Healing Addiction An Integrated Pharmacopsychosocial Approach to Treatment

by Martin, Peter; Weinberg, Bennett Alan; Bealer, Bonnie K.

• ISBN13: 9780471656302
• ISBN10: 0471656305
• Edition: 1st
• Format: Paperback
• Copyright: 2006-10-27
• Publisher: Wiley

Summary

In this groundbreaking book, the authors, including a nationally recognized addiction researcher, advocate the benefit of using psychopharmacological medications alongside more traditional treatment approaches. In addition, Healing Addiction reconciles the mismatch between scientific knowledge and treatment and bridges the gap between researchers and the self-help community.

Author Biography

Peter R. Martin, MD, is Professor of Psychiatry and Pharmacology at Vanderbilt University School of Medicine and Director of the Division of Addiction Medicineat Vanderbilt.

Bennett Alan Weinberg, Esq, is a medical and science writer, pharmaceutical educator, and attorney. He is the author, with Bonnie Bealer, of The Caffeine Advantage.

Bonnie K. Bealer is a researcher, writer, and editor.

Table of Contents

Foreword	xi
Preface by Peter R. Martin, M.D.	xv
Preface by Bennett Alan Weinberg, Esq., and Bonnie K. Bealer	xxi
Acknowledgments	xxiii
Part I Out of Control: The Biopsychosocial Model of the Causes of Addiction
1 The Many Faces of Addiction	3	(12)
Who Is the Addict?	6	(2)
Symptoms of Addiction	8	(1)
Stages of Addiction	9	(1)
Primary and Secondary Addiction	10	(5)
2 The Historical Development of Drug Addiction	15	(7)
Changing Attitudes about Psychoactive Substances	16	(2)
Epidemiology: The Prevalence of Drug Use	18	(4)
3 Addiction as a Disease	22	(10)
The Drive to Use Drugs	23	(2)
Drugs and the Chemical Systems of the Brain	25	(1)
Neuroadaptation	26	(3)
Complications of Drug Abuse	29	(3)
4 Biopsychosocial Factors in Addiction	32	(9)
Biological Factors: Brain Chemistry	33	(1)
Psychological Factors	34	(1)
Social Factors	35	(1)
Biopsychosocial Factors and the Typical Course of Addiction	36	(5)
Part II The Integrated Approach: Pharmacopsychosocial Treatment of Addiction as a Bona Fide Mental Illness
5 The Players: Psychiatrists and Other Physicians, Therapists, Social Workers, Clergy, Family and Friends, and Support Groups	41	(11)
Addiction and Co-Occurring Psychiatric Conditions	43	(3)
Importance of Pharmaceuticals in Treatment	46	(2)
Advice to Caregivers: "Above All, Do No Harm!"	48	(4)
6 Identification and Diagnosis: Why Is It Difficult to Recognize Addiction?	52	(3)
7 Initiating Treatment	55	(11)
What Can the Family Do, and Why Is the Family Invaluable in Recovery?	58	(3)
How Should Treatment Continue after Detoxification or Stabilization?	61	(1)
Healing: When Treatment Requires Professional Supervision	62	(4)
8 Treatment Programs	66	(13)
Inpatient or Outpatient Treatment: Which Is More Effective or Gives the Better Value for the Money?	66	(2)
Who Really Decides What Treatment Is Best?	68	(2)
Psychosocial Treatment Programs	70	(2)
Medical Model	72	(2)
Safety of Medications in the Treatment of Primary Addiction: Why Become Addicted to a Doctor-Prescribed Medicine?	74	(5)
Part III Gaining Understanding: Treating Drug Addictions
9 Alcohol	79	(17)
The Case of Joe A.	81	(3)
Pharmacology	84	(1)
Chemical Considerations	85	(1)
Absorption, Distribution, and Elimination	86	(1)
Drug Interactions	87	(1)
Medical Complications	87	(5)
Other Issues Related to Treating Alcoholism	92	(2)
Alcoholism as a Paradigm for Understanding Drug Addiction	94	(2)
10 Heroin and Other Morphine-Related Drugs	96	(8)
Intoxication	96	(2)
The Case of Bob R.	98	(2)
Drug-Seeking Behavior: Sought-After Effects	100	(1)
Neuroadaptation	101	(3)
