People with substance abuse problems often depend on Medicaid to pay for treatment. Health Care Reform, as specified in the Patient Protection and Affordable Care Act of 2010, will increase the importance of Medicaid as a payment system for chemical dependency care. Now entering its second 50 years, Medicaid is a unique partnership of federal and state agencies financing health care services for low income people. This book is an invaluable resource for patients, family members, clinicians, administrators, and policy-makers concerned about ways to pay for addiction treatment. Written by national experts, the book summarises the provisions of Medicaid of most relevance to substance abuse treatment, reviews the pertinent history of this complex and ever changing program, and describes key findings from numerous "natural experiments" such as the implementation of Medicaid managed behavioural health care as well as cutbacks in Medicaid coverage.

Problems related to substance use, abuse and dependence are a major concern on societies today, persisting to require considerable attention from the community. For decades studies have been showing that drug consumption represents a main risk factor for physical, social and mental health problems. Unfortunately, reality shows that in many cultures and fractions of population, heavy substance use is the norm. This book examines the cognitive-behavioural indicators of substance abuse and various corresponding treatment techniques.

Treatment of an ever-increasing variety of addictive behaviours owes much to a wide range of psychotherapeutic approaches which have tended to roll continuously in and out of fashion. Over recent years, an initiative has been established to appraise critically the use of psychotherapy in all areas of psychiatry. This work serves as a timely review of psychological treatments in the addictions field and provides a rare combination of expertise both from addiction specialists and those who use psychotherapeutic approaches to solve a wide range of personal problems. Its coverage includes contextual ideas which are basic to the choice of approach to therapy, and an exploration of particular treatment strategies. Throughout, this volume is able both to provide authoritative statements and to engage the reader in the excitement of debate. It forms a valuable reference which is sure to appeal to a wide range of practitioners and researchers concerned with alcohol and drug problems.

This book selectively discusses recent advances in human experimental models relating to the treatment of opioid dependence. The author critically reviewed three independent lines of research conducted during the past decade with heroin-dependent volunteers. One research strategy involves studying the -opioid receptor ( OR), which is the molecular target for the reinforcing and physical dependence producing effects of heroin-like drugs. This has been accomplished by varying medication dose conditions, measuring the availability of brain -receptors in vivo and plasma pharmacokinetics, then correlating these biological concentration measures with clinically relevant endpoints including opioid withdrawal symptoms, heroin craving, and blockade of the euphoric and respiratory depressant effects of -agonist challenges. These studies provide an initial benchmark for estimating OR occupancy or plasma concentration requirements for effective pharmacotherapy. A second research strategy determines the conditions under which -agonist medications function as reinforcers, and the ability of medication dose and the availability of non-drug alternative reinforcement to attenuate opioid choice. Taken together, these studies provide information relevant to the ability of the medication to stimulate adherence and reduce drug demand. A third research strategy seeks to determine whether non-opioid medications can attenuate the naloxone-precipitated (i.e. withdrawal related) discriminative stimulus, subjective and/or physiological effects in opioid-maintained individuals. These studies aim to identify compounds that may be safe and effective adjuncts during opioid detoxification and, potentially, anti-relapse agents. Evidence is also reviewed concerning individual differences identified in these models. Implications of these findings for clinical treatment are also discussed.

The Office of the US Surgeon General, in a detailed report entitled "Women and Smoking," made the following statement: "When calling attention to public health problems, we must not misuse the word 'epidemic.' But there is no better word to describe the 600-percent increase since 1950 in women's death rates for lung cancer, a disease primarily caused by cigarette smoking. Clearly, smoking-related disease among women is a full-blown epidemic." -- David Satcher, MD, PhD Tobacco use accounts for nearly one third of all cancer deaths. Tens of thousands of women will die this year from lung cancer, which has greatly surpassed breast cancer as the leading cause of cancer death among women. More than 90% of these deaths will be due to smoking. In addition to increasing the risk for lung cancer, smoking is a risk factor for cancers of the cervix, mouth, larynx (voice box), pharynx (throat), esophagus, kidney, bladder, pancreas, and stomach. It is also connected to some forms of leukemia. This book presents the latest research in this field from around the world.

