'Darkly angelic prose... a joy to read, with the final part in particular recalling David Foster Wallace at his best' Alex Preston, Observer ________________________________ Will's mother's hokey homily, Waste not, want not... hisses in his ears as he oscillates furiously on the spot, havering on the threshold between the bedroom and the dying one... all the while cradling the plastic leech of the syringe in the crook of his arm. Oscillating furiously, and, as he'd presses the plunger home a touch more... and more, he hears it again and again: Waaaste nooot, waaant nooot..! whooshing into and out of him, while the blackness wells up at the periphery of his vision, and his hackneyed heart begins to beat out weirdly arrhythmic drum fills - even hitting the occasional rim-shot on his resonating rib cage. He waits, paralysed, acutely conscious, that were he simply to press his thumb right home, it'll be a cartoonish death: That's all folks! as the aperture screws shut forever. ________________________________________ 'Self's writing has the same technicolour velocity, malign comedy as his best novels' Evening Standard 'Refreshing . . . Self is never happier than when frolicking in the hinterland between sincerity and performative, winking hyperbole' TLS

Becoming a quality parent doesn't happen by accident or coincidence - it needs conscious awareness and intentional effort. Working a programme of recovery is among the greatest gifts a parent can give his or her child. It is, also, a frequently underappreciated and underutilised asset in terms of how recovering people can approach parenting. When practised, the principles of recovery not only improve the well-being and functioning of a person in recovery, but can, also, facilitate healthy, quality parenting in ways that better meet the needs of children and their parents. ROOTS AND WINGS is designed to provide the practical guidance that will help people develop the awareness and skills they need to become the parents they want to be - the parents their children need them to be or even the parents they wished they themselves had.

Alcohol Use Disorders takes a life-span/developmental approach to understanding the etiologic processes that heighten risk or resilience factors for alcohol use disorders (AUD). Contemporary understanding benefits from thirty years of longitudinal studies that were specifically designed to assess pre-onset origins, predictors of onset, and outcomes through early adulthood. The overriding theme of the volume is that the origins and expression of AUD are best understood within the context of developmental processes and dynamic systems organization and change. Such dynamic systems give rise to diverse pathways that are characterized by multi-finality and equi-finality due to the exchanges among genes, epigenetic processes, and the complexities of the individual organism's experiential world. For some individuals, these dynamic processes lead to risk cumulative or cascade effects that embody adverse childhood experiences that exacerbate risk, predict early onset drinking (or smoking), and are highly likely to lead to AUD during the transitions to adolescence and emerging adulthood. In other cases, protective factors within or outside of the individual's immediate family enable embodiment of normative stress regulatory systems and neural networks that support resilience and prevention of AUD and other addictive behaviors.

Grounded in decades of CBT research and clinical practice, as well as cutting-edge cognitive science, this book provides critical tools for understanding and treating the full range of addictive behaviors. Bruce S. Liese and Aaron T. Beck explain how to systematically develop case conceptualizations and support clients in achieving their recovery goals. The authors use vivid case examples to illustrate CBT techniques, structure, psychoeducation, motivational interviewing, group treatment, relapse prevention, and other effective therapeutic components. Several reproducible forms can be downloaded and printed in a convenient 8 1/2" x 11" size. Reflecting nearly 30 years of important advances in the field, this entirely new book replaces the authors' classic Cognitive Therapy of Substance Abuse.

