This book is the first complete guide to implementing the Community Reinforcement Approach (CRA), an empirically based, highly effective cognitive-behavioral program for treating alcohol problems. An ideal program for any practitioner trying to reconcile the needs of their clients with mandates of HMOs and insurance providers, this approach has been deemed one of the most cost-effective treatments available by recent research. CRA acknowledges the powerful role of environmental contingencies in encouraging or discouraging drinking, and attempts to rearrange these contingencies so that a non-drinking lifestyle is more rewarding than a drinking one. Unique in its breadth, the approach utilizes social, recreational, familial, and vocational strategies to aid clients in the recovery process. This authoritative manual is a hands-on guide to applying these therapeutic procedures. Opening with an account of the history of CRA and the empirical support for its efficacy, the book addresses the clinical concerns of those treating substance abusing clients. Specific instructions are provided for conducting detailed assessments of the client and interviewing concerned others. Sobriety sampling and disulfiram use within CRA are discussed in chapters of their own. The authors then present a step-by-step guide to each component of the treatment plan, many of which have been shown to be effective forms of treatment in themselves. Topics include * behavioral skills training * social and recreational counseling * marital therapy * motivational enhancement * job counseling * relapse prevention Each chapter provides detailed instructions for conducting a procedure, describes what difficulties to expect, and presents strategies for overcoming them. Sample dialogues between clients and therapists, annotated by the authors, further illuminate the treatment process. The book concludes with a chapter that both addresses the common mistakes made when implementing CRA, and emphasizes the flexibility and benefits of this total treatment plan. An accessible and practical program, CRA can be implemented by all clinicians who treat alcohol abusing clients, regardless of orientation. Providing a cost-effective approach that is highly efficacious, Clinical Guide to Alcohol Treatment is an invaluable resource for the wide range of practitioners working in today's managed-care environment, including psychologists, psychiatrists, substance abuse counselors, and social workers.

Social drinking is an accepted aspect of working life in Japan, and women are left to manage their drunken husbands when the men return home, restoring them to sobriety for the next day of work. In attempting to cope with their husbands' alcoholism, the women face a profound cultural dilemma: when does the nurturing behavior expected of a good wife and mother become part of a pattern of behavior that is actually destructive? How does the celebration of nurturance and dependency mask the exploitative aspects not just of family life but also of public life in Japan? "The Too-Good Wife "follows the experiences of a group of middle-class women in Tokyo who participated in a weekly support meeting for families of substance abusers at a public mental-health clinic. Amy Borovoy deftly analyzes the dilemmas of being female in modern Japan and the grace with which women struggle within a system that supports wives and mothers but thwarts their attempts to find fulfillment outside the family. The central concerns of the book reach beyond the problem of alcoholism to examine the women's own processes of self-reflection and criticism and the deeper fissures and asymmetries that undergird Japanese productivity and social order.

In 1968, the International Olympic Committee (IOC) implemented sex testing for female athletes at that year's Games. When it became clear that testing regimes failed to delineate a sex divide, the IOC began to test for gender--a shift that allowed the organization to control the very idea of womanhood. Ranging from Cold War tensions to gender anxiety to controversies around doping, Lindsay Parks Pieper explores sex testing in sport from the 1930s to the early 2000s. Pieper examines how the IOC in particular insisted on a misguided binary notion of gender that privileged Western norms. Testing evolved into a tool to identify--and eliminate--athletes the IOC deemed too strong, too fast, or too successful. Pieper shows how this system punished gifted women while hindering the development of women's athletics for decades. She also reveals how the flawed notions behind testing--ideas often sexist, racist, or ridiculous--degraded the very idea of female athleticism.

To some it's anathema, to others it provides relief from crippling pain: to others still, it is a legal anomaly and should be decriminalized. Whatever the viewpoint, and by whatever name it is known, cannabis - or marijuana, hashish, dope, kif, weed, dagga, grass, ganga - incites debate at every level and its impact on the world's cultures and economies is undeniable. Dating back to the Neolithic period, the history of cannabis is a tale of medical advance, religious enlightenment, political subterfuge and human rights; of law enforcement and customs officers, cunning smugglers, street pushers, gang warfare, writers, artists, musicians and happy-go-lucky hippies and pot-heads.

