دانلود کتاب TEXTBOOK OF ADDICTION TREATMENT : international perspectives.

فهرست مطالب :

Preface: An International Perspective and Its Evolution
Sociocultural, Neurological, and Genetic Foundations
The Global Facets of Drug Use and the Current Trends in Biological Approaches
Behavioral Approaches and the Balance of Fidelity and Adaptation
Screening and Major Components of a Systems Approach
Policies and Training in Addiction
What Constitutes a Behavioral Addiction?
The Recognition of Medical Consequences and Comorbidities
The Co-occurring Care of Substance Use and Psychiatric Disorders and System Change
The Dilemmas of Special Populations
Meeting the Needs of Our Youth
Acknowledgments
Contents
Contributors
Part I: Basic Sciences and Clinical Foundations
1: Basic Sciences and Clinical Foundations: An Introduction
References
2: Neurobiology of Alcohol Dependence
2.1 Introduction
2.2 Dispositional Factors for the Development of Alcohol Dependence
2.2.1 Level of Response to Alcohol
2.3 Addiction and the Reward System
2.3.1 Disentangling “Liking” from “Wanting”
2.3.2 Dopamine in Mediating Learning Effects
2.3.3 Incentive Salience Theory of Addiction
2.3.4 Habitual Drug Seeking
2.4 Consequences of Chronic Alcohol Consumption
2.4.1 Neuroadaptive Dopaminergic Changes
2.4.2 Neuroanatomical Alterations
2.4.3 Alcohol Tolerance and Withdrawal
2.5 Pharmaco-fMRI: New Insights of Pharmacological Treatment
2.6 Conclusion
References
Glossary
3: Heritability of Alcohol Use Disorder: Evidence from Twin Studies and Genome-Wide Association Studies
3.1 Introduction
3.2 What Is Heritability in Addiction?
3.3 Genome-Wide Association Studies
3.4 Genome-Wide Association Studies in Psychiatric Disease
3.5 Future Directions of Psychiatric Genome-Wide Association Studies
3.6 Potential Markers
Box 3.1 How Can We Estimate Heritability
Twin Studies
Single-Nucleotide Polymorphism Heritability
Polygenic Scores
3.7 Environmental Influences on Heritability
3.7.1 Epigenetic Mechanisms
3.8 Aversive or Stressful Life Experience
References
4: Animal Models of Addiction
4.1 Introduction
4.2 The Cycle of Addiction
4.3 Animal Models of the Various Stages in the Cycle of Addiction
4.3.1 Preexisting Vulnerability to Addiction
4.3.2 Addictive Drug Self-Administration
4.3.3 Intoxication and the Drug-Induced “High”
4.3.3.1 The Brain’s Reward Circuitry
4.3.3.2 The Intense Nature of Brain Stimulation Reward
4.3.3.3 Dopamine: The Crucial Reward Neurotransmitter
4.3.4 Moderate Addictive Drug Use Versus Extended Access, Augmented Incentive Motivation for Drug Use, and Enhanced Reward Value of Addictive Drugs
4.3.5 Compulsive Drug Use
4.3.6 The “Opponent Process” Trap
4.3.7 Drug Withdrawal and Negative Affect: Additional Drivers of Relapse to Drug-Seeking and Drug-Taking
4.3.8 Animal Models of Relapse
4.3.8.1 Extinction-Based Relapse Models
Relapse Based on Operant Response Extinction
Relapse Based on Pavlovian Response Extinction
4.3.8.2 Abstinence-Based Relapse Models
Forced Abstinence by Removal from the Drug-Taking Environment
Incubation of Craving
Voluntary Abstinence Induced by Adverse Consequences of Drug Use
4.4 Conclusion
References
5: Burden of Disease: The Epidemiological Aspects of Addiction
5.1 The Transition into a Substance Use Disorder
5.2 The Global Burden of Disease Associated with Substance Use Disorders
5.2.1 Methodology and Limitations of the Burden of Disease Estimations
5.2.2 Global Burden of Substance Use Disorders and Regional Differences
Appendix
References
6: Cultural Aspects and Responses to Addiction
6.1 Introduction
6.2 Cultural Expectations About and Definitions of Psychoactive Substances and Their Effects
6.3 Norms Concerning Use and Related Behaviour
6.4 Cultural Factors in Responses to Substance Use
6.5 Intercultural Influences and Diffusion
References
7: Prevention Strategies
7.1 Introduction
7.1.1 Factors for the Development of Problem Drug Use
7.1.2 An Overarching Model for Prevention
7.1.3 Considerations for Practice
7.2 Prevention Strategies: Definitions and Effects
7.2.1 Mass Media Campaigns
7.2.2 Environmental Prevention
7.2.2.1 Environmental Influences in Schools and Communities
7.2.2.2 Environmental Influences in Nightlife
7.2.2.3 Environmental Influences within Families
7.2.2.4 Environment, Social Norms, and Substance Use
7.2.3 Universal Prevention: Intervening with Populations
7.2.4 Selective Prevention: Intervening with (Vulnerable) Groups
7.2.5 Family-Based Prevention: Universal and Selective
7.2.6 Indicated Prevention: Intervening with (Vulnerable) Individuals
7.2.7 Considerations for Practice
7.2.8 Transfer of Prevention Technologies
7.3 Conclusion
7.3.1 Prevention, Treatment, and Harm Reduction
7.3.2 Conceptual Developments
7.3.3 Implementation
References
Further Reading
8: Diagnostic Definitions and Classification of Substance Use Disorders
8.1 Introduction and Background
8.1.1 Introduction
8.1.2 The Range of Addictive Substances
8.1.3 Mechanisms Underlying Repetitive Substance Use
8.2 Concepts of Substance Use Disorders
8.2.1 Personality Disorder
8.2.2 The Disease Concept
8.2.3 Epidemiological and Sociological Formulations
8.2.4 Learnt Behaviour
8.2.5 Clinical Syndrome
8.2.6 Neurobiological Disorder
8.2.7 Genetic Influences
8.3 Diagnoses Applied to Use of Psychoactive Substances in DSM-IV, DSM-5, ICD-10 and ICD-11
8.3.1 Overview
8.3.1.1 Substance Intoxication (ICD-10, ICD-11, DSM-IV, DSM-5) (See Table 8.2)
8.3.1.2 Episode of Harmful Use of a Substance
8.3.1.3 Repetitive Substance Use which Does Not Fulfil Dependence Criteria
Hazardous Substance Use (ICD-11)
Harmful Substance Use (ICD-10) or Harmful Pattern of Substance Use (ICD-11)
Substance Abuse (DSM-IV)
8.3.1.4 Substance Dependence (DSM-IV and ICD-10; ICD-11)
8.3.1.5 Substance Use Disorder (DSM-5)
8.3.1.6 Other Definitions of Dependence or Addiction
8.3.1.7 Substance Withdrawal (DSM-IV, DSM-5, ICD-10 and ICD-11)
8.3.1.8 Substance-Induced Disorders
Substance-Induced Mental and Neurocognitive Disorders (DSM-IV, DSM-5, ICD-10 and ICD-11)
Substance-Induced or Substance-Related Physical Disorders
Substance-Related Social Problems
References
Part II: Drugs of Abuse and Pharmacotherapies for Substance Disorders
9: Drugs of Abuse and Pharmacotherapies for Substance Use Disorders: Introduction
