)*

• Alcohol and Domestic Violence, National Council on Alcohol and Drug Abuse fact sheet, Spring 1995. (Mike B., 9/1/96)*
   
• Writers and Alcohol, by Ann Waldron.  The impact of alcohol in wrecking the careers of some of the greats and not-so greats of American literature.  From the Washington Post, March 14, 1989.*
   
• Alcohol and Illicit Drug Abuse and the Risk of Violent Death in the Home, by Frederick P. Rivara, MD, MPH; et al., Journal of the American Medical Association, August 20, 1997. Living in a home where someone drinks or uses illicit drugs greatly increases the risk of being killed, even for the non-user. (Nick J., 9/5/97)*

• Paying the price of my father's booze, by Scott Russell Sanders, HARPER'S, Nov. 1989, pp. 68-75. His father's alcoholism, illuminated only by the Biblical tradition, left its indelible stamp on the author and all his family. (Tom S., 10/21/96)*

• Through a Chemist's Eyes: a Dispassionate Look at Alcohol, by John Emsley, Ph.D., CONSUMERS' RESEARCH July 1995. Analysis of the chemistry of alcohol in the body. (Tom S., 10/21/96)

• 'Recovery Movement': a Blame Game Carried Too Far, by Ronder Thomas Young, ATLANTA JOURNAL & CONSTITUTION (Atlanta, Ga.) Nov. 17, 1991. Between binges, his father taught him ethics, and seeing real addicts shaking in withdrawal has made the author leery of putting the 'addiction' label on everything. An appeal for balanced use of the "recovery" model. (Tom S., 10/27/96)

Alcoholism as a Disease

• The Alcoholism Revolution, by James Milam, Ph.D., Professional Counselor, Aug. 1992. In this classic manifesto, the author of Under the Influence outlines the clash between the 'psychogenic model,' which holds that alcoholism is a symptom or consequence of an underlying character defect, and the 'biogenic model,' which recognizes that alcoholism is a primary addictive response to alcohol in a biologically susceptible drinker, regardless of character and personality. (Mike B., 9/1/96)*

• To All Concerned With the Drug-Crime Epidemic, by James Milam, Ph.D., email broadcast, Nov. 17, 1995. The author of The Alcoholism Revolution answers critics and decries the mindless trend of expecting punishment to cure addiction. (Mike B., 9/1/96)*

• .Treat Heroin Like a Disease, Experts Say, by Maggie Fox, Health and Science Correspondent (Reuters). Heroin addiction is a disease and should be treated as such, a panel of U.S. experts said on Wednesday. [Nov.19, 1997], by Maggie Fox, Health and Science Correspondent (Reuters). Heroin addiction is a disease and should be treated as such, a panel of U.S. experts said on Wednesday. [Nov.19, 1997]

Women

• Women's Health and Gender Differences are the focus of this special section of the NIDA website. Many articles and links about women and addiction as well as other issues related to gender and health. (Scott N. 6/26/99)

• Wrapped in their shawls, "chujs" and sweaters, the Zapatista women lifted up their bandannas with the demand that "the federal army leave our communities". Along these lines, in the communiqué, they denounced the fact that soldiers, police and economic bosses have fomented alcoholism and prostitution in the indigenous communities. ("5,000 Zapatista women march in San Cristobal" Chiapas, Mex. La Jornada, March 9, 1996)(Marty N., 3/6/96)
   
• In the worst way, American women are closing the gap with men: Women are increasingly likely to abuse substances at the same rate as men and women are starting to smoke, drink and use drugs at earlier ages than ever before. Women get drunk faster than men, become addicted quicker and develop substance abuse-related diseases sooner. At least one of every five pregnant women uses drugs, drinks or smokes, putting herself and her newborn in great and avoidable danger. (Substance Abuse and the American Woman, National Center on Addiction and Substance Abuse at Columbia University, June 1996)(Marty N., 3/6/96)
   