"Heavy Drinking" informs the general public for the first time how recent research has discredited almost every widely held belief about alcoholism, including the very concept of alcoholism as a single disease with a unique cause. Herbert Fingarette presents constructive approaches to heavy drinking, including new methods of helping heavy drinkers and social policies for preventing heavy drinking and the harms associated with it.

What makes one of the most gifted, charismatic and successful young literary agents in New York fall into full-blown crack-addiction: a collapse that would cost him his business, his home, many of his friends and - very nearly - his life? In his utterly compulsive narrative, Bill Clegg leads us through the grimiest back-rooms of Manhattan's underbelly, through scenes of blank-eyed sex and squalor, into the febrile paranoia of a mind gone out of control. Ninety Days begins where Portrait of an Addict as a Young Man ends - and tells the wrenching story of Bill Clegg's battle to reclaim his life. The goal is ninety: just ninety clean and sober days to loosen the hold of the addiction. But as any recovering addict knows, hitting rock bottom is just the beginning. . . Published for the first time in one volume: Bill Clegg's unflinching account of the addiction that nearly ended everything.

In our current digital era, imagination and the cultural and material conditions by which it is developed are more crucially than ever implicated in the experienced adversities and contradictions of drug use. The technological changes of society underscore the need for rethinking dominant understandings which portray addiction as an immediate and even mindless relation between a person and a substance or behavior, only minimally affected by subjective significance and historical alterations of everyday life. Indeed, from ancient mythology to our modern times drugs have been part of our cultural history. Understandings and practices of their uses have developed through cultural ideas and cultural-material conditions like traditions, rituals and routines. Today, the omnipresence of digital media in everyday life is massively changing and expanding such cultural and material conditions. Digital media equip people with associations between drugs and an incredible abundance of images, ideas, facts, fiction, narratives, plots, soundtracks, characters, and much more, and thereby expanding their imaginable potentials for providing answers to biographical questions. People and potential drug use become connected in novel and labyrinthine ways through digital communities and arrangements of everyday life. And digital media are part of and transform the cultural-material practices in which activities and experiences of intoxication actually take place. In the book, all these details are extensively analyzed empirically based on qualitative data on the lives of a number of young, Danish people who were undergoing treatment for drug-related problems at the time of the research. An underlying premise of the entire work is that addiction may be seen as a more extreme expression of how the technological developments in our contemporary world more generally speaking magnify the contradictory implications of imagination for modern living. Over the recent years, psychological research into the significance of the human capacity to imagine for how people deal with and live their lives has received growing attention. Yet, the complex involvement of imagination in actual living and consequently the theoretical cruxes this engenders continue to amaze and surprise research and researchers. This book also contributes to these theoretical ambitions with a substantial work on the concept of imagination. It primarily suggests that a critical discussion of how imagining is essentially a contradictory process in everyday life and how it is always grounded in the agency of material aspects, ranging anywhere from mundane artifacts over mediated content to advanced technologies, is ultimately what makes the scientific study of imagination relevant to understanding and intervening in the dilemmas and crises of modern life and society. The book will primarily interest scholars of social psychology of everyday life, scholars working conceptually and empirically on imagination, scholars of social studies of media, materiality and technology, and researchers or practitioners working with addictions.

Stories from doctors, nurses, and therapists dealing on a daily basis with the opioid crisis in Appalachia should be heartbreaking. Yet those told here also inspire with practical advice on how to assist those in addiction, from a grass-roots to a policy level. Readers looking for ways to combat the crisis will find suggestions alongside laughter, tears, and sometimes rage. Each author brings the passion of their profession and the personal losses they have experienced from addiction, and posits solutions and harm reduction with positivity, grace, and even humor. Authors representing seven states from northern, Coalfields, and southern Appalachia relate personal encounters with patients or providers who changed them forever. This is a history document, showing how we got here; an evidenced indictment of current policies failing those who need them most; an affirmation that Appalachia solves its own problems; and a collection of suggestions for best practice moving forward.