Alcoholics Anonymous is one of the most significant self-help books of the twentieth century with an estimated thirty-seven million copies sold, translated into seventy languages. Released in 1939, the Big Book, as it is commonly known, has spawned a number of recovery communities around the world and remains a vibrant tool in introducing a plan of recovery from addiction in all its manifestations. It has been forty years since the last scholarly history of Alcoholics Anonymous (A.A.), Ernie Kurtz's Not God, published in 1979. Since then, all books that focus on one or more aspects of A.A. history have relied almost exclusively on the anecdotal stories told long after the fact by Bill Wilson and number of other early members, accounts that have proved at times to be inaccurate. Writing the Big Book is the result of eleven years of in-depth research into the formative years of A.A. Granted unprecedented access to the GSO archive, among others, the author reveals the inner workings of the early Fellowship, the conflicts, personalities, failures, and dispels myths of canonical texts such as Dr. Bob and the Good Old Timers, Alcoholics Anonymous Comes of Age, and A Brief History of the Big Book. Relying, whenever possible, on primary, real-time documents, the author pulls various threads into a remarkably coherent narrative. While the story focuses primarily on the eighteen months between October 1937 (when a book was first proposed) and April, 1939 (when Alcoholics Anonymous was published), relevant events both before and shortly after those dates are fully incorporated. Across the span of these eighteen months, the wealth of available archival materials allows a week-by-week accounting of events, which is presented here through an amazing amount of previously unreported details in a comprehensive and compelling story.

Review: Advance praise: 'This book brings together Jim Orford's vast knowledge of addiction research and theory and, using the unifying concept of power, it examines the multi-layered nature of how we are, at several levels, disempowered by our involvement with addictive consumptions. From the three case studies at the opening to his examples of communities reclaiming power at the end, his chapters move progressively from the individual, to families, to neighbourhoods and communities and onto the broader societal and industrial contexts that shape addictions in our lives. It is the first book on addiction I have read that thoroughly integrates so many important strands of thinking on this complex topic.' Peter J. Adams, Centre for Addiction Research, University of Auckland, and author of Fragmented Intimacy: Addiction in a Social World Advance praise: 'An important book with a powerful central message. Jim Orford masterfully weaves together wide-ranging and diverse fields of knowledge hitherto kept separate. The result is a fascinating exploration of the subtle but strong interconnections between addiction, powerless and power. Once again, Jim Orford breaks new ground.' Judith Harwin, Centre for Child and Youth Research, Brunel University Advance praise: 'This thought-provoking and beautifully written book delivers an important message for change on a broad canvas of integrated ideas: those most affected by addictions have been silenced and their voices need to be heard in the corridors of power.' Tim Stockwell, Director, Centre for Addictions Research of British Columbia, University of Victoria

The past thirty years have witnessed a revolution in the science of addiction, yet we still rely on outdated methods of treatment. Expensive new programs for managing addiction are also flourishing, but since they are not based in science, they offer little benefit to people who cannot afford to lose money or faith in their recovery. Clarifying the cutting-edge science of addiction for both practitioners and general readers, The Thirteenth Step pairs stories of real patients with explanations of key concepts relating to their illness. A police chief who disappears on the job illustrates the process through which a drug can trigger the brain circuits mediating relapse. One person's effort to find a burrito shack in a foreign city illuminates the reward prediction error signaled by the brain chemical dopamine. With these examples and more, this volume paints a vivid, readable portrait of drug seeking, escalation, and other aspects of addiction and suggests science-based treatments that promise to improve troubling relapse rates. Merging science and human experience, The Thirteenth Step offers compassionate, valuable answers to anyone who hopes for a better handle on a confounding disease.

After surviving nearly a decade of heroin abuse and hard living on the streets of San Francisco's Tenderloin District, Tracey Helton Mitchell decided to get clean for good. With raw honesty and a poignant perspective on life that only comes from starting at rock bottom, Tracey tells her story of transformation from homeless heroin addict to stable mother of three-and the hard work and hard lessons that got her there. Rather than dwelling on the pain of addiction, The Big Fix focuses on her journey of recovery and rebuilding her life, while exposing the failings of the American rehab system and laying out a path for change. Starting with the first step in her recovery, Tracey re-learns how to interact with men, build new friendships, handle money, and rekindle her relationship with her mother, all while staying sober, sharp, and dedicated to her future. A decidedly female story of addiction, The Big Fix describes the unique challenges faced by women caught in the grip of substance abuse, such as the toxic connection between drug addition and prostitution. Tracey's story of hope, hard work, and rehabilitation will inspire anyone who has been affected by substance abuse while offering hope for a better future.

