This volume, is developed from a collaborative study sponsored by the World Health Organization over a period of five years, the result of the combined effort of over 30 experts working in 19 different countries. The book presents a comprehensive survey of the development, policy, and procedures of methadone maintenance in countries with experience in this treatment. In addition to presenting a general overview of methadone's role in treating opioid addiction, the volume also focuses on specific questions of current interest, particularly the critical issue of methadone maintenance in the prevention of AIDS. Public health specialists and policymakers will find this book an invaluable source of information about what can be expected from methadone maintenance programs and why such programs have achieved some success in the rehabilitation of opiate users, while so many other attempts in this area have failed.

Following an introductory chapter, the contributors look at the impact of AIDS epidemiology on methadone policy. The role of methadone in addressing intravenous drug abuse and unsafe sex practices in drug dependent persons is explored in an attempt to assess the ability of methadone maintenance programs to stem the spread of AIDS. Subsequent chapters review the world literature on methadone in treating opioid dependency, explore national policies and practices regarding methadone maintenance, present an international survey of methadone's role, and analyze the present state of research on methadone. A bibliography and index complete the volume.

This book documents the history of ideas about problem gambling and its link to addictive disorders. The book uses a combination of literature review and conceptual and linguistic analysis to explore the way ideas about problem gambling gave changed over time. It examines the religious, socio-cultural, and medical influences on the development of the concept of problem gambling as a disease, along with the ways in which such ideas were influenced by attitudes about substance abuse. The history of mental illness, notably as it pertains to themes such as loss of control over behavior, is also addressed. The book ends with a discussion of the current status and future prospects, with an eye to which ideas about problem gambling and addictions seem most promising and which should perhaps be left behind.

"Keane's work is thoughtful and thought provoking and incorporates elements of medical history and philosophy."--"Psychiatric Services"

"A theoretically engaging exploration of the arbitrariness of the field of addiction studies."
--Robert Granfield, co-author of "Coming Clean"

We assume that there is something wrong with addiction. But how exactly is it bad to be an addict? What's Wrong with Addiction? explores the ways in which our views of addiction categorize certain ways of being as unnatural, diseased, and self-destructive, often working to reinforce existing social hierarchies. Under the rubric of addiction, pleasure and desire are demonized, while the addict is viewed as damaged and in need of physical and moral rectificaiton.

Keane examines the ambiguities in medical science's quest to construct addiction in chemical and biological terms, revealing the strains in the oppositions between disease and health, and addiction and normality. She demonstrates how these strains have become more insistent as the net of addiction has spread wider, moving beyond chemical substances to other problems of consumption and conduct such as compulsive eating and sex addiction. The book also critically examines the ideals of health, freedom, and happiness found in popular self-help literature, suggesting that it is the practices of self-surveillance and self-interrogation promoted in recovery guides which actually produce the inner self as an object of concern.

This newly updated and streamlined edition of Group Psychotherapy with Addicted Populations provides proven strategies for combating alcohol and drug addiction through group psychotherapy. The interventions discussed in the book build on a foundation of addiction as an attachment disorder rooted in the understanding of addiction as a family disease. An appreciation of group and organizational dynamics is used to address the complex experience of developmental trauma that underlies addiction. Having identified the essential theoretical underpinnings of supporting recovery from addiction, the second half of the book gives a thorough nuts and bolts description of constructing a psychotherapy group and engaging productively in the successive phases of its development from initiation of treatment to termination. The book concludes with specific recommendations for group psychotherapists to increase their competence with groups, deepen their appreciation of group and organizational dynamics and develop a community of support for their own well-being. These methods are important for psychotherapists working with addicted populations who are inexperienced with group psychotherapy as well as seasoned group psychotherapists wishing to enhance their work.

Using an innovative translational approach between the work of experimental scientists and clinical practitioners this book addresses the current, modest, understanding of how and why addiction treatment works. Through bridging this gap it provides a critical insight into why people react as they do in the context of addiction treatment.

