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Stigma and Addiction Treatment

  • Linda RichterEmail author
  • Lindsey Vuolo
  • Mithra S. Salmassi
Chapter

Abstract

The history of stigma around addiction and its treatment is long and pervasive. Stigma permeates the public’s perceptions of people with substance use disorders, the self-perceptions of those who have the disease, and the way in which it is addressed on a structural level. Instead of offering evidence-based clinical treatments within a medical setting, addiction typically is addressed outside mainstream health care by providers who are not trained to offer the comprehensive clinical care needed by those who have this complex, chronic condition. Even worse, because of stigma, addiction frequently is criminalized and those who have it often are penalized and denied effective treatment. Stigma even surrounds treatment itself, especially medication-based treatment, which is offered to only a fraction of the people who need it and only under the weight of onerous regulations and restrictions, despite the mounds of scientific evidence attesting to its safety and effectiveness. As drug overdose deaths continue to climb, we cannot afford to wait until stigma is eradicated through widespread public acceptance to treat addiction as a disease. The government, the health care system, the criminal justice system, and employers—the systems in power—must override stigma’s influence by ensuring that addiction is addressed with compassion, by trained health care professionals, using proven clinical treatments. As addiction begins to be viewed as the treatable disease that it is, stigma will recede and we will more effectively be able to contain our nation’s addiction crisis.

Keywords

Addiction Medication-assisted treatment Opioids Stigma Substance use disorders Treatment 

References

  1. 1.
  2. 2.
    42 C.F.R. Part 8, Subpart F (2016). Authorization to increase patient limit to 275 patients. Available at: http://federalregister.gov/a/2016-16120.
  3. 3.
    42 C.F.R. § 8.12 (2016). Federal opioid treatment standards. Available at: https://www.gpo.gov/fdsys/pkg/CFR-2002-title42-vol1/pdf/CFR-2002-title42-vol1-sec8-12.pdf.
  4. 4.
    42 U.S.C. § 300gg-6(a) (2010). Coverage for essential health benefits package. Available at: https://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap6A-subchapXXV-partA-subpart1-sec300gg-6.pdf.
  5. 5.
    45 C.F.R. § 156.115(a)(3) (2015). Health insurance issuer standards under the Affordable Care Act, including standards relating to exchanges, essential health benefits. Provision of EHB. Available at: https://www.gpo.gov/fdsys/pkg/CFR-2013-title45-vol1/pdf/CFR-2013-title45-vol1-sec156-115.pdf.
  6. 6.
    78 Fed. Reg. 68,240, 68,254 (2013). Final rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Available at: https://www.gpo.gov/fdsys/pkg/FR-2013-11-13/pdf/2013-27086.pdf.
  7. 7.
    American Psychiatric Association. Practice guideline for the treatment of patients with substance use disorders (2nd Ed.). 2010. Available at: https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/substanceuse.pdf.
  8. 8.
    American Society of Addiction Medicine. Public policy statement on office-based opioid agonist treatment (OBOT). Chevy Chase, MD: Author; 2010.Google Scholar
  9. 9.
    Andrilla CHA, Coulthard C, & Larson EH. Changes in the supply of physicians with a DEA data waiver to prescribe buprenorphine for opioid use disorder. Data Brief #162. Seattle, WA: WWAMI Rural Health Research Center, University of Washington; 2017.Google Scholar
  10. 10.
    Ashford RD, Brown AM, Curtis B. Systemic barriers in substance use disorder treatment: a prospective qualitative study of professionals in the field. Drug Alcohol Depend. 2018;189:62–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Bayer R. Stigma and the ethics of public health: not can we but should we. Soc Sci Med. 2008;67(3):463–72.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Blummer KH, Marcus SC. Changing perceptions of depression: ten-year trends from the general social survey. Psychiatr Serv. 2009;60(3):306–12.CrossRefGoogle Scholar
  13. 13.
    Botticelli MP, Koh HK. Changing the language of addiction. JAMA. 2016;316(13):1361–2.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Boyd SJ, Fang LJ, Medoff DR, Dixon LB, Gorelick DA. Use of a ‘microecological technique’ to study crime incidents around methadone maintenance treatment centers. Addiction. 2012;107(9):1632–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Brady TM, Ashley OS. Women in substance abuse treatment: Results from the alcohol and drug services study (ADSS). Substance Abuse and Mental Health Services Administration. Rockville: Substance Abuse and Mental Health Services Administration; 2005.Google Scholar
  16. 16.
