Any role for spirituality in addressing the serious clinical and public health problems related to substance misuse and addiction might seem antiquated at best, and clinical malpractice at worst. Yet, from a phenomenological perspective, addiction often penetrates and pervades the core of conscious thought and behaviour, undermining personal values and meaning and purpose in life – factors that many people associate with a diminished sense of personal spirituality. Research on spiritual/religious identity and practices has shown that these both protect against the onset of substance misuse and help millions each year to recover from it. This chapter reviews the interplay of morality, spirituality/religion and substance misuse, suggests why addiction in particular is so prone to spiritual pathology, and describes why spirituality/religion have played such prominent roles in successful remission and stable recovery. Spiritually oriented treatment approaches to addiction are reviewed along with their implications for practice and research.

This chapter reviews current research related to prevention, early interventions, and treatment strategies for "food addiction." However, the paucity of directly relevant investigation resulted in the necessity to broaden the focus to include studies in the area of general addiction disorders, and those targeting compulsive overeating and chronic weight gain. Included are discussions of school-based interventions aimed at reducing caloric intake, such as taxation on sweetened-beverage consumption, and the increased availability of fruits and vegetables in cafeteria menus. Consideration is also extended to discussions about the efficacy of public health policies and regulatory agencies aimed at reducing consumption of highly caloric foods at the population level – based on evidence of their addictive properties. This approach is based on past evidence that increasing prices and decreasing ease of access has reduced use of other addictive substances such as nicotine. Applied to addictive foods, this may indicate that implementing taxes on foods such as sugary candy and soda may aid in reducing consumption. Regarding treatment, although more focused research is still needed, perhaps the most promising evidence-based strategies occur in the field of cognitive interventions, which target hedonic overeating. These approaches are mostly theory driven and mesh with an experimental-medicine approach toward intervention development. It was also concluded that future research should carefully assess possible moderating effects of prevention/intervention and treatment approaches, including individual differences in sex/gender, personality traits such as impulsivity, and varying patterns of compulsive overeating. In addition, it would behoove future researchers to include standardized control groups in order to understand better the theoretical bases on which the interventions and treatments have been developed.

Evidence for the idea that some individuals may experience an addictive-like response to certain foods has grown in the past decade. Food addiction parallels substance use disorders to suggest that highly processed foods (e.g., chocolate, French fries) may exhibit an addictive potential and trigger addictive-like responses in vulnerable individuals. An opposing conceptualization of addictive-like eating was recently developed, suggesting that the behavioral act of eating may be addictive rather than highly processed foods. However, the arguments for a behavioral eating addiction do not consider the central role of behaviors within substance use disorders and are not supported by preliminary research demonstrating that highly processed foods may directly contribute to the addictive-like eating phenotype. The primary goal of this chapter is to argue that a substance-based, food addiction framework is the most appropriate reflection of the current state of the literature and more closely parallels scientific understanding of addictive disorders. Specifically, this chapter will review theoretical debates between the food versus eating addiction perspectives, raise concerns about discrepancies between eating addiction and existing behavioral addictions, and review assessment tools for food and eating addiction. Finally, implications for stigma, intervention, and future research are discussed.

The landscape of gambling has dramatically changed. In addition to more and more jurisdictions having casinos, electronic gambling machines, lotteries and sports wagering in close proximity to individuals, online gambling has dramatically increased. Gambling has moved from being a negatively perceived activity associated with sin and vice to its current state of being viewed as a socially acceptable recreational pastime. Upwards of 80 percent of individuals report having gambled for money during their lifetime, and governments throughout the world have come to recognize that regulated forms of gambling can be a significant source of revenue. While the vast majority of individuals have no gambling-related issues, an identifiable proportion of both adults and adolescents experience significant gambling-related problems. In spite of the growing body of research which has identified many of the risk and protective factors associated with excessive problematic gambling, a limited number of prevention and treatment programs exist. This chapter examines current knowledge concerning the efficacy of existing harm minimization prevention programs and treatment of gambling disorders.

Approximately 23.5 million people in America need assistance for an alcohol, tobacco, or other drug use (ATOD) disorder, although many do not obtain the help that they need. This disorder is extremely difficult to resolve, as it can be hard to make the necessary lifestyle changes to accommodate sobriety. Sometimes, individuals may recover without formalized treatment, otherwise known as natural recovery. Other times, inpatient or outpatient treatment, or partial-hospitalization, is warranted. Even for individuals taking the proper steps and going to treatment, attrition rates are high, with consistent drop-out rates of 30 percent to 40 percent within three months of treatment initiation. Racial and gender disparities in both treatment participation and outcomes exist, indicating a need for tailoring of treatments and further research on breaking barriers to treatment entrance. Motivation is central in several recovery models proposed to explain stages of change in treatment. Treatment options include initial detoxification and pharmacological options (such as medication-assisted treatment using buprenorphine for opioid use disorder), cognitive-behavioral therapy, motivational interviewing, cue exposure, attentional retraining, twelve-step programs, and group/family therapy. Relapse rates are high, and oftentimes individuals move from one addiction to another. Harm reduction approaches may be beneficial to those that cannot fully quit an addiction, and relapse prevention is an important treatment component, as addiction is a life-long battle.