By Avram H. Mack MD, Kathleen T. Brady MD Ph.D., Sheldon I. Miller MD, Richard J. Frances MD
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Additional resources for Clinical Textbook of Addictive Disorders
Government instability, corruption, or inefficiency can cause or result from drug production, export, and/or smuggling today. Unstable countries in South Asia, the Middle East, Africa, and Latin America have become producers, transshippers, or importers of illicit drugs. Societal breakdown has led to substance abuse in some Moslem countries, contributing to a backlash of Islamic fundamentalism. Likewise, in the United States and Latin America, widespread alcoholism predates the shift to Christian fundamentalism.
The so-called Minnesota Model of treatment developed from several sources: a state hospital program (at Wilmar) and a later private program (at Hazelden), supplemented by the first day program for alcoholism (at the Minneapolis Veterans Administration Hospital). The characteristics of this “model” have varied over time as treatment has evolved and changed, and definitions still differ from one person to the next. However, characteristics often ascribed to the model include the following: 1. A period of residential or inpatient care, ranging from a few weeks to several months.
Habitués of opium dens, taverns, and cocktail lounges). In these latter instances, group norms for alcohol or drug use may foster substance abuse rather than prevent it (Dumont, 1967). Medicinal reasons for substance use have prevailed in one place or another with virtually all psychoactive substances, including alcohol, opium, cannabis, tobacco, the stimulants, and the hallucinogens (Hill, 1990). Insofar as substances are prescribed or administered solely by healers or physicians, abuse is rare or absent.