Nicotine is almost universally believed to be the major factor that motivates smoking and impedes cessation. Authorities such as the Surgeon General of the USA and the Royal College of Physicians in the UK have declared that nicotine is as addictive as heroin and cocaine. This book is a critique of the nicotine addiction hypothesis, based on a critical review of the research literature that purports to prove that nicotine is as addictive drug. The review is based on a re-examination of more than 700 articles and books on this subject, including animal and human experimental studies, effects of nicotine replacement therapies', and many other relevant sources. This review concludes that on present evidence, there is every reason to reject the generally accepted theory that nicotine has a major role in cigarette smoking. A critical examination of the criteria for drug addiction demonstrates that none of these criteria is met by nicotine, and that it is much more likely that nicotine in fact limits rather than facilitates smoking.

The Importance of Measuring Alcohol Consumption To date, alcohol studies have attended far more to issues of alco hol dependence and the harmful consequences of drinking than to the level of alcohol consumption itself. This is, perhaps, not surprising since dependence on alcohol is believed to constitute a meaningful and distinct medical syndrome, regardless of the level of alcohol consumption associated with it (Edwards and Gross, 1976). Also, of society is generally more concerned with the adverse consequences drinking (e. g., traffic fatalities, homelessness, health care and legal expenses, and academiclbehavioral problems in young drinkers), than with the quantity of alcohol actually consumed. Nevertheless, accurate assessment of alcohol usage is important in its own right in at least four contexts: 1. Evaluating the effectiveness of alcoholism and alcohol abuse treatment and prevention efforts. Such efforts include both applied evaluations of existing programs and formal, well-controlled efficacy studies on experimental interventions. These investigations require rigorous methodologies to assess outcomes precisely and contrast what may be quite subtle differences between programs and between pre treatment and posttreatment outcomes. Although these studies are usually characterized by the employment of multiple measures of success-including general improvements in social and physical functioning, reduction in degree of dependence, and resolution of problems directly resultant from drinking-it is by their assessment of changes in drinking behavior that they are potentially able to achieve the highest level of objectivity and exactitude."

This text provides a comprehensive overview of psychological approaches to understanding addictions. Without denying the importance of biological factors, emphasis is placed more upon social, psychological and emotional factors as is necessary to a complete understanding of addiction. Within this framework, an addiction is not limited to substance-based behaviours such as drinking alcohol, smoking or drug use. Although these important areas are covered, a wider perspective is taken to include behavioural addictions such as gambling, violence and joy riding. Finally, prevention approaches are discussed with reference to the public health model which encompasses issues relating to the agent, the host and the environment. A list of resources and references is provided for those wishing to obtain further information.;Written in a jargon-free style, "The Psychology of Addiction" is aimed at students at the beginning of their courses. It should also be a valuable resource for professionals: nurses, social workers, police and probation officers and medical students, who often encounter the problems described in the book.

Find fresh perspectives on the treatment of addictions and effective methods for helping recovering alcohol and drug abusers in this valuable book Addiction in Human Development provides practical strategies based on theories of human development for working with clients recovering from alcoholism and drug addiction. An understanding of these theories will help therapists and addictions counselors recognize stages of recovery and better select appropriate interventions for every phase of treatment of addicted clients.Addiction in Human Development shows how a developmental perspective is particularly appropriate to the treatment of alcohol and substance abusers and the patterns involved in their addiction. Disruptions in clients'childhood or adolescent development, stemming from their own or a parent 's drug abuse, can influence their present recovery process. This informative book also describes the developmental course of addiction and provides tools designed to interrupt addictive patterns. In addition, stages in the developmental process of recovery are identified to help therapists select appropriate interventions.Some of the topics related to human development and addiction covered in this insightful volume include developmental deficits and developmental arrest in recovering clients, delayed reactions to sexual abuse and other childhood trauma, stages in recovery from alcoholism or drug addiction, developmental issues in the professional 's own life, and multi-problem families with a multigenerational history of substance abuse. Applying these developmental strategies to work with addicted individuals will significantly improve communication and rapport between helping professionals and recovering addicts and lead to more success in alcohol and drug addiction therapy.

