Chemical Dependency : A Systems Approach

by McNeece, C. Aaron; DiNitto, Diana M.

• ISBN13: 9780205342754
• ISBN10: 0205342752
• Edition: 3rd
• Format: Paperback
• Copyright: 2005-01-01
• Publisher: Allyn & Bacon

Summary

The latest edition of this well-respected book by C. Aaron McNeece and Diana DiNitto presents a comprehensive look at chemical dependency, covering the most recent issues in the areas of epidemiology, etiology, substance abuse policy and treatment. Taking a systems perspectiveChemical Dependency: A Systems Approach, Third Edition,presents all major theories of addiction, as well as the major physiological and psychological results of substance abuse, including fetal alcohol syndrome. Coverage of the latest developments in treatment and research incorporates the most recent findings on genetic causes of alcoholism. This edition includes an up-to-date discussion of the most recent trends in designer drugs, to account for the considerable frequency in which drug use patterns occur. In addition, the most recent policy changes at the state, federal, and international levels have been added.

Table of Contents

Preface	xv
Part One Theories, Models, and Definitions	1	(90)
1 Definitions and Epidemiology of Substance Use, Abuse, and Disorders	3	(22)
By C. Aaron McNeece and Lisa D. Barbanell
Introduction	3	(3)
Alcohol Use	4	(2)
Drug Use	6	(1)
Definitions and Myths	6	(5)
Disease, Addiction, or Behavioral Disorder?	7	(4)
Epidemiology	11	(9)
Alcohol	11	(2)
Illicit Drugs	13	(5)
Tobacco	18	(2)
Polydrug Use/Comorbidity	20	(1)
Summary	20	(1)
Endnotes	21	(1)
Resources	21	(1)
References	21	(4)
2 The Etiology of Addiction	25	(17)
Etiological Theories	26	(8)
The Moral Model	26	(1)
Psychological Theories	26	(3)
Biological Theories	29	(2)
Sociocultural Theories	31	(3)
Alternative Explanations	34	(1)
Stages of Alcoholism	34	(2)
The Course of Cocaine Addiction	36	(1)
A Multicausal Model	37	(1)
Summary	37	(1)
Resources	38	(1)
References	38	(4)
3 The Brain Biology of Drug Abuse and Addiction	42	(19)
By Richard E. Wilcox and Carlton K. Erickson
Introduction: Background on Abuse, Addiction, and Treatment	42	(1)
Terminology	42	(1)
The Genetics of Addiction	43	(1)
Brain Chemistry and the Anatomy of Addiction	44	(3)
Sensitization in Addiction	47	(2)
Emotional Learning in Addiction	49	(1)
Addiction Therapy without Medication	49	(2)
Drug Therapy for Addiction	51	(1)
Role of Detoxification in Treating Addiction	52	(1)
Drug Therapy for Reducing Craving	53	(4)
Alcoholism	53	(1)
Stimulant Addictions: Cocaine and the Amphetamines	54	(2)
Heroin and Other Opioid Addictions	56	(1)
Nicotine Addiction	57	(1)
Summary	57	(1)
Resources	58	(1)
References	58	(3)
4 The Physiological and Behavioral Consequences of Alcohol and Drug Abuse	61	(30)
The Effects of Alcohol	61	(7)
The Metabolization of Alcohol	62	(1)
Intoxication	63	(1)
Withdrawal	64	(1)
The Digestive System	64	(1)
The Cardiovascular System	65	(1)
The Neurologic System	66	(1)
Alcohol and Other Disorders	67	(1)
The Effects of Cannabis	68	(4)
The Effects of Stimulants	72	(5)
Cocaine	72	(3)
Amphetamines and Methamphetamines	75	(2)
MDMA	77	(1)
The Effects of Sedatives	77	(1)
The Effects of Narcotics	78	(3)
The Digestive System	79	(1)
The Endocrine System	79	(1)
Integument	79	(1)
The Genitourinary System	80	(1)
Other Problems	80	(1)
OxyContin	80	(1)
The Effects of Hallucinogens	81	(1)
The Effects of Inhalants	82	(1)
The Effects of Drugs on Offspring	83	(2)
Alcohol	83	(1)
Opiates	84	(1)
Tobacco	84	(1)
Amphetamines and Cocaine	84	(1)
Other Drugs	84	(1)
Summary	85	(1)
Glossary	85	(1)