Like the never-ending War on Terror, the drugs war is a multi-billion-dollar industry that won't go down without a fight. Pills, Powder, and Smoke explains why. The War on Drugs has been official American policy since the 1970s, with the UK, Europe, and much of the world following suit. It is at best a failed policy, according to bestselling author Antony Loewenstein. Its direct results have included mass incarceration in the US, extreme violence in different parts of the world, the backing of dictatorships, and surging drug addiction globally. And now the Trump administration is unleashing diplomatic and military forces against any softening of the conflict. Pills, Powder, and Smoke investigates the individuals, officials, activists, victims, DEA agents, and traffickers caught up in this deadly war. Travelling through the UK, the US, Australia, Honduras, the Philippines, and Guinea-Bissau, Loewenstein uncovers the secrets of the drug war, why it's so hard to end, and who is really profiting from it. In reporting on the frontlines across the globe - from the streets of London's King's Cross to the killing fields of Central America to major cocaine transit routes in West Africa - Loewenstein reveals how the War on Drugs has become the most deadly war in modern times.

It has become almost accepted knowledge within international policy circles that efforts against drug trafficking and drug abuse violate human rights, and that the entire international drug control regime needs to be changed (or even discarded altogether) to adopt a more 'rights respecting' approach. Though this view has been promoted by many prominent figures and organisations, the author of this book uses his expertise in both human rights and drug control to show that the arguments advanced in this area do not stand close scrutiny. The arguments are in fact based on selective and questionable interpretations of international human rights standards, and on a general notion - more and more clearly stated - that there is a human right to take drugs, and that any effort to combat drug abuse by definition violates this right. There is no such right in international law, and the author objects to the misuse of human rights language as a marketing tool to bring about a 'back door' legalisation of drugs. Human rights issues must be addressed, but that in no way means that the international drug control regime must be discarded, or that efforts against drugs must be stopped.

When an economy is fueled by the alcohol industry, which is a powerful and a resource-intense industry, governments who lack technical capacity and financial resources to combat the alcohol industry may fear the economic impact of restrictive alcohol polices. How can a country address the public health concerns from alcohol misuse and abuse? Because alcohol is no ordinary commodity, the public has a right to understand and expect a more enlightened approach to the development and implementation of an alcohol policy. An enlightened approach of using evidence to inform policies, include key members of the community and target the general population, at high-risk drinkers and at people already experiencing alcohol-related problems. Alcohol is a drug and a currency, making it a unique commodity. In this book, the authors present research on alcohol and advertisement, alcohol related traffic accidents, suicidal behavior and many more aspects of alcohol use and misuse in the Caribbean area.

Critics of narcology-as addiction medicine is called in Russia-decry it as being "backward," hopelessly behind contemporary global medical practices in relation to addiction and substance abuse, and assume that its practitioners lack both professionalism and expertise. On the basis of his research in a range of clinical institutions managing substance abuse in St. Petersburg, Eugene Raikhel increasingly came to understand that these assumptions and critiques obscured more than they revealed. Governing Habits is an ethnography of extraordinary sensitivity and awareness that shows how therapeutic practice and expertise is expressed in the highly specific, yet rapidly transforming milieu of hospitals, clinics, and rehabilitation centers in post Soviet Russia. Rather than interpreting narcology as a Soviet survival or a local clinical world on the wane in the face of globalizing evidence-based medicine, Raikhel examines the transformation of the medical management of alcoholism in Russia over the past twenty years. Raikhel's book is more than a story about the treatment of alcoholism. It is also a gripping analysis of the many cultural, institutional, political, and social transformations taking place in the postSoviet world, particularly in Putin's Russia. Governing Habits will appeal to a wide range of readers, from medical anthropologists, clinicians, to scholars of post-Soviet Russia, to students of institutions and organizational change, to those interested in therapies and treatments of substance abuse, addiction, and alcoholism.

