Chronic pain is one of the most prevalent medical conditions in the US. Besides physical symptoms, it has a profound impact on mental health and quality of life. The physiological mechanisms underlying chronic pain are complex; thus, treatments are limited. Opioid analgesics are one of the most commonly prescribed medications for the management of chronic pain; however, a major pitfall of the use of opioids is their addictive potential. Here we examine, in a mouse model, how chronic pain influences opioid addiction, with the hypothesis that chronic pain potentiates addiction due to the dual rewarding effects of opioids—euphoria and analgesia. We tested this using conditioned place preference (CPP), and find that this is not the case, as acquisition of a drug memory was attenuated under a chronic pain context. We also observe that chronic pain may facilitate extinction of the drug memory, suggesting that the mechanism of addiction under a chronic pain context is more complex than previously assumed. This complex behavioral phenotype is possibly a reflection of the underlying neural mechanisms involving multiple brain regions. In order to start understanding this mechanism, we mapped the expression of immediate early genes brain wide to identify key brain regions involved in both chronic pain and addiction. The prefrontal cortex (PFC) is one major brain region known to directly modulate circuits involved in both pain and drug addiction. However, the PFC consists of a myriad of cell types that project to distinct downstream targets, whose roles in specific behaviors are still largely unknown. A recent study classified the different subtypes of neurons in the PFC using single cell RNA sequencing (scRNA-seq), which identified a layer 5 pyramidal neuron (Pou3f1+) that is involved in pain and opioid taking. Using chemogenetic techniques, we manipulated the activity of Pou3f1+ neurons to test their response under pain and opioid use. These neurons appear to bi-directionally regulate pain perception, as activation increases mechanical sensitivity measured using von Frey filaments, and inhibition diminishes sensitivity. On the other hand, opioid administration under a chronic pain state potently activated Pou3f1+ neurons, as determined by cfos mRNA expression. These findings indicate potential interactions between the neural processing of chronic pain and opioid addiction, opening up the possibility of exploring common brain regions, and ultimately discrete cell types that can be therapeutically targeted to alleviate pain without the risk of addiction. / 2025-01-27T00:00:00Z

This dissertation examined the relationship between the predictor variables of adolescent refusal self-efficacy, social capital, and the common liability to addiction and the outcome variable of continuing care choices. Using a sample of 71 adolescents who had attended The CASTLE, High Point treatment center’s adolescent center in 2011, evidence was found to support the relationship between refusal self-efficacy, social capital and these outcomes. Following the results of preliminary analyses, family history of drug use was included in the list of predictor variables examined, in relation to the outcome of adolescent continuing care choices. It was determined that refusal selfefficacy and social capital were related to outcome choices of adolescents during treatment. Furthermore, including the independent variables of family history of drug use and common liability to addiction provided a more robust display of the directions adolescents moved towards.

Focusing on policy consultation, my dissertation consults on the current US addiction epidemic and aims to answer, "What is our disposition to addiction?" Borrowing and clarifying Ulmer's MEmorial method, as established in his text Electronic Monuments, the dissertation combines the ancient Greek practice of theoria, Deleuzian theory, and psychogeographic counter-mapping methods to trace ways in which ideological apparatuses construct addiction. The aim of the dissertation is to reveal an abject value by constructing MEmorials which provide space for individuals to mourn loss and see their relation to that loss. Through mourning, individuals strengthen their ties to other community members and new policy can be made possible. Currently there is not an AIDS-like quilt for the victims of the addiction epidemic; therefore, the dissertation proposes the construction of a physical and electronic MEmorial to addiction. By conducting a psychogeography, a method directly tied to logic and reasoning appropriate to electracy, I traced the abject value of desire as it is constructed through the assemblages that construct the values of the Bradenton, FL community. The psychogeography revealed a categorical image "DE" which I traced through the ideological state apparatuses working their effects on Bradenton, FL. The image also connects to Bradenton, FL to the larger National War on Drugs through the star emblem of John Wayne. Concluding from the method, I argue to create a MEmorial to addiction at the John Wayne Birthplace Museum to reveal the horror of our communal desires and call for national drug policy reform.

Thesis (M.S.)--Boston University

No description available.

The thirteen essays in this collection center on the narrator's shifting relationship to opioid painkillers and other drugs. The narrator and protagonist, Amy, begins using opioids recreationally with her boyfriend Ryan, an opiate addict who initiates Amy's drug use. Years after the couple breaks up, Amy's childhood headaches return as migraines and transform into chronic daily headaches, which she relieves with oxycodone (and sometimes other drugs). The narrative chronicles Amy's relationship with Ryan and her iatrogenic dependence on narcotic painkillers, detoxification, return to opioids following a year spent "clean," and the ways in which her headache treatment regimen shapes her relationship to her family, friends, various medical personnel, and her own embodied subjectivity. / MFA

The number of people who access the Internet has increased considerably over the past decade. The use of the Internet for sexual purposes (Cybersex) has begun to get the attention of clinicians as more and more families are affected. However, to date little research has been conducted to determine how much of a problem Cybersex is. The purpose of this study was to explore the degree to which marriage and family therapists are seeing clients who have had Cybersex related difficulties. A questionnaire was mailed to 500 randomly selected clinical members of the American Association for Marriage and Family Therapy. Thirty four percent of the sample responded. The results indicated that most of the respondents are seeing clients with Cybersex issues and the number of clients has been increasing over the past two years. The partners and children of Cybersex users were identified most often as the ones who came for therapy. Those who came with Cybersex as a secondary problem and individuals with Cybersex problems were identified less often. Although most respondents felt prepared to diagnose and treat adults with Cybersex problems, a half felt unprepared to diagnose and treat children. Most of the respondents reported that the required courses they took in College were not helpful in preparing them to diagnose and treat Cybersex related problems. / Master of Science

"What I Mean To Say" is a book length essay that explores the entanglement of writing, addiction, and grief.

No description available.

Occupational therapy (OT) has been greatly influenced by the medical model, despite its origins as an alternative to medicine. OT practice that finds its theoretical basis in a medical model is criticized as limited in therapeutic value, and as lacking boundaries distinguishing OT from other disciplines. By advancing a philosophical anthropology (Gehlen) with biological evidence from detachment theory (Moss), this project identifies and illuminates the power and unique value of occupational therapy. Occupational participation, made possible by OT, is described as a tool for structuring human lives into manageable temporal components with varying degrees of motivation and social interconnection. The value of providing opportunities for occupational participation is described as analogous to the value of instincts in animals’ lives; occupations are seen as the core elements that drive and shape human experiences. The inadequacies of current definitions of and research on addiction are reviewed and, as an alternative to current approaches, an occupational model for understanding addiction is outlined. Addiction is described as an attempt to create a manageable life—that is, as an occupation, and the concept of focused flexibility is introduced to normatively distinguish ‘addiction-occupations’ from other, potentially more ‘healthy’ occupations. Health is discussed in relation to the proposed philosophical anthropological, social, and biological situation of human beings. Finally, a qualitative study is undertaken to examine whether an occupational model of addiction accurately describes the experiences of addicts, thereby warranting further research. Findings from this preliminary study suggest addiction is experienced as an occupation, and that the concept of addiction as an occupation should be further explored.