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A Family Perspective on Substance Use Disorder

Yıl 2024, Cilt: 25 Sayı: 4, 1 - 1

Öz

Substance use disorder is a disease that deeply affects the family, with biological, psychological, and social dimensions impacting both the individual and the family. In the literature, numerous factors causing substance use disorder have been identified, with the family holding a significant place among them. The aim of this current research is to evaluate substance use disorder from a family perspective. While the family is considered a potential risk factor for substance use disorder, it is also recognized for its protective qualities. Genetic factors, the presence of substance use in a family member, family relationships, and parenting styles constitute potential risky aspects of the family. Protective aspects include positive family relationships and functional parenting styles. After the development of substance use disorder, family involvement in treatment is a crucial factor. Regulating dysfunctional family relationships, enhancing the family's social support, and eliminating co-dependent behaviors are decisive in treatment. Prevention programs should encompass both the potential risk factors and protective factors of the family to enhance their effectiveness. Treatment programs, diagnosing individuals with substance use disorder, should involve the family in the process, focusing on improving family skills and providing support to enhance treatment motivation and prevent relapses.

Kaynakça

  • Gruber KJ, Taylor MF. A family perspective for substance abuse: Implications from the literature. J Soc Work Pract Addict 2006; 6(1-2): 1–29.
  • Saraçlı Ö. Zonguldak Karaelmas Üniversitesi Öğrencilerinde Sigara, Alkol Ve Madde Kullanımı İle İlişkili Bireysel ve Psikososyal Faktörler. Tıpta uzmanlık tezi, Zonguldak: Zonguldak Karaelmas Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, 2007.
  • Ögel K. Bağımlı Aileleri İçin Rehber Kitap (3. Baskı). İstanbul: Türkiye İş Bankası Yayınları, 2018.
  • Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal 2013; 21(4): 73-76.
  • Barret A, Turner R. Family structure and substance use problems in adolescence and early adulthood: Examining explanations for the relationship. Addiction 2006; 101(1): 109-120.
  • Ögel K. Madde kullanım bozuklukları epidemiyolojisi. Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi 2005; 1: 61-64.
  • Bierut LJ, Dinwiddie SH, Begleiter H, et al. Familial transmission of substance dependence: alcohol, marijuana, cocaine, and habitual smoking: a report from the Collaborative Study on the Genetics of Alcoholism. Arch Gen Psychiatry 1998; 55(11): 982-988.
  • Rusby JC, Light JM, Crowley R, Westling E. Influence of parent–youth relationship, parental monitoring, and parent substance use on adolescent substance use onset. J Fam Psychol 2018; 32 (3): 310–320.
  • Walker DM, Nestler EJ. Neuroepigenetics and addiction. Handb Clin Neurol. 2018; 148: 747-765.
  • Brook JS, Balka EB, Crossman AM, et al. The relationship between parental alcohol use, early and late adolescent alcohol use, and young adult psychological symptoms: A longitudinal study. Am J Addict 2010; 19(6): 534-542.
  • Connors GJ, Donovan DM, DiClemente CC. Substance abuse treatment and the stages of change: Selecting and planning interventions. New York, NY: Guilford, 2004.
  • Kumpfer KL, Alvarado R, Whiteside HO. Family-based interventions for the substance abuse prevention. Subst Use Misuse 2003; 38(11–13): 1759–1787.
