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Concepts of Chemical Dependency

by
Edition:
6th
ISBN13:

9780534632847

ISBN10:
053463284X
Format:
Paperback
Pub. Date:
7/6/2005
Publisher(s):
Brooks Cole
List Price: $110.33

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Summary

1. Why Worry About Recreational Chemical Use in the United States? 2. What Do We Mean When We Say Substance Abuse and Addiction? 3. The Medical Model of Chemical Addiction. 4. Are People Predestined to Become Addicted to Chemicals? 5. Addiction as a Disease of the Human Spirit. 6. An Introduction to Pharmacology. 7. An Introduction to Alcohol. 8. Chronic Alcohol Abuse/Addiction. 9. Abuse of and Addiction to the Barbiturates and Barbiturate-Like Drugs. 10. Abuse & Addiction to Benzodiazepines and Similar Agents. 11. Abuse and Addiction to Amphetamines and CNS Stimulants. 12. Cocaine. 13. Marijuana Abuse & Addiction. 14. Opiate Abuse & Addiction. 15. Hallucinogen Abuse & Addiction. 16. Abuse of and Addiction to the Inhalants and Aerosols. 17. The Unrecognized Problem of Steroid Abuse and Addiction. 18. The Over-the-Counter Analgesics. 19. Tobacco Products and Nicotine Addiction. 20. Chemicals and the Neonate: The Consequences of Drug Abuse During Pregnancy. 21. The Hidden Faces of Chemical Dependency. 22. The Dual Diagnosis Client: Chemical Addiction and Mental Illness. 23. Chemical Abuse by Children and Adolescents. 24. Codependency and Enabling. 25. Addiction and the Family. 26. The Evaluation of Substance Abuse Problems. 27. The Process of Intervention. 28. The Treatment of Chemical Dependency. 29. Treatment Formats for Chemical Dependency Rehabilitation. 30. The Process of Recovery. 31. Problems That Arise in Treating Chemical Dependency. 32. Pharmacological Intervention Tactics and Substance Abuse. 33. Substance Abuse/Addiction and Infectious Disease. 34. Self Help Groups. 35. Crime and Drug Use. Appendices. Glossary. References.

Table of Contents

Preface xix
Why Worry About Recreational Chemical Abuse?
1(8)
Introduction
1(1)
Who Treats Those Who Abuse or Are Addicted to Chemicals?
2(1)
The Scope of the Problem of Chemical Abuse/Addiction
3(2)
The Cost of Chemical Abuse/Addiction in the United States
5(2)
Why Is It So Difficult to Understand the Drug Abuse Problem in the United States?
7(1)
Summary
7(2)
What Do We Mean When We Say Substance Abuse and Addiction?
9(7)
Introduction
9(1)
The Continuum of Chemical Use
9(2)
Definitions of Terms Used in This Book
11(1)
What Do We Really Know About the Addictive Disorders?
12(1)
The State of the Art: Unanswered Questions, Uncertain Answers
13(2)
Summary
15(1)
The Medical Model of Chemical Addiction
16(13)
Introduction
16(1)
Why Do People Abuse Chemicals?
16(4)
What Do We Mean When We Say That Someone Is ``Addicted'' to Chemicals?
20(8)
Summary
28(1)
Are People Predestined to Become Addicted to Chemicals?