• Women's hearts are damaged more easily by alcohol than men's.   The Greater Risk of Alcoholic Cardiomyopathy and Myopathy in Women Compared With Men, by Alvaro Urbano-Marquez, MD; Ramon Estruch, MD; Joaquin Fernandez-Sola, MD; Jose Ma Nicolas, MD; Juan Carlos Pare, MD; Emanuel Rubin, MD.  JAMA. 1995;274:149-154.  (Nick J., 7/6/98)*

• Gender-limited research.  In past research on drug abuse, as well as other fields of public health, research subjects have been almost exclusively male; as a result little data have been available on women.  But that is changing.  (NIDA)
   
• Three large cohort studies, involving over 500,000 men and women, observed increasing all-cause mortality beginning at 4 drinks per day in men and above 2 drinks per day in women. Women achieve higher blood alcohol levels than do men, due to smaller size and slower metabolism. Compared to nondrinkers and light drinkers, overall mortality was 30-38% higher among men, and more than doubled among women, who drank 6 or more drinks per day. (Screening for Problem Drinking, NIH research monograph, 1995)(Marty N., 3/6/96)

• Fetal Alcohol Syndrome (FAS) is a pattern of mental and physical defects which develops in some unborn babies when the mother drinks too much alcohol during pregnancy. A baby born with FAS may be seriously handicapped and require a lifetime of special care. (Missouri Department of Mental Health 1994 Fact Sheet) Marty N., 3/6/96)
   
• Problems associated with alcohol, tobacco, and other drug use during pregnancy are well documented in the research literature. CSAP's publication Alcohol, Tobacco, and Other Drugs May Harm the Unborn presents recent findings of basic research and clinical studies on the effects of alcohol, tobacco, and other drugs on the unborn, on the mother herself, and on the baby after birth through lactation. (National Resource Center for Prevention of Perinatal Abuse of Alcohol and Other Drugs, ?1992). (Marty N., 3/6/96)

• In a special issue of Bar Leader magazine devoted to the topic of women and substance abuse, Judge Sarah L. Krauss of the Kings County Civil Court in Brooklyn writes for the first time about her personal journey "from alcoholism to sobriety, recovery and the bench." (American Bar Association Bar Leader Magazine, May 1996) (Marty N., 3/6/96)

• Dr. Jean Kirkpatrick couldn't cope with the fact that she was the first woman to receive the Fels Fellowship award at the University of Pennsylvania, so she went out and got drunk. Fearing that a mistake had been made and the funds to write her doctoral dissertation would be taken away, Dr. Kirkpatrick broke 3 years of sobriety with a drunk that lasted 13 years. (Profile of the founder of Women for Sobriety, WFS Home Page) Marty N., 3/6/96)
   
• A recent study linking victimization to alcohol problems found that almost 90% of alcoholic women were physically or sexually abused as children. (National Council for Alcohol and Drug Dependence fact sheet, 1996).(Marty N., 3/6/96)

• Repeated or sustained episodes of alcohol intoxication may suppress hormonal activity in women. Studies suggest that there is a higher prevalence of menstrual dysfunction and accelerated onset of menopause among alcoholic women. Other problems such as obstetrical disorders and gynecological surgery are also more common. (U.S. Department of Health and Human Services, Office for Substance Abuse Prevention, 1991)(Marty N., 3/6/96)

Children, Youth, Students

• The Origins of Addiction: Evidence from the Adverse Childhood Experiences Study, by Vincent J. Felitti, MD.  Results of a study by Kaiser Permanente in San Diego, published as PDF 2/16/2004.  (Thanks Gil Shepar MFT for the link, 4/12/05)). 

• Binge Drinking in College by Leslie Gevirtz.

• Mind Over Matter   This series is designed to encourage young people in grades five through nine to learn about the effects of drug abuse on the body and the brain.         (Thanks Bernie P. for the link, SN 7/31/98).