  • Lochman JE, van den Steenhoven A. Family-based approaches to substance abuse prevention. J Prim Prev 2002; 23(1): 49-114.
  • Van Ryzin MJ, Fosco GM, Dishion TJ. Family and peer predictors of substance use from early adolescence to early adulthood: an 11-year prospective analysis. Addict Behav 2012; 37(12): 1314–1324.
  • Matejevic M, Jovanovic D, Lazarevic V. Functionality of family relationships and parenting style in families of adolescents with substance abuse problems. Procedia Soc Behav Sci 2014; 128: 281-287.
  • Pomini V, Gournellis R, Kokkevi A, et al. (2014). Rejection attitudes, poor parental bonding, and stressful life events in heroin addicts’ families. Subst Use Misuse 2014; 49(14): 1867-1877.
  • Klostermann K. Substance abuse and intimate partner violence: treatment considerations. Subst Abuse Treat Prev Policy 2006; 1: 1–24.
  • Özcan-Demir N. Ailedeki madde bağımlılığının ergenin sapmış davranışlara yönelmesindeki etkisi: lise son sınıf gençliği örneği. Hacettepe Üniversitesi Edebiyat Fakültesi Dergisi 2006; 23(1): 119-129.
  • Gezek, F. Sokakta Yaşayan Gençlerin Aile Yapısı ve Madde Bağımlılığı arasındaki ilişki. Yüksek Lisans Tezi, İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü, 2007.
  • Abasi I, Mohammadkhani P. Family risk factors among women with addiction-related problems: an integrative review. Int J High Risk Behav Addict 2016; 5(2): 1-5.
  • Sánchez-Queija I, Oliva A, Parra Á, Camacho C. Longitudinal analysis of the role of family functioning in substance use. J Child Fam Stud 2016; 25(1): 232-240.
  • Supic ZT, Milicevic MS, Sbutega I, Vasic V. The importance of family relations for cannabis users: The case of serbian adolescents. Iran J Public Health 2013; 42(3): 249-260.
  • Kızıltaş A, Tuncay T. Üniversite öğrencilerinin alkol ve madde kullanma risklerinin çeşitli değişkenler açısından incelenmesi. Toplum ve Sosyal Hizmet 2021; 32(3): 867-882.
  • Supriyanto A, Hendiani N, Hartini S, Sabri F. Addiction counselor profession: perception of family support for recovering from drug abuse addiction. Counsellia: Jurnal Bimbingan dan Konseling 2021; 11(1): 17-30.
  • Gövebakan R, Duyan V. Madde Bağımlılığı ve Aile. İstanbul: Yeni İnsan Yayınevi, 2015.
  • Child Welfare League of America. Promoting protective factors for in-risk families and youth: A Brief for Researchers. Networker February 2014: 1-8.
  • United Nations Office of Drugs and Crime. Guide to Implementing Family Skills Training Programmed For Drug Abuse Prevention. Vienna, Austria: United Nations Office of Drugs and Crime, 2019.
  • Çavuşoğlu F, Bahar Z. Influence of socioeconomic factors and family social support on smoking and alcohol use among health school students. Int J Caring Sci 2010; 3(2): 74-88.
  • Kelly AB, O’Flaherty M, Toumbourou JW, et al. Gender differences in the impact of families on alcohol use: a lagged longitudinal study of early adolescents. Addiction 2011; 106: 1427–1436.
  • DiClemente RJ, Wingood GM, Crosby R, et al. Parental monitoring: Association with adolescents’ risk behaviors. Pediatrics 2001; 107(6): 1363–1368.
  • Dick DM, Viken R, Purcell S, et al. Parental monitoring moderates the importance of genetic and environmental influences on adolescent smoking. J Abnorm Psychol 2007; 116(1): 213–218.
  • Baumrind D. The influence of parenting style on adolescent competence and substance use. J Early Adolesc 1991; 11(1): 56–95.
  • Kopak AM, Chia-Chen A, Haas S, Gillmore MR. The importance of family factors to protect against substance use related problems among Mexican heritage and White youth. Drug Alcohol Depend 2012; 124(1-2): 34–41.
