Substance Use and Misuse is a comprehensive and practical text that covers the core elements of substance use and misuse in both acute and community settings. The text reflects those areas in which health-care professionals are assuming greater responsibility for those people misusing psychoactive substances. It adopts a skills-orientated approach, providing a framework of good clinical practice and is written by a group of clinicians and academics. This book is an invaluable tool for undergraduate and postgraduate students, educators and clinical practitioners in all branches of nursing, midwifery and health visiting. It is also relevant to others in the healing professions as well as generic and specialist health-care professionals.

* emphasis placed on prevention
* an up-to-date, practical and comprehensive text for students and practitioners in health care
* adopts a skills-orientated approach, supported by the latest research and case vignettes
* written by experts in clinical practice, management, education and research

First published in 1996. Routledge is an imprint of Taylor & Francis, an informa company.

In the pursuit of more muscle, enhanced strength, sustained endurance and idealised physiques, an increasing number of elite athletes, recreational sport enthusiasts and body-conscious gym-users are turning to performance and image enhancing drugs and substances (PIEDS). In many instances, such use occurs with little regard for the health, social and economic consequences. This book presents a nuanced, evidence-based examination of PIEDS. It provides a classification of PIEDS types, physical impacts, rates of use, user profiles, legal and sporting status, and remedial program interventions, covering both elite and recreational use. It offers the perfect guide to assist students, government policy makers and sport managers in understanding the complex issues surrounding PIEDS consumption.

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?"
  

The phenomenon of psycho-active drugs, and our reactions to them, is one of the most fascinating topics of the social history of mankind. Starting with an analysis of the 'policy of fear' in which law enforcement is 'haunted' by drug money, Drugs and Money offers a radical reconsideration of this highly contentious issue.
In this intriguing book, Petrus C. van Duyne and Michael Levi expose an ever-unfolding series of problems:

• the proliferation of mind-influencing substances
• the complications of international drug regulation
• the interaction between markets and economic actors, with the consequent amassing of huge amounts of crime-money.

The social, cultural and economic aspects of this crime-money are explored, alongside the ongoing threat it poses to the legitimate economy and the state.

In 1884 American physicians discovered the anesthetic value of cocaine, and over the next three decades this substance derived from the coca plant became so popular that it became, ironically, a public health problem. Demand exceeded supply; abuse proliferated. The black market produced a legendary underground of "cocaine fiends." As attempts at regulation failed, Congress in 1914 banned cocaine outright, and America launched its longstanding war against now-illegal drugs.

Challenging "traditional thinking about both the 'rise' and 'fall' of drug problems" (which makes legal prohibition the pivotal point in the story), Spillane examines phenomena that have eluded earlier students of drug history. He explores the role of American business in fostering consumer interest in cocaine during the years when no law proscribed its use, the ways in which authorities and social agents tried nonetheless to establish informal controls on the substance, and the mixed results they achieved.

In asking how this pain-allaying drug became recognizably dangerous, how reformers tried to ameliorate its social effects, and how an underground of cocaine abusers developed even before regulation of the drug industry as a whole, Spillane discovers contingency, complication, and mixed motives. Arguing that the underground drug culture had origins other than in federal prohibition can tell us as we face questions about drug policy today.

Analysing both UK and international case law, this book develops unique regulatory ideas and insights which better respond to the complexity of human drug use.

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.

This study is based on five years of ethnographic fieldwork with Colombian drug traffickers (traquetos) in The Netherlands and Colombia. The author has uncovered the social world of traquetos: how and why they get involved in illicit activities, the nature of their work, and how they organize their businesses. This book will be valued by criminologists, social scientists, drug researchers, policymakers, organized crime scholars, and by those interested in Colombia, Latino immigrants issues, and the cocaine business.

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.

Philippe Bourgois's ethnographic study of social marginalization in inner-city America, won critical acclaim when it was first published in 1995. For the first time, an anthropologist had managed to gain the trust and long-term friendship of street-level drug dealers in one of the roughest ghetto neighborhoods--East Harlem. This new edition adds a prologue describing the major dynamics that have altered life on the streets of East Harlem in the seven years since the first edition. In a new epilogue Bourgois brings up to date the stories of the people--Primo, Caesat, Luis, Tony, Candy--who readers come to know in this remarkable window onto the world of the inner city drug trade. Philippe Bourgois is Professor and Chair of the Department of Anthropology, History and Social Medicine at the University of California, San Francisco. He has conducted fieldwork in Central America on ethnicity and social unrest and is the author of Ethnicity at Work: Divided Labor on a Central American Banana Plantation (Johns Hopkins University Press, 1989). He is writing a book on homeless heroin addicts in San Francisco. 1/e hb ISBN (1996) 0-521-43518-8 1/e pb ISBN (1996) 0-521-57460-9

