Reflections of an Academic Clinical Researcher on the past 40 Years of Addiction Development

Abstract

This paper reflects on three areas of addiction: prescription drug abuse, perinatal addiction, and the clinical fields of addiction medicine and addiction psychiatry. The concerns about the abuse and misuse of prescription drugs date back over a century with numerous laws passed to address these problems. Despite these laws, there has been increasing concern over the past decade about the increases in the nonmedical use and abuse of prescription drugs. This begs the question of whether the passing of laws addressing the supply side of the problem is the correct approach. Abuse of licit and illicit drugs by pregnant women creates concern because of the effects of drugs and alcohol on the fetus and future development of the child. Most of the studies have addressed newborn development without adequate studies of the effects of the drugs and withdrawal on pregnancy and the fetus. In addition, studies of long-term effects on the development of the child are needed. The only way to adequately address these important clinical issues will be to have well-trained clinicians and clinical investigators in addiction medicine and addiction psychiatry.