To say that drugs have become the major affliction of society is not stating the situation too strongly. No sector of life is untouched by this epidemic. Crime and violence are the most obvious byproducts, but amorality, aborted educations and, indeed, ruined lives are no less serious and just as widespread. And the problem is not limited to street drugs; the effects of medical and psychiatric drugs, whether painkillers, tranquilizers or "antidepressants," are as disastrous. L. Ron Hubbard addressed this problem, not with the objective of resolving the physical ills of individuals but as a continuation of his quest to free man as a spirit and handle, along this route, any barrier that needed to be resolved. Drugs were such a barrier. Until Mr. Hubbard developed a workable drug rehabilitation program, there was no solution. Psychiatric-inspired programs had many more failures than successes and some only created worse addictions. Other people, more well-intentioned, found that good intentions weren't enough. They lacked a technology that worked. Mr. Hubbard's program provides that technology. From helping the person discover why he took drugs in the first place, to eliminating the mental and spiritual damage done by drugs, to detoxifying the body of long-term drug residues, to providing the person with tools that will enable him to stay off drugs for good, it is without doubt the most thorough and effective program in the world. Today, for the first time, as hundreds of thousands will attest, those addicted to drugs and alcohol can free themselves of this tyranny and face life with renewed vigor and hope. This section contains some of the elementary principles of this program and provides the first real understanding of substance abuse problems.

Whether drinking Red Bull, relieving chronic pain with oxycodone, or experimenting with Ecstasy, Americans participate in a culture of self-medication, using psychoactive substances to enhance or manage our moods. A "drug-free America" seems to be a fantasyland that most people don't want to inhabit. High: Drugs, Desire, and a Nation of Users asks fundamental questions about US drug policies and social norms. Why do we endorse the use of some drugs and criminalize others? Why do we accept the necessity of a doctor-prescribed opiate but not the same thing bought off the street? This divided approach shapes public policy, the justice system, research, social services, and health care. And despite the decades-old war on drugs, drug use remains relatively unchanged. Ingrid Walker speaks to the silencing effects of both criminalization and medicalization, incorporating first-person narratives to show a wide variety of user experiences with drugs. By challenging current thinking about drugs and users, Walker calls for a next wave of drug policy reform in the United States, beginning with recognizing the full spectrum of drug use practices.

Italian Association on Addiction Psychiatry 2002 International Meeting Proceedings. This volume is a wide-spectrum reflection springing from the contributions of some of the most important European and American researchers in the dual diagnosis field, who were involved in the national SIP.Dip. Conference in Milan on July 2002. They contributed to a shared understanding of issues such as the relevance of psychiatric diagnosis in addiction treatment planning, with experiences from Germany, Netherlands, Greece, Spain, England, and Thomas McLellan's paradigmatic research on assessment instruments carried out over the last 30 years in the USA.

The last three decades have seen an explosion of social, psychological and clinical research to identify effective strategies to prevent and treat alcohol-related problems. This ""Essential Handbook"" contains an updated selection of reviews of "what works" drawn from the critically acclaimed "International" "Handbook of Alcohol Dependence and Problems."

Selected specifically for health and other professionals, who need to provide effective responses in their work, these authoritative, science-based reviews are a distillation of the more practical elements, designed to save time for the busy practitioner.

Clinical Addiction Psychiatry is an anthology of essays that represent the most current and authoritative information now available on addiction theory, practice and research, covering dozens of provocative, fascinating and essential subdomains of the field. Each chapter is authored by a recognized authority in the field and detailed attention is paid to environment, genetics, culture and spirituality as well as treatment and pharmacology. History, street culture, and medical science are brought together in masterful discussions that encompass the full spectrum of addictive disorders, emphasizing assessment and clinical management. This unique resource gathers complex medical and scientific data in a way which is accessible to both health care professionals and readers without medical or psychology backgrounds. Essential reading for addiction counselors and other mental health professionals, this book will also be of interest to patients and their families, and residents and physicians in all fields of medicine.