9.1 Introduction
9.2 Use/Abuse of Legal Substances
9.3 Illegal or Medically Prescribed but Misused Drugs
References
10: Pharmacological Treatment of Alcohol Use Disorder
10.1 Introduction
10.2 Approved Pharmacological Treatments
10.2.1 Disulfiram
10.2.1.1 Mechanism of Action
10.2.1.2 Efficacy
10.2.1.3 Administration
Dose and Regimen
Contraindications
Side Effects
10.2.2 Naltrexone
10.2.2.1 Mechanism of Action
10.2.2.2 Efficacy
10.2.2.3 Administration
Dose and Regimen
Contraindications
Side Effects
10.2.3 Acamprosate
10.2.3.1 Mechanism of Action
10.2.3.2 Efficacy
10.2.3.3 Administration
Dose and Regimen
Contraindications
Side Effects
10.2.4 Nalmefene
10.2.4.1 Mechanism of Action
10.2.4.2 Efficacy
10.2.4.3 Administration
Dose and Regimen
Contraindications
Side Effects
10.2.5 Comparison of Approved Treatments
10.3 ‘Off-Label’ Pharmacological Treatments
10.3.1 Topiramate
10.3.2 Gabapentin
10.3.3 Baclofen
10.4 Other Pharmacological Agents Under Investigation
10.5 Choice of Pharmacotherapy
10.6 Predictors of Treatment Response
10.7 Conclusion
References
11: Benzodiazepine and Nonbenzodiazepine Hypnotics (Z-Drugs): The Other Epidemic
11.1 Scope of the Problem
11.2 Pharmacology of Benzodiazepines and Other BZD-Site Agonists
11.3 Pharmacokinetic
11.4 Clinical Indications for BZDs and Z-Drugs
11.5 Problems Related to the Long-Term Use of BZDs
11.6 BZD Use Disorders
11.7 BZD Withdrawal Syndrome
11.8 BZD Use in Specific Populations
11.8.1 Adolescents and Young Adults
11.8.2 Elderly
11.8.3 Women
11.8.4 Polysubstance Users
11.8.5 Drug-Facilitated Sexual Assault (DFSA)
11.9 Treatment of BZD Use Disorders
11.9.1 Intervention and BZD Detoxification
11.9.2 Adjuvant Medications for BZD Withdrawal Treatment
11.9.3 Pharmacologic Treatment of Underlying Conditions
11.9.4 Non-pharmacologic Treatment of BZD Use Disorders
11.10 Prevention of BZD UD
11.10.1 Awareness of Professional Guidelines
11.10.2 Screening
11.10.3 Patient Education
11.10.4 Monitoring Patients Receiving BZD Prescriptions
11.11 Conclusions
References
12: Cannabis Use Disorder and Its Treatment
12.1 Introduction
12.2 Pharmacology and Phenomenology
12.2.1 Cannabis Use
12.2.2 Cannabis Use Disorder
12.3 Treatment for Cannabis Misuse and CUD
12.4 Digital Health Interventions
12.5 Brief Interventions
12.6 Pharmacotherapies for CUD
12.7 Conclusions and Future Directions
References
13: Cocaine Addiction and Treatment
13.1 Introduction
13.2 Overview of Pharmacological Treatment
13.3 Medication Options
13.3.1 Antidepressants
13.3.2 Dopamine Agonists (Antiparkinson Agents)
13.3.3 Disulfiram
13.3.4 Stimulants
13.3.5 Antipsychotics
13.3.6 Anticonvulsants
13.3.7 Serotonergic Medications
13.3.8 Cholinergic Medications
13.3.9 Opioid Medications
13.3.10 Other Medications
13.3.11 Medication Combinations
13.3.12 Nutritional Supplements and Herbal Products
13.3.13 Other Physical Treatments
13.4 Special Treatment Situations
13.4.1 Mixed Addictions
13.4.2 Psychiatric Comorbidity
13.4.3 Medical Comorbidity
13.4.4 Gender-Specific Issues
13.4.5 Age
13.5 International Perspectives
13.6 Future Prospects
13.7 Conclusion
References
14: Pharmacotherapy of Addiction to Amphetamine-Type Stimulants
14.1 Introduction
14.2 Pharmacology
14.3 Health Consequences
14.3.1 Treatment of Addiction to ATS
14.3.2 Agonist Medications
14.3.3 Antagonist Medications
14.3.4 Other Medications
14.4 Future Medication Options
14.5 In Summary
References
15: Nicotine and Tobacco
15.1 Introduction: Epidemiology of Tobacco Use
15.2 Biology of Nicotinic Receptors
15.3 Clinical Effects of Nicotine and Tobacco
15.4 Electronic Cigarettes
15.5 Psychosocial Treatments (See Table 15.1)
15.6 Pharmacological Treatments (See Table 15.1)
15.6.1 Nicotine Replacement Therapies
15.6.2 Sustained-Release Bupropion
15.6.3 Varenicline
15.6.4 Off-Label Medications
15.7 Integration of Tobacco Use Disorder Treatment into Mental Healthcare Settings
15.8 Conclusions
References
16: Addiction to Caffeine and Other Xanthines
16.1 Introduction
16.2 Caffeine and Methylxanthines
16.3 Caffeine, Coffee, Tea, and Energy Drinks
16.4 Main Effects of Caffeine
16.5 Risks of Caffeine Use
Acute Risks
16.6 Chronic Risks of Caffeine Use
Caffeine Dependence and Addiction
16.6.1 Other Chronic Risks
16.7 Benefits of Methylxanthine
16.7.1 Caffeine
16.7.2 Theophylline
16.7.3 Theobromine
16.7.4 Caffeine Abuse Treatment
16.8 International Perspectives
16.9 Conclusion
References
Further Reading
17: Khat Addiction
17.1 Introduction
17.2 The Khat Controversy
17.3 From a Niche Crop to a Cash Crop
17.4 Development from Traditional Use to Binge Patterns
17.5 What Is Known About Khat Addiction?
17.6 Measurement and Diagnosis of Khat Addiction
17.7 Neurocognitive Deficits and Comorbid Disorders
17.8 Comorbid Disorders
17.9 Treatment of Khat Addiction
17.10 Conclusion
References
Further Reading
18: Opioid Addiction and Treatment
18.1 Introduction
18.2 Pharmacology of Opioids
18.2.1 Morphine
18.2.2 Diacetylmorphine (Diamorphine, Heroin)
18.2.3 Methadone
18.2.4 Codeine
18.2.5 Buprenorphine
18.2.6 Fentanyl
18.2.7 Oxycodone
18.2.8 Tramadol
18.2.9 Naloxone
18.2.10 Naltrexone
18.2.11 Nalmefene
18.3 Opioid-Related Disorders
18.4 Treatment of Opioid-Related Disorders
18.4.1 Opioid Acute Intoxication
18.4.2 Opioid Withdrawal
18.4.3 Opioid Use Disorder
18.4.3.1 Abstinence-Oriented Treatments
18.4.3.2 Detoxification
18.4.3.3 Continued Total Abstinence
18.4.3.4 Medication Assisted Treatment: Opioid Substitution Treatments (OST)
Methadone Maintenance Treatment (MMT)
(R)-Methadone Maintenance Treatment
Buprenorphine Maintenance Treatment
Slow-Release Oral Morphine (SROM)
Diacetylmorphine (Diamorphine, Heroin) Maintenance
18.4.3.5 Psychosocial Interventions in Opioid Use Disorder
18.4.3.6 Harm Reduction Strategies
18.5 Conclusion
References
19: Addiction of Hallucinogens, Dissociatives, Designer Drugs and “Legal Highs”: Update on Potential Therapeutic Use