This book provides clinicians and students with insights on the use of psychodynamic therapy to treat drug abuse and addiction, combining theory with clinical case material. The perspectives of analysts such as Abraham, Rado, Zimmel, Tibout, Wurmser, Khanzian, Krystal and McDougall are reviewed alongside original and more recent conceptualizations of drug addiction and recovery based on Kleinian, Winnicottian and Kohutian ideas. The case material deals with clinical phenomena that characterize working with this complex population, such as intense projective identification, countertransference difficulties and relapses. The theoretical analysis covers a range of concepts, such as John Steiner's psychic shelters and Betty Joseph's near-death-addiction, which are yet to be fully explored in the context of addiction. Prevalent topics in the addiction field, such as the reward system, the cycle of change and the 12-step program, are also discussed in relation to psychodynamic theory and practice. Written by an experienced therapist, Psychodynamic Approaches for Treatment of Drug Abuse and Addiction is useful reading for anyone looking to understand how psychodynamic thought is applicable in the treatment of drug abuse and addiction. It may also be of some relevance to those working on treating alcohol use disorders and behavioral addictions.

First published in 1992. Part I of the book covers phases of treatment for specific phases of recovery by describing key concepts and focusing on three dominant treatment modalities, inpatient, outpatient, and long-term residential therapeutic communities. Part II covers, in substantial depth, psychoanalytic/psychodynamic approaches. art III of the book examines cognitive-behavioral, self-help, and relapse prevention approaches to the treatment of the chemically dependent. Part VI mentions in all phases of treatment and recovery. Part IV of the book provides an overview of contemporary trends in research, while also discussing implications for treatment. n the therapeutic community. Part V attempts to draw the field of chemical dependency toward recognition of the importance of considering distinct population characteristics and how these characteristics may dictate modifications in treatment design. The book is suitable as a text in a course on substance abuse or as a critical reference for anyone doing clinical work or research in the field of chemical dependency.

This book provides a holistic evidence-based perspective on conceptual, clinical, assessment, and treatment aspects of key non-substance-based addictive disorders related to: gambling, gaming, social media, smartphone, internet, love, sex, exercise, work, and shopping. Each chapter focuses on a different addictive disorder and is structured in a user-friendly way to enable the reader fast navigation, yet the main aspects of the respective disorders are covered in the necessary depth. All in all, this book offers a timely, self-contained introduction to both key concepts and the latest scientific developments in behavioral addictions. It addresses mental health practitioners, researchers in psychology, neuroscience and communication, and undergraduate and postgraduate students alike.

Co-dependency has finally become recognized in the late 1980s as a legitimate and a key issue in the chemical dependency field. Most of the literature available on the topic is addressed to the consumer--the co-dependent individual. In Co-dependency, leading therapists share some remarkable insights into the characteristics of the alcoholic home, co-dependents'patterns of responding to the alcoholic, and the particular problems that family members experience as a result of the environment, including fear, shame and guilt, anger, denial, and confusion. Clinical case material is used to illustrate the value of helping co-dependents through education, peer support, outpatient treatment and psychotherapy. Creative solutions for working with lesbian and gay men and children of alcoholics are also featured.

Co-dependency has finally become recognized in the late 1980s as a legitimate and a key issue in the chemical dependency field. Most of the literature available on the topic is addressed to the consumer--the co-dependent individual. In Co-dependency, leading therapists share some remarkable insights into the characteristics of the alcoholic home, co-dependents'patterns of responding to the alcoholic, and the particular problems that family members experience as a result of the environment, including fear, shame and guilt, anger, denial, and confusion. Clinical case material is used to illustrate the value of helping co-dependents through education, peer support, outpatient treatment and psychotherapy. Creative solutions for working with lesbian and gay men and children of alcoholics are also featured.

