" This important book reveals why the young start smoking and why, as adults, they regret having started. It is a great contribution to helping end a national epidemic."

? CHERYL HEALTON, President/CEO, American Legacy Foundation

? MATTHEW MYERS, President, Campaign for Tobacco Free Kids

Do individuals really know and understand the risks entailed by their smoking decisions? The question is particularly important in the case of young persons, because most smokers start during childhood and adolescence. After years of intense publicity about the damages of smoking, it is generally believed that every teenager and adult in the U.S. knows that smoking is dangerous to health, thus decisions to smoke are informed choices. This book presents a counter-view, based on a survey of several thousand young persons and adults, probing attitudes, beliefs, feelings, and perceptions of risk associated with smoking. The authors agree that young smokers give little or no thought to health risks or the problems of addiction. The survey data contradicts the model of informed, rational choice and underscores the need for aggressive policies to counter tobacco firms? marketing and promotional efforts and to restrict youth access to tobacco.

When smokers inhale smoke into their lungs, they take the drug nicotine into their bodies and brains, where it affects how the smokers feel and act. When smokers display their cigarettes, they are saying something symbolic and personal about themselves. And when smokers smoke, they put themselves at risk, often knowingly, of early disability or death.

Smoking is one of the world?s most pressing public health problems. Cigarettes, Nicotine, and Health reviews the severe problems caused by smoking and examines individual and public health approaches to reducing smoking and its attendant health problems. Cigarettes are the most popular, most addictive, and most deadly form of tobacco use, with cigarette design contributing directly to the dangers of smoking; most of the book focuses on this predominant form of nicotine use.

This book presents a culturally informed framework for understanding and treating substance abuse problems. From expert contributors, chapters cover specific ethnocultural groups in the United States, including Americans of African, Native American, Latino, European, Middle Eastern, and Asian descent. Authors examine how ethnocultural factors may affect a person's attitudes toward alcohol and other drugs, patterns of substance use, reasons for seeking treatment, and responsiveness to various interventions. Themes addressed include the impact of migration and acculturation issues, spiritual values and traditions, family structures, gender roles, and experiences of prejudice and discrimination. Featuring a wealth of illustrative clinical material, the book makes concrete recommendations for more competent, effective assessment and intervention. It also guides clinicians toward greater awareness of the ways their own ethnocultural backgrounds may affect their interactions with clients.

New research has shown that children exposed to cocaine before birth are at risk of learning and behavioral problems. Such problems have broad implications for education, social welfare, and criminal justice in the United States. However, there are numerous opportunities to minimize prenatal cocaine exposure and its impacts and thus to enhance the well-being of women and their children. This report, a collaborative effort of the RAND Drug Policy Research Center and the New York Academy of Sciences, presents an overview of the current state of knowledge regarding the effects of cocaine on the developing brain and offers policy considerations for addressing the issues that arise from cocaine use by pregnant women. The report discusses three prevention strategies: primary prevention (preventing substance use before and during pregnancy); secondary prevention (identifying pregnant women who use drugs and minimizing their drug use); and tertiary prevention (reducing the adverse consequences of substance exposure in children who were exposed in utero). In addition, the report presents a number of areas where more research is needed and offers a rationale for making more resources available for women and children affected by cocaine. (JD)

Concept-based therapeutic communities emerged out of the informal group meetings of Charles Dederich and a number of former Alcoholics Anonymous members in California in the late 1950s. The model was exported worldwide and has not only become the most widely used approach to residential treatment but has proved enormously influential in the development of many other treatment approaches; both residential and ambulatory. Concept-based therapeutic communities are hierarchical, and the staff and residents form a chain of command. Staff are often qualified for their work by virtue of having been residents in such a community themselves. Like other types of therapeutic community, a central tenet of the approach is the emphasis on self help and the belief in the influence of the group dynamic in facilitating therapeutic interventions. Written by academics and practitioners from around the world, this is a comprehensive overview of the development of therapeutic communities and their benefits in the treatment of drug users. Contributors describe how the model operates in the community, and how it has been modified over time to fit different settings, different types of client and different referral requirements. Illustrated by descriptions of staff and client experiences, this book also provides an inside view of how this sort of therapeutic community actually operates. This authoritative study concludes by examining the research evidence for treatment effectiveness. It will be of interest to policy makers, managers and researchers in the field of drug abuse treatment.