Drug and alcohol addiction are critical social problems in the United States. Drug and alcohol abuse are powerful facilitators of health and economic disparities, making recovery and re-entry into the community difficult. Alcohol and drug abuse/addiction are among the costliest of health problems, totaling approximately $428 billion annually. A range of services have been developed to address the problem of substance dependence, including inpatient services, outpatient services, and recovery housing. However, only about 11% of those with substance addictions reach any type of substance abuse treatment, and those that are treated evidence high rates of relapse. Thus, it is critical to understand the mechanisms by which individuals are successful, and sustain abstinence after receiving treatment and aftercare. This book provides a collection of research that explores alternative models, aftercare programs, employment services, trauma issues that affect recovery, gender-specific, and culturally modified treatment and aftercare programs. Each chapter is an individual study that addresses key unanswered questions in substance abuse and recovery research. Furthermore, the editors and authors identify potentially important, understudied topics for further research and formulate public policy recommendations. This is a must read for addiction researchers, academics, students, and individuals interested in learning about the dangers of substance abuse.

Current public health literature suggests that the mentally ill may represent as much as "half "of the smokers in America. In "Smoking Privileges," Laura D. Hirshbein highlights the complex problem of mentally ill smokers, placing it in the context of changes in psychiatry, in the tobacco and pharmaceutical industries, and in the experience of mental illness over the last century.Hirshbein, a medical historian and clinical psychiatrist, first shows how cigarettes functioned in the old system of psychiatric care, revealing that mental health providers long ago noted the important role of cigarettes within treatment settings and the strong attachment of many mentally ill individuals to their cigarettes. Hirshbein also relates how, as the sale of cigarettes dwindled, the tobacco industry quietly researched alternative markets, including those who smoked for psychological reasons, ultimately discovering connections between mental states and smoking, and the addictive properties of nicotine. However, " Smoking Privileges" warns that to see smoking among the mentally ill only in terms of addiction misses how this behavior fits into the broader context of their lives. Cigarettes not only helped structure their relationships with other people, but also have been important objects of attachment. Indeed, even after psychiatric hospitals belatedly instituted smoking bans in the late twentieth century, smoking remained an integral part of life for many seriously ill patients, with implications not only for public health but for the ongoing treatment of psychiatric disorders. Making matters worse, well-meaning tobacco-control policies have had the unintended consequence of further stigmatizing the mentally ill.A groundbreaking look at a little-known public health problem, "Smoking Privileges" illuminates the intersection of smoking and mental illness, and offers a new perspective on public policy regarding cigarettes.

Can drugs be used intelligently and responsibly to expand human consciousness and heighten spirituality? This two-volume work presents objective scientific information and personal stories aiming to answer the question. The first of its kind, this intriguing two-volume set objectively reports on and assesses this modern psycho-social movement in world culture: the constructive medical use of entheogens and related mind-altering substances. Covering the use of substances such as ayahuasca, cannabis, LSD, peyote, and psilocybin, the work seeks to illuminate the topic in a scholarly and scientific fashion so as to lift the typical division between those who are supporters of research and exploration of entheogens and those who are strongly opposed to any such experimentation altogether. The volumes address the history and use of mind-altering drugs in medical research and religious practice in the endeavor to expand and heighten spirituality and the sense of the divine, providing unbiased coverage of the relevant arguments and controversies regarding the subject matter. Chapters include examinations of how psychoactive agents are used to achieve altered states in Judaism, Christianity, Islam, and Buddhism as well as in the rituals of shamanism and other less widely known faiths. This highly readable work will appeal to everyone from high school students to seasoned professors, in both the secular world and in devoted church groups and religious colleges. Includes coverage of a variety of drugs, most of which are currently illegal in the United States, accompanied by scientific explanations of how they spur spiritual experiences Offers compelling narratives from individuals-both laypeople and professionals-who found new dimensions within their lives and heightened their spirituality by the use of entheogens Supplies information about medical experiments and new treatment modes that provide definitive breakthrough methods for caring for suffering people