1. Introduction: The Brain-Immune Axis: Role of Opiates and Other Substances of Abuse, the Hypothalmic-Pituitary-Adrenal Axis and Behavior.- 2. Detection of ?-Opioid Receptor mRNA in Immature T Cells.- 3. Identification of Opioid Receptors in the Immune System Using a Novel Combination of Selective Opioid Ligands and Indirect Phycoerythrin Immunofluorescence.- 4. Kappa Opioid Receptors on Three Related Thymoma Cell Lines: Differences in Receptor-Effector Coupling.- 5. Delta Opioid Agonists Inhibit Proliferation of Highly Purified Murine CD4+ and CD8+ T-Cells.- 6. Mitogenic Activation of Human T Lymphocytes Induces a High Affinity Morphine Binding Site.- 7. Morphine-Induced Suppression of Thymocyte Proliferation Is Mediated by Inhibition of I1-2 Synthesis.- 8. Active ?-Endorphin Metabolites Generated by T-Cell Ectopeptidases.- 9. The Cellular Basis for Opioid-Induced Immunosuppression.- 10. Endogenous Opioid Peptides Suppress Cytokine-Mediated Upregulation of HIV-1 Expression in the Chronically Infected Promonocyte Clone U1.- 11. Relevance of Opioid Bimodality to Tolerance/Dependence Formation: From Transmitter Release to Second Messenger Formation.- 12. Agonist Induced Constitutive Receptor Activation As a Novel Regulatory Mechanism: ? Receptor Regulation.- 13. Expression of Cannabinoid Receptor mRNA in Murine and Human Leukocytes.- 14. Cannabinoid Stimulation of Arachidonate Metabolism in Human Peripheral Blood Mononuclear Leukocytes.- 15. Marijuana, Receptors and Immunomodulation.- 16. Mouse Strain Differences in in vivo and in vitro Immunosuppressive Effects of Opioids.- 17. The Clastogenicity of Morphine Sulfate in vivo.- 18. Cellular Mechanisms Involved in Morphine-Mediated Suppression of CTL Activity.- 19. Evidence for the Involvement of Macrophage-Derived Nitric Oxide in the Immunomodulatory Effect of Morphine and Aversive Pavlovian Conditioning.- 20. Mechanisms Whereby Macrophage-Derived Nitric Oxide Is Involved in the Immunomodulatory Effects of Morphine.- 21. Effects of Central Administration of Morphine on Immune Status in Lewis and Wistar Rats.- 22. Morphine Alteration of Histamine Release in vivo.- 23. Effect of Chronic Morphine Treatment on Immune Responses to Keyhole Limpet Hemocyanin in Swine.- 24. SIV Mutations Detected in Morphine-Treated Macaca mulatta Following SIVmac239 Infection.- 25. Adjuvant Effects on Morphine-Induced Suppression of Immune Responses to MN rgp120/HIV-1 in Mice.- 26. Possible Mechanisms of Immunotoxicity Following in vivo Exposure to the Inhalant, Isobutyl Nitrite.- 27. Role of Immune Processes in Peripheral Opioid Analgesia.- 28. Chronic Treatment with Morphine and Ethanol, but Not Cocaine, Attenuates I1-1? Activation of FOS Expression in the Rat Hypothalamic Paraventricular Nucleus.- 29. Effects of r-Hu-Interferon-?2A in the Brain.- 30. Quantification of Macrophage-Derived Substance P Receptor mRNA Using Competitive Polymerase Chain Reaction.- 31. HIV-1 Heterogeneity and Cytokines: Neuropathogenesis.

This timely book brings together for the first time critical information about the evaluation of employee assistance programs. Although EAPs have existed for over 40 years, the assessment of their value has been fragmented. Contributors to this new volume--blending practical and academic insights--document concerns, address the newer issues and developments in the field of EAPs, and present case examples of actual evaluations. The range and diversity of topics reflect EAPs in transition, their growth patterns, evaluation needs, and evaluation methods. Overall, this important volume emphasizes that successful evaluations depend not only on methodological expertise but a consideration of much broader salient and societal issues.