Written in a clear, informative, and easy to follow manner, Dual Diagnosis is an important book on one of the hottest topics in mental health today. After opening chapters on general issues and problems with dual diagnosis, the book follows with in-depth discussions on major illnesses and analyzes the issues relevant to each when drug abuse is involved, as well as discussing the empirically validated treatment approaches available. The book closes with a summary and integration of the conclusions from earlier chapters and presents a grid showing the relationships between certain disorders and the processes of change that have been shown or theorized to be particularly helpful in their treatment. This is a book that will be extremely useful to practicing professionals in mental health and substance abuse fields, as well as students in psychology and drug abuse.

American Journal of Nursing, 2001 Book of the Year Award in Psychiatric & Mental Health Nursing

Developed by a highly experienced author working in both nursing and psychology environments, Addiction Treatment presents the caregiver with a brief global perspective of different types of addictions, techniques for identifying and assessing the addicted client, and strategies for effective change. The book utilizes assessment, planning, and intervention summaries to enable the reader to scan for immediate recall and application. Chapter objectives enable readers to use the book as a continuing education tool, and the appendix provides an overview of perspectives on addiction and its treatment by a variety of organizations heavily invested in the care of the addicted client. Illustrative cases (with both successful and unsuccessful outcomes) are included throughout.

Do you work with addicted women? How can you help them to get sober and to lead healthier lives? What are the issues women face as they work through problems with substance abuse? How does motherhood influence the recovery process? To what extent do relationships support or undermine a woman?s efforts to overcome alcoholism or other addiction?

This book answers these and other questions surrounding the effective treatment of women addicts. It offers hands-on practical guidance to counselors, nurses, social workers, and others who help women along the journey from substance abuse to healthy and fulfilling lives.

Harm reduction programs accept the reality of drug use while attempting to reduce its harmful consequences to individuals and society. This term, coined about 15 years ago in the U.K., has become a policy paradigm increasingly explored throughout most of the industrialized world. An example of a harm reduction program is the widely accepted substitution of methadone for the more "harmful" heroin. Programs that divert drug-involved offenders into treatment are another example of the operationalization of harm reduction policies.

In these 10 original chapters, international contributors discuss the philosophical basis and history of harm reduction policies and examine their outcome. They also cover controversial topics related to harm reduction, especially conflicts between the public health system where most programs are located, and a worldwide criminal justice system that further marginalizes drug users. Included in this book are descriptions of programs in the United States, the United Kingdom, Canada, Brazil, the Netherlands, Switzerland, and Australia.

The editors provide the context with a substantive introductory chapter focusing on the nature of harm reduction. The first part contains five chapters presenting the American perspectives on harm reduction; Part II includes five chapters presenting international perspectives from countries with particularly innovative harm reduction programs and policies.

Adolescent alcohol use is prominent among today?s teens and has elicited rising concerns among parents, health practitioners, social policymakers, and the public at large. Yet there is an absence of a relatively concise book that summarizes and integrates existing knowledge on the various facets of adolescent alcohol use. This book attempts to fill this void by integrating research from the multiple fields of study (e.g., prevalence of use), describing measurement approaches (e.g., survey and clinical diagnostic), reviewing risk and protective factors, reporting on findings from prominent prevention and treatment studies, and suggesting future research directions. The coverage is intended to examine issues relevant to etiology, developmental courses, and prevention and treatment, as well as to identify future research directions.

This instructive manual presents a pragmatic and clinically proven approach to the prevention and treatment of undergraduate alcohol abuse. The BASICS model is a nonconfrontational, harm reduction approach that helps students reduce their alcohol consumption gradually and decrease the behavioural and health risks associated with heavy drinking. Including numerous reproducible handouts and assessment forms, the book takes readers step-by-step through conducting BASICS assessment and feedback sessions. Special topics covered include the use of DSM-IV criteria to evaluate alcohol abuse, ways to counter student defensiveness about drinking, and obtaining additional treatment for students with severe alcohol dependency.