Gambling Disorder: A Clinical Guide to Treatment is a systematic, eloquent, and exhaustive examination of the etiology, psychopathology, neurobiology, and treatment of the disorder, which was reclassified for DSM-5. Building on its 2004 predecessor, Pathological Gambling, which was groundbreaking for its era, the second edition has been thoroughly restructured and is designed to prepare clinicians to diagnose, treat, and-most important of all-understand their patients with the disorder. More common than previously supposed, gambling disorder is associated with decreased self-esteem, comorbid substance use disorders, financial and legal difficulties, relationship and family stress, and suicidality. Yet, many clinicians are unaware of the personal and social consequences of this disorder, as well as its implications for public health. Accordingly, the book provides a detailed look at the effects of gambling on societal, familial, and individual health and well-being and prepares clinicians to accurately assess their patients and provide effective treatments. As befits a field that has been the recent focus of so much innovative and promising research, the new edition boasts a fresh roster of contributors, each of whom bring special insight to their areas of expertise. Noteworthy topics include: * Currently available screening and assessment instruments for diagnosing gambling disorder and monitoring symptom change are discussed in-depth, including psychometric properties, norms, administration methods, and scoring and interpretation of each instrument. * Online gambling and gambling-gaming convergence is considered in a new chapter, which explores the complex interplay between gambling and technology. Highlighted issues include the growth of interactive platforms, role of new player experiences and reward structures, tailoring of products to individuals, and integration into other online activities, such as gaming and social media.* Gender differences in epidemiology, phenomenology, psychiatric comorbidity, and biology have been identified among patients with gambling disorder, with important treatment implications. Similarly, older adults and young people can exhibit significant differences in behavior. These are explored in separate, clinically rich, chapters.* The always evolving field of gambling and criminal/legal issues is explored in a chapter on forensic issues in gambling, which examines the relationship of gambling disorder to antisocial personality disorder and domestic abuse, and looks at the interface between gambling and the legal system.* Tremendous advances in the treatment of gambling disorder have been made since the last edition, and these are reflected in comprehensive chapters on psychosocial and pharmacological treatments. Full of expert clinical knowledge and cutting-edge research, Gambling Disorder: A Clinical Guide to Treatment is the clinician's comprehensive guide to helping patients with gambling disorder find relief from this disabling disorder.

Drugs in Society: Causes, Concepts, and Control, Eighth Edition, focuses on the many critical areas of America's drug problem, providing a foundation for rational decision-making within this complex and multidisciplinary field. Lyman offers a comprehensive big-picture examination of the US drug problem, dealing with drugs, abusers, drug enforcement, and public policy. Organized in three sections: Understanding the Problem, Gangs and Drugs, and Fighting Back, topics covered include the business of drugs and the role of organized crime in the drug trade, drug legalization and decriminalization, legal and law enforcement strategies, an analysis of the socialization process of drug use and abuse, and a historical discussion of drug abuse that puts the contemporary drug problem into perspective. Suitable for upper-level undergraduates in Criminal Justice, Criminology, and related programs, Drugs in Society, Eighth Edition, uses logical organization and strong pedagogy (case studies, focused text boxes with related information, critical thinking tasks) to support learning objectives.

The Provider's Guide (Criminal Conduct and Substance Abuse Treatment for Adolescents) identifies psychological, biological, and social factors that contribute to the onset of adolescent deviance, including substance abuse, delinquency, and crime. Causal models for these problem behaviors are described, followed by a review of assessment and treatment protocols widely used in contemporary practice. Guidelines are provided for delivery of the 32- session PSD-C treatment curriculum, specifically designed for adolescents who manifest co-existing juvenile justice and substance abuse problems. The PSD-C Provider's Guide explains how effective adolescent treatment derives from integration of the following evidence-based: strategies: motivational enhancement; stages of change; gender and diversity proficiency; cognitive-behavioral skill development; relapse and recidivism prevention; differential assessment; and individualized treatment planning. The Provider's Guide delineates principles for effective adolescent-focused treatment in tandem with the Participant's Workbook: Pathways to Self-Discovery and Change (PSD-C).

Dentists have been inundated by patients with an array of complicated medical conditions and pain/sedation management issues. This is in addition to a variety of legal regulations dentists must follow regarding the storage and recordkeeping of controlled substances. Avoid unknowingly putting your practice at risk by becoming victim to a scam or violating a recordkeeping requirement with The ADA Practical Guide to Substance Use Disorders and Safe Prescribing. This Practical Guide is ideal for dentists and staff as they navigate: Detecting and deterring substance use disorders (SUD) and drug diversion in the dental office (drug-seeking patients) Prescribing complexities Treating patients with SUD and complex analgesic and sedation (pain/sedation management) needs and the best use of sedation anxiety medication Interviewing and counselling options for SUD Federal drug regulations Commonly used illicit, prescription, and over-the-counter drugs, as well as alcohol and tobacco, are also covered. Special features include: Clinical tools proven to aid in the identification, interviewing, intervention, referral and treatment of SUD Basic elements of SUD, acute pain/sedation management, and drug diversion Summary of evidence-based literature that supports what, when and how to prescribe controlled substances to patients with SUD Discussion of key federal controlled substance regulations that frequently impact dental practitioners Checklists to help prevent drug diversion in dental practices Chapter on impaired dental professionals Case studies that examine safe prescribing and due diligence