29(15)
Introduction
29(1)
Multiple Models
29(1)
Reaction Against the Disease Model of Addiction
29(12)
The Final Common Pathway Theory of Addiction
41(1)
Summary
42(2)
Addiction as a Disease of the Human Spirit
44(11)
Introduction
44(1)
The Rise of Western Civilization, or How the Spirit Was Lost
44(2)
Diseases of the Mind---Diseases of the Spirit: The Mind-Body Question
46(1)
The Growth of Addiction: The Circle Narrows
46(1)
The Circle of Addiction: Addicted Priorities
47(1)
Some Games of Addiction
48(1)
Honesty as a Part of the Recovery Process
49(1)
False Pride: The Disease of the Spirit
50(2)
Denial, Rationalization, Projection, and Minimization: The Four Horsemen of Addiction
52(2)
Summary
54(1)
An Introduction to Pharmacology
55(15)
Introduction
55(1)
The Prime Effect and Side Effects of Chemicals
55(1)
Drug Forms and How Drugs Are Administered
56(2)
Bioavailability
58(4)
The Drug Half-Life
62(2)
The Effective Dose
64(1)
The Lethal Dose Index
64(1)
The Therapeutic Index
64(1)
Peak Effects
65(1)
The Site of Action
65(4)
The Blood-Brain Barrier
69(1)
Summary
69(1)
Alcohol: Humans' Oldest Recreational Chemical
70(12)
Introduction
70(1)
A Brief History of Alcohol
70(1)
How Alcohol Is Produced
71(1)
Alcohol Today
72(1)
Scope of the Problem of Alcohol Use
72(1)
Pharmacology of Alcohol
73(2)
The Blood Alcohol Level
75(1)
Subjective Effects of Alcohol on the Individual: At Normal Doses in the Average Drinker
76(1)
Effects of Alcohol at Intoxicating Doses: For the Average Drinker
77(1)
Medical Complications of Alcohol Use in the Average Drinker
78(2)
Alcohol Use and Accidental Injury or Death
80(1)
Summary
81(1)
Chronic Alcohol Abuse and Addiction
82(18)
Introduction
82(1)
Scope of the Problem
82(1)
Is There a ``Typical'' Alcohol-Dependent Person?
83(1)
Alcohol Tolerance, Dependence, and ``Craving'': Signposts of Alcoholism
83(2)
Complications of Chronic Alcohol Use
85(14)
Summary
99(1)
Abuse and Addiction to the Barbiturates and Barbiturate-like Drugs
100(12)
Introduction
100(1)
Early Pharmacological Therapy of Anxiety Disorders and Insomnia
100(1)
History and Current Medical Uses of the Barbiturates
101(1)
Pharmacology of the Barbiturates
102(2)
Subjective Effects of the Barbiturates at Normal Dosage Levels
104(1)
Complications of the Barbiturates at Normal Dosage Levels
105(2)
Effects of the Barbiturates at Above-Normal Levels
107(1)
Neuroadaptation, Tolerance to, and Dependence on the Barbiturates
108(1)
Barbiturate-like Drugs
109(1)
Summary
110(2)
Abuse of and Addiction to Benzodiazepines and Similar Agents
112(16)
Introduction
112(1)
Medical Uses of the Benzodiazepines
112(2)
Pharmacology of the Benzodiazepines
114(1)
Side Effects of the Benzodiazepines When Used at Normal Dosage Levels
115(1)
Neuroadaptation to Benzodiazepines and Abuse/Addiction to These Agents
116(2)
Complications Caused by Benzodiazepine Use at Normal Dosage Levels
118(2)
Subjective Experience of Benzodiazepine Use
120(1)
Long-Term Consequences of Chronic Benzodiazepine Use
121(1)
Buspirone
122(2)
Zolpidem
124(1)
Zaleplon
125(1)
Rohypnol
126(1)
Summary
127(1)
Abuse of and Addiction to Amphetamines and CNS Stimulants