This brief and readable volume focuses on five case studies in judicial innovation - the dedicated drug treatment courts in Miami, Oakland, Ft. Lauderdale, Portland, and Phoenix. Each case is presented in a chapter written by a local expert to describe and evaluate five prime examples of dedicated drug treatment courts. Editor W. Clinton Terry, III introduces this volume with a chapter that covers judicial innovation and dedicated drug courts, revealing that dedicated courts are unique because of their focus on treatment; the nontraditional, collaborative approach to treatment; and monitoring of by the judiciary. As Terry emphasizes, the court becomes an integral part of the treatment process itself, not just a referral point for offenders. The subsequent chapters are written to a common outline, creating a tightly edited and cohesive volume that addresses the following points: - Community demographics - Structural organization of the court - Court caseloads, including drug cases - Description of the initial decision to implement dedicated drug treatment courts - Successes and failures of initial goals and objectives, and subsequent adaptations - Measures of long-term successes and failures (recidivism and successful completion of treatment programs) The concluding chapter, written by John Goldkamp, a proven researcher of drug courts, synthesizes the research from the evaluation of the exemplar courts, and examines other areas of possible research that would provide a firmer understanding about these courts - all of which speaks to the continued development and refinement of dedicated drug treatment courts. With approximately one billion dollars in federal monies earmarked for the creation of drug courts, this unique book offers a road map to the effective utilization of those funds.

Recently, the Research Triangle Institute completed a five-year study sponsored by the National Institute on Drug Abuse called The Washington, D.C., Metropolitan Area Drug Study (DC*MADS). The study attempted to look at the nature and extent of drug abuse among diverse populations living in a single metropolitan area, focusing particularly on underrepresented populations such as the homeless, the institutionalized, and juvenile offenders along with populations that have been studied in more depth, such as persons living in households. The goal was to not only establish prevalence, correlates, and consequences of drug abuse, but to establish a research model for conducting other such studies. Drug Use in Metropolitan America describes, relates, and integrates findings from the DC*MADS study. More than that, though, this book places the findings in the larger context of our national drug abuse problem. Therefore, while there is some reporting of findings, there is more emphasis on examining the policy, research, and program implications that flow from the studies. This book will be of interest to researchers, practitioners, and policy makers in a number of areas, as well as to academics in Sociology courses dealing with drugs, deviance, social problems, and research methodology. It should also appeal to those concerned with Psychology and Medicine/Allied Health.

The problems of substance abuse affect not only the abuser but the people involved in his or her life. Family members and significant others often confront therapists, requesting recommendations on how they can contribute to the abusers recovery. The traditional attitude of therapists has been that the substance abuser cannot be helped until he or she is motivated. Therefore, significant others have typically been given little advice or guidance. Family Recovery offers clinicians a structured, research-based approach to working with significant others involved with substance abusers. Unilateral family therapy offers methods for therapists to improve the well-being of concerned significant others of substance abusers and to teach them how to restructure their relationship to the abuser in ways that may enhance the substance abuser's motivation to change. Family Recovery will be useful to both experienced clinicians and those who are training to be clinical social workers, clinical psychologists, family therapists, and substance abuse counselors.

The first volume to provide access to information on drug treatment systems from a wide cross-section of 20 countries, Drug Treatment Systems in an International Perspective examines the ways in which other counties from around the world have chosen to cope with the spread of illicit drugs. Now health planners and administrators, treatment professionals, researchers, and students can place the development of their own treatment systems in a wider context and can examine the extent to which that development shares common structural features with those of other countries and cultures. Following a comparative discussion of the various countries, the volume addresses four key issues: gender specific treatment, the politics of financing and evaluation, the private sector and state control, and exporting drug treatment ideologies. It provides a comparative and cross-cultural perspective on drug treatment approaches today and examines the influence of social, political, and economic forces on the treatment of drug addicts. In addition, the editors have included a handy glossary, which explains key terms unfamiliar to readers outside the particular country. Providing and interdisciplinary and cross-cultural perspective to drug treatment, Drug Treatment Systems in an International Perspective will be of interest academics, students, and professionals in psychology, especially those focusing on clinical psychology, addiction, dependency, and treatment. It will also be of great interest to public health planners and administrators.