    Brener L, Von Hippel W, Von Hippel C, Resnick I, Treloar C. Perceptions of discriminatory treatment by staff as predictors of drug treatment completion: utility of a mixed methods approach. Drug Alcohol Rev. 2010;29(5):491–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. Adult drug court discretionary grant program FY 2015 competitive grant announcement. 2015. Available at: https://www.bja.gov/Funding/15DrugCourtSol.pdf.
  18. 18.
    Carson EA, Anderson E. Prisoners in 2015. Washington, D.C.: Bureau of Justice Statistics, Office of Justice Programs, United States Department of Justice; 2016. Available at: https://www.bjs.gov/content/pub/pdf/p15.pdfGoogle Scholar
  19. 19.
    CASAColumbia. Addiction medicine: closing the gap between science and practice. New York: Author; 2012.Google Scholar
  20. 20.
    Claxton G, Rae M, Cox C, & Levitt, L. An analysis of out-of-network claims in large employer health plans. Petersen-Kaiser Health System Tracker. 2018. Available at https://www.healthsystemtracker.org/brief/an-analysis-of-out-of-network-claims-in-large-employer-health-plans/?post_types=brief#item-start.
  21. 21.
    Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rüsch N, Brown J, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27.PubMedCrossRefGoogle Scholar
  22. 22.
    Commonwealth of Massachusetts. 2015. Baker-Polito administration announces groundbreaking medical school program to curb opioid crisis. Available at: https://core.ac.uk/download/pdf/146529648.pdf.Google Scholar
  23. 23.
    Commonwealth of Massachusetts. 2016. Baker-Polito administration, advanced practice nurses, physician assistants and community health centers expand on core competencies to combat opioid epidemic. Available at: https://www.mass.gov/news/baker-polito-administration-advanced-practice-nurses-physician-assistants-and-community-health.Google Scholar
  24. 24.
    Connery HS. Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harv Rev Psychiatry. 2015;23(2):63–75.PubMedCrossRefGoogle Scholar
  25. 25.
    Consolidated Appropriations Act. 2018 Pub. L. No. 115–141. Available at: https://www.congress.gov/115/bills/hr1625/BILLS-115hr1625enr.pdf.
  26. 26.
    Corrigan PW, Kerr A, Knudsen L. The stigma of mental illness: explanatory models and methods for change. Appl Prev Psychol. 2005;11(3):179–90.CrossRefGoogle Scholar
  27. 27.
    Courtwright DT. A century of American narcotic policy. In: Gerstein DR, Harwood HJ, editors. Treating drug problems, vol. 2. Washington, D.C.: National Academy Press; 1971.Google Scholar
  28. 28.
    Courtwright DT. Dark paradise: a history of opiate addiction in America. 2nd ed. Cambridge, MA: Harvard University Press; 2001.Google Scholar
  29. 29.
    Courtwright DT. Preventing and treating narcotic addiction: a century of federal drug control. N Engl J Med. 2015;373(22):2095–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Creedon TB, Lê Cook B. Access to mental health care increased but not for substance use, while disparities remain. Health Aff. 2016;35(6):1017–21.CrossRefGoogle Scholar
  31. 31.
    Dole VP, Nyswander M. A medical treatment for diacetylmorphine (heroin) addiction: a clinical trial with methadone hydrochloride. J Am Med Assoc. 1965;193(8):80–4.CrossRefGoogle Scholar
  32. 32.
    Drug War Facts. 2017. Total annual drug arrests in the United States by offense type. Available at: http://drugwarfacts.org/node/234#.
  33. 33.
    Duncan D, Nicholson T, White JB, Ellis-Griffith G. A brief history of prohibition and treatment solutions for substance abusers. Int J Criminol Soc. 2014;3:186–99.CrossRefGoogle Scholar
  34. 34.
    Durose MR, Cooper AD, Snyder HN. Recidivism of prisoners released in 30 states in 2005: Patterns from 2005 to 2010 (NCJ 244205). Washington, DC: U.S. Department of Justice; 2014.Google Scholar
  35. 35.
    Estelle v. Gamble, 429 US. 97, 103. (1976).Google Scholar
  36. 36.
    Friedmann PD, Schwartz RP. Just call it treatment. Addict Sci Clin Pract. 2012;7:10.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Fu JJ, Zaller ND, Yokell MA, Bazazi AR, Rich JD. Forced withdrawal from methadone maintenance therapy in criminal justice settings: a critical treatment barrier in the United States. J Subst Abuse Treat. 2012;44(5):502–5.CrossRefGoogle Scholar
  38. 38.