19.1 Introduction
19.2 Classical Hallucinogens
19.2.1 Origin and Synthesis
19.2.2 Epidemiology and Pattern of Consumption
19.2.3 Mechanism of Action
19.2.4 LSD
19.2.5 Hallucinogen Use Disorder
19.2.6 Intoxication of Hallucinogens
19.2.7 Hallucinogen Persisting Perception Disorder
19.2.8 Persistent Psychosis Related to Mental Illness
19.2.9 Hallucinogen-Induced Affective Disorders
19.2.10 Somatic Complications of Hallucinogens
19.2.11 Treatment of Hallucinogen Use Disorder
19.2.12 Mescaline
19.2.13 Tryptamines
19.2.14 Dextromethorphan
19.2.15 Salvia divinorum
19.2.16 Ayahuasca
19.2.17 Ibogaine
19.3 Dissociatives
19.3.1 Phencyclidine
19.3.2 Ketamine
19.4 Designer Drugs and “Legal Highs”: MDMA and New Psychoactive Substances
19.4.1 Definitions
19.4.2 Origin and Synthesis
19.4.3 Epidemiology and Pattern of Consumption
19.4.4 Pharmacological Properties and Consequences of the Use of MDMA (Ecstasy)
19.4.5 Consequences of the Use of “Legal Highs” and New Psychoactive Substances
19.5 Update on Therapeutic Use of Hallucinogens
19.5.1 LSD
19.5.2 Psilocybin
19.5.3 MDMA
19.5.4 Esketamine
19.5.5 Ayahuasca
19.6 Conclusion
References
20: Inhalant Addiction
20.1 Definition and Classification
20.2 Disorders Due to Use of Volatile Inhalants in ICD-11
20.3 Epidemiology: How Widespread Is Its Use?
20.4 Use Among Special Populations
20.5 Patterns of Use
20.6 Health Effects
20.6.1 Acute Effects
20.6.2 Chronic Effects
20.6.3 Prenatal Effects
20.6.4 Molecular Effects
20.6.5 Morbidity and Mortality
20.7 Correlates
20.8 Prevention
20.9 Treatment
20.9.1 Recovery Potential and Treatment
20.10 Evaluation of Biomedical Conditions and Their Complications
20.10.1 Physical Exam
20.10.2 Evaluation of the Presence of Cognitive Impairment: Mini-Mental State Examination
20.10.3 History and Current Status of Substance Use
20.10.4 Evaluation Instruments
20.11 Psychiatric Medical Evaluation
20.11.1 Subtypes of Consumers of Inhalable Solvents
20.11.2 Comorbid Mental Disorders
20.11.3 Anxiety Disorders
20.11.4 Affective Disorders
20.11.5 Psychotic Disorders
20.11.6 Personality Disorders
20.12 Exploration of Medical Complications
20.12.1 Kidney
20.12.2 Kidney Tubular Acidosis
20.12.3 Other Organs and Tissues
20.12.4 Heart
20.12.5 Pregnancy
20.12.6 Fetal Solvent Syndrome
20.13 Psychiatric Medical Intervention
20.13.1 Pharmacological Management of Disorders Due to the Use of Solvents
20.13.2 Management of Damage to Organs and Systems
20.13.3 Policy Options
References
21: Anabolic Steroid Use Disorders: Diagnosis and Treatment
21.1 Introduction
21.2 Epidemiology of AAS Use
21.3 Adverse Effects of Long-Term AAS Use
21.4 AAS Dependence Syndromes
21.5 Treatment of AAS Abuse and Dependence
21.6 Treatment of AAS-Associated Psychiatric Syndromes
21.7 Conclusion
References
22: Prescription Drug Abuse: Risks, Diversion, and Prevention
22.1 Introduction
22.2 Epidemiology of Prescription Drug Abuse
22.2.1 Monitoring Populations or Patients
22.2.2 Monitoring Sources of Drugs
22.3 Prescription Drugs of Abuse
22.3.1 Sedative Drugs
22.3.1.1 Analgesics
22.3.1.2 Central Stimulants
22.3.1.3 Other Drugs
22.4 Terminology and Diagnosis
22.5 Strategies for Prevention
22.6 Treatment
22.7 Brief Summary
References
Part III: Behavioural Approaches
23: Behavioral Approaches: An Introduction
23.1 Introduction
23.2 Summary
24: Motivational Interviewing, Behaviour Change in Addiction Treatment
24.1 Introduction
24.2 Addiction and Choice Theories of Behaviour Change
24.3 Theories of Motivation
24.3.1 Trans-theoretical Model of Change
24.3.2 Identity Shift Theory
24.3.3 PRIME Theory of Motivation
24.4 About Ambivalence
24.5 What Is Motivational Interviewing?
24.6 How to Create Atmosphere for Change?
24.7 The Processes and Skills in MI
24.7.1 Engaging
24.7.2 Focusing
24.7.3 Evoking
24.7.4 Planning
24.7.4.1 Express Empathy
24.7.4.2 Develop Discrepancy
24.7.4.3 Avoid Argument
24.7.4.4 Roll with Resistance
24.7.4.5 Support Self-Efficacy
24.8 About Information and Advice
24.9 How Effective Is Motivational Interviewing for Substance Use Disorders?
24.10 Clinical Relevance
24.11 Conclusion
References
25: Cognitive Behavioural Therapies for Alcohol and Other Drug Use Problems
25.1 Introduction
25.1.1 What Is Cognitive Behavioural Therapy and Where Did It Come from
25.2 Assumptions Behind Cognitive Behavioural Therapies
25.2.1 Thoughts, Behaviours and Emotions Are Learned
25.2.2 Therapeutic Alliance Is a Necessary but Not Sufficient for Change
25.2.3 Focus on the Here and Now
25.2.4 The Client as Their Own Therapist and the Importance of Homework
25.2.5 Guided Discovery as a Self-Reflection Tool
25.2.6 The Scientist-Practitioner Approach and Collaborative Empiricism
25.3 Cognitive Behavioural Therapy in Practice
25.3.1 Length
25.3.2 Structure
25.4 Key Cognitive Behavioural Therapies for Alcohol and Other Drug Problems
25.4.1 Relapse Prevention
25.4.2 Cognitive Therapy
25.4.3 Coping Skills Therapy
25.4.4 Mindfulness-Based Cognitive Behavioural Approaches
25.5 Variations in Cognitive Behavioural Therapies for Alcohol and Other Drug Problems
25.5.1 Brief Cognitive Behavioural Therapies
25.5.2 Low-Intensity Cognitive Behavioural Therapies
25.5.3 Digital Cognitive Behavioural Therapies
25.6 The General Application of Cognitive Behavioural Therapies to Alcohol and Other Drug Treatment
25.6.1 A General Cognitive Behavioural Model for Alcohol and Other Drug Disorders
25.6.2 Triggers
25.6.3 Thoughts and Beliefs
25.6.4 Feelings
25.6.5 Behaviour
25.7 International Considerations
25.8 Summary
References
Key Reading
26: Psychodynamic Psychotherapy for the Treatment of Substance Use Disorders
26.1 Introduction
26.2 Addiction as a Self-Regulation Disorder
26.2.1 Disordered Emotions
26.2.2 Disordered Relations with Self and Others
26.2.3 Disordered Self-Care
26.3 Implications for Psychodynamic Psychotherapy
26.4 Summary and Conclusion
References
27: Mindfulness-Based Approaches in Addiction Treatment
27.1 Introduction
27.2 Mindfulness
27.3 Mindfulness-Based Interventions
27.3.1 Mindfulness-Based Stress Reduction (MBSR)
27.3.2 Mindfulness-Based Cognitive Therapy (MBCT)
27.3.3 Dialectical Behavioral Therapy (DBT)
27.3.4 Acceptance and Commitment Therapy (ACT)
27.3.5 Mindfulness-Based Relapse Prevention (MBRP)
27.3.6 Mindfulness-Oriented Recovery Enhancement (MORE)
27.4 Effectiveness of Mindfulness-Based Interventions for SUD-Related Issues
27.4.1 Heterogenous Substance Use Disorders
27.4.2 Tobacco Use Disorder
27.4.3 Alcohol Use Disorder
27.4.4 Opioid Use Disorder
27.5 Conclusion
References
28: A Trauma-Informed Approach to Enhancing Addiction Treatment
28.1 ACE Study
28.2 Women with Co-occurring Disorders and Violence Study (WCDVS)
28.3 Why Attend to Trauma in Substance Abuse Treatment System
28.4 Trauma-Specific Interventions
28.5 Trauma-Informed Practice
28.6 What Does a Trauma-Informed Program Look like?
28.7 Screening
28.8 Intake/Reception Procedures
28.9 Reducing Re-Traumatization in Substance Abuse Treatment
28.10 Staff Care/Self-Care
References
29: Contingency Management as a Behavioral Approach in Addiction Treatment
29.1 Introduction
29.2 Underlying Logic of CM Approaches
29.3 Prototypic Examples
29.4 Key Factors
29.5 Barriers
29.6 Combining Experimental Technologies with Incentives for Behavior Change Remotely Monitoring Outcomes
29.7 Attendance and Medication Adherence Technologies
29.8 Limitations
29.9 Conclusion
References
30: Group Therapy for Substance Use Disorders
30.1 Introduction
30.2 Is Group Therapy Effective for the Treatment of SUDs?
30.2.1 Comparing Group Therapy to Treatment-As-Usual or No Group Therapy
30.2.2 Adding Group Therapy to Pharmacotherapy
30.3 Is Group Therapy as Good as Individual Therapy?
30.4 What Types of Group Therapy Are Most Effective?
30.5 Comparing Group Therapies for Co-Occurring Disorders
30.6 How Can We Maximize Outcomes in Group Therapy?
30.6.1 Adjunctive Treatments
30.6.2 Intensity and Group Composition
30.7 Summary and Integration of the Literature
30.7.1 Why Is There So Little Research on Group Therapy for SUDs?
30.7.2 Conclusion
References
31: Couple and Family Therapy in Treatment of Alcoholism and Drug Abuse
31.1 The Concept of Family
31.2 Co-dependence and Enabling
31.3 The Relationship Between Substance Use and Family Maladjustment
31.4 Foundational Frameworks
31.5 Couples Therapy
31.6 Family Therapy Approaches
31.7 Family Treatments for Adolescent Substance Use Disorders
31.8 Barriers to Couple and Family Therapy
31.9 Future Directions
31.9.1 Dissemination
31.9.2 Specific Populations
31.9.3 Mechanisms of Action
31.9.4 Partner- and Family-Involved Treatment in the Context of Stepped Care
31.10 Conclusion
References
32: Network Therapy
32.1 Introduction
32.2 The Network Therapy Technique
32.2.1 Key Elements
32.3 CBT and Social Support
32.3.1 Initial Encounter: Starting a Social Network
32.3.2 Defining the Network’s Membership
32.3.3 Defining the Network’s Task
32.3.4 Use of Pharmacotherapy in the Network Format
32.3.5 Format for Medication Observation by the Network
32.3.6 Meeting Arrangements
32.3.7 Adapting Individual Therapy to the Network Treatment
32.4 Twelve-Step Facilitation (TSF)
32.4.1 General Approach
32.5 Research on Network Therapy
32.5.1 An Office-Based Clinical Trial
32.5.2 Treatment by Psychiatry Residents
32.5.3 Treatment by Addiction Counselors
32.5.4 Use of the Internet
32.5.5 Network Therapy in Buprenorphine Maintenance
32.5.6 Use of Alcoholics Anonymous and Other Self-Help Groups
32.6 Adaptations of Network Therapy Treatment
32.7 Principles of Network Treatment
32.7.1 Start a Network as Soon as Possible
32.7.2 Manage the Network With Care
32.7.3 Keep the Network’s Agenda Focused
References
33: CRA and CRAFT: Behavioral Treatments for Both Motivated and Unmotivated Substance-Abusing Individuals and Their Family Members
33.1 Introduction
33.2 Understanding and Using CRA, A-CRA, and CRAFT
33.2.1 CRA Procedures
33.2.1.1 CRA Functional Analyses
33.2.1.2 Sobriety Sampling
33.2.1.3 CRA Treatment Plan: Happiness Scale and Goals of Counseling
33.2.1.4 Positive Communication Skills
33.2.1.5 Problem-Solving Skills
33.2.1.6 Drink and Drug Refusal Skills
33.2.1.7 Job-Finding Skills
33.2.1.8 Social/Recreational Counseling
33.2.1.9 Relapse Prevention
33.2.1.10 Medication Monitoring
33.2.1.11 Relationship Therapy
33.2.2 CRA Scientific Support
33.2.2.1 CRA and Contingency Management
33.2.2.2 International Considerations
33.2.3 A-CRA Procedures
33.2.3.1 Additional or Modified Procedures
33.2.4 A-CRA Scientific Support
33.2.4.1 International Considerations
33.2.5 CRAFT Procedures
33.2.5.1 Enhancement of the Concerned Significant Other’s Motivation
33.2.5.2 Functional Analysis of IP’s Substance-Using Behavior
33.2.5.3 Domestic Violence Precautions
33.2.5.4 Communication Skills
33.2.5.5 Positive Reinforcement for Clean and Sober IP Behavior
33.2.5.6 Negative Consequences for Substance-Using Behavior
33.2.5.7 Helping CSOs Improve Their Own Lives
33.2.5.8 Inviting the IP to Sample Treatment
33.2.6 CRAFT Scientific Support
33.2.6.1 International Considerations
33.2.7 Conclusion
References
34: Exercise for Substance Use Disorders
34.1 Exercise Is Effective for Medical Conditions and Symptoms
34.2 Exercise Is Effective for Psychiatric Conditions and Symptoms
34.3 Exercise Improves Cognition
34.4 Exercise and Substance Use Disorders
34.4.1 Neurobiology of Exercise and Substance Use Disorders
34.4.2 Exercise for Reducing Substance Use and Preventing Relapse
34.5 Study of Exercise as an Intervention for Methamphetamine Use Disorder
34.5.1 Results from the Exercise Study
34.6 Summary/Conclusion
References
35: Towards Addiction Treatment: Technological Advances & Applying Technology
35.1 Introduction