• WHO WILL BECOME AN ALCOHOLIC?, by Theresa Tamkins, from AMERICAN HEALTH, June 1994, p. 16. Young men who show an above-average tolerance for alcohol when they start drinking are more likely to become alcoholics, especially if their fathers are alcoholics also. (Tom S., 10/22/96)*

• Students Like it 'Substance-Free', From The Oakland Tribune, Sept. 5, 1996. Even at party schools, a growing number of students are sick of the drugs-and-drinking subculture and are demanding -- and getting -- substance-free housing. (Marty N., 10/22/96)*

• Intrauterine Exposure to Drugs and Alcohol: How Do the Children Fare? by Sarojini S. Budden, MD, Medscape Women's Health 1(10), 1996. A study of young children in Oregon suggests that children of mothers who used alcohol and/or a variety of drugs during pregnancy tended to have dramatically higher rates of behavior problems after age 3, together with speech and cognitive defects. Children diagnosed with Fetal Alcohol Syndrome also tended to have a degree of mental retardation. (Nick J., 11/20/96)*

Cigarettes, Tobacco

• Nicotine: The Elephant in the Treatment Room.  Report on an Oakland CA workshop for substance abuse and mental health treatment providers, organized by the ATOD (Alcohol Tobacco and Other Drugs) Network June 5 2002.  With PDF reprints of a series of written materials.  (In the Cutting Edge section of this website).  (6/11/02)
   
• Drug May Suppress the Craving for Nicotine.  An epilepsy drug called gamma vinyl-GABA (GVG) suppresses a neurochemical hallmark of nicotine and other addictive drugs: a rise of the neurotransmitter dopamine in the brain's "reward centers."

• Research report on Nicotine Addiction from NIDA Extensive report on the neuroscience and scientific treatment of nicotine addiction. (Thanks Bernie P. for the Link SN7/31/98).

• Most Alcoholics Die From Tobacco-Related Diseases. A Mayo clinic study of death records of 845 persons admitted to an inpatient alcohol recovery program found that more than half died of tobacco-related causes, only a third of causes related to alcohol. The physician conducting the research suggests that most persons undergoing treatment for alcoholism should undergo treatment for nicotine dependence, as well. (Nick J., 11/20/96)*

• Lung Test May Help Smokers Quit. A new test may help detect cancer in smoker's lungs before it gets started. The test, called LungCheck, uses sputum samples to detect signs of an immune response to lung toxins, and the presence of precancerous and cancerous changes, 3 to 5 years before such changes are evident on an x-ray, according to the manufacturer. (Nick J., 11/20/96)*

• Depressed Teens Smoke More. Teenagers suffering from depression are much more likely to reach for a cigarette than contented teens, says a new study from New Zealand. (Nick J., 11/20/96)*

• A Prospective Study of Cigarette Smoking and Age-Related Macular Degeneration in Women and ... in Men, (Abstracts), Journal of the American Medical Association (JAMA), October 9, 1996. Cigarette smoking increases the risk of blindness in old age, in women and men. (Nick J. 10/15/96)*

• Effects of Cigarette Smoking on Lung Function in Adolescent Boys and Girls, (abstract) The New England Journal of Medicine, Sept. 1996 . Cigarette smoking in adolescents leads to airway obstruction and slower growth in lung function, probably more severe in girls. (Nick J., 10/15/96)*

             See also: The Unhooked Sober Alcoholic's Stop Smoking Support Page

Dual Diagnosis

• Neurobiology of Depression by Charles Nemeroff.  The search for biological underpinnings of depression is intensifying. Emerging findings promise to yield better therapies for a disorder that too often proves fatal. Scientific American article. (Scott N., 9/12/98)

• Attention Deficit Disorder by Russell A Barkley. A new theory suggests the disorder results from a failure in self-control. ADHD may arise when key brain circuits do not develop properly, perhaps because of an altered gene or genes. A Scientific American article.  (Scott N., 9/12/98)

Advocacy, Law & Politics

Toward a New Recovery Movement, by William L. White.  Sees a new era of pluralism in recovery and discusses the ideas and organizational problems of the new movement.  White is the author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America, among other works.  He is a Senior Research Consultant at Lighthouse Institute / Chestnut Health Systems bwhite@chestnut.org.  PDF format.  [MN 2/25/01]