  • Li L, Lin C, Liang LJ, et al. Evaluating an intervention for family members of people who use drugs in Vietnam. Soc Sci Med 2020; 261: 113238.
  • Ögel K, Çelikay H, Başabak A. Aile Bağımlılık Profil İndeksinin geliştirilmesi, geçerlik ve güvenirliği. Klinik Psikiyatri Dergisi 2017; 20(4): 255-262.
  • Atadokht A, Hajloo N, Karimi M, Narimani M. The role of family expressed emotion and perceived social support in predicting addiction relapse. Int J High Risk Behav Addict, 2015; 4(1): 1-5.
  • Lemke S, Brennan PL, Schutte KK. Upward pressures on drinking: Exposure and reactivity in adulthood. J Stud Alcohol Drugs 2007; 68(3): 437–445.
  • Sugaya N, Haraguchi A, Ogai Y, et al. Family dysfunction differentially affects alcohol and methamphetamine dependence: a view from the Addiction Severity Index in Japan. Int J Environ Res Public Health 2011; 8(10): 3922-3937.
  • Tseng KC, Hemenway D, Kawachi I, Subramanian SV. Family ties and the frequency of heroin use. J Subst Use 2010; 15(1): 60-74.
  • Liddle HA, Dakof GA, Parker K, et al. Multidimensional family therapy for adolescent drug abuse: results of a randomized clinical trial. Am J Drug Alcohol Abuse 2001; 27(4): 651-688.
  • Salonia G, Mahajan R, Mahajan NS. Codependency and coping strategies in the spouses of substance abusers. Scholars Journal of Applied Medical Sciences 2021; 9(7): 1130-1138.
  • Kaplan Ö, Özbaran B. Alkol-Madde kullanıcılarının bağımlılık şiddeti ile aile üyelerinin eş bağımlılık düzeyleri arasındaki ilişki. Bağımlılık Dergisi 2024; 25(2): 113-121.
  • da Costa B, Marcon SS, Paiano M, et al. Feelings and codependent behavior in the family of illicit drugs users. Acta Scientiarum Health Sciences 2017; 39(2): 175-181.
  • Şimşek M, Öncü F, Kabil M. Bağımlılıkta eş bağımlılık faktörü (BEŞF) ölçeği’nin geçerlik ve güvenilirlik çalışması. Psikiyatride Güncel Yaklaşımlar 2020; 12(Suppl 1): 268-280.
  • McGillicuddy NB, Rychtarik RG, Duquette JA, Morsheimer ET. Development of a skill training program for parents of substance-abusing adolescents. J Subst Abuse Treat 2001; 20(1): 59-68.
  • Szapocznik J, Zarate M, Duff J, Muir J. Brief strategic family therapy: engaging drug using/problem behavior adolescents and their families in treatment. Soc Work Public Health 2013; 28(3-4): 206-223.
  • Kahyaoğlu G, Dinc M, Işık S, Ögel K. Effects of engaging family in addiction treatment for substance use and treatment compliance: A preliminary study. Addicta 2020; 7(4): 229-233.
  • Goldberg ZE, Chin NP, Alio A, et al. A qualitative analysis of family dynamics and motivation in sessions with 15 women in drug treatment court. Subst Abuse 2019; 13: 1178221818818846.
  • Martin TC, Lewis T, Josiah-Martin JA, Sinnott T. Client family-member participation is associated with improved residential treatment program completion at an international drug and alcohol treatment center. J Groups Addict Recover 2010; 5(1): 34–44.
  • Baharudin DF, Mohd Hussin AH, Sumari M, et al. Family intervention for the treatment and rehabilitation of drug addiction: An exploratory study. J Subst Use 2014; 19(4): 301-306.
  • Ozechowski TJ, Liddle HA. Family-based therapy. In C.A. Essau (Ed.), Substance abuse and dependence in Adolescence: Epidemiology, Risk Factors, and Treatment (pp. 203-226). East Sussex, UK: Brunner-Routledge, 2002.
  • Hogue A, Schumm JA, MacLean A, Bobek M. Couple and family therapy for substance use disorders: Evidence‐based update 2010–2019. J Marital Fam Ther 2002; 48(1): 178-203.
  • Sparks SN, Tisch RA. Family-centered program to break the cycle of addiction. Fam Soc 2018; 99(2): 100-109.