It is difficult to understand how society could have failed to recognize that children in abusive situations often live in families in which alcohol and other drugs are abused. Aimed at fostering more discussion between practitioners and scholars, this book explores unified approaches for prevention of and treatment for children and their parents who find themselves in these circumstances. The multidisciplinary cast of contributors probes such topics as the history of abusive behavior and intoxication using literary examples to illustrate key points; the research literature on drug-exposed children in the child welfare system and the interventions that facilitate their optimum development; the legislative and policy contexts in which potential collaborations between the fields of substance abuse and child welfare are being developed or abandoned; the damaging effects that parental and family substance abuse add to a host of child welfare problems; the need for clinicians to develop a sound therapeutic foundation to enhance their effectiveness with clients; and the search for solutions within drug-abuse treatment systems to develop services that improve the quality of life for children living with a drug-dependent parent. In addition, many contributors use writing devices to enhance comprehension of the issues. For example, one contributor uses a metaphor to examine what is important in the fields of substance abuse and child welfare, how we would begin to link them, what the stresses on this bridge would be, and why anyone would want to cross it. And, another contributor uses examples of successful collaborative efforts to examine the institutional, professional, and interpersonal barriers to collaboration between the fields of child welfare and substance abuse as well as the principles for overcoming these barriers. The book concludes with a provocative chapter that reminds us that not all substance abusers are child abusers. This book will help readers identify promising approaches to improve our nation?s health and the gaps that need to be bridged in order for meaningful improvement to occur.

In a state-of-the-art presentation, Heroin in the Age of Crack-Cocaine presents articles by experts in the field on current developments and emerging trends in addition to a historical overview of heroin use in this country. Filling a void in the literature on whatAEs known about the "new" heroin users, this volume also updates the readers on the status of aging heroin addicted populations who initiated use of the drug prior to the "age of cocaine." Having moved from the stereotypical "shooting galleries" of back alleys in inner city neighborhoods, heroin addiction continues to rise in mainstream culture and new ways of administration have come into use. A relative abundance of purer Southeast Asian heroin, the rapid rise in popularity of crack-cocaine, treatment controversies, and the realized role that injection drug use plays in the transmission of HIV all suggest increased dimensions of the heroin problem and in their saliency for the 1990s and beyond. Academics, researchers, practitioners, policymakers, and students will find Heroin in the Age of Crack-Cocaine to be a comprehensive and significant contribution to existing research, as well as a stimulant to further discussion and study of this rapidly evolving issue and its impact in the health and criminal justice arenas of our society.

Working with Children of Alcoholics was originally published when the plight of children of alcoholics was just beginning to gain widespread public attention. It was the first book to provide professionals with a direct, step-by-step approach that shows them not only what to look for when working with children but what they can do to help them. Some of the critical topics covered include identifying children of alcoholics, establishing effective childrenÆs programs, treatment strategies for children of alcoholics, life and survival in an alcoholic home, the intergenerational transmission of alcoholism, the psychological adjustment of children of alcoholics, health and safety hazards, and academic and behavioral concerns. Working with Children of Alcoholics includes extensive resources such as names of helpful organizations, periodicals, therapeutic games, and curriculum materials. The book will be of interest to social workers, public health workers, psychologists, school administrators, drug and alcohol counselors, pastoral counselors, teachers, and treatment centers. It makes an excellent supplemental text for graduate and undergraduate courses in family and community, adjustment problems of children and youth, substance abuse, human services and community problems.

ARE YOU OR IS SOMEONE YOU LOVE STRUGGLING WITH ADDICTION?

