A comprehensive overview of major 12-step programs, this practical manual also describes the nuances of the various programs that address the same addictive behavior to assist the clinician in assessing and referring clients to any 12-step program. One of the unique features of this book is a description of how 12-step program philosophy aligns with eight major psychotherapy orientations. Another feature is the integration of the client's individual needs and ego structure with the appropriateness and timing of a referral to a 12-step program within the overall therapeutic process.

In this day of managed care, it is essential for clinicians to make informed referrals. This book bridges the gap between the desire to refer and a comprehensive understanding of the intricacies of the various programs. Through the use of detailed description, case vignettes, and clinical examples, this book proves an invaluable resource assisting clinicians to guide their clients through the process of integrating psychotherapy with adjunctive 12-step program involvement. Also included is a description of terms used in 12-step programs that allows the clinicians to join the client in a common language.

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 A-Z encyclopedia provides a broad and evenhanded overview of America's complex relationship with marijuana, examining political, recreational, cultural, medical, and economic aspects of marijuana use both historically and in the present day. Marijuana in America is an accessible and comprehensive exploration of the many changes in medical, legal, and cultural issues surrounding cannabis in the United States. This multidisciplinary volume features contributions from several different fields to explain all facets of marijuana, including its chemical composition, evolving depictions in popular culture, and historical, legal, and social settings in which marijuana use occurs. A mix of coverage provides readers with a full and accurate understanding of the spectrum of issues and controversies swirling around marijuana today, including: the changing legal landscape pertaining to the sale, possession, and use of marijuana, both at the state and federal levels; the factual basis for arguments for and against so-called "medical marijuana"; claims that marijuana is a gateway drug to harder drugs; changing cultural attitudes about marijuana and "potheads"; economic arguments for and against marijuana legalization; and the impact of marijuana on families, communities, the economy, and the criminal justice system. Detailed, authoritative, and evenhanded coverage of all medical, legal, cultural, and economic aspects of legal and illegal marijuana in America. Information sources for further research included in each entry. Timeline of legal, cultural, and social events and trends concerning marijuana and its use in the United States. Contributions from several different fields giving the volume a multidisciplinary focus.

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.

The most important writings on the psychoanalytic understandings and treatments of drug and vice addiction Drug abuse, alcoholism, compulsive gambling, and other destructive addictions plague our society. Theories of addiction locate its cause variously-in factors related to the substance, the addict's personality, or to the addict's environment. Arguments about effective treatment programs are fierce. Essential Papers on Addiction presents the most important writing and the various sides of the debate on the psychoanalytic understanding and treatment of addiction. Daniel Yalisove outlines the history of the treatment of addiction and introduces important psychoanalytic concepts used in understanding addicts. The book includes case studies which illustrate the course of addiction and presents the work of the most influential theorists in the field. Divided into eight sections focusing on historical work on addiction, psychoanalytic theories of addiction, transference and countertransference issues in treating addiction, psychoanalytic treatment for the addictions, psychoanalytic therapy and disease concepts, and psychiatric illness and addiction, this definitive volume includes contributions by the most experienced and renowned experts on the subject. Contributors include S. Freud, E. Glover, S. Rado, R. P. Knight, L. Wurmser, N. E. Zinberg, H. Krystal, D. Jacobs, R. Fine, J. Gustafson, C. L. Brown, M. L. Selzer, V. Davidson, J. Imhof, R. Hirsch, R. E. Terenzi, M. E. Chafetz, A. Silber, R. J. Rosenthal, E. M. Pattison, M. B. Sobell, L. C. Sobell, J. E. Zweben, E. Simmel, B. Brickman, E. J. Khantzian, R. D. Weiss, S. M. Mirin, A. T. McLellan, and H. J. Richards.

"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.

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.

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.

It describes the process of solution-focused intervention in a step-by-step fashion and includes case examples, sample assessment forms, and advice for how this approach can be adapted to a variety of service programs.

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.

"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