الفهرس 
Biological Model of Substance Abuse..Only 14 pages are availabe for public view
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Abstract
A
ddiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors (ASAM, 2015).
Certain non-substance behaviors-such as gambling, Internet use, video-game playing, sex, eating, and shopping bear resemblance to alcohol and drug dependence.
“Substance-Related and Addictive Disorders” in DSM-5, was newly introduced diagnostic category. Current evidence points to overlaps and differences between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts (Yau and Potenza, 2016).
Gambling disorder (GD) is the only best arguably studied behavioral addiction to date in the main section of DSM-5 (non-substance-related disorders). Internet gaming disorder (IGD) is a possible candidate for future inclusion in the addictions category in DSM-5 (Potenza, 2014).
The objectives of this study were to estimate the prevalence of addictive behaviors in a sample of patients with psychoactive substance use disorder (SUD) and compare the differences and similarities in socio-demographic, clinical variables and legal (criminal) factors in substance dependant individuals with and without addictive behaviors.
We hypothesized that; there would be a high prevalence of addictive behaviors among the patients with substance dependence.
Participants involved in the study were subjected to:
1- Informed consent: A written consent was obtained from them after explaining the objectives of the study.
2- Full neuropsychiatric history and examination for patients with substance use disorder (SUD) using psychiatric sheet of The Abbassia Mental Health Hospital (AMHH).
3- Routine laboratory investigation including liver and kidney function, complete blood picture, virology tests as well as ECG were performed to confirm exclusion of major physical illness.
4- A urine screen for substances of abuse: for common substances of abuse (opiates, cannabis, benzodiazepines, barbiturates, cocaine and amphetamines).
5- Arabic version of Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I): for clinical assessment and diagnosis of substance use disorder and exclude other psychiatric disorders.
6- Addiction Severity Index (ASI): to assess the problems presented by patients with substance use disorder.
7- Gambling Addiction Test (GAT): to assess the severity level of pathological gambling Addiction.
8- Internet Addiction Test (IAT): to assess the severity level of internet and computer addiction.
9- Global assessment of functioning (GAF): to determine the social, occupational, and psychological functioning of adults by DSM–IV criteria.
The main findings of this study were:
Gambling disorder (11%) and internet addiction (22%) had higher overall prevalence among substance use disorder patients. Consequently, Proper management of these addictive behaviors should be taken starting from withdrawal and all through the stages of recovery.
Socio-demographic characteristics of the study sample showed that age, marital status, socioeconomic level and educational level were insignificantly different among control, gambling disorder and internet addiction which could be attributed to the small sample size.
The legal (criminal) issue by ASI was the highest within Gambling disorder 81.8% group among the study sample followed by (SUD and IA) (31.9% and 22.7%) respectively.
Heroin use disorder was found to be the highest (79%) among substances use disorders and the highest (92.2%) in legality.
Our findings suggest that Addiction Severity Index (ASI), Internet Addiction Test (IAT) and Gambling Addiction Test (GAT) were found to be as objective tools in catchment and assessment of SUD, IA, GD and patients.
While investigating predictors, the Addiction Severity Index (ASI) was a significant predictor of increasing gambling disorder (GD) among substance abusers.
Those findings and predictor identified point to the need for therapeutic interventions aimed at optimizing illness management and consequently improving outcome.