This new, and heavily revised, edition of Psychopharmacology, provides a comprehensive scientific study of the effects of drugs on the mind and behaviour. With the growing prevalence of psychiatric and behavioral disorders and the rapid advances in the development of new drug therapies, this textbook offers an essential understanding of the necessary details of drug action. The book presents its coverage in the context of the behavioral disorders they are designed to treat, rather than by traditional drug classifications, to strengthen understanding of the underlying physiology and neurochemistry, as well as the approaches to treatment. Each disorder from the major diagnostic categories is discussed from a historical context along with diagnostic criteria and descriptions of typical cases. In addition, what we presently know about the underlying pathology of each disorder is carefully described. Providing a solid foundation in psychology, neuroanatomy and physiology, the book also offers a critical examination of drug claims, as well as coverage of evidence-based alternatives to traditional drug therapies. Throughout, this text discusses how drug effectiveness is measured in both human and animal studies. Topics new to this edition include: a stronger emphasis on the environmental impacts on drug effectiveness; more on the mechanisms of adverse reactions to drugs and information on managing drug side effects; the risks and benefits of using "mood stabilizing drugs" to address behavior in youth with ADHD or ASD; and discussion of the research-to-practice gap in pharmacological care for children and adolescents. Accompanied by a robust companion website of instructor materials, this textbook is ideal for undergraduate and pre-professional students on courses in Psychopharmacology, Clinical Psychopharmacology, Drugs and Behavior. It is a valuable contribution to highlight the symbiotic relationship between psychopharmacology and the neural and behavioral sciences.

The primary purpose of this book and its companion volume The Neuropharmacology of Nicotine Dependence is to explore the ways in which recent studies on nicotine and its role in tobacco addiction have opened our eyes to the psychopharmacological properties of this unique and fascinating drug. While the present volume considers the molecular and genetic factors which influence behavioral responses to nicotine and how these may impact on the role of nicotine in tobacco dependence, the book The Neuropharmacology of Nicotine Dependence focuses on the complex neural and psychological mechanisms that mediate nicotine dependence in experimental animal models and their relationship to tobacco addiction in humans. These volumes will provide readers with a contemporary overview of current research on nicotine psychopharmacology and its role in tobacco dependence from leaders in this field of research and will hopefully prove valuable to those who are developing their own research programmes in this important topic.

Drug abuse and addiction are common in clinical practice. Often they interfere with patient treatment or require an alternative approach. Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment is a major contribution to the literature, a gold standard title offering a comprehensive range of topics for those who care for patients with addiction, conduct research in this area, or simply have an interest in the field. Offering state-of-the-art information for all those working with drug abusing or addicted patients, or for those interested in this topic from other research perspectives, the volume is a first of its kind book -- rich, comprehensive, yet focused, addressing the needs of the very active theoretical, basic, and clinical research in the field. Comprised of 46 chapters organized in four sections and developed by the leading international experts, Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment covers virtually every core, as well as contemporary, topic on addiction, from the established theories to the most modern research and development in the field. Enhancing the educational value of the volume, every chapter includes an abstract and two boxes summarizing learning objectives and directions for future research. Drug Abuse and Addiction in Medical Illness: Causes, Consequences, and Treatment discusses the topic in a authoritative, systematic manner and is an indispensable reference for all clinicians and researchers interested in this rapidly changing field.

"Perioperative Addiction" addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations.

Features:

Guidance for spotting and managing addicted patients

All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol

Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals

Fascinating overview of the long history of addiction

Genetic basis of addiction, and the range of pharmacological treatments for addiction

Get high. Become addicted. Commit crimes. Get arrested and be sent to jail. Get released. Repeat. It's a cycle often destined to persist, in large part because the critical step that is often missing in the process, which is treatment geared toward ensuring that addicts are able to reenter society without the constant threat of imminent relapse. The Handbook of Evidence-Based Substance Abuse Treatment in Criminal Justice Settings probes the efficacy of corrections-based drug interventions, particularly behavioral treatment. With straightforward interpretation of data that reveals what works, what doesn't, and what needs further study, this volume navigates readers through the criminal justice system, the history of drug treatment for offenders, and the practical problems of program design and implementation. Probation and parole issues as well as concerns specific to special populations such as women, juvenile offenders, and inmates living with HIV/AIDS are also examined in detail. The Handbook's wide-ranging coverage includes: * Biology and genetics of the addicted brain. * Case management for substance-abusing offenders. * Integrated treatment for drug abuse and mental illness. * Evidence-based responses to impaired driving. * Monitoring technology and alternatives to incarceration. * The use of pharmacotherapy in rehabilitation. This must-have reference work is a comprehensive and timely resource for clinicians, researchers, and graduate students across a variety of disciplines including clinical psychology, criminology and criminal justice, counseling, and educational policy makers.