Madde Kullanım Bozukluğuna Aile Perspektifinden Bir Bakış

Yıl 2024, Cilt: 25 Sayı: 4, 1 - 1

Öz

Madde kullanım bozukluğu aileyi derinden etkileyen ve aileden etkilenen biyolojik, psikolojik ve sosyal boyutları olan bir hastalıktır. Alanyazında madde kullanım bozukluğuna sebep olan birçok faktör belirlenmiştir. Belirlenen faktörler arasında aile de önemli bir yer arz etmektedir. Bu kapsamda mevcut araştırmada ise madde kullanım bozukluğunu aile perspektifinden değerlendirmek amaçlanmıştır. Aile, madde kullanım bozukluğu için potansiyel bir risk faktörü olarak görülürken aynı zamanda koruyucu nitelikleri olduğu da bilinmektedir. Genetik faktörler, ailede madde kullanımı olan bir üyenin olması, aile ilişkileri ve ebeveynlik stilleri ailenin potansiyel riskli yönlerini oluşturmaktadır. Koruyucu yönleri ise aile ilişkilerinin iyi olması ve işlevsel ebeveynlik stilleri olarak değerlendirilebilir. Madde kullanım bozukluğu geliştikten sonra ise ailenin tedaviye katılımının önemli bir etmen olduğu bilinmektedir. Ailede işlevsel olmayan ilişkilerin düzenlenmesi, ailenin sosyal desteği ve eş bağımlı davranışların ortadan kaldırılması tedavide belirleyici nitelikte olmaktadır. Oluşturulacak önleme programlarının ailenin risk etmeni olabilecek yönlerini ve koruyucu etmen yönlerini kapsaması önleme programlarının etkililiğini artıracaktır. Tedavi programlarının ise madde kullanım bozukluğu tanısı alan bireylerin yanında aileyi de sürece dahil ederek ailenin becerilerini geliştirmeyi ve ailenin desteklenmesini içermesi tedavi motivasyonunu artırmada ve nüksleri önlemede önemli bir rol oynayacaktır.