128(18)
Introduction
128(1)
The CNS Stimulants as Used in Medical Practice
128(1)
The Amphetamine-like Drugs
128(4)
The Amphetamines
132(4)
CNS Stimulant Abuse
136(1)
Scope of the Problem of CNS Stimulant Abuse and Addiction
136(1)
Effects of the CNS Stimulants When Abused
136(8)
Summary
144(2)
Cocaine
146(15)
Introduction
146(1)
A Brief Overview of Cocaine
146(1)
Cocaine in Recent U.S. History
147(1)
Cocaine Today
148(1)
Pharmacology of Cocaine
149(2)
How Illicit Cocaine Is Produced
151(1)
How Cocaine Is Abused
152(2)
Subjective Effects of Cocaine When It Is Abused
154(1)
Complications of Cocaine Abuse/Addiction
155(4)
Summary
159(2)
Marijuana Abuse and Addiction
161(13)
Introduction
161(1)
History of Marijuana Use in the United States
161(2)
A Question of Potency
163(1)
A Technical Point
163(1)
Scope of the Problem of Marijuana Abuse
164(1)
Pharmacology of Marijuana
165(2)
Methods of Administration
167(1)
Subjective Effects of Marijuana
168(1)
Adverse Effects of Occasional Marijuana Use
168(1)
Consequences of Chronic Marijuana Abuse
169(3)
The Addiction Potential of Marijuana
172(1)
Summary
172(2)
Opiate Abuse and Addiction
174(23)
Introduction
174(1)
The Medical Uses of Narcotic Analgesics
174(1)
A Short History of the Narcotic Analgesics
174(2)
The Classification of Narcotic Analgesics
176(1)
Where Opium Is Produced
177(1)
Current Medical Uses of the Narcotic Analgesics
177(1)
Pharmacology of the Narcotic Analgesics
177(3)
Neuroadaptation to Narcotic Analgesics
180(2)
Subjective Effects of Narcotic Analgesics When Used in Medical Practice
182(1)
Complications Caused by Narcotic Analgesics When Used in Medical Practice
182(2)
Fentanyl
184(1)
Buprenorphine
185(1)
Opiates As Drugs of Abuse
186(1)
The Mystique of Heroin
186(2)
Other Narcotic Analgesics That Might Be Abused
188(1)
Methods of Opiate Abuse
189(2)
Scope of the Problem of Opiate Abuse and Addiction
191(1)
Complications Caused by Chronic Opiate Abuse
192(3)
Overdose of Illicit Opiates
195(1)
Summary
196(1)
Hallucinogen Abuse and Addiction
197(16)
Introduction
197(1)
History of Hallucinogens in the United States
197(2)
Scope of the Problem
199(1)
Pharmacology of the Hallucinogens
199(2)
Subjective Effects of Hallucinogens
201(2)
Phencyclidine (PCP)
203(4)
Ecstasy: Evolution of a New Drug of Abuse
207(5)
Summary
212(1)
Abuse of and Addiction to the Inhalants and Aerosols
213(8)
Introduction
213(1)
History of Inhalant Abuse
213(1)
Pharmacology of the Inhalants
214(1)
Scope of the Problem
215(1)
Method of Administration
216(1)
Subjective Effects of Inhalants
216(1)
Complications From Inhalant Abuse
217(1)
Anesthetic Misuse
218(1)
Abuse of Nitrites
219(1)
Summary
220(1)
The Unrecognized Problem of Steroid Abuse and Addiction
221(8)
Introduction
221(1)
An Introduction to the Anabolic Steroids
221(1)
Medical Uses of Anabolic Steroids
222(1)
The Legal Status of Anabolic Steroids
222(1)
Scope of the Problem of Steroid Abuse
222(1)
Sources and Methods of Steroid Abuse
222(1)
Problems Associated With Anabolic Steroid Abuse
223(2)
Complications of Steroid Abuse
225(2)
Are Anabolic Steroids Addictive?