35.2 How Is Technology Relevant for Substance Use Disorder Treatment?
35.3 Why Should SUD Providers Care?
35.4 How Are Digital Therapeutics Being Used in Substance Use Disorder Treatment?
35.4.1 Digital Treatments Integrated with Traditional Care
35.4.1.1 Intensive Digital Interventions Alongside Care
35.4.1.2 Digital Health Following Brief In-person Interventions
35.4.2 Standalone Digital Treatments
35.4.2.1 Brief Standalone Digital Interventions
35.4.2.2 Intensive Standalone Digital Interventions
35.4.2.3 EMI
35.4.2.4 Gaming Elements
35.5 What Can Help Guide the Use of Digital Therapeutics?
35.6 What Are Concerns and Limitations of Digital Therapeutics?
35.7 Conclusion
References
36: Cultural Adaptation of Empirically Validated Therapies for Treating Drug Dependence: International Considerations
36.1 Introduction
36.1.1 The Case for the Cultural Adaptation of Drug Abuse Treatments
36.1.2 Issues Involving Fidelity and Adaptation
36.1.3 Lessons Learned From the Clinical Trials Network
36.1.4 Intervention Dissemination and Implementation Within Diverse Settings
36.1.5 Cultural Considerations in Drug Abuse Treatment
36.2 Description of Approach
36.2.1 Exemplar of a Tested and Effective Drug Abuse Treatment Program
36.2.2 Cultural Adaptation of the Matrix Model
36.3 Evidence to Support the Approach
36.3.1 Evidence Regarding the Effects of Core Components
36.3.2 Evidence on the Need for Assessing Cultural Factors
36.3.3 Evidence Regarding Engagement and Retention
36.4 International Considerations
36.4.1 General Considerations in Dissemination and Implementation
36.4.2 General Considerations in International Adaptations
36.4.3 Stage Models of Adaptation and Applications Across Cultures
36.4.4 Approaches to International Adaptation
36.5 Conducting a Streamlined Cultural Adaptation: A Five-Stage Model
36.5.1 A Practical Approach to the Cross-Cultural Adaptation of a Treatment Program
36.5.2 General Strategy and Procedures for a Streamlined Intervention Adaptation
36.5.3 Five Basic Stages in a Local or Cultural Adaptation
36.6 Some Recommendations for Adaptation of Drug Abuse EVTs
References
37: Multidisciplinary Management of Acute and Chronic Pain in the Presence of Substance Use Disorder (SUD)
37.1 Introduction
37.2 Substance Use Disorder Complicates the Treatment of Pain
37.3 Diagnosis and Assessment of Addiction in the Pain Treatment Setting
37.4 Acute Pain in Addicted Patients
37.5 Treating Chronic Pain with Opioids
37.6 Treating Chronic Pain in the Setting of Substance Use Disorder
37.7 Problems with Tapering and Stopping Opioids
37.8 Palliative Care in Addicted Patients
37.9 Best Practices for Risk Management
37.10 Cooperation with Allied Providers
37.11 Conclusion
References
Part IV: Main Systems Components in Addictions Treatment
38: Main Elements of a Systems Approach to Addiction Treatment: An Introduction
39: Treatment Systems for Population Management of Substance Use Disorders: Requirements and Priorities from a Public Health Perspective
39.1 Introduction
39.2 Concepts, Requirements, and Priorities
39.2.1 Definitions and Rationale
39.2.2 History and Conceptual Developments
39.2.3 Requirements of an Optimal Treatment System
39.2.3.1 Policies
39.2.3.2 Structural Resources
39.2.3.3 System Qualities
39.2.3.4 Effectiveness and Population Impact
39.2.4 Priorities
39.2.4.1 Service Mapping
39.2.4.2 Estimating Demand for Treatment and Treatment Needs
39.2.4.3 Needs-Based Planning
39.2.4.4 Mutual Help Organizations
39.3 Conclusion
References
40: Screening, Early Detection, and Brief Intervention of Alcohol Use Disorders
40.1 Broadening the Spectrum of Intervention for Alcohol Use Disorders
40.2 The Spectrum of Nondependent Alcohol Use Disorders
40.2.1 Hazardous Alcohol Use (ICD-11)
40.2.2 Harmful Alcohol Use (ICD-10) or Harmful Pattern of Alcohol Use (ICD-11)
40.2.3 Alcohol Use Disorder: Mild (DSM-V)
40.3 Alcohol Dependence (ICD-10, ICD-11, DSM-IV TR)
40.4 Screening
40.5 Development of the AUDIT
40.6 Derivatives of the AUDIT and Alternative Screening Instruments
40.6.1 AUDIT-C
40.6.2 Screening in Special Populations
40.7 Brief Interventions: Background and Evidence
40.8 Implementation of Screening and Brief Intervention in Clinical Practice
40.9 Brief Intervention in Practice: The Techniques
40.10 Electronic Screening and Brief Intervention
Resources
References
41: Clinical Assessment of Alcohol Use Disorders
41.1 Evaluation of Alcohol Use
41.1.1 Clinical Severity of Addiction
41.1.2 Dependence/Withdrawal Symptoms
41.1.3 Craving/Impulsiveness
41.1.4 Self-Efficacy and Expectancy
41.1.5 Motivation to Change
41.2 Psychiatric Comorbidity Assessment
41.3 Neuropsychological Performance
41.4 Psychosocial Functioning and Quality of Life
41.4.1 Disability
41.4.2 Quality of Life
41.4.3 Functioning
References
42: Biological State Marker for Alcohol Consumption
42.1 Introduction
42.1.1 Direct Ethanol Metabolites
42.2 Ethyl Glucuronide
42.2.1 Selected Applications for the Use of EtG
42.2.2 Methodological Aspects
42.2.3 Limitations
42.2.4 Clinical Impact of Ethyl Glucuronide
42.3 Ethyl Sulfate
42.4 Fatty Acid Ethyl Esters
42.5 Phosphatidylethanol
42.5.1 Methodological Aspects
42.5.2 Clinical Applications
42.5.3 Limitations
42.6 Hair Analyses
42.6.1 Other Influencing Factors
42.6.2 Practical Use
42.7 Summary
42.8 Traditional Biomarkers for Alcohol Consumption
42.8.1 Blood Alcohol Content Calculation
42.9 Gamma-Glutamyl Transferase (γ-GT)
42.10 Mean Corpuscular Erythrocyte Volume (MCV)
42.11 Carbohydrate-Deficient Transferrin (CDT)
42.12 Serum Transaminases (ASAT/ALAT)
42.13 HDL Cholesterine and Apolipoprotein
42.14 Cholesteryl Ester Transfer Protein (CETP)
42.15 β-Hexosaminidase
42.16 Methanol (MeOH)
42.17 Acetone and Isopropanol
42.18 Combination of Individual State Markers
42.19 Gamma-Glutamyl Transferase and Carbohydrate-Deficient Transferrin
42.20 Alc Index
42.21 Early Detection of Alcohol Consumption (EDAC) Test
42.22 GGT-ALT Combination
42.23 Conclusion
References
43: Clinical Screening for Illegal Drug Use, Prescription Drug Misuse and Tobacco Use
43.1 Introduction
43.2 Screening in Different Settings
43.2.1 Healthcare Facilities
43.2.1.1 Primary Care
43.2.1.2 Secondary Care
General Medicine
Emergency Medicine
Services for Youngsters
Services for the Elderly
Pain Clinics
Psychiatric Units
Antenatal Care
43.2.2 Medicolegal Practice
43.2.2.1 Criminal Justice System
43.3 Some General Considerations
43.3.1 Ethics
43.3.2 Psychometric Properties
43.3.3 Main Aims of Screening
43.4 Screening Instruments for Substance Use
43.4.1 Instruments Inquiring about the Use of One or More Drugs
43.4.2 Instruments that Ask about the Use of Single Drugs
43.4.2.1 Cannabis
43.4.2.2 Opioids
43.4.2.3 Nicotine
43.4.3 Instruments that Inquire about Multiple Drug-Related Problems and Comorbidity
43.5 Conclusion
References
44: Drug Testing in Addiction Medicine
44.1 Introduction
44.2 Drug Screening and Limitations of Testing
44.3 Clinical Role of Drug Testing in Addiction Practice
44.4 Dealing with a Positive Test Result
44.5 Testing in the Emergency Department
44.6 Point-of-Care Testing
44.7 Saliva/Oral Fluid/Mobile Drug Testing
44.8 Detection Times
44.9 Drug Testing Technologies
44.9.1 Immunoassay
44.9.2 Chromatography and Mass Spectrometry
44.10 Detecting Specific Drug Classes
44.10.1 Amphetamines
44.10.2 Benzodiazepines
44.10.3 Cannabis
44.10.4 Opioids
44.10.5 Morphine, Codeine, and Heroin
44.10.6 Methadone
44.10.7 Fentanyl
44.10.8 Buprenorphine
44.10.9 Cocaine
44.10.10 GHB
44.10.11 Nitrous Oxide
44.10.12 Ketamine and Phencyclidine
44.10.13 Lysergic Acid Diethylamide (LSD)
References
45: Brief Intervention for Illicit Drug Use
45.1 Introduction
45.2 General Approach to Brief Interventions
45.3 Linking to Stage of Behavioral Change
45.4 Assessing Level of Risk
45.4.1 The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
45.4.2 Linking Assessed Risk to a Brief Intervention
45.4.3 The ASSIST-Lite
45.5 Settings for Brief Intervention
Appendix A: WHO - ASSIST V3.1
References
46: Screening and Assessment for People with Substance Use Disorders: A Focus on Developed Countries
46.1 Introduction
46.2 Rationale for Screening and Assessment
46.3 Collaborative Models for Screening and Assessment
46.4 Best Practices for Screening and Assessment
46.4.1 Diversity Lens
46.4.2 Developmental Perspective
46.4.3 Screening
46.4.3.1 Stage 1 Screening: Risk Assessment/Case Finding
46.4.3.2 Stage 2 Screening: Case Definition
46.4.4 Assessment
46.4.4.1 Stage 1 Assessment: Information Gathering and Service Placement
46.4.4.2 Stage 2 Assessment: Case Conceptualization and Comprehensive Treatment Plan
46.4.5 Treatment and Support and Outcome Monitoring
46.4.5.1 Stage 1: Within-Treatment Monitoring
46.4.5.2 Stage 2: Posttreatment Monitoring
46.5 Implementation and Evaluation of Evidence-Based Screening and Assessment
46.6 Conclusion
References
47: Stepped Care Models in Addiction Treatment
47.1 Introduction
47.1.1 A Concept for Patient Placement
47.1.2 Models of Stepped Care
47.1.2.1 From First Line to Intensive Care
47.1.2.2 The ASAM Patient Placement Model
47.1.2.3 MATE: A Model for Patient Assessment and Referral
47.1.3 The Main Elements of Stepped Care Models: A Comparative Overview
47.1.4 The NICE Model of Stepped Care
47.1.5 Evaluation Results and Perspectives
47.2 Further Developments
References
48: Therapeutic Communities for Addictions: Essential Elements, Cultural, and Current Issues
48.1 Introduction
48.2 Essential Elements
48.2.1 The TC Perspective
48.2.1.1 View of Disorder
48.2.1.2 View of the Person
48.2.1.3 View of Recovery
48.2.1.4 View of Right Living
48.2.2 The TC Approach: Community as Method
48.2.3 TC Program Model
48.2.3.1 Social Organization
48.2.3.2 Peers as Role Models
48.2.3.3 Staff Members as Rational Authorities
48.2.3.4 Therapeutic Educational Activities (Groups and Individual Counseling)
48.2.3.5 Community Enhancement Activities (Meetings)
48.2.3.6 Community and Clinical Management Elements
48.2.3.7 Program Stages and Phases
48.2.3.8 Aftercare
48.2.4 The Effectiveness of Therapeutic Communities
48.2.5 Adaptations and Modifications of the TC for Special Populations and Settings
48.2.6 TCs Worldwide
48.2.7 TC Outcome Research Worldwide
48.2.8 Cultural Adaptations of the TC
48.2.9 Issues and Challenges to the TC
48.2.10 Funding and Planned Duration of Treatment
48.2.11 Workforce
48.2.12 Research
48.2.13 Treatment Fidelity
48.2.14 Diversity of TC Programs
48.2.15 Classification of TC Programs
48.3 Conclusion
References
Further Reading
49: Spiritual Aspects of the 12-Step Method in Addiction Treatment
49.1 Introduction
49.1.1 AA as a Spiritual Recovery Movement
49.2 Spiritual Aspects
49.2.1 Spirituality as a Psychological Construct
49.2.2 Spirituality and Religious Experience
49.2.3 Spiritually Grounded Recovery in AA
49.2.4 Danshukai
49.2.5 AA in the Professional Context
References
50: Addiction Recovery in Services and Policy: An International Overview
50.1 Introduction
50.2 Recovery as a Guiding Vision of Substance Use Services and Policy
50.3 What Does ‘Recovery’ Mean?
50.4 Recovery Prevalence
50.5 What Does Adopting a Recovery Orientation Mean for Addiction Treatment Services?
50.6 Recovery-Oriented Systems of Care (ROSC)
50.7 What Do Recovery-Oriented Addiction Services Systems Look Like?
50.8 Individual Recovery Support Services Elements
50.9 Therapeutic Communities
50.10 What Can Professionals, Peers and Communities Do to Promote Recovery Amongst Problem Drug Users?
50.11 The Recovery Landscape in Europe
50.12 Conclusion
References
51: Strategies of Drug Prevention in the Workplace: An International Perspective of Drug Testing and Employee Assistance Programs