Kaynakça

  • Gruber KJ, Taylor MF. A family perspective for substance abuse: Implications from the literature. J Soc Work Pract Addict 2006; 6(1-2): 1–29.
  • Saraçlı Ö. Zonguldak Karaelmas Üniversitesi Öğrencilerinde Sigara, Alkol Ve Madde Kullanımı İle İlişkili Bireysel ve Psikososyal Faktörler. Tıpta uzmanlık tezi, Zonguldak: Zonguldak Karaelmas Üniversitesi Tıp Fakültesi, Psikiyatri Anabilim Dalı, 2007.
  • Ögel K. Bağımlı Aileleri İçin Rehber Kitap (3. Baskı). İstanbul: Türkiye İş Bankası Yayınları, 2018.
  • Daley DC. Family and social aspects of substance use disorders and treatment. J Food Drug Anal 2013; 21(4): 73-76.
  • Barret A, Turner R. Family structure and substance use problems in adolescence and early adulthood: Examining explanations for the relationship. Addiction 2006; 101(1): 109-120.
  • Ögel K. Madde kullanım bozuklukları epidemiyolojisi. Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi 2005; 1: 61-64.
  • Bierut LJ, Dinwiddie SH, Begleiter H, et al. Familial transmission of substance dependence: alcohol, marijuana, cocaine, and habitual smoking: a report from the Collaborative Study on the Genetics of Alcoholism. Arch Gen Psychiatry 1998; 55(11): 982-988.
  • Rusby JC, Light JM, Crowley R, Westling E. Influence of parent–youth relationship, parental monitoring, and parent substance use on adolescent substance use onset. J Fam Psychol 2018; 32 (3): 310–320.
  • Walker DM, Nestler EJ. Neuroepigenetics and addiction. Handb Clin Neurol. 2018; 148: 747-765.
  • Brook JS, Balka EB, Crossman AM, et al. The relationship between parental alcohol use, early and late adolescent alcohol use, and young adult psychological symptoms: A longitudinal study. Am J Addict 2010; 19(6): 534-542.
  • Connors GJ, Donovan DM, DiClemente CC. Substance abuse treatment and the stages of change: Selecting and planning interventions. New York, NY: Guilford, 2004.
  • Kumpfer KL, Alvarado R, Whiteside HO. Family-based interventions for the substance abuse prevention. Subst Use Misuse 2003; 38(11–13): 1759–1787.
  • Lochman JE, van den Steenhoven A. Family-based approaches to substance abuse prevention. J Prim Prev 2002; 23(1): 49-114.
  • Van Ryzin MJ, Fosco GM, Dishion TJ. Family and peer predictors of substance use from early adolescence to early adulthood: an 11-year prospective analysis. Addict Behav 2012; 37(12): 1314–1324.
  • Matejevic M, Jovanovic D, Lazarevic V. Functionality of family relationships and parenting style in families of adolescents with substance abuse problems. Procedia Soc Behav Sci 2014; 128: 281-287.
  • Pomini V, Gournellis R, Kokkevi A, et al. (2014). Rejection attitudes, poor parental bonding, and stressful life events in heroin addicts’ families. Subst Use Misuse 2014; 49(14): 1867-1877.
  • Klostermann K. Substance abuse and intimate partner violence: treatment considerations. Subst Abuse Treat Prev Policy 2006; 1: 1–24.
  • Özcan-Demir N. Ailedeki madde bağımlılığının ergenin sapmış davranışlara yönelmesindeki etkisi: lise son sınıf gençliği örneği. Hacettepe Üniversitesi Edebiyat Fakültesi Dergisi 2006; 23(1): 119-129.
  • Gezek, F. Sokakta Yaşayan Gençlerin Aile Yapısı ve Madde Bağımlılığı arasındaki ilişki. Yüksek Lisans Tezi, İstanbul: Marmara Üniversitesi Sağlık Bilimleri Enstitüsü, 2007.
  • Abasi I, Mohammadkhani P. Family risk factors among women with addiction-related problems: an integrative review. Int J High Risk Behav Addict 2016; 5(2): 1-5.
  • Sánchez-Queija I, Oliva A, Parra Á, Camacho C. Longitudinal analysis of the role of family functioning in substance use. J Child Fam Stud 2016; 25(1): 232-240.
  • Supic ZT, Milicevic MS, Sbutega I, Vasic V. The importance of family relations for cannabis users: The case of serbian adolescents. Iran J Public Health 2013; 42(3): 249-260.
  • Kızıltaş A, Tuncay T. Üniversite öğrencilerinin alkol ve madde kullanma risklerinin çeşitli değişkenler açısından incelenmesi. Toplum ve Sosyal Hizmet 2021; 32(3): 867-882.
  • Supriyanto A, Hendiani N, Hartini S, Sabri F. Addiction counselor profession: perception of family support for recovering from drug abuse addiction. Counsellia: Jurnal Bimbingan dan Konseling 2021; 11(1): 17-30.
  • Gövebakan R, Duyan V. Madde Bağımlılığı ve Aile. İstanbul: Yeni İnsan Yayınevi, 2015.
  • Child Welfare League of America. Promoting protective factors for in-risk families and youth: A Brief for Researchers. Networker February 2014: 1-8.
  • United Nations Office of Drugs and Crime. Guide to Implementing Family Skills Training Programmed For Drug Abuse Prevention. Vienna, Austria: United Nations Office of Drugs and Crime, 2019.
  • Çavuşoğlu F, Bahar Z. Influence of socioeconomic factors and family social support on smoking and alcohol use among health school students. Int J Caring Sci 2010; 3(2): 74-88.