With an estimated 20 million people addicted to drugs or alcohol, America is in the grip of an unrivaled epidemic. Overcoming Addition reveals how seemingly contradictory treatment theories must come together to understand and end dangerous substance abuse. Addiction treatment has become a billion-dollar industry based on innumerable clinical and psychological perspectives. Zealous clinicians and researchers have gathered around the theories, proclaiming each as the sole truth and excluding alternate views. In this book, leading bioethicist Gregory Pence demystifies seven foundational theories of addiction and addiction treatment. From Alcoholics and Narcotics Anonymous to methadone clinics and brain chemistry studies, each method holds foundation beliefs about human nature, free will, and biology. Understanding the diversity of these theories allows us to build a framework for more effective treatment for all addiction types. For individuals suffering from addiction, their families, and those who devote their lives to ending addiction's grasp on our society, this book offers a fresh perspective and a framework for long-term solutions.

Adolescence is a developmental period marked by dramatic and rapid biological and social transformation; it is also a time of increasing rates of experimentation with substance use. This period and the risk behaviors that often accompany it cannot be fully understood from the vantage point of any single discipline, nor can they be described by focusing on only the behavioral and social problems of the period, the characteristics of normal development, or the pharmacology and addictive potential of specific drugs. Instead, a comprehensive approach requires knowledge of the brain's systems of reward and control, genetics, psychopharmacology, personality, child development, psychopathology, family dynamics, peer group relationships, culture, social policy, and more. Drawing on the expertise of leading researchers from multiple fields, The Oxford Handbook of Adolescent Substance Abuse provides the most comprehensive summarization to date of current knowledge about substance abuse during life's most tumultuous developmental stage. The Handbook is organized into eight sections covering the literature on the developmental context of this life period, the epidemiology of adolescent use and abuse, similarities and differences in use, addictive potential, and consequences of use for different drugs; etiology and course as characterized at different levels of mechanistic analysis ranging from the genetic and neural to the behavioral and social. Two sections cover the clinical ramifications of abuse, and prevention and intervention strategies to most effectively deal with these problems. The last section addresses the role of social policy in framing the problem and in addressing it, and explores its potential role in alleviating it. This volume's authoritative treatment of these issues and the breadth of its coverage make it suitable as a compendium of what is currently known; at the same time, its level of detail provides a reference text and a jumping off place for researchers already at work in the field.

Addiction is the United States' most pervasive and damaging public health problem, yet most Americans receive care that results in a failure rate that is both astronomically high and shielded from public view. The New Addiction Treatment examines the current state of the addiction treatment business and explores the reasons why (unlike those for all other behavioral, psychological, or neurological disorders) the treatment of addiction has been stagnant and little improved since the founding of Alcoholics Anonymous in 1935. After describing the size and scope of the problem and examining actual recovery rates for those who undergo treatment, David A. Patterson Silver Wolf asserts that there are effectively two kinds of treatment regimes in the United States: those that medical doctors receive, and those for the rest of us. The former has about an 80% success rate, the latter about an 80% failure rate. Drawing from his own experience as a former patient and person in long-term recovery, as well as his 22 years as a clinician, professor, and researcher, Patterson Silver Wolf describes many of the impediments to effective treatment today. This book offers a plausible and cost-effective way to disrupt the dismal status quo and realistically aspire to a higher success rate for everyone who receives professional help for a substance use disorder.

A fact-filled guide to coping with compulsive overeating problems by an experienced addictions doctor who draws on many patients' stories of recovery. Overeating, binge eating, obesity, anorexia, and bulimia - Food Junkies tackles the complex, poorly understood issue of food addiction from the perspective of a medical researcher and dozens of survivors. What exactly is food addiction? Is it possible to draw a hard line between indulging cravings for "comfort food" and engaging in substance abuse? For people struggling with food addictions, recognizing their condition remains a frustrating battle. This revised second edition contains the latest research as well as practical strategies for people facing the complicated challenges of eating disorders and addictions, offering an affirming and manageable path to healthy and sustainable habits.

"Scripting Addiction" takes readers into the highly ritualized world of mainstream American addiction treatment. It is a world where clinical practitioners evaluate how drug users speak about themselves and their problems, and where the ideal of "healthy" talk is explicitly promoted, carefully monitored, and identified as the primary sign of therapeutic progress. The book explores the puzzling question: why do addiction counselors dedicate themselves to reconciling drug users' relationship to language in order to reconfigure their relationship to drugs?