When it comes to drug and alcohol addiction, it's hard to know where to turn for help. The professionals at the Betty Ford Center--one of the world's leading and most trusted sources of treatment for oddiction--hove provided thousands with the strength, support, and expertise that substance abusers need to get well. Now, the former medical director of the Betty Ford Center shares that expertise in this remarkably honest and complete book, which answers vital questions that surround this difficult subject:

• "My son seems to be following in his alcoholic father's footsteps. How can I help him?"
  
• "My wife's the alcoholic, why do I need treatment?"
  
• "Can the brain rerover from cocaine abuse?"
  
• "Even a double dose of my prescription tranquilizers doesn't seem to help. Am I addicted?"
  
• "If I get sober, what are my chances of staying sober?"
  
• "l am uncomfortable with the spiritual aspect of AA. Is there on alternative?"
  
• "Is it true that people who are forced into treatment get nothing out of it?"
  

From impotence to diabetes, cataracts to psoriasis, the proven dangers of smoking go well beyond heart and lung disease. Here, for the first time in one complete volume, noted experts detail all the known health threats of smoking. Each day thousands of people decide to smoke. This book offers the cold, hard facts about smoking so that the decision can be an informed one. The health experts urge consumers to look beyond the headlines, the politics, the propaganda, and opinion polls to learn what research has proven about the dangers of smoking, the leading cause of preventable death in the world. Twenty eye-opening chapters all carefully reviewed by independent health experts explain clearly and honestly how cigarette smoking can effect the body from head to toe.They go far beyond the obvious risks of heart disease, lung cancer and emphysema, stroke, and concerns over second-hand smoke. Probed in depth are conditions few would even associate with smoking risks to which moderate to light smokers are susceptible: blood vessel disease, skin disease and wrinkles, risks during surgery, joint and bone problems, paediatric illness, male infertility and impotence, nerve disorders, numerous types of cancer, depression, hearing loss, eye disorders, Crohn's disease, and more.

Research in the mid-1980s on the effects of prenatal drug abuse characterized cocaine-exposed children as moody, inconsolable, less socially interactive, and less able to bond than other children. "Crack babies," in particular, were believed to be less attentive and less able to focus on specific tasks than nonexposed children. Research concluded that these conditions were irreversible and that no amount of special attention or educational programs could turn these cocaine-exposed infants into well-functioning and adjusted children. Methodological problems in these early studies, combined with the fact that cocaine using mothers abuse other drugs as well, have left the research and public health communities uncertain about the cause and effect relationship between cocaine use and pre- and postnatal consequences. Cocaine-Exposed Infants examines what is known about the problem and unravels some of the contradictions in the extant literature. The authors also explore in-depth the media frenzy over so-called crack babies and the resulting legislation that served to criminalize drug use during pregnancy. For researchers, academics, health care providers, and mental health and legal professionals/practitioners, Cocaine-Exposed Infants provides state-of-the-art information in a field now entering its second generation of research. The book is also an excellent supplementary text for courses in criminal justice, corrections, policing, drug/alcohol studies, psychology, public health, and nursing.

Ensure that your substance abuse programs meet accreditation requirements by using the Substance Abuse Program Accreditation Guide, a practical guidebook that addresses the new 1995 accreditation standards of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Now thereAEs an easy-to-use volume designed to support program staff and administrators of treatment programs in their efforts to comply with the complete revision of the JCAHO standards. The new accreditation standards are wide-ranging and encompass a broad scope of material from patient care to organizational elements. Although the vast areas covered can be daunting to those in need of practical translation of specific regulations, this pragmatic volume serves as a definitive guide for understanding and abiding by all aspects of the new standards. The contributors thoroughly explain the accreditation standards, offer clear suggestions for programs and centers to meet those standards, and illustrate specifically what happens in the accreditation process. This guide brings knowledge into action, providing program staff and administrators with practical steps to ensure that their programs meet accreditation requirements and stay in compliance. This wide-reaching volume crosses over a wide array of disciplines including substance abuse, program evaluation, social work, clinical/counseling psychology, and drugs and behavior.