The failure to deal with social-sexual issues may impair the progress of recovery in a chemically dependent individual and his or her family. The failure to deal with sexual compulsivity in intravenous drug abusers may seriously impair our ability to deal with AIDS. The failure to deal with chemical dependence may render family therapy ineffective in the treatment of sex offenders. Despite the connection between chemical dependency and intimacy dysfunction, the intimacy concerns are rarely recognized in the diagnosis, treatment, and aftercare of the chemically dependent person and his or family. In this pioneering work, experts in the fields of chemical dependence and human sexuality provide professionals with information and skills to deal with intimacy dysfunction issues--offering hope for improving treatment and rehabilitation of chemically dependent individuals and their families. Typical intimacy dysfunctions are explored, as well as treatment methods and strategies that have proven to be effective. A valuable resource guide, this comprehensive volume addresses the key issues in the multidisciplinary approach to the study of chemical dependency and intimacy dysfunction.

Invaluable clinical and treatment information on the most powerful mind-altering drugs in use today. Compiled by two leading professionals from the renowned Haight Ashbury Clinic, the information is based on national and international studies undertaken at the clinic, as well as from 600,000 patient visits, a thorough review of practice and background as reported in the literature, and from their own private practices. An up-to-date reference source, this important guide includes information on the trademark, generic, and popular names of drugs; the use and abuse of drugs; and their acute and chronic effects. An innovative index and cross reference system provide quick, easy access for the physician who must act quickly in an emergency.

This unique volume discusses research, policy, and treatment approaches to one of America s most serious problems--the drunk driver. The authors--many of the countries most dedicated professionals from academic, research, correctional, public health, and judicial system backgrounds--present an extraordinary array of creative and thought-provoking approaches to the drunk driver. Their thorough descriptions will help you better understand the drunk driver, and their exploration of new sentencing and treatment strategies provides a comprehensive look at the options to confronting and solving the problem of alcohol and traffic safety in the United States. Chapters challenge many long-held assumptions about those who drink and drive; address policy issues; examine the need for culturally specific education and training programs for police, court officials, and human service providers; and offer helpful suggestions for designing programs for women and adolescent offenders.

The Neuroscience of Autism provides a comprehensive accounting of autism spectrum disorders by integrating scientific findings from behavioral, cognitive and neurobiological research. The book begins by defining autism, identifying characteristics and prevalence, exploring its history, and then moving on to the cognitive and social bases of behavioral symptoms, the brain bases of behavioral and cognitive symptoms, and finally, intervention practices. It examines theoretical models such as weak central coherence, enhanced perceptual functioning, and the extreme male brain hypothesis. Finally, the book addresses the increased attention on the brain connectivity model of autism, looking at the synchronization of brain activity across different brain areas, the causal influence of a brain region on another, and white matter cable connections in the brain.

Community corrections programs are emerging as an effective alternative to incarceration for drug-involved offenders, to reduce recidivism and improve public health and public safety. Since evidence-based practice is gaining recognition as a success factor in both community systems and substance abuse treatment, a merger of the two seems logical and desirable. But integrating evidence-based addiction treatment into community corrections is no small feat-costs, personnel decisions, and effective, appropriate interventions are all critical considerations.

Featuring the first model of implementation strategies linking these fields, "Implementing Evidence-Based Practices in Community Corrections and Addiction Treatment "sets out criteria for identifying practices and programs as evidence. The book's detailed blueprint is based on extensive research into organizational factors (e.g., management buy-in) and external forces (e.g., funding, resources) with the most impact on the adoption of evidence-based practices, and implementation issues ranging from skill building to quality control. With this knowledge, organizations can set realistic, attainable goals and achieve treatment outcomes that reflect the evidence base.

Included in the coverage:
Determining evidence for "what works."Organization change and technology transfer: theory and literature review.The current state of addiction treatment and community corrections.Unique challenges of evidence-based addiction treatment under community supervision.Assessing suitability of evidence-based practice in real-world settings.A conceptual model for implementing evidence-based treatment in community corrections.

