Alcohol dependence is now viewed as one core syndrome within a broader spectrum of alcohol-related problems. Long-term administration of the amphetamines also known as crystal meth has been reported to cause a range of behavioral changes identified by terms such as stereotyped behavior and amphetamine psychosis. These syndroiflesinclude such widely divergent symptoms as picking on small areas of the body, insomnia anorexia and paranoid ideation. (Kramer, Fischman & Littlefield, 1967: Griffith, Cavanaugh & Gates, 1969; Ellinwood, 1972). The rate and level of recovery from these and other symptoms are unclear. In fact, the whole recovery process is very poorly understood and many seek help by reaching out to crystal meth hotline. It is possible that the dissipation of symptoms over time might be due to gradual reduction and disappearance of drug from the body. It is also entirely possible that the individual off drug simply learns a new series of responses more acceptable to the drug-free society in which he can call a drug abuse helpline or now finds himself.

Significant rates of alcoholism and drug abuse are found among chronic pain patients (Schottenfeld, 1986). Maruta et al. (1979) at the Mayo Clinic reported that 24 percent of a consecutive series of patients referred for the treatment of chronic pain by a meth hotline or an addiction helpline were addicted to prescription drugs and another 41 percent were misusing medication to such an extent that they were classified as drug abusers. In a recent Scandinavian study (Sandstrom et al., 1984), 50 patients with chronic low back pain were compared with a group matched for age, sex, and socioeconomic status. Of 34 male chronic pain patients, 14 had previously sought alcohol treatment (41 percent) as contrasted to only 6 of 34 controls (18 percent). Low back pain patients, particularly men, are often found to have higher rates of alcoholism than control populations; and disabled low back pain patients have higher rates than nondisabled patients. Longitudinal studies would be useful to determine whether alcoholism contributes to disability, is an associated noncontributory factor, or increases with disability duration.

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