The Rhetoric of Recovery Advocacy:  An Essay On the Power of Language,  by William L. White.  Strives to end language abuse and to forge a new vocabulary for an era of pluralism in recovery.   White is the author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America, among other works.  He is a Senior Research Consultant at Lighthouse Institute / Chestnut Health Systems bwhite@chestnut.org.  PDF format.  [MN 2/25/01]

• The Creation of a Criminal Class, by Bradley Herman.  An unhooked original.  Rates of incarceration are skyrocketing, although crimes of violence and crimes against property have declined.  The new inmates are prisoners of the War on Drugs.  How are they treated?  What can they do after release?  This  documented first-person account pleads for sanity and intelligence in how our future neighbors are treated.
      

• ALCOHOLICS ANONYMOUS AS A CONDITION OF DRUNK DRIVING PROBATION: WHEN DOES IT AMOUNT TO ESTABLISHMENT OF RELIGION? By Michael G. Honeymar, Jr., Columbia Law Review, March 1997.  Argues that coerced AA attendance violates Establishment Clause but that "coercion" may be difficult to pin down.  [PDF]
   

• RELIGION AND REHABILITATION: THE REQUISITION OF GOD BY THE STATE, by DEREK P. APANOVITCH.  From Duke Law Journal.  Discusses the legality of government mandates to prisoners to attend 12-Step meetings.  Extensive analysis of constitutional issues, including cases cited below.  

• "Drug addiction is not a disease but a SIN" -- Bush's Texas record.  Article from the Washington Post reviewing religious-based drug and alcohol rehab facilities in Texas under Gov. Bush: a preview of what may lie ahead for the nation. 

• U.S. Supreme Court lets stand Second Circuit's decision that AA is religious.  News story recounting the Nov. 15 order of the U.S. Supreme Court denying Orange County's petition for certiorari in the Warner case, below.  (MN 11/15/99)
  

• Warner v. Orange County Department of Probation (2).  Full text of the April 1999 decision of the Second Circuit Court of Appeals reaffirming its 1996 decision (below) that the AA program is religious in nature.  (MN 11/15/99)
  

• Warner v. Orange County Department of Probation.  Full text of the 1996 Second Circuit Court of Appeals opinion holding that a prisoner's mandatory attendance at Alcoholics Anonymous meetings violates the Establishment Clause of the U.S. Constitution because of the AA program's religious nature.  (Marty N. 11/29/97)*
  

• DiStefano v. Emergency Housing Group.  Full text of decision by Second Circuit Court of Appeals, filed April 7, 2001, remanding case to trial court to determine whether counselors in publicly-supported private alcohol treatment program "indoctrinated" or "inculcated" AA teachings, even absent coercion, in violation of Establishment Clause.  [MN 2/11/03]
  

• Evans v. Tennessee Board of Paroles.   Full text of the Nov. 1997 Tennessee Supreme Court opinion holding that a prisoner may not be required to attend Alcoholics Anonymous as a condition of parole insofar as AA is a religious program within the meaning of the First Amendment and no alternative secular program is available to him.  (Marty N. 11/29/97)*
  

• Kerr v. Farrey. Full text of the 1996 Seventh Circuit Court of Appeals opinion holding that Narcotics Anonymous is a religious program and that a prisoner cannot be forced to attend NA without violating the Establishment Clause. (Marty N. 3/26/97)*
   

• Inmates can't be forced to attend drug abuse program, court rules, By Amy Rinard, Milwaukee Journal Sentinel staff, August 30, 1996. Press account of the story behind Kerr v. Farrey (above). (Marty N., 4/4/97)*

• Griffin v. Coughlin. Full text of the 1996 New York Court of Appeals opinion upholding the right of a prisoner to attend a secular alternative to AA on the ground that mandatory attendance at AA violates the constitutional separation of church and state. (Nick J., 2/22/97)*