51.1 Introduction
51.2 Drug Prevention in the Workplace
51.3 Drug Testing in the United States Workplace
51.4 Alcohol Testing
51.5 Drug Testing in the European Workplace
51.6 Employee Assistance Programs
51.7 Summary
Glossary
Appendix: Additional Graphics (U.S.) and Other Data
References
52: Harm-Reduction Interventions
52.1 Introduction
52.2 Interventions
52.2.1 Opioid Substitution Treatment
52.2.2 Needle and Syringe Programmes
52.2.3 Supervised Drug Consumption Facilities
52.2.4 Overdose Prevention
52.2.5 Outreach, Peer Education and Health Promotion
52.2.6 Testing, Vaccination and Treatment of Infectious Diseases
52.2.6.1 Agenda 2030 for Sustainable Development
52.2.7 Interventions for Stimulant Use
52.3 Conclusion
References
Part V: Policies and Training in Addiction
53: Policy and Training in Addiction: An Introduction
References
54: Good Practice and Quality Standards
54.1 Introduction
54.2 From Knowledge to Implementation
54.2.1 Knowledge Translation into Practice: From Evidence to Change
54.2.2 Quality of Interventions: The Main Tools and Their Life Cycle
54.2.2.1 Adaptation of Guidelines to Everyday Practice Under Local Circumstances
54.2.3 Participation: A Key for Successful Implementation
54.2.3.1 Implementation Strategies
54.2.3.2 Training Initiatives
54.2.4 Examples of Frameworks for Quality Standards
54.3 Conclusion
Glossary
References
55: The United Nations Drug Conventions: Evidence on Effects and Impact
55.1 Introduction
55.2 Intended Functions of the Treaties
55.2.1 A Penal Regime to Enforce Drug Prohibition
55.2.2 A Trading and Marketing Control Regime
55.2.3 A Central Planning Scheme to Supply Medical Needs
55.3 Institutional Arrangements for Implementation of the Treaties
55.4 What Can Be Said About the Effects and Impact of the System?
55.5 Signs and Directions of Change
References
56: Ethical and Legal Aspects of Interventions in Addiction Treatment
56.1 Introduction
56.2 International Frameworks and National Diversities
56.2.1 Legal Aspects
56.2.1.1 The International Framework: The United Nations Conventions
56.2.1.2 Other International Frameworks
56.2.1.3 Diversity of National Legislation
56.2.1.4 Sanctions
56.2.2 Ethical Aspects
56.2.2.1 Ethical Basis of Interventions: Human Rights
56.2.2.2 Ethical Basis of Interventions: Medical Ethics
56.2.2.3 Ethical Justification of Interventions
56.2.2.4 The Goals of Treatment: A Hierarchy of Objectives
56.2.2.5 Cure or Care?
56.2.2.6 Tailoring Treatment to Individual Needs
56.2.2.7 Public Health Interventions Versus Individual Care
56.2.2.8 The Case of Agonist Maintenance Treatment
56.2.2.9 Conflicts in Ethical and Legal Orientation
56.3 Conclusion
References
57: Monitoring and Evaluation of Addiction Treatment
57.1 Introduction
57.2 Main Aspects of Monitoring and Evaluation
57.2.1 Definitions and Rationale
57.2.1.1 Monitoring Treatment
57.2.1.2 Process Evaluation of Treatment
57.2.1.3 Outcome Evaluation of Treatment
57.2.1.4 Economic Evaluation of Treatment
57.2.1.5 Meta-Evaluation
57.2.1.6 Comparable Terms
57.2.2 Preparing for Monitoring and Evaluation
57.2.2.1 Conceptual Issues
57.2.2.2 Goals of Monitoring and Evaluation Projects
57.2.2.3 Determining the Research Questions
57.2.2.4 Typology of Treatment Evaluation
57.2.2.5 Evaluation by Whom?
57.2.2.6 Evaluation Level and Timing
57.2.2.7 Resources
57.2.2.8 Partners
57.2.2.9 Expected Obstacles
57.2.3 Implementation of Monitoring and Evaluation
57.2.3.1 Available Guidelines and Instruments for Treatment Evaluation
57.2.3.2 Adaptation of Guidelines to Special Situations Recommendations
57.2.3.3 Meta-Analysis and Reviews of Evaluation Studies
57.2.3.4 Study Designs and Protocols
57.2.3.5 Quantitative and Qualitative Methods
57.2.3.6 Use of Results
57.2.3.7 Checklists for Assuring the Evaluation Process
57.2.4 Treatment Outcomes: Selected Evidence-Based Guidelines and Systematic Reviews
57.2.4.1 Cochrane Library (Selected Reviews)
57.2.4.2 Campbell Library (Selected Reviews)
References
58: Pathways to the Specialty Recognition of Addiction Medicine
58.1 Introduction
58.2 The Netherlands
58.3 Canada
58.4 Norway
58.4.1 The Specialty Regulations and Other Requirements to Become a Specialist in Addiction Medicine
58.4.2 The Status in June 2019
58.4.3 National Conference in Addiction Medicine
58.4.4 Strengths, Weaknesses, Opportunities and Threats Analysis
58.4.5 Conclusion
58.5 Indonesia
58.6 India
58.7 Australia
58.7.1 Addiction Medicine Training Programme
58.7.2 Outcomes to Date
58.8 United States
58.9 Conclusion
References
59: International Society of Addiction Medicine’s International Certification of Addiction Medicine: The First 15 Years
59.1 Introduction
59.2 The Certification Process
59.2.1 Chronological Development of an International Certification
59.2.2 The Minimum Performance Level Method
59.2.2.1 Example Item from an ISAM Examination
59.2.3 Psychometric Analysis
59.2.3.1 Item Analysis
59.2.3.2 Reliability and Validity
59.2.4 Criteria of Eligibility and Applicants’ Countries of Practice
59.2.5 Lessons Learned
References
60: National Institute on Drug Abuse International Fellowships: Research Training for Addiction Specialists
60.1 Introduction
60.2 Fellowships Supported by the National Institute on Drug Abuse International Program
60.3 Professional Advantages of the National Institute on Drug Abuse International Program Fellowships
60.4 The Way Forward
60.5 Conclusions
References
61: Undergraduate Medical Training in Substance Misuse
61.1 Introduction
61.2 Historical and Contextual
61.3 Description of the Project
61.3.1 Phase 1
61.4 Substance Misuse Core Curriculum Aims and Learning Outcomes
61.4.1 Core Topics and Learning Outcomes
61.4.2 Phase 2
61.5 Opportunities and Threats
61.6 Evaluation
61.7 Conclusions
61.7.1 Clinical Relevance
References
Part VI: Behavioural Addictions & Management Implications
62: Behavioral Addictions and Management Applications: An Introduction
63: Biological Underpinning of Behavioral Addictions and Management Implications
63.1 Introduction
63.2 Gambling Disorder
63.2.1 Neural Systems
63.2.2 Neurochemistry
63.2.3 Genetics/Family History
63.2.4 Conclusion
63.3 Internet Addiction Disorder
63.3.1 Neural Systems
63.3.2 Neurochemistry
63.3.3 Genetics/Family History
63.3.4 Conclusion
63.4 Internet Gaming Disorder
63.4.1 Neural Systems
63.4.2 Neurochemistry
63.4.3 Genetics/Family History
63.4.4 Conclusion
63.5 Hypersexual Disorder or Compulsive Sexual Behavior Disorder
63.5.1 Neural Systems
63.5.2 Neurochemistry
63.5.3 Genetics/Family History
63.5.4 Conclusion
63.6 Food Addiction
63.6.1 Neural Systems
63.6.2 Neurochemistry
63.6.3 Genetics/Family History
63.6.4 Conclusion
63.7 Compulsive Shopping or Buying
63.7.1 Neural Systems
63.7.2 Neurochemistry
63.7.3 Genetics/Family History
63.7.4 Conclusion
63.8 Conclusion
References
64: The Transdiagnostic Mechanisms of Behavioral Addictions and Their Treatment
64.1 Introduction
64.2 Transdiagnostic Mechanism of Behavioral and Substance Addictions and Their Intervention Possibilities
64.2.1 Deficits in Motivation
64.2.2 Urgency
64.2.3 Deficits in Self-Control
64.2.4 Maladaptive Expectancies and Motives
64.2.5 Deficits in Social Support
64.2.6 Compulsivity and Maladaptive Perseveration of Behavior
64.2.7 Relapse Prevention and Addiction Substitution
64.3 Summary and Implications
64.3.1 Component Model of Addiction Treatment
64.3.2 Clinical Applications of the CMAT
64.4 Conclusion
References
65: Psychological Management of Gambling Disorder With or Without Other Psychiatric Comorbidities
65.1 Introduction
65.2 Psychological Intervention for Gambling Disorder
65.2.1 Treatment Goals for Gambling Disorder
65.2.2 Effective Treatments for Gambling Disorder
65.2.2.1 Behavioral Therapies
65.2.2.2 Cognitive-Behavioral Therapies
65.2.2.3 Motivational Enhancement Therapy
65.2.2.4 Gamblers Anonymous
65.2.3 Relapse Prevention
65.2.4 Pharmacotherapy
65.3 Issues in Treatment
65.4 Internet Gambling
65.5 Treating Comorbid Gambling Disorder and Severe Mental Disorders
65.5.1 Treatment of Gambling Disorder with Affective and Addictive Disorders
65.5.2 Treatment of Gambling Disorder with Schizophrenia
65.6 Concluding Remarks
References
Key References
66: Gambling and Gaming Addictions in Women
66.1 Gambling Disorder in Women
66.1.1 Definitions and Diagnostic Criteria
66.1.2 Gender Differences in Development and Course of Illness
66.1.3 Comorbidities and Suicide
66.1.4 Treatment Seeking (Including Barriers to Treatment)
66.2 Treatment
66.2.1 Pharmacotherapy
66.3 Gaming Disorder in Women
66.3.1 Definitions and Diagnostic Criteria
66.3.2 Gaming Prevalence and Patterns
66.3.3 Gender Differences in Risk, Aetiology and Comorbidity of GmD
66.4 Screening and Treatment
References
67: Problematic Internet Use
67.1 Introduction
67.2 The Concept of Internet Addiction and Its Major Criticisms
67.3 The Development of Diagnostic Criteria: From Internet Addiction to Gaming Disorder
67.4 Etiology and Theoretical Models of General and Specific Problematic Internet Use
67.5 Assessment of Problematic Internet Use and Gaming Disorder
67.6 Prevalence Estimates of Problematic Internet Use and Gaming Disorder
67.7 Treatment Approaches to Problematic Internet Use
67.8 Conclusion and Future Directions
References
68: Conceptual and Methodological Considerations of Gaming Disorder and Internet Gaming Disorder
68.1 Introduction
68.2 Conceptual Definitions
68.3 Game Classifications and Behaviours
68.3.1 Game Types
68.3.2 Gaming Function
68.3.3 Gaming Forms
68.4 Behavioural Measures