Since the late 1990s, marijuana grow operations have been identified by media and others as a new and dangerous criminal activity of "epidemic" proportions. With Killer Weed, Susan C. Boyd and Connie Carter use their analysis of fifteen years of newspaper coverage to show how consensus about the dangerous people and practices associated with marijuana cultivation was created and disseminated by numerous spokespeople including police, RCMP, and the media in Canada. The authors focus on the context of media reports in Canada to show how claims about marijuana cultivation have intensified the perception that this activity poses "significant" dangers to public safety and thus is an appropriate target for Canada's war on drugs. Boyd and Carter carefully show how the media draw on the same spokespeople to tell the same story again and again, and how a limited number of messages has led to an expanding anti-drug campaign that uses not only police, but BC Hydro and local municipalities to crack down on drug production. Going beyond the newspapers, Killer Weed examines how legal, political, and civil initiatives that have emerged from the media narrative have troubling consequences for a shrinking Canadian civil society.

This trailblazing study examines the history of narcotics in Japan to explain the development of global criteria for political legitimacy in nations and empires in the nineteenth and twentieth centuries. Japan underwent three distinct crises of sovereignty in its modern history: in the 1890s, during the interwar period, and in the 1950s. Each crisis provoked successively escalating crusades against opium and other drugs, in which moral entrepreneurs--bureaucrats, cultural producers, merchants, law enforcement, scientists, and doctors, among others--focused on drug use as a means of distinguishing between populations fit and unfit for self-rule. Moral Nation traces the instrumental role of ideologies about narcotics in the country's efforts to reestablish its legitimacy as a nation and empire. As Kingsberg demonstrates, Japan's growing status as an Asian power and a "moral nation" expanded the notion of "civilization" from an exclusively Western value to a universal one. Scholars and students of Japanese history, Asian studies, world history, and global studies will gain an in-depth understanding of how Japan's experience with narcotics influenced global standards for sovereignty and shifted the aim of nation building, making it no longer a strictly political activity but also a moral obligation to society.

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) conducted an environmental scan of the training, outreach, and resources offered by the Single State Agencies (SSAs) in charge of drug and alcohol treatment and prevention services to respond to the needs of returning veterans and their families. This scan was conducted to learn how to more effectively serve returning veterans and family members impacted by substance use disorders (SUDs). To accomplish this, NASADAD conducted case studies of nine states that had been identified as having the largest number of initiatives for returning veterans. This book examines the data for these case studies which were gleaned from 36 interviews with SSA staff and staff from publicly funded SUD treatment facilities. NASADAD staff gathered data on state policies, trainings, and outreach efforts, as well as recommendations for future development of technical assistance and training materials to address the gaps in services.

Luigi Zoja argues that the pervasive abuse of drugs in our society can in large part be ascribed to a resurgence of the collective need for initiation and initiatory structures: a longing for something sacred underlies our culture's manic drive toward excessive consumption. In a society without ritual, the drug addict seeks not so much the thrill of a high as the satisfaction of an inner need for a participation mystique in the dominant religion of our times: consumerism.

Bringing anthropological perspectives to bear on addiction, the contributors to this important collection highlight the contingency of addiction as a category of human knowledge and experience. Based on ethnographic research conducted in sites from alcohol treatment clinics in Russia to Pentecostal addiction ministries in Puerto Rico, the essays are linked by the contributors' attention to the dynamics-including the cultural, scientific, legal, religious, personal, and social-that shape the meaning of "addiction" in particular settings. They examine how it is understood and experienced among professionals working in the criminal justice system of a rural West Virginia community; Hispano residents of New Mexico's Espanola Valley, where the rate of heroin overdose is among the highest in the United States; homeless women participating in an outpatient addiction therapy program in the Midwest; machine-gaming addicts in Las Vegas, and many others. The collection's editors suggest "addiction trajectories" as a useful rubric for analyzing the changing meanings of addiction across time, place, institutions, and individual lives. Pursuing three primary trajectories, the contributors show how addiction comes into being as an object of knowledge, a site of therapeutic intervention, and a source of subjective experience. Contributors. Nancy D. Campbell, E. Summerson Carr, Angela Garcia, William Garriott, Helena Hansen, Anne M. Lovell, Emily Martin, Todd Meyers, Eugene Raikhel, A. Jamie Saris, Natasha Dow Schull