Resources	85	(1)
References	86	(5)
Part Two Intervention, Prevention, and Public Policy	91	(174)
5 Screening, Diagnosis, Assessment, and Referral	93	(37)
Screening	94	(6)
Can Alcoholics and Addicts Be Believed?	100	(2)
Diagnosis	102	(5)
Assessment	107	(8)
Education	110	(1)
Employment	110	(1)
Military History	111	(1)
Medical History	111	(1)
Legal History	111	(1)
Drinking and Drug History	112	(1)
Psychological or Psychiatric History	113	(1)
Family History	113	(1)
Current Family and Social Relationships	114	(1)
Religion and Spirituality	115	(1)
Why the Individual Is Seeking Services	115	(1)
Denial, Resistance, and Motivation for Recovery	115	(3)
The Ethics of Chemical Dependency Treatment	118	(6)
Referrals	124	(1)
Summary	125	(1)
Endnotes	126	(1)
Resources	126	(1)
References	127	(3)
6 Treatment: The System of Care	130	(71)
Components of the Treatment System	130	(40)
Detoxification Programs	130	(5)
Intensive Treatment	135	(5)
Residential Programs	140	(6)
Outpatient Services	146	(10)
Pharmacotherapy	156	(10)
Aftercare	166	(1)
Maintenance	167	(1)
Education and Psychoeducation	168	(1)
Adjunctive Services	169	(1)
More Treatment Effectiveness Issues	170	(6)
Length of Stay	170	(1)
Amount and Intensity of Services	171	(1)
Client Characteristics	171	(1)
Therapist Characteristics	172	(1)
Theoretical Perspectives	173	(2)
Cost Effectiveness of Treatment	175	(1)
Nontraditional Approaches	176	(6)
Controlled or Moderated Drinking	176	(2)
Acupuncture	178	(3)
Biofeedback	181	(1)
Incentives to Improve Treatment Outcomes	181	(1)
Self-Help Groups	182	(6)
Alcoholics Anonymous	182	(4)
Research and Self-Help Groups	186	(1)
Narcotics Anonymous and Other Self-Help Groups	187	(1)
Summary	188	(1)
Endnotes	188	(1)
Resources	189	(1)
References	190	(11)
7 Preventing Alcohol and Drug Problems	201	(26)
By C. Aaron McNeece and Machelle Denine Madsen
Overview of Prevention	201	(3)
Public Information and Education	204	(4)
Programs Directed at Children and Adolescents	205	(3)
Service Measures	208	(2)
Technologic Measures	210	(1)
Legislative and Regulatory Measures	211	(6)
Advertising and the Media	212	(4)
DUI Prevention	216	(1)
Family and Community Approaches	217	(1)
Spirituality and Religious Factors	217	(1)
Cultural Factors	217	(1)
Economic Measures	218	(1)
Cost/Benefit Analysis	218	(1)
Summary	218	(1)
Resources	219	(1)
References	219	(8)
8 Regulating Drugs and Their Consequences	227	(38)
Sociocultural Influences on Public Drug Policy	227	(1)
Economic and Political Factors	228	(1)
Changes in Drug Use Patterns	229	(1)
The Nature of Drug Control	229	(1)
Assumptions Underlying Regulation	230	(1)
Regulation of Alcohol	231	(7)
The Lessons of Prohibition	231	(1)
Current U.S. Policies	232	(6)
Control of Illicit Drugs	238	(8)
The "War on Drugs"	240	(1)
The Economics of Drug War/Peace	241	(2)
Legalization	243	(2)
Medical Marijuana	245	(1)
Drugs, Alcohol, and Crime	246	(1)
Alcohol and Drug Law Violations	247	(3)
Drug Use by Criminals	250	(1)
Drug Use by Crime Victims	251	(1)
Domestic Violence	251	(1)
Drug/Crime Trends in the 1990's	252	(5)
Drug Trafficking	253	(1)
Drugs, Crime, and Prison	254	(1)
Treating Substance-Abusing Offenders	254	(2)
Drug Courts	256	(1)
Needle and Syringe Exchange Programs	256	(1)
Summary	257	(1)
Endnote	258	(1)
Resources	259	(1)
References	259	(6)
Part Three Chemical Dependency in Special Populations	265	(282)
9 Treating Substance-Abusing Youth	269	(24)
By David W. Springer
Developmental and Contextual Factors	270	(2)
Medical and Psychiatric Context	270	(1)
Legal Context	271	(1)
Social Context	271	(1)