68.5 Clinical Implications
References
69: Compulsive Buying Disorder
69.1 Introduction
69.2 Epidemiology
69.3 Course and Consequences of Compulsive Buying Disorder
69.4 Diagnosis and Assessment Scales
69.5 Psychiatric Comorbidity and Relationship with Other Mental Disorders
69.6 Psychopathology Dimensions
69.7 Subtypes of Compulsive Buyers
69.8 Neurobiology, Genetics, and Risk Factors
69.9 Treatment
69.9.1 Psychotherapy
69.9.2 Psychopharmacology
69.9.3 Self-Help/Community Resources
References
70: Sex Addiction
70.1 Introduction
70.1.1 Relationship with Paraphilias
70.2 Assessment
70.3 Etiology and Neurobiology
70.4 Prevalence
70.5 Comorbidity
70.6 Treatment Approaches
70.6.1 Psychosocial Approaches
70.6.2 Pharmacological Approaches
70.7 Conclusion
References
71: The Association Between Binge Eating, Obesity, and Addiction
71.1 Introduction
71.2 Neurobiology
71.2.1 Feeding and Reward
71.2.2 Obesity
71.2.3 Binge Eating
71.2.4 Screening Individuals for Food Addiction
71.2.5 Management of Food Addiction
71.3 Conclusion
References
Part VII: Comorbid Medical Disorders & Responses
72: Medical Disorders and Complications of Alcohol and Other Drugs and Multiple Morbidities: An Introduction
References
73: Cardiovascular Consequences of Addiction
73.1 Introduction
73.2 Main Text
73.2.1 Alcohol
73.3 Atrial Fibrillation
73.3.1 Hypertension and Vascular Disease
73.4 Cardiomyopathy
73.5 Sudden Cardiac Death
73.6 Cocaine
73.6.1 Hemodynamic Effects
73.6.2 Myocardial Ischemia
73.6.3 Cardiac Conduction and Arrhythmia
73.6.4 Other Effects: Cardiomyopathy, Endocarditis, Aortic Dissection, and Stroke
73.7 Amphetamines
73.8 Amphetamine-Like Drugs
73.9 Opioids
73.9.1 Heroin
73.9.2 Methadone and Synthetic Opioids Used in Addiction Treatment
73.9.3 Nicotine
73.10 Cannabis
73.11 Anabolic Steroids
References
74: Respiratory Problems and Substance Misuse
74.1 Introduction
74.2 Non-specific Pulmonary Complications
74.2.1 Infective Complications: Pneumonia, Lung Abscess, Septic Embolisation, and Mycobacterium Tuberculosis
74.2.2 Non-infective Complications
74.3 Pulmonary Complications of Specific Substances
74.3.1 Alcohol
74.3.2 Cannabis
74.3.3 Miscellaneous Inhaled Substances
74.3.4 Opioids
74.3.4.1 Airway Complications
74.3.4.2 Respiratory Drive and Respiratory Failure
74.3.4.3 Pleuroparenchymal Disease
74.3.4.4 Pulmonary Vascular Disease
74.3.5 Amphetamines and Amphetamine-Like Substances
74.3.5.1 Airway Complications
74.3.5.2 Pleuroparenchymal Complications
74.3.5.3 Pulmonary Vascular Disease
74.3.6 Cocaine
74.3.6.1 Pulmonary Symptoms
74.3.6.2 Airway Complications
74.3.6.3 Pleuroparenchymal Complications
74.3.6.4 Pulmonary Vascular Disease
74.3.7 Cigarettes
74.3.7.1 Respiratory Infections
74.3.7.2 Airways
74.3.7.3 Pleuroparenchymal Complications
74.3.7.4 Malignancy
74.3.7.5 Electronic Cigarettes (E-Cigarettes)
74.4 Conclusion
References
75: Oral Health and Addiction: Consequences of Substance Use
75.1 Introduction
75.1.1 Dental and Oral Diseases
75.2 The Oral Health Effects of Substance Misuse
75.2.1 Depressants and Oral Health: Alcohol (Table 75.1)
75.2.1.1 Tooth-Related
75.2.1.2 Mucosa-Related
75.2.1.3 Other
75.2.2 Depressants and Oral Health: Opioids (Table 75.1)
75.2.2.1 Tooth-Related
75.2.2.2 Mucosal-Related
75.2.3 Depressants and Oral Health: Cannabis (Table 75.1)
75.2.3.1 Tooth-Related
75.2.3.2 Mucosal-Related
75.2.3.3 Other
75.2.4 Stimulants and Oral Health: Cocaine (Table 75.2)
75.2.4.1 Tooth-Related
75.2.4.2 Mucosa-Related
75.2.4.3 Other
75.2.5 Stimulants and Oral Health: Amphetamines and Related Compounds
75.2.5.1 Methamphetamine
Tooth-Related
Mucosa-Related
Other
75.2.5.2 MDMA (3,4-Methylenedioxy-Methamphetamine)
Tooth-Related
Mucosa-Related
Other
75.2.6 Other Drugs and Oral Health: Tobacco (Nicotine)
75.2.6.1 Tobacco Smoking
Tooth-Related
Mucosal-Related
Other
75.2.6.2 Smokeless Tobacco
Tooth-Related
Mucosa-Related
75.2.7 Other Drugs and Oral Health: Gabapentin
75.3 Conclusion
75.4 Clinical Relevance
References
76: Gastrointestinal Disorders Related to Alcohol and Other Drug Use
76.1 Introduction
76.2 Alcohol
76.2.1 Parotid Glands and Oral Cavity
76.2.2 Esophagus
76.2.3 Stomach
76.2.3.1 Alcoholic Gastritis
76.2.3.2 Dyspepsia and Ulcer
76.2.3.3 Alcohol-Related Pancreatitis
Definitions
Etiology
Predisposing Factors
Pathogenesis
Diagnosis
Assessment of Severity
Treatment
Chronic Pancreatitis (CP)
Clinical Features
Treatment
76.2.3.4 Small Intestine
76.2.3.5 Colon
76.2.3.6 Alcohol and Gastrointestinal Cancer
Oropharynx and Esophagus
Stomach
Colonic
Pancreatic
76.2.4 Prescription Medications
76.2.4.1 Opioids
76.2.4.2 Laxative Misuse
76.2.4.3 Misuse of Anticholinergics
76.2.5 Tobacco
76.2.5.1 Gastroesophageal Reflux
Peptic Ulceration
Pancreatic Disease
76.2.5.2 Inflammatory Bowel Disease
76.2.5.3 Gastrointestinal Malignancy
E-Cigarettes
76.2.6 Body Packing
76.2.7 Psychostimulants
76.2.8 Cannabis
References
Further Reading
77: Liver Disorders Related to Alcohol and Other Drug Use
77.1 Introduction
77.1.1 Epidemiology of Substance-Related Liver Disease
77.2 Pathophysiology of Substance Related Liver Disease
77.2.1 Alcohol-Related Liver Disease
77.2.2 Drug-Related Liver Disease
77.2.3 Drug-Induced Liver Injury
77.2.3.1 Cocaine
77.2.3.2 Ecstasy (MDMA)
77.2.3.3 Heroin, Marijuana and Amphetamines
77.2.3.4 Anabolic Steroids
77.3 Investigation and Staging of Liver Disease
77.3.1 Biochemical Markers
77.3.2 Imaging
77.3.3 Staging of Liver Disease Using Non-invasive Fibrosis Scores
77.3.4 Liver Biopsy
77.4 Diagnosis of Alcohol and Drug-Related Liver Disease
77.5 Clinical Management of Advanced Liver Disease
77.5.1 Compensated Cirrhosis
77.5.2 Decompensated Cirrhosis
77.5.2.1 Hepatic Encephalopathy
77.5.2.2 Ascites
77.5.2.3 Variceal Bleeding
77.5.3 Alcoholic Hepatitis
77.5.4 Hepatocellular Carcinoma
77.5.5 Liver Transplant
References
78: Kidney Disease and Electrolyte Disorders in the Context of Drug Use
78.1 Introduction
78.2 Classification and Assessment of Renal Disease
78.3 Acute Kidney Injury
78.3.1 Overview
78.3.2 Pre-renal AKI
78.3.3 Intra-renal AKI
78.3.4 Post-renal AKI
78.3.5 Management of AKI
78.3.6 Drug-Specific Associations with AKI
78.3.6.1 Alcohol
78.3.6.2 Cocaine
78.3.6.3 Amphetamines and Other Stimulants
78.3.6.4 Opioids
78.3.6.5 Cannabis and Synthetic Cannabinoids
78.3.7 Rhabdomyolysis
78.3.8 Hepatorenal Syndrome
78.4 Glomerulonephritis Associated with Drug Use
78.4.1 Diagnosis of Glomerulonephritis
78.4.2 Rapidly Progressing Glomerulonephritis
78.4.3 Glomerular Disease Associated with Bacterial Infection
78.4.4 Nephrotic Syndromes
78.4.5 Cirrhosis-Associated IgA Nephropathy
78.4.6 BBV in Drug Users and Renal Consequences
78.4.6.1 Hepatitis B
78.4.6.2 Hepatitis C
78.4.6.3 HIV
78.5 Chronic Kidney Disease Associated with Drug Use
78.5.1 Classification
78.5.2 Approach to Chronic Kidney Disease in the Drug User
78.6 Renal Replacement Therapy in the Setting of Drug Use
78.7 Metabolic Derangements Associated with Drug Use
78.7.1 Dysnatraemias
78.7.2 Disorders of Acid-Base Balance and Other Electrolytes
78.8 Conclusions
References
79: Trauma and Addiction Medicine
79.1 Introduction
79.1.1 Injury Profiles
79.2 Clinical Considerations
79.2.1 Initial Assessment and Management
79.2.2 Acute Physiological Changes Related to Drugs and Alcohol Use
79.2.2.1 Haemodynamic Status
79.2.2.2 Neurological Status
79.2.3 Chronic Physiological Effects of Drugs and Alcohol
79.3 Emergency Department Considerations
79.3.1 Behavioural Management
79.3.2 Mental Health Assessment
79.3.3 Social Problems
79.3.4 Security
79.3.5 Emergency Department Burden
79.3.6 Screening and Brief Intervention
References
80: Neurobiological Complications of Alcohol and Substance Misuse
80.1 Introduction
80.2 Sedatives
80.2.1 Alcohol
80.2.1.1 Neurobiological Mechanisms of Action
80.2.1.2 Acute Intoxication
80.2.1.3 Complications of Dependence
Wernicke’s Encephalopathy and Korsakoff’s Syndrome
Central Pontine and Extrapontine Myelinolysis
Hepatic Encephalopathy
Cerebellar Ataxia
Neuropathy
80.2.1.4 Withdrawal
80.2.2 Benzodiazepines and Barbiturates
80.2.2.1 Neurobiological Mechanisms of Action
80.2.2.2 Acute Intoxication
80.2.2.3 Complications of Dependence
80.2.2.4 Withdrawal
80.3 Stimulants
80.3.1 Cocaine
80.3.1.1 Neurobiological Mechanisms of Action
80.3.1.2 Acute Intoxication
80.3.1.3 Complications of Dependence
80.3.1.4 Withdrawal
80.3.2 Amphetamines, MDMA and Bath Salts
80.3.2.1 Neurobiological Mechanisms of Action
80.3.2.2 Acute Intoxication
80.3.2.3 Complications of Dependence
80.3.2.4 Withdrawal
80.4 Opioids
80.4.1 Neurobiological Mechanism of Drug Action
80.4.2 Acute Intoxication
80.4.3 Complications of Dependence
80.4.3.1 Toxic Leukoencephalopathy
80.4.3.2 Neurodegeneration and Brain Atrophy
80.4.3.3 Peripheral Neuropathy and Neuromuscular
80.4.4 Withdrawal
80.5 Hallucinogens
80.5.1 Cannabinoids
80.5.1.1 Neurobiological Mechanisms of Action
80.5.1.2 Acute Intoxication
80.5.1.3 Complications of Dependence
80.5.1.4 Withdrawal
80.5.2 Non-cannabinoid Hallucinogens
80.5.2.1 Neurobiological Mechanisms of Action
80.5.2.2 Acute Intoxication
80.5.2.3 Complications of Dependence
80.5.2.4 Withdrawal
80.6 Organic Solvents/Inhalants
80.6.1 Neurobiological Mechanisms of Action
80.6.2 Acute Intoxication
80.6.3 Complications of Dependence
80.6.4 Withdrawal
References
81: Neurocognitive Disorders in Substance Use Disorders
81.1 Introduction
81.2 Main Domains of NCDs
81.2.1 Positive Valence Domain
81.2.2 Negative Valence Domain
81.2.3 Cognitive Control System Domain