Drug and alcohol abuse monitoring and prevention has been pushed from the national to the local and community level. How do communities go about measuring the effectiveness of their drug and alcohol abuse programs? Aimed at providing communities and researchers with the needed analytic and practical tools for assessing their programs, Measuring Community Indicators begins with a presentation of how to collect community indicator data. The authors argue that while highly aggregated national data perform a number of important research and policy functions, such data are distinct from community indicator data and are of questionable use to local policy-oriented officials. They present a theoretical perspective--developed from community systems theory--as a basis for the practical strategies outlined in the book. They then cover such topics as different community indicators, the role of community surveys in filling the gaps in available "official statistics," and specific techniques for the primary collection of community indicator data (such as geographical mapping, systems of community data acquisition, and community contact maintenance). Researchers and evaluators of substance abuse and substance abuse programs will find this book provides them with the interdisciplinary information necessary to conceptualize and measure community drug and alcohol problems.

The market for illicit drugs is expanding inexorably around the world. More kinds of drugs are becoming more available in more places than ever before. But the drug trade is not only growing, it is changing in character. It has ceased to be a marginal area of criminal activity and has now become a major global enterprise controlled by formidable interests that threaten much more than the health of drug users. Global retail sales of illicit drugs are estimated at between $180 billion and more than $300 billion annually, thus ranking as one of the world's biggest commercial activities. Moreover, the immense wealth that has been amassed from selling drugs has given the principal trafficking organizations enormous power to corrupt and intimidate public officials and government institutions. In this major book, Paul Stares presents a compelling portrait of the global drug market and the consequences of this international plague. He explains that there are good reasons to fear that the global market for drugs will continue to expand in the coming years: profits to the traffickers are huge; the revolutionary advances in communications, transportation, and information technology facilitate smuggling, as do the lowering of border controls and trade tariffs and the trends toward privatization and deregulation. Meanwhile, the expanded volume of global trade, travel, and financial transactions makes it harder for customs and police authorities to detect and stop illicit activities. Added to the growing incentives and opportunities to supply illicit drugs, the level of demand is increasing in many new areas of the world, particularly in formerly communist countries and many areas of the developingworld. What can done about this growing problem? One option is legalization, but Stares contends that its implementation would be problematic while its benefits remain unclear. Yet, continuing on the present course will not work either. Stares argues that reducing both the supply and demand for illicit drugs requires a fundamental shift away from the current overwhelming emphasis on negative sanctions to deter and deny their production, trafficking, and consumption. Instead, he calls for more positive control measures that primarily rely on persuasion and cooperation. He advocates the creation of a global drug monitoring and evaluation network, a global drug use prevention program, a global drug treatment training program, and an international drug crisis response program. According to Stares, the effectiveness of reorienting drug control policy to curb the global habit will ultimately depend on the international community's willingness to address much larger concerns to which the drug problem is inextricably linked-- including overpopulation, environmental degradation, poverty, illiteracy, ethnic strife, and disease. Only by recognizing the fundamental relationship between these larger issues and the global drug problem can meaningful progress be made. Selected by Choice as an Outstanding Book for 1996

Exploring current issues of drug use by young people, Intervening with Drug-Involved Youth provides a special analysis of intervention by an outstanding group of experts in the field. Noteworthy topics considered include the scope of the problem, prevention and treatment initiatives, and international perspectives. The contributors examine what programs have proved effective and which initiatives lack the outcome necessary to reduce drug use among youths. Prevention and treatment strategies analyzed include school- and street-based programs operated by law enforcement, family therapy, residential approaches, programs in Brazil and India, and more. This comprehensive volume also features a fascinating and thorough introduction on the history of drug use, giving the reader a frame of reference for understanding drug-involved youth and options for intervention. Prevention of other high-risk behaviors, including those that increase the risk of contracting HIV, is also considered. Intervening with Drug-Involved Youth is an essential resource for drug abuse counselors, clinicians, and researchers and provides an organized overview of specific interventions that will be useful in college courses in counseling, social work, family therapy, drug abuse, juvenile delinquency, and criminology.