Educational Context	272	(1)
Assessment with Substance-Abusing Youth	272	(2)
Problem Oriented Screening Instrument for Teenagers (POSIT)	273	(1)
Drug Use Screening Inventory-Revised (DUSI-R)	273	(1)
Child and Adolescent Functional Assessment Scale (CAFAS)	273	(1)
Substance Abuse Subtle Screening Inventory for Adolescents (SASSI-A2)	274	(1)
Treatment with Substance-Abusing Youth	274	(11)
Managed Care and Dual Diagnoses	275	(1)
Prevention	275	(1)
Drug Education	276	(1)
Outpatient Treatment	277	(2)
Abstinence-Oriented Approaches	279	(1)
Family-Based Treatment	280	(2)
Inpatient Treatment	282	(1)
Residential Treatment/Treatment Communities	283	(2)
Case Example	285	(1)
Treatment Effectiveness with Substance-Abusing Juvenile Offenders: A Brief Review	286	(1)
Summary	287	(1)
Endnotes	287	(1)
Resources	287	(1)
References	288	(5)
10 Family Systems and Chemical Dependency	293	(1)
By Catherine A. Hawkins
A Family Perspective in Theory, Research, and Treatment	294	(2)
Theories on Alcoholism and the Family	296	(1)
Family Systems Theory of Alcoholism and the Family	297	(3)
Rituals and Routines	297	(1)
Shame	298	(1)
Rules and Roles	299	(1)
Codependency and Related Constructs	300	(4)
Codependency	300	(2)
Children of Alcoholics	302	(1)
Adult Children of Alcoholics	303	(1)
Assessment and Treatment of Alcoholic Families	304	(9)
Behavioral Perspective	309	(1)
Stress-Coping Perspective	310	(1)
Family Therapy Perspective	311	(2)
Effectiveness of Family Treatment	313	(1)
Case Example	314	(7)
Summary	321	(1)
Resources	322	(1)
References	322	(6)
11 Ethnicity, Culture, and Substance Use Disorders	328	(2)
Substance Use and Abuse among American Indians and Alaskan Natives	330	(14)
History and Background	330	(2)
Explaining Alcohol and Drug Problems among American Indians and Alaskan Natives	332	(1)
Substance Use Disorders among American Indians and Alaskan Natives	333	(3)
Prevention and Treatment Services for American Indians and Alaskan Natives	336	(8)
Substance Use and Abuse among African Americans	344	(12)
History and Background	344	(2)
Substance Use Disorders and Related Problems among African Americans	346	(4)
Chemical Dependency Treatment for African Americans	350	(4)
Prevention in African American Communities	354	(2)
Substance Use and Abuse among Hispanic Americans	356	(9)
History and Background	356	(1)
Substance Use Disorders and Related Problems among Hispanic Americans	356	(3)
Cultural Influences on Substance Use and Abuse among Hispanic Americans	359	(2)
Prevention and Treatment Services for Hispanic Americans	361	(4)
Substance Use and Abuse among Asian and Pacific Islander Americans	365	(14)
History and Background	365	(2)
The Influence of Asian Traditions on Substance Use	367	(1)
Substance Use and Related Problems among Asian and Pacific Islander Americans	368	(2)
Sociocultural and Genetic Influences on Asian Americans' Substance Use	370	(4)
Treatment Services for Asian and Pacific Islander Americans	374	(4)
Prevention Services for Asian and Pacific Islander Americans	378	(1)
Substance Use and Abuse among Jewish Americans	379	(6)
History and Background	379	(1)
Explanations of Low Rates of Alcoholism among Jewish Americans	380	(2)
Extent of Alcohol and Other Drug Problems among Jewish Americans	382	(2)
Prevention and Treatment Services for Jewish Americans	384	(1)
Summary	385	(1)
Endnotes	386	(1)
Resources	387	(1)
References	388	(13)
12 Substance Abuse Treatment with Sexual Minorities	401	(1)
By Catherine Lau Crisp and Diana M. DiNitto
Historical Overview	401	(2)
Substance Abuse in Lesbians and Gay Men	403	(2)
Similarities in Identities	405	(2)