227(1)
Summary
228(1)
The Over-the-Counter Analgesics: Unexpected Agents of Abuse
229(16)
Introduction
229(1)
A Short History of the OTC Analgesics
229(1)
Medical Uses of the OTC Analgesics
230(2)
Pharmacology of the OTC Analgesics
232(3)
Normal Dosage Levels of OTC Analgesics
235(2)
Complications Caused by Use of OTC Analgesics
237(4)
Overdose of OTC Analgesics
241(2)
Summary
243(2)
Tobacco Products and Nicotine Addiction
245(15)
Introduction
245(1)
History of Tobacco Use in the United States
245(1)
Scope of the Problem
246(1)
Pharmacology of Cigarette Smoking
247(3)
The Effects of Nicotine Use
250(1)
Nicotine Addiction
251(1)
Complications of the Chronic Use of Tobacco
252(7)
Summary
259(1)
Chemicals and the Neonate: The Consequences of Drug Abuse During Pregnancy
260(15)
Introduction
260(1)
Scope of the Problem
260(1)
The Fetal Alcohol Spectrum Disorder
261(2)
Cocaine Use During Pregnancy
263(3)
Amphetamine Use During Pregnancy
266(1)
Opiate Abuse During Pregnancy
266(2)
Marijuana Use During Pregnancy
268(1)
Benzodiazepine Use During Pregnancy
269(1)
Hallucinogen Use During Pregnancy
270(1)
Buspirone Use During Pregnancy
270(1)
Bupropion Use During Pregnancy
270(1)
Disulfiram Use During Pregnancy
271(1)
Cigarette Use During Pregnancy
271(1)
Over-the-Counter Analgesic Use During Pregnancy
272(1)
Inhalant Abuse During Pregnancy
273(1)
Summary
273(2)
Hidden Faces of Chemical Dependency
275(15)
Introduction
275(1)
Women and Addiction: An Often Unrecognized Problem
275(5)
Addiction and the Homeless
280(1)
Substance Use Problems and the Elderly
280(4)
The Homosexual and Substance Abuse
284(2)
Substance Abuse and the Disabled
286(1)
Substance Abuse and Ethnic Minorities
287(2)
Summary
289(1)
The Dual-Diagnosis Client: Chemical Addiction and Mental Illness
290(14)
Introduction
290(1)
Definitions
290(1)
Dual-Diagnosis Clients: A Diagnostic Challenge
291(1)
Why Worry About the Dual-Diagnosis Client?
291(1)
The Scope of the Problem
292(1)
Characteristics of Dual-Diagnosis Clients
293(1)
Psychopathology and Drug of Choice
293(6)
Problems in Working With Dual-Diagnosis Clients
299(1)
Treatment Approaches
300(3)
Summary
303(1)
Chemical Abuse by Children and Adolescents
304(16)
Introduction
304(1)
The Importance of Childhood and Adolescence in the Evolution of Substance-Use Problems
304(1)
Scope of the Problem
305(5)
Why Do Adolescents Use Chemicals?
310(3)
The Adolescent Abuse/Addiction Dilemma: How Much Is Too Much?
313(4)
Possible Diagnostic Criteria for Adolescent Drug/Alcohol Problems
317(1)
The Special Needs of the Adolescent in a Substance-Abuse Rehabilitation Program
318(1)
Summary
319(1)
Codependency and Enabling
320(10)
Introduction
320(1)
Enabling
320(1)
Codependency
321(5)
Reactions to the Concept of Codependency
326(3)
Summary
329(1)
Addiction and the Family
330(11)
Introduction
330(1)
Scope of the Problem
330(1)
Addiction and Marriage
330(2)
Addiction and the Family
332(3)
The Adult Children of Alcoholics (ACOA) Movement
335(4)
Summary
339(2)
The Evaluation of Substance-Use Problems
341(15)
Introduction
341(1)
The Theory Behind Alcohol- and Drug-Use Evaluations
341(1)
Screening
342(2)
Assessment
344(1)
Diagnosis
345(1)
The Assessor and Data Privacy
346(1)
Diagnostic Rules
347(1)
The Assessment Format
348(4)
Other Sources of Information
352(3)
The Outcome of the Evaluation Process
355(1)
Summary
355(1)
The Process of Intervention
356(9)
Introduction
356(1)
A Definition of Intervention
356(1)
Characteristics of the Intervention Process
357(1)
The Mechanics of Intervention
357(1)
Family Intervention
358(2)
Intervention With Other Forms of Chemical Addiction
360(1)
The Ethics of Intervention
361(1)
Intervention via the Court System
362(2)
Other Forms of Intervention
364(1)
Summary
364(1)
The Treatment of Chemical Dependency
365(9)
Introduction
365(1)
Characteristics of the Substance-Abuse Rehabilitation Professional
365(2)
The Minnesota Model of Chemical-Dependency Treatment
367(1)
The Treatment Plan
368(1)
Other Treatment Formats for Chemical Dependency
369(4)
Aftercare Programs
373(1)
Summary
373(1)
Treatment Formats for Chemical-Dependency Rehabilitation
374(12)
Introduction
374(1)
Outpatient Treatment Programs
374(3)
Inpatient Treatment Programs
377(4)
Inpatient or Outpatient Treatment?