• War Ends, Drugs Win. Amidst a growing consensus that the "War on Drugs" has failed, there are significant defections, even high up in the ranks of the warriors. Prevention, treatment, and harm reduction rather than criminalization and punishment make more sense to growing numbers of those in the front lines. From The Nation, January 6, 1997. (Marty N., 12/26/96)*

• Crack Sentencing Challenged. A sentencing guideline that punishes possession of crack cocaine much more severely than possession of an equivalent amount of powdered cocaine has no medical rationale and is unfairly biased against poor and minority small-time users while ignoring wealthy white abusers and dealers, says a University of Minnesota study. (Nick J., 11/20/96)*

• New Law Denies SSI, SSDI To Those With Alcoholism And Drug Addictions by Dee Mukherjee, Home Page of NAMI (National Alliance for the Mentally Ill). Congress has cut alcoholism and addiction from the list of disabilities qualifying for SSI or SDI. (Marty N., 10/15/96)

For the Physician and Counselor

• Addiction Psychiatry: Training, Certification, and Internet Resources. By John T. Pichot, MD, Luz Starck, MD, John T. Harris, MD, Texas Health Science Center at San Antonio; Jeffrey M. Benzick, MD, US Air Force Wilford Hall Medical Center. The psychiatrist who specializes in treatment of addictions is frequently misunderstood and shunned by peers. Practitioners are attempting to win professional recognition for addiction psychiatry as a subspecialty. The article reviews the principal issues and contains links to related materials. (Nick J., 7/13/97)*

• Brief Physician Advice for Problem Alcohol Drinkers: A Randomized Controlled Trial in Community-Based Primary Care Practices; by Michael F. Fleming, MD, MPH Michael F. Fleming, MD, MPH et al. A report on "Project Treat." The study showed that individuals who were problem drinkers but had not yet developed signs of alcohol dependence could be influenced to reduce their drinking by relatively brief words of advice from their physicians. From JAMA April 2. 1997--Vol 277 No. 13. (Nick J., 4/7/97)


 

• Alcoholics Anonymous and the Counseling Profession: Philosophies in conflict. By Christine Le, Erik P. Ingvarson, and Richard C. Page. From: Journal of Counseling & Development, 07-01-1995, p. 603. AA's emphasis on powerlessness, guilt, repentance and external removal of character defects is at odds with many elements in the general approach of the counseling profession. Before referring to AA groups, counselors should ask whether this approach will really be helpful for their clients, and should consider alternatives. (Tom S., 2/14/97)*
   

• Project Match: Three Types of Alcoholism Outpatient Treatment Equally Effective. The National Institute on Alcohol Abuse and Alcoholism reported the main findings of Project Match, the largest study of alcoholism treatment ever undertaken. More than 1700 patients were given controlled three-month treatments in programs using either the 12-step philosophy, or a cognitive-behavioral approach, or a motivational approach. All three approaches were equally effective in producing abstinence, relief of depression and improved liver function, the study reported. (NIAAA press release 12/17/96, Marty N. 12/20/96)
   

• Project Match redux: Alcoholics Synonymous: Heavy drinkers of all stripes may get comparable help from a variety of therapies, by Bruce Bower, from Science News, Jan. 25, 1997, p. 62. The costliest alcoholism study seems to prove whatever proponents claim it proves, and critics of its design and methods are not lacking. (Nick J., 2/21/97).*
   

• A RANDOMIZED TRIAL OF TREATMENT OPTIONS FOR ALCOHOL-ABUSING WORKERS, Diana Chapman Walsh et al., New England Journal of Medicine 1991; 325: 775-82. Of three groups of workers at a large industrial plant referred for alcohol problems, the group assigned to inpatient treatment did the best and the group required to attend AA meetings only did the worst and needed the most subsequent interventions. (Nick J., 8/16/97)
   

• Some Cocaine Abusers Fare Better With Cognitive-Behavioral Therapy, Others With 12-Step Programs.  Treatment response depended on the patients' abstract reasoning capacity and level of religious beliefs. By Barbara Shine, NIDA NOTES Contributing Writer.  NIDA Notes Vol. 15 No. 1.  (M.H. 6/03)