Treatment: Together or Separate?	407	(1)
Gay Affirmative Practice	408	(4)
Practitioners' Knowledge	409	(1)
Practitioners' Attitudes	410	(1)
Practitioners' Skills	411	(1)
Treatment with Transgendered and Bisexual Clients	412	(2)
Transgendered Clients	413	(1)
Bisexual Clients	414	(1)
Gay and Lesbian Youth	414	(2)
Twelve-Step Groups for Gays and Lesbians	416	(1)
Summary	417	(1)
Endnotes	418	(1)
Resources	418	(1)
References	419	(4)
13 Substance Use Disorders and Co-Occurring Disabilities	423	(1)
By Diana M. DiNitto and Deborah K. Webb
Identification and Attitudes	424	(1)
Disability Legislation	425	(1)
Mental Illness and Substance Use Disorders	426	(19)
Prevalence of Co-Occurring Mental Illness and Substance Use Disorders	426	(3)
Theories of Co-Occurring Mental Illness and Substance Use Disorders	429	(2)
Assessment of Co-Occurring Mental Illness and Substance Use Disorders	431	(4)
Treatment of Co-Occurring Mental Illness and Substance Use Disorders	435	(10)
Developmental Disabilities and Substance Use Disorders	445	(7)
Intellectual Disability	446	(6)
Other Developmental Disabilities	452	(1)
Mobility Impairments and Substance Use Disorders	452	(4)
Traumatic Brain Injury and Substance Use Disorders	456	(5)
Sensory Disabilities and Substance Use Disorders	461	(6)
Deafness and Other Hearing Impairments	461	(4)
Blindness and Other Visual Impairments	465	(2)
Other Physical Disabilities and Substance Use Disorders	467	(3)
Heart Disease	467	(1)
Diabetes	468	(1)
Epilepsy	469	(1)
Chronic Pain	470	(1)
Summary	470	(1)
Endnotes	471	(1)
Resources	471	(1)
References	472	(12)
14 Alcohol and Drug Use among Elderly People	484	(1)
By Linda Vinton and Kathryn G. Wambach
Prevalence and Patterns	484	(3)
Alcohol Abuse	484	(2)
Alcohol and Drug Abuse	486	(1)
Antecedents and Correlates	487	(3)
Sociocultural Models	487	(1)
Psychologic and Psychosocial Models	488	(2)
Assessment and Biopsychosocial Effects	490	(1)
Assessment Strategies and Problems	490	(1)
Effects	491	(1)
Medical Complications	491	(2)
Cognitive Impairment	492	(1)
Depression and Suicide	492	(1)
Outreach and Treatment	493	(3)
Community Education and Awareness	493	(1)
Treatment	494	(2)
Case Examples	496	(2)
Summary	498	(1)
Resources	498	(1)
References	499	(4)
15 Gender and the Use of Drugs and Alcohol: Fact, Fiction, and Unanswered Questions	503	(1)
By Diane R. Davis and Diana M. DiNitto
An Equality Women Don't Want	503	(3)
Biological Differences	506	(11)
Genetics and Etiology	506	(2)
Is Biology Destiny?	508	(9)
Social Differences	517	(4)
Falling from the Pedestal	517	(1)
Social Supports	518	(2)
Crime	520	(1)
Psychological Differences	521	(5)
Psychological Distress	521	(2)
Effects of Physical and Sexual Abuse	523	(2)
Child Maltreatment	525	(1)
Gender, Treatment, and Recovery	526	(6)
Treatment Matching	527	(2)
Serving Women with Children	529	(1)
Getting a Fair Shake	530	(1)
Self-Help Groups	530	(1)
Moving toward a Relational Model	531	(1)
Gender Differences Revisited	532	(4)
Summary	536	(1)
Resources	537	(1)
References	537	(10)
Part Four Summary and Conclusions	547	(1)
16 Chemical Dependency: Current Issues and Future Prospects	549	(16)
By C. Aaron McNeece, Diana M. DiNitto, and Paul R. Raffoul
Research	551	(4)
Research on Harm Reduction	551	(1)
Research on Treatment	552	(3)
Policy Change	555	(1)
Delivery of Treatment Services	556	(3)
Third-Party Coverage	556	(1)
Managed Care	557	(1)
Public Funding	558	(1)
Implications for Education and Training	559	(1)
Summary and Concluding Thoughts	560	(1)
Endnote	561	(1)
Resources	561	(1)
References	561	(4)
Index	565