“Almost Addicted”: Drug Issues Can Be Diagnosed and Treated Sooner

Another book from Harvard’s Almost Effect series (see yesterday’s post) is Almost Addicted by psychiatrist J. Wesley Boyd, MD, PhD, and medical writer Eric Metcalf.

The “almost addicts” don’t meet the standard criteria for addiction diagnosis but have a problem nevertheless, states the book description. Why wait until a substance abuse problem is full-blown?

Most people who abuse illegal drugs don’t fit the image of the dysfunctional, hustling addict who can’t fit into normal society. Between the estimated 10 percent of the population who are true addicts and those who don’t use drugs at all falls a group of regular drug users who often don’t realize how much their use is affecting their daily lives.

On the rise is abuse of prescription medications, often given for specific medical conditions, then overused. A special vulnerability exists among youth and young adults, whose frontal cortexes are not yet fully developed.

Although Kate Williams, Psych Central, gives Almost Addicted a positive review, she also mentions some problematic areas:

For starters, it is at once meant for an audience of almost-addicted readers and for an audience of concerned loved ones. Granted, Boyd does try to divide guidelines into separate sections, but it’s still difficult to distinguish the approach he intends for each group.

Boyd also attempts to mention and include all drugs, yet concentrates overwhelmingly on marijuana. Pot is becoming more and more accepted, though, and instead of scapegoating it as the source of all drug problems (which seems simplistic at best), I wondered why Boyd didn’t focus more on prescription drugs—especially since this is the fastest growing area of abuse and addiction.

Finally, there’s a bit of a problem in the last part of the book, where Boyd recommends seeing a primary care doctor to begin the recovery process: The suggestion comes after an entire section on how primary care practitioners don’t have time, motivation, or expertise to notice, let alone care about, the almost-addicted population.

Joseph Shrand, MD, gives a more wholehearted thumbs up:

Almost Addicted is not an almost read but a must read. Through compelling and poignant stories, supported with a foundation of research that is deeply understood and applied, Dr. Boyd guides the reader through this often hidden and invisible part of our culture. This new view of addiction may help to stem the tide, prevent scores of people from progressing to full blown addiction, and save millions of dollars by identifying and treating those among us who are almost addicted.

Below Dr. Boyd gives his concepts the personal touch:

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