This book provides an introduction for psychologists to screening, brief intervention, and referral to treatment (SBIRT), an evidence-based approach to identifying and treating substance use across a variety of behavioral health care settings and client populations. SBIRT has proven to be an efficient, cost effective way to identify harmful substance use and related problems and enhance individuals' motivation to change their behavior. Chapters present overviews of screening tools and approaches to brief intervention appropriate for diverse target populations; concrete steps for implementing SBIRT in a range of practice settings; and recommendations for training, advocacy, and policy. Psychologists who learn and implement SBIRT will be better equipped to meet the needs of their clients and help address the public health problem of substance use in this country. br> The aim of this book is to attend to psychologists' reluctance to address substance use with their clients. By engaging clients in proactive, open-minded conversations on this topic, providers can help lower the rates of harmful substance use.

The timely recognition of physical health problems in patients with severe mental disorders is emerging as an important priority in the medical health field. Although it is well known that persons with addictions to illicit substances often develop a variety of mental health and physical health conditions, the epidemiological associations between physical illness and addiction to illicit substances are poorly understood. This book comprehensively surveys recent literature to critically review the relationships between physical illness and drugs of abuse, describing the association between each of the principal classes of illicit drugs (cocaine, marijuana, opioids, and common hallucinogens and stimulants) and the major categories of physical illness. Clear summary tables accompany detailed discussions, providing the reader with a quick reference guide. Physical Illness and Drugs of Abuse will be essential reading for all health professionals, students, practising clinicians and policy makers with interests in mental health, public health and epidemiology.

In most countries, problematic drug use is dealt with primarily as a criminal justice issue, rather than a health issue. Accordingly, a large proportion of people in prison have a history of alcohol, tobacco and/or illicit drug use and, despite the best efforts of correctional authorities, some continue to use these substances in prison, often in very risky ways. After release from prison, many relapse to risky substance use, and are at high risk of poor health outcomes, preventable death, or reincarceration. In this edited volume, for the first time we bring together 40 contributors from 10 countries to review what is known about alcohol, tobacco and illicit drug use in people who cycle through prisons, and the harms associated with use of these substances. We consider some evidence-based responses to these harms - both in prison and after return to the community - and discuss their implications for policy reform. This book is international in scope and multi-disciplinary in character. It brings together and integrates the perspectives of public health and addictions researchers, criminologists and correctional leaders, epidemiologists, physicians, and human rights lawyers. Our contributors are unified in their commitment to evidence-informed policy - that is, doing what we know works. An overarching theme pervading all of the chapters is that people who cycle through prisons come from the community, and almost always return to the community. Their health problems are therefore our health problems; in other words, 'prisoner health is public health'.

Why do individuals smoke? In discussing this central question, the authors first examine a number of studies of the complex interaction between the toxicology of smoking and genetically based susceptibility to smoking-related disease, which suggest that the link between smoking and disease is more equivocal than recent epidemiological studies have claimed. Several theories of smoking recruitment and maintenance are considered and judged in the light of the known pharmacological effects of nicotine, a psychoactive drug that is the primary reinforcer in smoking. A review of psychological and behavioural evidence from animal and human studies indicates that nicotine can promote psychological comfort and performance enhancement in a variety of tasks; such effects are produced by self-titration, evidenced in smoking style, which itself is subject to some genetically imposed constraints. The effectiveness of smoking intervention and cessation strategies is assessed, and some improvements suggested, against the background of these putative smoking motives. The book is of value to pharmacologists, psychologists, and specialists in the treatment of drug abuse and in preventive health.