One of the few books on the topic, this updated edition offers alternatives to disease models of addiction by exploring personal pathways to recovery. Focusing on alcohol and drug problems, it provides a literature review of 40 years of studies on self-change with particular emphasis on the current decade and methodological issues (starting with how much or how little treatment constitutes "treatment"). The 24 experts keep the coverage consistently readable, and dozens of brief narratives from individuals who have successfully recovered from an addictive behavior without formal help lend valuable personal perspectives.

1. Metabolism of Ethanol.- 1.1. Pathways of Ethanol Oxidation.- 1.2. Alteration in the Metabolism of Ethanol after Chronic Ethanol Consumption.- 1.3. Effects of Liver Disease, Blood Flow, Circadian Rhythm, Gender, and Other Factors on Hepatic Alcohol Metabolism.- 1.4. Effects of Other Drugs on Ethanol Metabolism.- 1.5. Ethnic and Genetic Factors in Ethanol Metabolism.- 1.6. Extrahepatic Ethanol Metabolism.- 1.7. Summary.- References.- 2. Acetaldehyde and Acetate.- 2.1. Pathways of Acetaldehyde and Acetate Metabolism.- 2.2. Effect of Chronic Ethanol Consumption on Acetaldehyde and Acetate Metabolism.- 2.3. Effect of Liver Injury on Acetaldehyde Metabolism.- 2.4. Effects Attributable to Acetaldehyde and Acetate after Acute and Chronic Ethanol Consumption.- 2.5. Summary.- References.- 3. Alcohol, Hormones, and Metabolism.- 3.1. Hypothalamic-Pituitary-Thyroidal Axis.- 3.2. Parathormone and Calcitonin.- 3.3. Adrenocortical Function: Glucocorticoid Secretion.- 3.4. Adrenocortical Function: Mineralocorticoid Secretion.- 3.5. Adrenal Medullary Function.- 3.6. Growth Hormone.- 3.7. Antidiuretic Hormone and Oxytocin.- 3.8. Pancreatic and Gastrointestinal Hormones.- 3.9. Alteration of Carbohydrate Metabolism by Alcohol.- 3.10. Effects of Ethanol on Ketone Metabolism.- 3.11. Alcoholic Ketoacidosis.- 3.12. Hyperlactacidemia and Lactic Acidosis.- 3.13. Alcoholic Hyperuricemia and Its Relationship to Gouty Attacks.- References.- 4. Ethanol and Lipid Disorders, Including Fatty Liver, Hyperlipemia, and Atherosclerosis.- 4.1. Interaction of the Metabolism of Ethanol and Lipids.- 4.2. Pathogenesis of the Alcoholic Fatty Liver.- 4.3. Agents and Procedures that Prevent the Alcoholic Fatty Liver.- 4.4. Effects of Ethanol on Blood Lipids: Characteristics and Pathogenesis of Alcoholic Hyperlipemia.- 4.5. Ethanol, Atherosclerosis, and High-Density Lipoproteins.- 4.6. Interaction of Ethanol with Vascular Prostacyclin Production.- 4.7. Summary.- References.- 5. Effects of Ethanol on Amino Acid and Protein Metabolism.- 5.1. Effects of Ethanol on Nitrogen Balance and Body Protein Composition.- 5.2. Effects of Ethanol on Amino Acids.- 5.3. Effects of Ethanol on Hepatic Protein Synthesis.- 5.4. Effects of Ethanol on Hepatic Protein Secretion.- 5.5. Effects of Ethanol on Hepatic Protein Catabolism.- 5.6. Hepatic Accumulation of Protein after Chronic Ethanol Feeding.- 5.7. Dietary Requirements for Protein in the Alcoholic.- 5.8. Summary.- References.- 6. Interaction of Ethanol with Other Drugs.- 6.1. Interaction with Drug Absorption.- 6.2. Interaction with Plasma Protein Binding.- 6.3. Interaction with Hepatic Blood Flow.- 6.4. Interaction with Hepatic Cell Uptake.- 6.5. Interaction with Hepatic Metabolism.- 6.6. Pharmacological Interactions.- 6.7. Summary and Therapeutic Guidelines.- References.- 7. Alcohol and the Liver.- 7.1. Epidemiology of Alcoholic Liver Disease.- 7.2. Pathology and Symptomatology of the Various Stages of Alcoholic Liver Injury.- 7.3. Pathogenesis of Alcoholic Liver Injury.- 7.4. Diagnosis of Alcoholic Liver Injury.- 7.5. Prognosis and Treatment of Alcholic Liver Injury.- References.- 8. Alcohol and the Hematologic System.- 8.1. Red Cells.- 8.2. Platelets.- 8.3. Granulocytes.- 8.4. Monocytes and Macrophages.- 8.5. Lymphocytes.- 8.6. Other Factors Favoring Infection.- 8.7. Summary.- References.- 9. Immunologic Reactions in Alcoholic Liver Disease.- 9.1. Morphological Considerations.- 9.2. Genetic Factors.- 9.3. Immunoglobulins, Antibodies, and Immune Complexes.- 9.4. Hepatitis B Virus (HBV).- 9.5. Hepatitis C Virus (HCV).- 9.6. Serum Factors and Cytokine Activity.- 9.7. Cell-Mediated Alterations.- 9.8. Abnormal Antigen Expression on Liver Cells.- 9.9. Alcohol and Alteration of the Immune Response in Alcoholics without ALD.- 9.10. Summary.- References.- 10. Alcohol and the Digestive Tract.- 10.1. Introduction.- 10.2. Oropharynx and Salivary Glands.- 10.3. Esophagus.- 10.4. Stomach.- 10.5. Effect of Alcohol on the Small Intestine.- 10.6...