81.3 Mechanisms for Neurocognitive Disorders in Substance Use Disorder
81.3.1 Neural Adaptations and Dysfunctions
81.3.2 Substance-Specific Neurocognitive Disorders
81.3.2.1 Premorbid Alterations
81.3.2.2 Cannabis
81.3.2.3 Stimulants
81.3.2.4 Opioids
81.3.2.5 Alcohol
81.3.2.6 Polysubstance Use
81.4 Neurocognitive Deficits Across Time
81.4.1 Minutes to Hours
81.4.2 Days to Weeks
81.4.3 Months to Years
81.5 Interventions in Neurocognitive Deficits
81.5.1 Pharmacotherapy
81.5.2 Cognitive Interventions
81.5.3 Neuromodulation
81.6 Clinical Implications and Future Horizons for NCDs in Addiction Medicine
References
82: Substance Use and Co-occurring Infections (Including Immunology)
82.1 Introduction
82.2 Immunologic Effects of Substance Use
82.3 HIV Infection: Epidemiologic Considerations
82.4 HIV Infection: Clinical Considerations
82.5 HCV Infection: Epidemiologic Considerations
82.6 HCV Infection: Clinical Considerations
82.7 Selected Bacterial Infections in Substance Users
82.7.1 Cellulitis and Abscesses
82.7.2 Endocarditis
82.7.3 Osteomyelitis
82.7.4 Epidural Abscesses
82.7.5 Prevention of Bacterial Infections
82.8 A Multidisciplinary Approach to the Care of Infections Among Substance Users
82.9 Conclusion
References
83: Sleep Disorders in Addiction: An Overview
83.1 Introduction
83.2 Sleep Disorders
83.2.1 Incidence
83.2.2 Implications and Consequences of Sleep Problems
83.2.3 NPSG and MSLT
83.3 Sleep Physiology
83.3.1 Normal Human Sleep
83.3.2 NREM
83.3.3 Rem
83.4 Classification of Sleep Disorders
83.4.1 ICSD
83.4.2 Insomnia
83.4.3 Other Sleep Disorders
83.4.3.1 Sleep-Related Breathing Disorders
83.4.3.2 Circadian Rhythm Sleep-Wake Disorders (CRSWD)
83.4.3.3 Sleep-Related Movement Disorders
83.5 Psychiatric Disorders and Sleep
83.6 Role of Sleep Disturbance in Initiation, Maintenance, and Relapse in Substance Use Disorders
83.7 Contributing Medications and Substances Causing Sleep Problems
83.7.1 Stimulants
83.7.2 CNS Depressants
83.7.3 Opiates
83.7.4 Alcohol
83.7.5 Cannabinoids
83.8 Diagnosis of Sleep Disorders
83.8.1 Intake History and Physical Examination
83.8.2 Sleep Questionnaires
83.9 Treatment of Insomnia
83.10 Treatment of Chronic Insomnia: An Overview
83.10.1 Behavioral/Psychological
83.10.1.1 Sleep Hygiene Therapy
83.10.1.2 Behavioral Therapy
83.10.1.3 Stimulus Control Therapy
83.10.1.4 Sleep Restriction Therapy
83.10.1.5 Progressive Muscle Relaxation
83.10.1.6 Paradoxical Intention
83.10.1.7 Biofeedback
83.10.1.8 Multifaceted Cognitive Behavioral Therapy
83.10.2 Pharmacotherapy of Insomnia in the Addiction Population
83.10.2.1 OTC
83.10.2.2 Prescription Drugs
83.11 Medications and Potential for Abuse
83.11.1 Abuse Liability Signs
83.11.2 Precautions and Contraindications
83.12 Conclusion
References
84: Endocrine Manifestations of Alcohol and Other Drug Use Disorders
84.1 Introduction
84.2 Hormones and Addiction
84.2.1 Hypothalamic-Pituitary-Adrenal Axis
84.2.1.1 Action of Opioids
84.2.1.2 Adrenal Insufficiency
84.2.2 Alcohol-Related Hypercortisolaemia
84.2.3 Other Drugs and the HPA Axis
84.2.4 Gonadal, Sexual and Reproductive Function
84.2.5 Alcohol and Hypogonadism
84.2.6 Opioids and Hypogonadism
84.2.6.1 Clinical Considerations
84.2.7 Thyroid Function and Addiction
84.2.8 Thyroid and Alcohol
84.2.9 Thyroid and Tobacco
84.2.9.1 Thyroid Function and Other Drugs
84.3 Weight, Glucose Metabolism and Appetite in Addiction
84.3.1 Opioids
84.3.2 Alcohol
84.3.3 Tobacco
84.3.4 Cannabis
84.3.5 Appetite Factors
84.4 Bone and Skeletal Metabolism
84.4.1 Alcohol and Bone
84.4.1.1 Tobacco Smoking and Bone
84.4.1.2 Opioids and Bone
84.4.1.3 Other Drugs and Bone
84.4.1.4 Clinical Management
84.5 Key Points and Conclusions
References
85: Sexual Function and Alcohol and Other Drug Use
85.1 Introduction
85.2 Substances and Sexual Dysfunction
85.2.1 Models and Neurochemical Substrates of Normal Sexual Function
85.2.2 How Common Is Sexual Dysfunction? Evidence from Population Studies
85.2.3 Deliberate Use of Psychoactive Substances in Sexual Behavior
85.2.4 Understanding the Etiology of Sexual Dysfunction in General
85.2.4.1 Hormonal Factors
85.2.4.2 Vascular and Neural Factors
85.2.4.3 Bodyweight, Obesity, Sleep Apnea, and Exercise
85.2.4.4 Other Medical Illnesses
85.2.4.5 Psychological Factors
85.2.4.6 Psychiatric Disorders and Their Treatment
85.2.5 Sexual Dysfunction Related to Substance Use and Dependence
85.2.5.1 Tobacco and Cannabis
85.2.5.2 Alcohol
85.2.5.3 Opioids
85.2.5.4 Stimulants
85.2.6 Sexual Function and Alcohol and Other Drug Use: Clinical Assessment and Management
85.2.7 Treating Sexual Dysfunction
85.2.7.1 The Example of Opioid Pharmacotherapy
85.2.7.2 Some Specific Issues for Women
85.2.7.3 Some Specific Issues for Men
85.2.7.4 Setting the Management of Sexual Dysfunction Within the Social Context
85.2.8 International and Public Health Perspectives
85.3 Clinical Relevance
85.4 Conclusion
References
86: Patients with Substance Use Disorder and Addiction: Acute Pain Including Perioperative Issues
86.1 Introduction
86.2 Social and Psychological Factors
86.3 General Assessment of SUD
86.4 Societal Factors
86.5 Alcohol
86.5.1 Alcohol’s Impact on Operative Outcomes
86.5.2 Preoperative Considerations and Management
86.5.3 Management of Perioperative Alcohol Withdrawal
86.6 Nicotine
86.6.1 Tobacco’s Impact on Operative Outcome
86.6.2 Management of Preoperative Tobacco Use
86.7 Opioids
86.7.1 Illicit Opioids
86.7.2 Prescribed Opioids
86.8 Opioid Substitution Therapy (OST)
86.9 Intoxication
86.10 Withdrawal
86.11 Assessment of the Patient for Anaesthesia
86.11.1 Physical
86.11.2 Infections
86.11.3 Perioperative Pain Management
86.12 Prediction of Poorly Controlled Post-operative Pain
86.13 Other Substances Cannabis
86.14 Synthetic Cannabinoids
86.15 Cocaine, Amphetamines and Methamphetamine
86.16 Hallucinogens, Ecstasy and Other Club Drugs
86.17 Factors That May Improve Post-operative Care for Individuals with Substance Use Disorder
86.18 Components of Enhanced Recovery After Surgery [58]
86.19 Conclusion
References
87: Chronic Pain and Dependence
87.1 Introduction
87.2 Nature of Chronic Pain
87.3 Nociceptive Pain
87.4 Neuropathic Pain
87.5 Nociplastic Pain
87.6 Biopsychosocial or Sociopsychobiomedical Model
87.7 Elements of the Problems Leading to Increased Prescribing and Dependence in Chronic Pain
87.8 Neurobiology of Dependence and Pain
87.9 Strategies to Reduce Opioid Dependence and Harm in Chronic Pain
87.9.1 Reducing Supply
87.9.2 Monitoring Opioid Use
87.9.3 Reducing Risk
87.9.4 Substituting Other Medications or Therapies
87.9.5 Opioid Reduction Programmes
87.9.6 Education
87.10 Relevance
87.11 Conclusion
References
88: COVID-19 and Substance Use Disorders: Syndemic Responses to a Global Pandemic
88.1 Introduction
88.2 Syndemic Theory and Substance Use Disorders
88.3 Syndemics and Complex Systems Thinking
88.4 Empirical Methods to Study Syndemics
88.5 Applying Syndemic Theory and Complex Systems Thinking
88.5.1 What Happens When a Syndemic Collides with a Pandemic? The Acute Phase
88.6 Multilevel Analysis
88.7 Conclusions
References
Part VIII: Psychiatric Comorbidities & Complications of Alcohol and Other Drugs
89: Psychiatric Comorbidities and Complications of Alcohol, Other Drugs: An Introduction, and International Perspectives: An Introduction and International Perspectives: An Introduction
90: Substance-Induced Mental Disorders
90.1 Introduction
90.2 Dimensions of Substance-Induced Mental Disorders
90.2.1 Examples
90.2.1.1 Cannabis-Induced Mental Disorders
90.2.1.2 MDMA-Induced Neurotoxic Damage and Mental Disorders
90.2.1.3 Chronic Opioid Use and Neuropsychological/Cognitive Impairment
90.2.2 Presentations
90.2.3 Sedative-Induced Mental Disorders
90.2.3.1 Alcohol-Induced Amnesia (Blackout)
90.2.3.2 Alcohol-Induced Psychosis/Hallucinosis
90.2.3.3 Alcohol Withdrawal Syndrome (AWS)
90.2.3.4 Delirium Tremens
90.2.3.5 Wernicke’s Encephalopathy and Korsakoff Psychosis
90.2.4 Stimulant-Induced Mental Disorders
90.2.5 Hallucinogen-Induced Mental Disorders
90.3 Conclusion
References
91: Co-occurring Mood and Substance Use Disorders
91.1 Introduction
91.2 Prevalence and Co-occurrence
91.2.1 DSM-IV and DSM-5
91.2.2 Depressive Disorders
91.2.2.1 Major Depressive Disorder
91.2.2.2 Persistent Depressive Disorder
91.2.2.3 Prevalence and Co-occurrence of Depressive Disorders with Substance Use Disorders
91.2.2.4 Prognostic Effects of Depressive Disorders on Substance Use Disorders
91.2.3 Bipolar Disorders
91.2.3.1 Bipolar I Disorder
91.2.3.2 Bipolar II Disorder
91.2.3.3 Co-occurrence of Bipolar and Substance Use Disorders and Prognostic Effects
91.2.4 Co-occurring Depression and Substance Use as a Signal for Other Disorders
91.3 Diagnosis of Co-occurring Mood Disorders with  Substance Use Disorders
91.3.1 DSM-IV/DSM-5 Approach to Co-occurring Mood and Substance Use Disorders
91.3.1.1 Independent Mood Disorder
91.3.1.2 Substance-Induced Mood Disorder
91.3.1.3 Usual Effects of Substances
91.3.1.4 Co-occurring Bipolar and Substance Use Disorder
91.3.2 Course and Prognosis of DSM-IV Independent and Substance-Induced Depression
91.3.2.1 Structured Diagnostic Assessment
91.3.2.2 Prognostic Effects
91.3.2.3 A Note About Terminology
91.3.3 Summary and Recommendations for Diagnostic Assessment
91.3.3.1 Screening Instruments
91.3.3.2 Clinical History and DSM-IV/DSM-5 Criteria
91.3.3.3 Search the History for Mania or Hypomania
91.3.3.4 Look for Other Co-occurring Disorders
91.4 Treatment of Co-occurring Mood Disorders
91.4.1 Depressive Disorders