To answer this question, anthropologist Summerson Carr traces the charged interactions between counselors, clients, and case managers at "Fresh Beginnings," an addiction treatment program for homeless women in the midwestern United States. She shows that shelter, food, and even the custody of children hang in the balance of everyday therapeutic exchanges, such as clinical assessments, individual therapy sessions, and self-help meetings. Acutely aware of the high stakes of self-representation, experienced clients analyze and learn to effectively perform prescribed ways of speaking, a mimetic practice they call "flipping the script."

As a clinical ethnography, "Scripting Addiction" examines how decades of clinical theorizing about addiction, language, self-knowledge, and sobriety is manifested in interactions between counselors and clients. As an ethnography of the contemporary United States, the book demonstrates the complex cultural roots of the powerful clinical ideas that shape therapeutic transactions--and by extension administrative routines and institutional dynamics--at sites such as "Fresh Beginnings."

The cigarette is the deadliest artifact in the history of human civilization. It is also one of the most beguiling, thanks to more than a century of manipulation at the hands of tobacco industry chemists. In "Golden Holocaust," Robert N. Proctor draws on reams of formerly-secret industry documents to explore how the cigarette came to be the most widely-used drug on the planet, with six trillion sticks sold per year. He paints a harrowing picture of tobacco manufacturers conspiring to block the recognition of tobacco-cancer hazards, even as they ensnare legions of scientists and politicians in a web of denial. Proctor tells heretofore untold stories of fraud and subterfuge, and he makes the strongest case to date for a simple yet ambitious remedy: a ban on the manufacture and sale of cigarettes.

Addiction: A biopsychosocial perspective provides students with an evidence-based approach to addiction whilst covering a broad range of topics, critical perspectives and influential theories in addiction. With chapters discussing key theories, psychological, biological and societal aspects of addiction, this is a highly accessible and essential resource for students and researchers that: Offers an evidence-based discussion of addiction Addresses the neuroscience and psychology of addiction Provides a critical account of the science and research in addiction Includes chapter overviews and summaries, learning aims and case studies to help students in their study

Substance and Behavioral Addictions: Concepts, Causes, and Cures presents the concepts, etiology, assessment, prevention, and cessation of substance (tobacco, alcohol, other drugs, and food) and behavioral (gambling, Internet, shopping, love, sex, exercise, and work) addictions. The text provides a novel and integrative appetitive motivation framework of addiction, while acknowledging and referencing multi-level influences on addiction, such as neurobiological, cognitive, and micro-social and macro-social/physical environmental. The book discusses concurrent and substitute addiction, and offers prevention and treatment solutions, which are presented from a more integrative perspective than traditional presentations. This is an ideal text for upper-level undergraduates and graduate students, practitioners, and researchers.

Written by leaders in the addictions field, 100 authors from six countries, this handbook is a thoroughly comprehensive resource. Philosophical and legal issues are addressed, while conceptual underpinnings are provided through explanations of appetitive motivation, incentive sensitization, reward deficiency, and behavioral economics theories. Major clinical and research methods are clearly mapped out (e.g. MRI, behavioral economics, interview assessments, and qualitative approaches), outlining their strengths and weaknesses, giving the reader the tools needed to guide their research and practice aims. The etiology of addiction at various levels of analysis is discussed, including neurobiology, cognition, groups, culture, and environment, which simultaneously lays out the foundations and high-level discourse to serve both novice and expert researchers and clinicians. Importantly, the volume explores the prevention and treatment of such addictions as alcohol, tobacco, novel drugs, food, gambling, sex, work, shopping, the internet, and several seldom-investigated behaviors (e.g. love, tanning, or exercise).

One of the Washington Post's Ten Best Books of 2013

More than twenty-three thousand women die from heavy drinking in the United States each year. Incidents of binge drinking and so-called drunkorexia are on the rise, contributing to an exponential increase in the number of health conditions and cancers among women.

Combining in-depth research with her own personal story of recovery, the award-winning journalist Ann Dowsett Johnston tells of maintaining her high-powered career as a vice principal of McGill University while wrestling with the demon that defeated her own mother: alcohol addiction. After a very private exit from her professional life, Dowsett Johnston went to rehab; now sober, she has dedicated her career to examining the relationship between women and high-risk drinking.

In Drink, Dowsett Johnston dissects the psychological, social, and workplace factors that contribute to this crisis, and explores its far-reaching effect on both society at large and individual lives. Comprehensive and emotionally compelling, Drink is a brave and powerful story, beautifully told, and an important investigation into an epidemic that we can no longer afford to ignore.