    Furr-Holden CD, Milam A, Nesoff ED, Johnson RM, Fakunle DO, Jennings JM, Thorpe RJ. Not in my Back yard: a comparative analysis of crime around publicly funded treatment centers, liquor stores, convenience stores, and corner stores in one mid-Atlantic city. J Stud Alcohol Drugs. 2016;77(1):17–24.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Goffman E. 2009. Original work published in 1963. Stigma: Notes on the management of spoiled identity. Available at: https://books.google.com/books?id=zuMFXuTMAqAC.
  40. 40.
    Gopman S. Prenatal and postpartum care of women with substance use disorders. Obstet Gynecol Clin N Am. 2014;41(2):213–28.CrossRefGoogle Scholar
  41. 41.
    Green CA. Gender and use of substance abuse treatment services. Alcohol Res Health. 2006;29(1):55–62.PubMedGoogle Scholar
  42. 42.
    Greenfield SF, Brooks AJ, Gordon SM, Green CA, Kropp F, McHugh RK, Lincoln M, Hien D, Miele GM. Substance abuse treatment entry, retention, and outcome in women: a review of the literature. Drug Alcohol Depend. 2007;86(1):1–21.PubMedCrossRefGoogle Scholar
  43. 43.
    Grogan CM, Andrews C, Abraham A, Humphreys K, Pollack HA, Smith BT, Friedmann PD. Survey highlights differences in Medicaid coverage for substance use treatment and opioid use disorder medications. Health Aff. 2016;35(12):2289–96.CrossRefGoogle Scholar
  44. 44.
    Guttmacher Institute. Substance use during pregnancy. Guttmacher Institute: State Laws and Policies. 2018. Available at: https://www.guttmacher.org/state-policy/explore/substance-use-during-pregnancy.
  45. 45.
    Hegarty P, Golden A. Attributional beliefs about the controllability of stigmatized traits: antecedents or justifications of prejudice? J Appl Soc Psychol. 2008;38(4):1023–44.CrossRefGoogle Scholar
  46. 46.
    Jaffe JH, O’Keeffe C. From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States. Drug Alcohol Depend. 2003;70:S3–S11.PubMedCrossRefGoogle Scholar
  47. 47.
    Jones CM, Campopiano M, Baldwin G, McCance-Katz E. National and state treatment need and capacity for opioid agonist medication-assisted treatment. Am J Public Health. 2015;105(8):e55–63.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Jones HE, Heil SH, Baewert A, Arria AM, Kaltenbach K, Martin PR, Coyle MG, Selby P, Stine SM, Fischer G. Buprenorphine treatment of opioid-dependent pregnant women: a comprehensive review. Addiction. 2012;107(1):5–27.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Keyes KM, Hatzenbuehler ML, McLaughlin KA, Link B, Olfson M, Grant BF, Hasin D. Stigma and treatment for alcohol disorders in the United States. Am J Epidemiol. 2010;172(12):1364–72.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Lee PR, Lee DR, Lee P, Arch M. 2010: U.S. drug and alcohol policy, looking back and moving forward. J Psychoactive Drugs. 2010;42(2):99–114.PubMedCrossRefGoogle Scholar
  51. 51.
    Leshner A. Addiction is a brain disease, and it matters. Science. 1997;278(5335):45–7.PubMedCrossRefGoogle Scholar
  52. 52.
    Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27(1):363–85.CrossRefGoogle Scholar
  53. 53.
    Lloyd C. The stigmatization of problem drug users: a narrative literature review. Drugs: Educ Prev Policy. 2013;20(2):85–95.Google Scholar
  54. 54.
    Lopez G. How Obama quietly reshaped America’s war on drugs. 2017. Available at: https://www.vox.com/identities/2016/12/19/13903532/obama-war-on-drugs-legacy.
  55. 55.
    Lopez G. How America’s prisons are fueling the opioid epidemic. 2018. Available at: https://www.vox.com/policy-and-politics/2018/3/13/17020002/prison-opioid-epidemic-medications-addiction.
  56. 56.
    Marlowe DB & National Association of Drug Court Professionals. Research update on adult drug courts. 2010. Available at: http://www.antoniocasella.eu.
  57. 57.
    McCance-Katz EF, George P, Scott NA, Dollase R, Tunkel AR, McDonald J. Access to treatment for opioid use disorders: medical student preparation. Am J Addict. 2017;26(4):316–8.PubMedCrossRefGoogle Scholar
  58. 58.
    McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. J Am Med Assoc. 2000;284(13):1689–95.CrossRefGoogle Scholar
  59. 59.
    Miller NS, Sheppard LM, Colenda CC, Magen J. Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders. Acad Med. 2001;76(5):410–8.CrossRefGoogle Scholar
  60. 60.