381(2)
Partial Hospitalization Options
383(2)
Summary
385(1)
The Process of Recovery
386(11)
Introduction
386(1)
The Decision to Seek Treatment
386(1)
The Stages of Recovery
386(4)
Specific Points to Address in the Treatment of Addiction to Common Drugs of Abuse
390(6)
Summary
396(1)
Problems Frequently Encountered in the Treatment of Chemical Dependency
397(19)
Introduction
397(1)
Limit Testing by Clients in Treatment
397(1)
Treatment Noncompliance
397(2)
Relapse and Relapse Prevention
399(3)
``Cravings'' and ``Urges''
402(1)
The ``Using'' Dream
403(1)
Controlled Drinking
404(1)
The Uncooperative Client
404(2)
Toxicology Testing
406(6)
The Addicted Patient With Chronic Pain Issues
412(1)
Insurance Reimbursement Policies
412(2)
D.A.R.E. and Psychoeducational Intervention Programs
414(1)
Summary
415(1)
Pharmacological Intervention Tactics and Substance Abuse
416(16)
Introduction
416(1)
Pharmacological Treatment of Alcohol Abuse and Dependence
416(5)
Pharmacological Treatment of Opiate Addiction
421(6)
Pharmacological Treatment of Cocaine Addiction
427(1)
Pharmacological Treatment of Amphetamine Abuse/Dependence
428(1)
Pharmacological Treatment of Nicotine Dependence
428(3)
Summary
431(1)
Substance Abuse/Addiction and Infectious Disease
432(14)
Introduction
432(1)
Why Is Infectious Disease Such a Common Complication of Alcohol/Drug Abuse?
432(1)
The Pneumonias
433(1)
Acquired Immune Deficiency Syndrome (AIDS)
434(6)
Tuberculosis (TB)
440(1)
Viral Hepatitis
441(4)
Summary
445(1)
Self-Help Groups
446(16)
The Twelve Steps of Alcoholics Anonymous
446(1)
Introduction
446(1)
The History of AA
446(1)
Elements of AA
447(2)
AA and Religion
449(1)
One ``A'' Is for Anonymous
450(1)
AA and Outside Organizations
450(1)
The Primary Purpose of AA
450(2)
Of AA and Recovery
452(1)
Sponsorship
452(1)
AA and Psychological Theory
453(1)
How Does AA Work?
453(1)
Outcome Studies: The Effectiveness of AA
454(2)
Narcotics Anonymous
456(1)
Al-Anon and Alateen
456(1)
Support Groups Other Than AA
457(2)
Criticism of the AA/12-Step Movement
459(1)
Summary
460(2)
The Debate Around Legalization
462(12)
Introduction
462(1)
The Debate Over Medicalization
462(1)
The ``War on Drugs'': The Making of a National Disaster
463(10)
Summary
473(1)
Crime and Drug Use
474(13)
Introduction
474(1)
Criminal Activity and Drug Use: Partners in a Dance?
474(2)
Urine Toxicology Testing in the Workplace
476(1)
Unseen Victims of Street Drug Chemistry
477(1)
Drug Analogs: The ``Designer'' Drugs
478(6)
Adulterants
484(1)
Drug Use and Violence: The Unseen Connection
485(1)
Summary
486(1)
Appendix One: Alcohol Abuse Situation Sample Assessment 487(3)
Appendix Two: Chemical Dependency Situation Sample Assessment 490(3)
Appendix Three: The ``Jellinek'' Chart for Alcoholism 493(2)
Appendix Four: Drug Classification Schedule 495(1)
Glossary 496(9)
References 505(66)
Index 571


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