Unlike diabetes or heart disease, addiction can’t be definitively detected through diagnostic tests. In many other ways, however, issues related to substance abuse mimic those of typical medical diseases. For example, the rates of depression and cardiovascular disease in the population are roughly equivalent to the incidence of addiction. By any measure, though, addiction presents a major public health problem. Just as they play important roles in the management of other common chronic conditions, so can dentists assist those suffering from the compulsive use of drugs or alcohol. Helping identify and treat such patients in the dental setting is the subject of a series of CE presentations by DOCS Education faculty member Dr. John Hexem. Part 1—released earlier this year--is called “Assessing Substance Abuse.” The second segment debuts this week; it’s entitled “Examining Addiction.” “Examining Addiction” is composed of three sections. They are “Pathophysiology,” “Clinical Course” and “Iatrogenic Risk.” The one-hour presentation is free for one month, and carries 1 CE (following successful completion of a quiz). A board-certified anesthesiologist, Dr. Hexem possesses both MD and PhD degrees, the latter earned in chemistry. That academic foundation gives him a unique perspective from which to study a field that is evolving in myriad ways across multiple fronts. The lack of shared definitions, varying meaning from one governmental agency to the next, complicates progress in the field. But many advances are taking place as well. One is the ability to look inside the brain through electronic imaging. Now researchers can hone in on the brain’s pleasure pathways, neurotransmitters such as dopamine. Evidence yields clarity on both sides of the spectrum—the extent of the damage caused by addiction along with the brain’s capacity to heal following recovery. Dr. Hexem’s first presentation addresses definitions, terminology and epidemiology. “Examining Addiction” continues the discussion. It reviews genetic, psychosocial and cultural factors involved in addiction and what scientists have recently learned about the physical effects on the brain. Lack of understanding about addiction and its causes is harmful because misinformation leads to undertreatment, including the failure to provide adequate pain relief. The misperception persists, Dr. Hexem explains, that substances such as opioids may result in addiction even where they are part of legitimate medical therapy. To use the example of cancer, the numbers of patients subsequently becoming addicted following the use of opioids for pain relief “is so small as to be completely insignificant.” People can and do recover from addiction. Referral to established treatment centers is always appropriate, Dr. Hexem adds. “Examining Addiction” offers one hour of CE credit. Like all DOCS Education online courses it is available at www.DOCSEducation.org and free for one month.
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