Alarmingly, heroin is growing in popularity amongst young people. This is despite the fact that it is - more than any other drug - associated with failure, death, misery and poverty. This book explores why people are tempted by heroin and how globalization has played a key role in increasing the number of abusers.
Rather than offer lofty and abstract theories on addiction, the author grounds his study firmly in the day-to-day lives of heroin users themselves. Norrkoping in Sweden is a mid-sized former industrial city like countless others throughout the world. It has suffered high unemployment as a result of its rapid decline as a hub of commerce. Once well known for housing the giant telecommunications company Ericsson, it sadly gains more notoriety today through its associations with heroin, which continues to be the drug of choice for Norrkoping's young people. Through privileged access to users themselves, Lalander is able to show us the real motivations and lifestyle choices behind addiction. Personal testimonies candidly expose the underground activities of a thriving subculture and spark vexing questions as to why these young people choose to flirt with fatality. What media representations influence heroin users? Is this phenomenon the inevitable by-product of modern life? What are the root causes at play?
Lalander's in-depth investigation overturns many of the stereotypes associated with heroin use. Accessible and gripping, Hooked on Heroin brings a disturbing reality closer to home and shows how global and local practices are intimately linked.

For many years, what has been known about recovery from addictive behaviors has come solely from treatment studies. Only recently has the study of recoveries in the absence of formal treatment or self-help groups provided an alternative source of information. This book on the process of self-change from addictive behaviors is the first of its kind, as it presents more than research findings. Rather, it presents the process of self-change from several different perspectives - environmental, cross-cultural, prevention and interventions at both societal and individual level. It provides strategies for how health care practitioners and government policy makers alike can aid and foster self-change. Directions for future research priorities are also presented.

This collection includes essays by eleven leading public health experts, economists, physicians, political scientists, and lawyers, whose activities encompass Congressional testimonies, Surgeon General's reports on youth smoking, and clinical trials for drugs for smoking cessation. They analyze specific strategies that have been used to influence tobacco use, including taxation, regulation of advertising and promotion, regulation of indoor smoking, control of youth access to cigarettes and other tobacco products, litigation, and subsidies of smoking cessation, and set them against the latest scientific findings about tobacco and the changing cultural and political setting against which policy decisions are being made.

Today, more than ever before, we have available to us a large body of knowledge about how to reach and influence youth, even high-risk youth and families, that help them build resiliency. Building Healthy Individuals, Families, and Communities describes a program, Creating Lasting Family Connections, which is based on COPES' successful demonstration program, Creating Lasting Connections (CLC). CLC, a research demonstration project, was designed as an ecumenical, community based program that focused on increasing community, family and individual (youth) protective factors that would lead to delaying the onset and reducing the frequency of alcohol and other drug use among at-risk 12-14 year olds. CLC received the Center for Substance Abuse Prevention's Exemplary Prevention Program Award for 1994 and CLFC received this honor in 1999; CLC has been included in the International Youth Foundation's YouthNet International, a directory of the most effective youth programs worldwide; finally, it was selected as one of only seven model prevention programs by the Center for Substance Abuse Prevention for national dissemination. While the program focuses on alcohol and other drug-related issues and outcomes, much of this approach is applicable to youth and families across a larger spectrum of issues and behaviors, including violence and inappropriate sexual behavior.

Relapse prevention, though relatively new, is becoming established as a foremost technique for treating people with addiction problems. All other available literature on relapse prevention is theoretical in nature, and this book fulfils the need for a practical manual showing how therapists should carry out this form of treatment. It is based on the actual experience of the authors in using relapse prevention methods and provides working details on the different topics to be covered in each group of individual sessions. "Homework" assignments are also provided and a chapter devoted to "Trouble Shooting" - how to deal with the potential problems encountered in each type of therapy.

At the beginning of the twenty-first century, Brazil ranked second only to the United States in the number of reported cases of AIDS. Because Brazil's extensive poverty and inequality, its fragile economic situation, and its limited network of health services, the scarce prevention/intervention resources targeted only the most visible at risk populations -- gay men, sailors, prostitutes, and street children. Virtually forgotten were Brazil's hidden drug users, as well as the tens of millions of individuals living in the country's thousands of favelas, or shantytowns, which are a characteristic part of almost every Brazilian city. In Sex, Drugs, and HIV/AIDS in Brazil the authors examine the emergence of AIDS in Brazil, its linkages to drug use and the sexual culture, and its epidemiology in such populations as cocaine users, "street children," and male transvestite prostitutes. Special attention is focused on an HIV/AIDS community outreach program established in Rio de Janeiro, which represented the first such prevention/intervention program in all of Brazil targeting indigent cocaine users. This 6-year initiative was funded by the U.S. National Institute on Drug Abuse, and carried out by the authors of this book. The research combines anthropological, sociological, and biological perspectives; all data were gathered through empirical and ethnographic techniques.

Prisons today contain large proportions of drug users. Drug Use and Prisons provides the first comprehensive account of patterns of drug use and risk behaviours in prisons, and of the different responses to this feature of prison life. Experts from Europe, North and South America, Africa and Australia, from a variety of professional backgrounds, provide an international perspective on this ongoing problem.