  • Kelly AB, O’Flaherty M, Toumbourou JW, et al. Gender differences in the impact of families on alcohol use: a lagged longitudinal study of early adolescents. Addiction 2011; 106: 1427–1436.
  • DiClemente RJ, Wingood GM, Crosby R, et al. Parental monitoring: Association with adolescents’ risk behaviors. Pediatrics 2001; 107(6): 1363–1368.
  • Dick DM, Viken R, Purcell S, et al. Parental monitoring moderates the importance of genetic and environmental influences on adolescent smoking. J Abnorm Psychol 2007; 116(1): 213–218.
  • Baumrind D. The influence of parenting style on adolescent competence and substance use. J Early Adolesc 1991; 11(1): 56–95.
  • Kopak AM, Chia-Chen A, Haas S, Gillmore MR. The importance of family factors to protect against substance use related problems among Mexican heritage and White youth. Drug Alcohol Depend 2012; 124(1-2): 34–41.
  • Li L, Lin C, Liang LJ, et al. Evaluating an intervention for family members of people who use drugs in Vietnam. Soc Sci Med 2020; 261: 113238.
  • Ögel K, Çelikay H, Başabak A. Aile Bağımlılık Profil İndeksinin geliştirilmesi, geçerlik ve güvenirliği. Klinik Psikiyatri Dergisi 2017; 20(4): 255-262.
  • Atadokht A, Hajloo N, Karimi M, Narimani M. The role of family expressed emotion and perceived social support in predicting addiction relapse. Int J High Risk Behav Addict, 2015; 4(1): 1-5.
  • Lemke S, Brennan PL, Schutte KK. Upward pressures on drinking: Exposure and reactivity in adulthood. J Stud Alcohol Drugs 2007; 68(3): 437–445.
  • Sugaya N, Haraguchi A, Ogai Y, et al. Family dysfunction differentially affects alcohol and methamphetamine dependence: a view from the Addiction Severity Index in Japan. Int J Environ Res Public Health 2011; 8(10): 3922-3937.
  • Tseng KC, Hemenway D, Kawachi I, Subramanian SV. Family ties and the frequency of heroin use. J Subst Use 2010; 15(1): 60-74.
  • Liddle HA, Dakof GA, Parker K, et al. Multidimensional family therapy for adolescent drug abuse: results of a randomized clinical trial. Am J Drug Alcohol Abuse 2001; 27(4): 651-688.
  • Salonia G, Mahajan R, Mahajan NS. Codependency and coping strategies in the spouses of substance abusers. Scholars Journal of Applied Medical Sciences 2021; 9(7): 1130-1138.
  • Kaplan Ö, Özbaran B. Alkol-Madde kullanıcılarının bağımlılık şiddeti ile aile üyelerinin eş bağımlılık düzeyleri arasındaki ilişki. Bağımlılık Dergisi 2024; 25(2): 113-121.
  • da Costa B, Marcon SS, Paiano M, et al. Feelings and codependent behavior in the family of illicit drugs users. Acta Scientiarum Health Sciences 2017; 39(2): 175-181.
  • Şimşek M, Öncü F, Kabil M. Bağımlılıkta eş bağımlılık faktörü (BEŞF) ölçeği’nin geçerlik ve güvenilirlik çalışması. Psikiyatride Güncel Yaklaşımlar 2020; 12(Suppl 1): 268-280.
  • McGillicuddy NB, Rychtarik RG, Duquette JA, Morsheimer ET. Development of a skill training program for parents of substance-abusing adolescents. J Subst Abuse Treat 2001; 20(1): 59-68.
  • Szapocznik J, Zarate M, Duff J, Muir J. Brief strategic family therapy: engaging drug using/problem behavior adolescents and their families in treatment. Soc Work Public Health 2013; 28(3-4): 206-223.
  • Kahyaoğlu G, Dinc M, Işık S, Ögel K. Effects of engaging family in addiction treatment for substance use and treatment compliance: A preliminary study. Addicta 2020; 7(4): 229-233.
  • Goldberg ZE, Chin NP, Alio A, et al. A qualitative analysis of family dynamics and motivation in sessions with 15 women in drug treatment court. Subst Abuse 2019; 13: 1178221818818846.
  • Martin TC, Lewis T, Josiah-Martin JA, Sinnott T. Client family-member participation is associated with improved residential treatment program completion at an international drug and alcohol treatment center. J Groups Addict Recover 2010; 5(1): 34–44.
  • Baharudin DF, Mohd Hussin AH, Sumari M, et al. Family intervention for the treatment and rehabilitation of drug addiction: An exploratory study. J Subst Use 2014; 19(4): 301-306.
  • Ozechowski TJ, Liddle HA. Family-based therapy. In C.A. Essau (Ed.), Substance abuse and dependence in Adolescence: Epidemiology, Risk Factors, and Treatment (pp. 203-226). East Sussex, UK: Brunner-Routledge, 2002.
  • Hogue A, Schumm JA, MacLean A, Bobek M. Couple and family therapy for substance use disorders: Evidence‐based update 2010–2019. J Marital Fam Ther 2002; 48(1): 178-203.
  • Sparks SN, Tisch RA. Family-centered program to break the cycle of addiction. Fam Soc 2018; 99(2): 100-109.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Madde Bağımlılığı
Bölüm Derleme
Yazarlar

Dilara Demircan 0000-0003-0905-0517

Lut Tamam 0000-0002-9750-7531

Yayımlanma Tarihi
Gönderilme Tarihi 6 Şubat 2024
Kabul Tarihi 4 Nisan 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 25 Sayı: 4

Kaynak Göster

AMA Demircan D, Tamam L. Madde Kullanım Bozukluğuna Aile Perspektifinden Bir Bakış. Bağımlılık Dergisi. 25(4):1-1.

Bağımlılık Dergisi - Journal of Dependence