"Implementing Evidence-Based Practices in Community Corrections andAddiction Treatment"is a breakthrough volume for graduate- and postgraduate-level researchers in criminology, as well as policymakers and public health researchers. "

Guidance for addiction counselors in understanding and applying ethical standards

Filled with proven strategies to help you examine your current practice for ethical snags and refresh your ethical thinking, "Ethics for Addiction Professionals" leads you in examining, building, and rebuilding aspects of your ethical practice with the goal of helping you become the strongest clinician possible--ethically speaking.Up-to-date and comprehensive, this practical guide examines real-life examples of ethical issues in clinical practice and illustrates potential pitfalls and the actions needed when faced with dilemmas. Helping addiction counselors learn how to deal with and apply ethical standards, "Ethics for Addiction Professionals" explores the gray area of common dilemmas and provides guidelines on how to determine the best course of action when the best course is unclear.Covers basic principles that affect current ethical concerns and dilemmasIncludes illustrative real-world case studiesFeatures well-defined professional codes of ethicsTreats ethics as a set of guidelines designed to protect the client, the clinician, and the profession as a whole

This book presents an in-depth qualitative study carried out with inpatients under treatment for substance use disorders (SUDs) in seven therapeutic communities (TCs) located in three countries: Peru, Nicaragua and Czech Republic. By comparing the experiences in these different cultural contexts, the book presents a grounded theory of SUDs treatment in TCs from a cross-cultural perspective, identifying factors that influence the efficacy of SUDs treatment in TCs based on interviews carried out with inpatients. Based on rigorous qualitative research methods, this book presents not only a comparative analysis of TCs located in different cultural contexts, but also analyzes the cross-cultural nature of the therapeutic programs adopted in these communities, such as the combination of traditional Amazonian medicine based on the therapeutic use of ayahuasca with conventional psychotherapy and occupational therapy, among other approaches. Departing from the interviews carried out with inpatients, the authors present a comparative analysis of how the different TCs address important issues related to SUDs treatment, and complement this analysis with machine-generated summaries of relevant scientific papers. These summaries contain results of similar research projects conducted in other cultural contexts. Substance Use Disorders Treatment in Therapeutic Communities: A Cross-Cultural Approach presents the results of a unique comparative study with great translational potential which will be of interest to both researchers and practitioners working in TCs. This unique comparative study identifies factors affecting the efficacy of therapeutic programs and proposes a grounded theory which aims to serve as an important source of information for therapists and other professionals working with SUDs treatment and for the replication of applied therapeutic methods in other TCs.

Clinical Management of Sex Addiction's newest edition updates many of the original chapters from 28 leaders in the field with new findings and treatment methods in the field of sex addiction. With a growing awareness of sex addiction as a problem, plus the advent of cybersex compulsion, professional clinicians are being confronted with sexual compulsion with little clinical or academic preparation. This is the first book distilling the experience of the leaders in this emerging field. It additionally provides new chapters on emerging areas of interest, including partner counseling, trauma and sexual addiction, and adolescent sex addiction. With a focus on special populations, the book creates a current and coherent reference for the therapist who faces quickly escalating new constellations of addictive sexual behavior. Readable, concise and filled with useful interventions, it is a key text for professionals new to the field and a classic reference for all clinicians who treat sex addiction.

'Solid, plausible, accurate and loaded with pertinent and highly referenced information regarding clinical and basic research in alcholism among women and ethnic groups...an essential text in the libraries of academicians, teachers, clinicians, researchers, and policy makers. The quality and scope of the work are groundbreaking, and it is convenient to have it all in one source.' -American Journal of Psychiatry Volume 12 highlights the remarkable evolution of alcoholism research during the last few years, focusing on gender in alcohol actions and consequences.