RESEARCH FINDINGS: Drugs in the Workplace: Extent and Impact of Alcohol and Drug Usage/Problems in the Workplace/Workforce (J. Martin). Predictors of Drug Use and Implications for the Workplace (M. Newcomb). Drug Testing Programs: Drug Testing Methods and Interpretation of Results (B. Kapur). The Impact and Effectiveness of Drug Testing Programs in the Workplace (S. Macdonald). Legal Issues: Some Legal Aspects of Drug Testing in the Canadian Workplace (M. Pinsonneault). Constitutional and Statuatory Treatment of Drug Testing in the United States (R.L. Lieberwitz). Other Workplace Programs: Behavioral Tests to Assess Performance (B. Butler). Alternatives to Drug Testing (M. Shain). PERSPECTIVES ON DRUG TESTING: Unions' Perspective on Workplace Drug Testing (S. Alvi). Drug Testing, the War on Drugs, Workers, and the Workplace (J. Blackwell). 5 additional articles. Index.

When Downeast "local" Annette Fiorno is found at the bottom of a ravine, "outsider" and relapsed drug addict Jimmy Sedgwick is accused of murder. Unassuming Maine lawyer Rob Hanston and big shot attorney Shawn Marks form an unlikely legal team as they attempt to discredit the overwhelming evidence. Addiction on Trial, the first in a series of Shawn Marks Thrillers, revolves around the murder cases of Attorney Marks, an egotistical yet likable high-powered Boston attorney who can juggle an array of female companions without taking his eye off the legal challenges of his work. Addiction on Trial sends a powerful message of societal discrimination toward drug addicts and explores common misperceptions about what drug addiction really is - a chronic illness requiring a similar treatment approach as other chronic diseases. Medical and behavioral aspects of addiction are woven into the intrigue of this thriller, which culminates in a riveting murder trial.