Concise Guide to Treatment of Alcoholism and Addictions

by Mack, Avram H., M.D.

• ISBN13: 9780880488037
• ISBN10: 0880488034
• Edition: 2nd
• Format: Paperback
• Copyright: 2001-05-01
• Publisher: Amer Psychiatric Pub Inc

Summary

This book is grounded in both the central importance of the doctor-patient relationship and in the empirically based DSM-IV-TR, systematically detailing all definitions and disorders within the entire addiction section. It also presents the latest research findings, including epidemiology data, treatment recommendations that address the newest medications and psychosocial therapeutic modalities, and entirely new tables and references. Its relevance is further enhanced by the experience of all three authors, who treat addictions and their complications daily in both inpatient and outpatient clinical settings.

Author Biography

Avram H. Mack, M.D., is a physician at The Brigham and Women's Hospital and Clinical Fellow at Harvard Medical School in Boston, Massachusetts.

John E. Franklin Jr., M.D., M.Sc., is Associate Professor of Psychiatry and Director of Addiction Psychiatry at Northwestern University School of Medicine in Chicago, Illinois.

Richard J. Frances, M.D., is President and Medical Director of Silver Hill Hospital in New Canaan, Connecticut; Clinical Professor of Psychiatry at New York University; and Adjunct Professor of Psychiatry at the University of Medicine and Dentistry of New Jersey in Newark, New Jersey.

Table of Contents

Introduction to the Concise Guides Series	xiii
Preface	xv
Introduction	1	(8)
General Tenets of the Treatments of SUDs	2	(1)
The Therapeutic Alliance	3	(4)
Potential Abuses in the Treatment of SUDs	7	(1)
References	7	(2)
Magnitude of the Problem	9	(18)
General Epidemiology	9	(1)
Facts of General Magnitude	9	(1)
Societal Cost	10	(1)
Alcohol	11	(1)
Cocaine	12	(1)
Amphetamines	13	(1)
Opioids	14	(1)
Tobacco	15	(1)
Phencyclidine and Ketamine	16	(1)
Hallucinogens	16	(1)
Marijuana	17	(1)
Inhalants	18	(1)
Sedatives, Hypnotics, and Anxiolytics	18	(1)
Polysubstance Problems	19	(1)
Underlying Issues Affecting Addiction Magnitude	20	(4)
References	24	(3)
Developmental Issues in the Field	27	(16)
The Disease Concept	27	(2)
Neurobiology of Addictions: Clinical Implications of Research Findings	29	(3)
Cellular Pathophysiology of Addiction	32	(1)
Prevention Efforts	33	(6)
Treatment Issues	39	(1)
References	40	(3)
Definition, Presentation, and Diagnosis	43	(38)
Nosology	43	(1)
DSM-IV Context	43	(1)
Generic Definitions and Diagnosis	44	(2)
Substance-Induced Disorders	46	(3)
Alcohol	49	(5)
Sedatives, Hypnotics, and Anxiolytics	54	(2)
Opioids	56	(2)
Cocaine	58	(4)
Amphetamines	62	(1)
PCP and Ketamine	63	(2)
Hallucinogens	65	(2)
Cannabis	67	(2)
Nicotine	69	(1)
Inhalants	70	(1)
Caffeine	71	(1)
Other (or Unknown) Substance-Related Disorders	72	(1)
Polysubstance Dependence	73	(1)
Drug Combinations	73	(1)
Making a Diagnosis	74	(2)
Psychiatric Comorbidity	76	(3)
References	79	(2)
The Front Line: Detecting and Approaching Substance Abuse in the General Hospital and in the Workplace	81	(14)
The General Hospital	81	(2)
Psychiatric Consultation to General Floors and the Emergency Department	83	(6)
The Workplace	89	(4)
References	93	(2)
Laboratory Findings and Diagnostic Instruments	95	(12)
Rationale for Testing	95	(1)
Laboratory Findings: Urine and Blood Screens	95	(1)
Selection of Toxicological Tests and Pharmacokinetics	96	(3)
Interpreting Test Results	99	(1)
Diagnostic Instruments	100	(5)
References	105	(2)
Natural Histories of Substance Abuse	107	(16)
Alcohol	107	(3)
Sedatives, Hypnotics, and Anxiolytics	110	(1)
Opioids	111	(2)
Cocaine	113	(2)
Amphetamines	115	(1)
Phencyclidine/Ketamine	116	(1)
Hallucinogens	116	(1)
Cannabis	117	(1)
Nicotine	118	(1)
Inhalants	119	(1)
References	120	(3)
Treatment Approaches for Substance Use Disorders	123	(48)
Abstinence	123	(1)
Achieving Recovery	123	(4)
Treatment Settings	127	(1)
Clinical Situations	128	(6)
Intoxication	134	(2)
Alcohol Withdrawal	136	(7)
Opioids	143	(5)
Cocaine, Cannabis, Hallucinogens, and Inhalants	148	(1)
Nicotine	149	(1)
Polysubstance Abuse	149	(1)
Treatment Modalities	150	(14)
Special Issues in Treatment	164	(3)
References	167	(4)
Treatment Approaches in Specific Populations	171	(24)
Women	171	(5)
Children and Adolescents	176	(6)
The Elderly	182	(3)
Chronic Patients, Disabled Patients, and Homeless Patients	185	(3)
Minorities	188	(3)
References	191	(4)
Index	195