Alcoholism is a pathological behavioural syndrome, characterised by comp- sive alcohol use, craving and relapses, even recurring after many years of abstinence. It is suggested that chronic alcohol abuse leads to persistent changes within several neurochemical pathways in the brain and furthermore that an imprinted drug and addiction memory may scarcely be extinguished. Hence, the question arises as to whether there ought to be a reasonable hope that pharmacological drugs will be developed that interfere with an addiction memory, and as a result, finally lead to a cure? In this book, leading preclinical and clinical experts in the field of alcohol relapse prevention strive to furnish an answer to this question. None of the researchers or clinicians believes in a magic bullet that will be of help to all alcoholic patients in overcoming this disease. However, there is now convi- ing evidence demonstrating that specific subpopulations of alcoholic patients experience satisfactory benefit from currently available treatments. Today we have two medications for relapse prevention on the market - acamprosate and naltrexone. Although, currently, only a minority of alcoholic patients benefit from these medications, the approval of these compounds may be considered a hallmark in the field of psychopharmacology, even comparable to the era when the first antidepressant compounds were introduced. In recent years we have been witnessing an enormous growth in the science and knowledge regarding the field of relapse prevention.

Obsessive-compulsive disorder affects approximately one person in 40 and causes great suffering. Effective treatments are available that can help many, and our understanding of the psychology, neurobiology, and clinical treatment of the disorder has advanced dramatically over the past 25 years. Nevertheless, much remains to be learned, and a substantial minority of patients benefit little even from the best treatments we have to offer today. This volume provides the first comprehensive summary of the state of the field, summarizing topics ranging from genetics and neurobiology through cognitive psychology, clinical treatment, related conditions, societal implications, and personal experiences of patients and clinicians. This book is unique in its comprehensive coverage that extends far beyond the realm of cognitive-behavioral therapy. As such it will serve as a valuable introduction to those new to the field, a fascinating resource for OCD suffers and their families, and an essential reference for students, clinicians, and researchers.

" The problems and needs of rural substance abusers vary from those of abusers in urban areas. Accordingly, the means of treatment must acknowledge and address these differences. Despite this call for specialized care, no theoretically grounded therapy has yet been made available to rural patients. Behavioral Therapy for Rural Substance Abusers, developed and piloted over three years by University of Kentucky faculty and staff and substance abuse counselors in rural eastern Kentucky, provides a model for effective treatment for this segment of the population. A two-phase outpatient treatment, this approach combines group and individual sessions in an environment that is both comfortable and useful for the client. The success of this method lies in its regional approach to therapy. Rather than using role-playing techniques to examine old behaviors, therapy is designed around storytelling activities. Rural patients respond more positively to such time-honored traditions and thus become active participants in their own treatment. This manual offers a clear and well-constructed guide through the strategies of Structured Behavioral Outpatient Rural Therapy (SBORT). Supplemented with illustrations, sample exercises, and case studies, Behavioral Therapy for Rural Substance Abusers is a vital tool in meeting the treatment needs of an otherwise ignored rural population.

This book provides professionals with the confidence and know-how to build a complete substance misuse management programme and deliver it within their respective workplace, regardless of sector or discipline. Organizations are frequently in the dark about their rights and obligations where substance misuse takes place in their workplace, affects performance or employee wellbeing, or in extreme cases has a devastating impact on both the company and its employees. There is no formal training for HR, Occupational Health or Health and Safety professionals, solicitors, union representatives and many more situations. This book is written in such a way that as to help those professions, as well as individuals, understand the step-by-step process for building a complete workplace substance and alcohol misuse programme. Managing Workplace Substance Misuse is written by the UK's only registered expert witness for substance misuse policy writing, implementation and mediation. With decades of expertise and first-hand experience of implementing effective policies in some of the UK and world's biggest organizations, Trevor Hall helps all organizations navigate this complex problem, offering consultancy advice and a roadmap to policy development and its implementation, providing you with a comprehensive consultancy in one volume. He explains, too, the central role industry and commerce plays in the identification of substance misuse and the rehabilitation of staff, as well as what organizations can do to protect themselves from the culpability of getting things wrong in a litigious society.