In the past, prisoners were one of the 'hidden populations' of drug users. But with increasing recognition of the potential for the prison setting to act as a conduit for HIV and transmission within the prisoner population and thence into the community, failure to face this prospect is no longer an option for public health researchers or policymakers, nor for those working in the prison system.

The American Disease is a classic study of the development of drug laws in the U.S. Supporting the theory that Americans' attitudes toward drugs have followed a cyclic pattern of tolerance and restraint, author David Musto examines the relations between public outcry and the creation of prohibitive drug laws from the end of the Civil War to the present day. Originally published in 1973, with an expanded edition in 1987, this third edition contains a new chapter and preface that cover the renewed debate on policy and drug legislation from the end of the Reagan administration to the present Clinton administration.

While associated with comfort and pleasure, alcohol has been and is a 'problem' substance, both for medical and political authorities and for many drinkers. In this broad-ranging and innovative historical-sociological investigation, Valverde explores the ways in which both authorities and individual consumers have defined and managed the pleasures and dangers of alcoholic beverages. The author explores the question of free will versus determinism and how it has been challenged by ideas about addiction, morality and psychology during the last 150 years. The book draws on sources from the US, UK, Canada and elsewhere, and covers topics including nineteenth century 'dipsomania', the history of inebriate homes, Alcoholics Anonymous, fetal alcohol education and liquor control. It will appeal to readers in legal studies, criminology, sociology, psychology, social theory and the history of medicine.

Storming Heaven is a riveting history of LSD and its influence on American culture. Jay Stevens uses the "curious molecule" known as LSD as a kind of tracer bullet, illuminating one of postwar America's most improbable shadow-histories. His prodigiously researched narrative moves from Aldous Huxley's earnest attempts to "open the doors of perception" to Timothy Leary's surreal experiments at Millbrook; from the CIA's purchase of millions of doses to the thousands of flower children who turned on and burned out in Haight-Ashbury. Along the way, this brilliant, novelistic work of cultural history unites such figures as Allen Ginsberg, Cary Grant, G. Gordon Liddy, and Charles Manson. Storming Heaven irrefutably demonstrates LSD's pivotal role in the countercultural upheavals that shook America in the 1960s and changed the country forever.

This book offers a comprehensive, yet condensed, overview of this enormous field of study in an attempt to help readers in the field of human health understand the different facets of this ever-growing problem. It provides detailed discussions that include the history,chemistry, biology, epidemiology, and salient characteristics of the most important substances of abuse. The authors provide clear and comprehensive explanations of available treatment options and address important social issues connected to substance abuse. The book is an important source of practical, up-to-the minute information, making it a necessity for anyone who must have ready access to accurate, concise information regarding substance abuse.

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Preventing Substance Abuse is an informal guide to successful programs for treating specific substance abuse problems, identifying their origins, implementation, outcomes, and, where possible, contacts for obtaining additional information. The emphasis is on information documented from outcomes of successful interventions rather than on theories of what should work or what works under experimental conditions. Key features include easy-to-follow charts and graphs and an appendix summarizing the National Structured Evaluation (mandated by Congress) of substance abuse prevention.

The nightly news and other media provide a constant reminder of illegal drug transport over American borders and along routes between various U.S. cities. The general public is well aware that law enforcement efforts to address the foreign supply and trafficking of illegal drugs into the United States is an ongoing battle.This useful and readable compendium gives a fascinating account of how illegal drugs are transported into and around the United States and throughout its neighborhoods. Criminologist and geographer George F. Rengert takes a unique approach to the problem of illegal drug distribution and U.S. drug markets. Using maps and charts to illustrate his findings, Rengert applies spacial diffusion models to the illegal drug trade and explains why certain drugs are transported and found in different parts of the country. For example, the highest concentration of marijuana plants is not on either coast, but rather across the middle of the United States--throughout what is known as the corn belt. At the local level Rengert assesses the patterns and processes that interconnect drug sales and neighborhood deterioration and change.The book also addresses the important issues of how illegal drugs in this country operate on wholesale and retail levels and ways in which law enforcement at the federal, state, and local levels contend with this widespread problem. Using ethnographic material to provide real-life examples, Rengert explores how drug dealers on the street expand spatially and predictably in their neighborhoods. He illustrates how this knowledge helps law enforcement in efforts to get these drugs off the streets.

In this health-conscious age there is increasing concern about tobacco smoking and inappropriate consumption levels of alcohol. Alcoholism poses an important occupational health problem which can affect an individual's personal welfare and limit his or her efficiency at work. There is concern about the increasing availability of drugs in society, the link between drug-taking and the spread of HIV in society, and the ways in which substance misuse generates more violence within society. Both excessive alcohol consumption and drug-taking may dispose an individual to antisocial actions and lead to criminal activities. By examining the underlying biological and psychological nature of these behaviours the book is intended to inform its readers of current advances in a number of relevant disciplines and to demonstrate some of the problems in collecting and interpreting information from particular groups. 2