11 CNS Depressants: Barbiturates, Benzodiazepines, and Other Hypnotics and Tranquilizers	104	(11)
Patterns of Use	107	(1)
The Case of Mike R.	108	(3)
Drug-Seeking Behavior: Sought-After Effects	111	(1)
Neuroadaptation	111	(4)
12 Stimulants: Cocaine and Amphetamines	115	(11)
Pharmacology	116	(2)
Amphetamines, Including Methamphetamine	118	(1)
The Case of Roy T.	119	(2)
Patterns of Use	121	(1)
Drug-Seeking Behavior: Sought-After Effects	122	(1)
Neuroadaptation	122	(2)
Medical and Other Complications	124	(2)
13 Marijuana and Tobacco	126	(13)
Gateway Drug?	128	(2)
The Case of John T.	130	(2)
Patterns of Use	132	(1)
Intoxication	133	(1)
Pharmacology	134	(1)
Absorption, Distribution, Metabolism, and Excretion	134	(1)
Endocannabinoid System	134	(1)
Medical Complications	135	(1)
Note on Tobacco	136	(3)
Part IV Gaining Understanding: Treating Behavioral Addictions
14 What Are Behavioral Addictions?	139	(10)
The Case of Marilyn B.	144	(1)
Sex Addiction: Problematic Hypersexuality	145	(1)
The Case of Alex T.	146	(3)
15 Pathological Gambling	149	(11)
Epidemiology	151	(1)
The Case of John C.	152	(3)
Gambling Addiction: Behavioral Characteristics	155	(1)
Neuroadaptation?	156	(4)
16 Food	160	(23)
Hardwiring the Brain	163	(2)
Pleasure and Pain	165	(1)
Obesity	166	(6)
Anorexia Nervosa	172	(2)
Bulimia Nervosa	174	(2)
Summary and Comparison of the Eating Disorders	176	(1)
Epidemiology	177	(1)
Neuroadaptation: Tolerance, Dependence, and Withdrawal?	178	(5)
Part V Recovery as an Ongoing Process: Control Is Never Complete
17 Criteria for Treatment Success	183	(2)
18 Entering a New Life	185	(5)
Denial and "Slips"	186	(1)
Continuing Relationship with the Physician or Therapist	187	(1)
Should Recovering Addicts Become Treatment Professionals?	188	(2)
19 Managing Long-Term Treatment	190	(35)
Recovery Requires Maintaining Health	190	(1)
Honesty with the Primary Care Doctor Helps Both Patient and Doctor	191	(1)
The Primary Care Doctor: Partner in Recovery and Point Man of the Recovery Net	192	(1)
Beware of the Quickly Drawn Pen and the Ever-Ready Prescription Pad	193	(1)
Denial Is Incompatible with Recovery—Healing Requires Acceptance of Addiction(s)	194	(1)
Responsible Recovery—The Blame Game Helps No One	194	(1)
Drugs Are Not Dangerous—People Who Take Drugs Can Make Them Dangerous	195	(4)
Mutual Trust, Respect, and Open Communication in the Physician–Patient Relationship	199	(2)
Recovery Is More than Abstinence	201	(3)
Pharmacopsychosocial Treatment Knits a Strong Recovery Safety Net	204	(3)
Peer Mutual Support Fellowship: A Safe Haven in the Storm of Addiction	207	(1)
Recovery Requires Self-Examination—with Help from Others Who Care about the Recovering Addict	208	(2)
Professional Guidance on the Journey from Active Addiction to Recovery	210	(3)
Psychotherapy with a Professional Is Highly Compatible with a 12-Step Program	213	(3)
How Does a Professional Help Recovering Addicts Understand Themselves Better and Enable Them to Heal Their Addiction?	216	(1)
Addiction as a Way to Cope?	217	(2)
Despondency During Recovery	219	(1)
Wanting to Do Things Differently	220	(1)
Setting Priorities in Order to Do Things Differently	220	(2)
How to Make Changes after Determining Priorities	222	(1)
Recovery Means Understanding the Role of Fundamental Emotions in Addiction, Such as Trust and Shame	222	(3)
Appendix A Glossary of Terms	225	(9)
Appendix B Helpful Web Sites	234	(2)
Appendix C Epidemiological Tables	236	(2)
Appendix D Pharmacological Treatment of Withdrawal Syndromes from Substances of Abuse	238	(2)
Appendix E Pharmacological Maintenance Strategies for Substance Dependence after Detoxification Is Completed	240	(1)
Bibliography	241	(2)
Index	243	(4)
About the Authors	247