    Mitchell SG, Kelly SM, Brown BS, Schacht Reisinger H, Peterson JA, Ruhf A, Agar MH, O’Grady KE, Schwartz RP. Uses of diverted methadone and buprenorphine by opioid-addicted individuals in Baltimore, Maryland. Am J Addict. 2009;18(5):346–55.PubMedCentralCrossRefGoogle Scholar
  61. 61.
    Musto DF. Iatrogenic addiction: the problem, its definition and history. In: Proceedings from the conference on developing guidelines for the use of sedatives and analgesics. New Haven, CT: Yale Child Study Center; 1984.Google Scholar
  62. 62.
    Musto DF. The American disease: origins of narcotic control. 3rd ed. New York: Oxford University Press; 1999.Google Scholar
  63. 63.
    National Institute on Drug Abuse. Trends and statistics. 2017. Available at: https://www.drugabuse.gov/related-topics/trends-statistics#supplemental-references-for-economic-costs.
  64. 64.
    National Institute on Drug Abuse. What is the treatment need versus the diversion risk for opioid use disorder treatment?. 2018. Available at: https://www.drugabuse.gov/publications/medications-to-treat-opioid-addiction/what-treatment-need-versus-diversion-risk-opioid-use-disorder-treatment.
  65. 65.
    National Safety Council. Drugs at work: What employers need to know. 2018. Available at: https://www.nsc.org/work-safety/safety-topics/drugs-at-work.
  66. 66.
    Padwa H, Guerrero EG, Braslow JT, Fenwick KM. Barriers to serving clients with co-occurring disorders in a transformed mental health system. Psychiatr Serv. 2015;66(5):547–50.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Pauly BB, McCall J, Browne AJ, Parker J, Mollison A. Toward cultural safety: nurse and patient perceptions of illicit substance use in a hospitalized setting. Adv Nurs Sci. 2015;38(2):121–35.CrossRefGoogle Scholar
  68. 68.
    Peele S. A moral vision of addiction: how people’s values determine whether they become and remain addicts. J Drug Issues. 1987;17(2):187–215.CrossRefGoogle Scholar
  69. 69.
    POLITICO-Harvard T. H. Chan School of Public Health. Americans’ views on policies to address prescription drug prices, the opioid crisis, and other current domestic issues. 2018. Available at: https://cdn1.sph.harvard.edu/wp-content/uploads/sites/94/2018/07/Politico-Harvard-Poll-July-2018-Rx-Drug-Prices-Opioids-Farm-Bill.pdf.
  70. 70.
    Rapp RC, Xu J, Carr CA, Lane DT, Wang J, Carlson R. Treatment barriers identified by substance abusers assessed at a centralized intake unit. J Subst Abus Treat. 2006;30(3):227–35.CrossRefGoogle Scholar
  71. 71.
    Rieckmann T, Kovas AE, Rutkowski BA. Adoption of medications in substance abuse treatment: priorities and strategies of single state authorities. J Psychoactive Drugs. 2010;6:227–38.PubMedCrossRefGoogle Scholar
  72. 72.
    Richter L, Foster SE. Effectively addressing addiction requires changing the language of addiction. J Public Health Policy. 2014;35(1):60–4.PubMedCrossRefGoogle Scholar
  73. 73.
    Roberts SCM, Pies C. Complex calculations: how drug use during pregnancy becomes a barrier to prenatal care. Matern Child Health J. 2010;15(3):333–41.PubMedCentralCrossRefGoogle Scholar
  74. 74.
    Roman PM, Abraham AJ, Knudsen HK. Using medication-assisted treatment for substance use disorders: evidence of barriers and facilitators of implementation. Addict Behav. 2011;36(6):584–9.PubMedPubMedCentralCrossRefGoogle Scholar
  75. 75.
    Salsitz E, Wiegand T. Pharmacotherapy of opioid addiction: putting a real face on a false demon. J Med Toxicol. 2016;12(1):58–63.PubMedCrossRefGoogle Scholar
  76. 76.
    Saunders SM, Zygowicz KM, D’Angelo BR. Person-related and treatment-related barriers to alcohol treatment. J Subst Abus Treat. 2006;30(3):261–70.PubMedCrossRefGoogle Scholar
  77. 77.
    Skewes MC, Gonzalez VM. The biopsychosocial model of addiction. In: Miller PM, editor. Principles of addiction: comprehensive addictive behaviors and disorders, vol. 1. San Diego: Academic Press; 2013. p. 61–70.CrossRefGoogle Scholar
  78. 78.
    Stringer, KL. Stigma as a barrier to formal treatment for substance use: A gendered analysis. (Master’s thesis, University of Alabama at Birmingham). 2012. Available at: http://www.mhsl.uab.edu/dt/2012m/stringer.pdf.
  79. 79.
    Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2012 National Survey on Drug Use and Health: Summary of national findings (NSDUH Series H-46, HHS Publication No. (SMA) 13–4795). Rockville, MD: Author; 2013.Google Scholar
  80. 80.
    Substance Abuse and Mental Health Services Administration. Medication and counseling treatment. 2015a. Available at: https://www.samhsa.gov/medication-assisted-treatment/treatment#medications-used-in-mat.
  81. 81.
    Substance Abuse and Mental Health Services Administration. Treatment episode data set (TEDS): 2012. Discharges from substance abuse treatment services. BHSIS Series S-81, HHS Publication No. (SMA) 16–4976. Rockville, MD: Author; 2015b.Google Scholar
  82. 82.
    Substance Abuse and Mental Health Services Administration. National Survey of Substance Abuse Treatment Services (N-SSATS): 2016. Data on Substance Abuse Treatment Facilities (BHSIS Series S-93, HHS Publication No. (SMA) 17–5039). Rockville, MD: Author; 2016.Google Scholar
  83. 83.
    Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Author; 2017.Google Scholar
  84. 84.
    Substance Abuse and Mental Health Services Administration. Buprenorphine waiver management. 2018. Available at: https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/training-materials-resources/buprenorphine-waiver.
  85. 85.
    Terplan M, Kennedy-Hendricks A, Chisolm MS. Prenatal substance use: exploring assumptions of maternal unfitness. Subst Abuse Res Treat. 2015;9(S2):1–4.Google Scholar
  86. 86.
    The American College of Obstetricians and Gynecologists. Medication-assisted treatment remains the recommended therapy for pregnant women. The American College of Obstetricians and Gynecologists. 2017. Available at: https://www.acog.org/About-ACOG/News-Room/News-Releases/2017/Medication-assisted-Treatment-Remains-the-Recommended-Therapy%2D%2Dfor-Pregnant-Women.
  87. 87.
    The National Center on Addiction and Substance Abuse at Columbia University. Women under the influence. Baltimore: Johns Hopkins University Press; 2006.Google Scholar
  88. 88.
    The National Center on Addiction and Substance Abuse at Columbia University. Shoveling up II: the impact of substance abuse on federal, state and local budgets. New York: Author; 2009.Google Scholar
  89. 89.
    The National Center on Addiction and Substance Abuse at Columbia University. Behind bars II: substance abuse and America’s prison population. New York: Author; 2010.Google Scholar
  90. 90.
    The National Center on Addiction and Substance Abuse. Uncovering coverage gaps: A review of addiction benefits in ACA plans. New York: Author; 2016.Google Scholar
  91. 91.
    The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation. Substance use disorders and the role of the states. 2015. Available at: http://www.pewtrusts.org/-/media/assets/2015/03/substanceusedisordersandtheroleofthestates.pdf.
  92. 92.
    United States v. Doremus, 249 U.S. 86. (1919).Google Scholar
  93. 93.
    Vestal C. In fighting an opioid epidemic, medication-assisted treatment is effective but underused. Health Aff. 2016;35(6):1052–7.CrossRefGoogle Scholar
  94. 94.
    Vigilant LG. The stigma paradox in methadone maintenance: Naïve and positive consequences of a “treatment punishment” approach to opiate addiction. Humanit Soc. 2004;28(4):403–18.CrossRefGoogle Scholar
  95. 95.
    Webb v. United States, 249 U.S. 96. (1919).Google Scholar
  96. 96.
    Weber EM. Failure of physicians to prescribe pharmacotherapies for addiction: regulatory restrictions and physician resistance. J Health Care Law Policy. 2010;13(49):49–76.Google Scholar
  97. 97.
    Weber E, Woodworth A, Vuolo L, Feinstein E, & Tabit M. Parity tracking project: making parity a reality. 2017. Available at: https://lac.org/wpcontent/uploads/2017/06/ES_ParityTrackingReport_ASC.pdf.
  98. 98.
    White WL. Slaying the dragon: the history of addiction treatment and recovery in America. 2nd ed. Bloomington: Chestnut Health Systems; 2014.Google Scholar
  99. 99.
    Williams AR, Nunes E, & Olfson M. To battle the opioid overdose epidemic, deploy the ‘cascade of care’ model. Health Affairs Blog. 2017. Available at: https://www.healthaffairs.org/do/10.1377/hblog20170313.059163/full/.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Linda Richter
    • 1
  • Lindsey Vuolo
    • 1
  • Mithra S. Salmassi
    • 2
  1. 1.Center on AddictionNew YorkUSA
  2. 2.College of the Holy CrossWorcesterUSA

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