91.4.1.1 Antidepressant Medications
91.4.1.2 Placebo Response and Other Factors Associated with Response to Antidepressants
91.4.1.3 Depression in Individuals on Medication for Opioid Use Disorder
91.4.1.4 Behavioral Treatments
91.4.1.5 Treatment of the Substance Use Disorder
91.4.1.6 Combined Medications for Depression and Substance Use
91.4.2 Bipolar Disorders
91.5 Conclusion
References
92: Comorbid Anxiety and Alcohol or Substance Use Disorders: An Overview
92.1 Introduction
92.2 Epidemiology
92.3 Etiological Hypotheses and Temporal Relationships of Comorbid Anxiety and Substance Use Disorders
92.4 Diagnosis and Classification
92.5 Clinical Features, Course, and Prognosis
92.6 Treatment and Management
92.7 Conclusions
References
93: The Comorbidity of Post-traumatic Stress Disorder (PTSD) and Substance Use Disorders
93.1 Introduction
93.1.1 Epidemiology of PTSD/SUD Comorbidity
93.1.1.1 United States
93.1.2 International Prevalence Estimates
93.2 Etiologic Relationship Between PTSD and SUD
93.2.1 Self-medication Hypothesis
93.2.2 Neurobiology
93.3 Assessment
93.3.1 Psychotherapeutic Treatment
93.3.2 Pharmacological Treatment
93.4 Conclusion
References
94: Psychotic Disorders and Substance Use Disorders
94.1 Introduction
94.2 Epidemiology
94.2.1 The United States of America
94.2.2 Europe
94.2.3 Critical Issues of Dual Diagnosis Epidemiological Studies
94.3 Potential Aetiological Relationships Among Psychotic and Substance Use Disorders
94.3.1 Correlates and Risk Factors for Dual Diagnosis
94.3.1.1 Genetics
94.3.1.2 Male Sex and Young Age
94.3.1.3 Low Educational Level and Unemployment
94.3.1.4 Substance Availability and Attitude Towards Substance Consumption
94.3.1.5 Personality and Neurodevelopmental Disorders
94.3.1.6 Early Onset of Illness and Good Premorbid Functioning
94.3.1.7 Subthreshold Psychotic Symptoms
94.3.2 Etiopathogenesis: Models and Evidence
94.3.2.1 The Self-Medication Model
94.3.2.2 Environmental Stress Vulnerability
94.3.2.3 Vulnerability to Comorbid Dependence
94.3.3 Cannabis and Psychotic Disorders
94.4 Clinical Features, Course of Illness and Diagnosis
94.4.1 Clinical Features and Course of Illness
94.4.2 Assessment
94.5 Treatment and Prognostic Issues
94.5.1 Pharmacological Treatment
94.5.2 Psychological and Psychosocial Interventions
94.5.3 Admission to Psychiatric Wards
94.5.4 Prognostic Factors and Course
94.6 Conclusions
References
95: Attention Deficit/Hyperactivity Disorder & Substance Abuse in Adults & Children
95.1 Introduction
95.2 ADHD & SUD Prevalence Rates
95.3 ADHD Diagnostic Criteria & Phenomenology
95.3.1 ADHD in Childhood
95.3.2 ADHD in Adolescence & Adulthood
95.3.3 Etiology of ADHD
95.3.4 Neural Correlates of ADHD
95.3.5 SUD Diagnostic Criteria & Risk
95.4 ADHD & Co-occurring Substance Use
95.4.1 Assessment and Diagnosis of Co-occurring ADHD & SUD
95.5 Pharmacological Treatments for ADHD+SUD
95.5.1 Stimulant Medications
95.5.2 Nonstimulant Medications
95.5.3 Psychosocial Interventions for ADHD+SUD
95.6 Conclusions
References
96: Personality Disorders and Addiction Disorders
96.1 Introduction: Conceptualization and Evolution of Personality Disorders
96.2 DSM-5 Personality Disorders
96.3 Personality Disorders and Addiction: A Common Comorbidity
96.3.1 Prevalence of Personality Disorders Among Individuals with SUDs
96.3.1.1 Cluster B
96.3.1.2 Cluster C
96.3.1.3 Cluster A
96.3.2 Prevalence of SUDs Among Individuals with Personality Disorders
96.3.3 Prevalence of Personality Disorders Among Individuals with Gambling Disorder
96.4 Risk Factors for Persistent SUDs in Individuals with PDs
96.5 Screening and Assessment
96.6 Treatment of Comorbid Addictions and Personality Disorders
96.6.1 The Role of Integrated Treatment
96.6.2 The Role of Medication
96.6.3 The Role of Psychotherapy
96.6.3.1 Cluster B
96.6.3.2 Cluster A
96.6.3.3 Cluster C
96.7 Barriers and Challenges to Treatment
96.7.1 Stigma
96.7.2 Countertransferential Challenges
96.8 Conclusion
References
Part IX: Special Interest Populations
97: Special Populations: An Introduction
98: Women and Addiction
98.1 Introduction
98.2 Overview of Epidemiology
98.2.1 United States
98.2.2 International Epidemiological Data
98.2.3 Substance Use in Sexual Minorities
98.2.4 Substance Use in Sex Workers
98.3 Gender Differences in Course of Illness
98.4 Gender Differences in Biology and Pharmacotherapy
98.4.1 Biological Influences
98.4.2 Pharmacotherapy
98.5 Treatment
98.5.1 Gender-Specific Treatment Programs
98.5.2 Gender-Specific Barriers to Treatment
98.5.3 Special Issues: Pregnancy
98.6 Conclusion
References
99: Older People and Substance Misuse
99.1 Introduction
99.1.1 Epidemiology
99.1.2 Risk Factors
99.1.3 Low-Risk Drinking
99.1.4 Economic Costs
99.1.5 Premature Ageing and Mortality
99.2 Assessment
99.2.1 Presentation of Substance Misuse in Older People
99.2.2 Screening
99.2.3 Barriers to Assessment
99.2.4 Diagnosis
99.2.5 Physical Examination
99.2.6 Mental State Examination
99.3 Co-occurring Mental and Physical Disorders
99.4 Interactions Between Substances and Prescribed Drugs in Older People
99.4.1 Alcohol
99.4.2 Other Substances
99.5 Treatment
99.5.1 Alcohol
99.5.1.1 Pharmacological Approaches
99.5.1.2 Psychosocial Approaches
99.5.2 Opioids
99.5.2.1 Intravenous Opioids
99.5.3 Tobacco
99.6 Service Provision
99.7 Legal and Ethical Considerations
99.8 Alcohol-Related Cognitive Impairment
References
Further Reading
100: Treatment in Criminal Justice Settings; Mandatory vs Voluntary Treatment and Rehabilitation
100.1 Introduction
100.2 The Social and Economic Costs of Illicit Drug Use and ‘Related’ Crime
100.3 A Shift in Policy Responses?
100.3.1 Effect
100.3.2 Mechanism
100.3.3 Moderator
100.3.4 Implementation
100.3.5 Economic Cost
100.4 Conclusion
References
101: Drug Courts
101.1 Introduction
101.2 Effectiveness of Adult Drug Courts
101.2.1 Criminal Recidivism
101.2.2 Cost-Effectiveness
101.2.3 Psychosocial Outcomes
101.3 Effective vs. Ineffective Drug Courts
101.3.1 Target Population
101.3.2 Best Practices
101.4 Best Practice Standards
101.5 International Drug Treatment Courts
101.6 Conclusion: Going to Scale
References
102: Addictions in Physicians: An Overview
102.1 Introduction
102.2 Epidemiology
102.3 Identifying and Helping the Sick Doctor
102.4 Treatment
102.5 Conclusions
References
103: Substance Use Disorders in Conflict-Displaced Populations
103.1 Introduction
103.2 Substance Use in Displacement
103.3 Substance Use Disorders in Displacement
103.4 Other Harms Related to Substance Use in Displacement
103.5 Comparison with Non-displaced Populations
103.6 Treatment and Care of Substance Use Disorders
103.6.1 Community-Based Outreach
103.6.2 Screening
103.6.3 Brief Intervention
103.6.4 Specialist Treatment
103.6.5 Guidance Materials
103.7 Conclusion
References
Part X: Children, Adolescents and Young Adults
104: Children, Adolescents, and Young Adults: An Introduction
104.1 Section Introduction Text
105: Adolescent Substance Misuse/Use Disorders: Characteristic Features
105.1 Introduction
105.2 Youth Substance Misuse
105.2.1 Epidemiology of Youth Substance Misuse
105.2.1.1 Epidemiology of Substance Use
105.2.1.2 Epidemiology and Burden of Substance Use Disorders (SUD)
105.2.2 Risks and Developmental Course
105.2.3 Comorbid Disorders
105.2.3.1 Conduct Disorder
105.2.3.2 Attention-Deficit/Hyperactivity Disorder (ADHD)
105.2.3.3 Depressive Disorders
105.2.3.4 Psychotic/Bipolar and Related Disorders
105.2.3.5 Other Comorbid Disorders
105.2.3.6 Co-occurrence of Physical and Other Psychosocial Complications of SUD
105.3 Conclusion
References
106: Adolescent Substance Misuse/Use Disorders: Management
106.1 Introduction
106.2 Screening/Assessment
106.3 Treatment
106.4 Addressing Comorbidities
106.5 Conclusions
References
107: Suicide and Substance Abuse in Adolescents
107.1 Introduction
107.2 Adolescent Suicidality
107.3 Adolescent Substance Use
107.3.1 Alcohol Use
107.3.2 Trends in Alcohol Use
107.3.3 Cannabis Use
107.4 Substance-Related Disorders as a Risk Factor for Suicidality
107.5 The Moderating Role of Psychiatric Morbidity
107.5.1 Mood Disorders as a Model
107.6 Gender Differences in Suicidality
107.6.1 Sexual Minority Youth (SMY)
107.7 Age Differences in Suicidality
107.8 Future Studies
107.9 Treatment and Prevention
107.10 Conclusions
References
108: Risk and Protective Factors for Substance Use and Addiction
108.1 Introduction
108.2 Psychosocial Risk Factors
108.2.1 Peer and Parental Influences
108.3 Biological Risk Factors
108.3.1 Genetic Associations
108.3.2 Neuroimaging Predictors
108.4 Prediction Analyses with Machine Learning
108.5 Discussion
References
109: Perinatal Substance Use Disorders: Intrauterine Exposure
109.1 Introduction
109.1.1 Epidemiology at Different Developmental Periods Related to Perinatal SUD
109.1.1.1 Preconceptional Period
109.1.1.2 Prenatal Period
109.1.1.3 Postnatal Period and Epidemiology of the Effects of PSE
109.2 Problems Faced by the Pregnant Women with SUD
109.3 Effects of Drugs on Fetal Neurodevelopment
109.3.1 Substance-Related Adverse Birth Outcomes
109.3.2 Congenital Malformations
109.3.3 Neurobehavioral Effects of Substance Exposures
109.3.3.1 Neurobehavioral and Regulatory Problems
109.3.3.2 Neonatal Abstinence Syndrome (NAS)
109.3.4 Problems Related to Individual Substance Exposures
109.3.4.1 Alcohol
109.3.4.2 Cocaine, Methamphetamine, and PCP
109.3.4.3 Nicotine
109.3.4.4 Opioids
109.3.4.5 Cannabis
109.3.4.6 Benzodiazepines
109.4 Identification of Pregnant Women with SUD
109.4.1 Identification of Women at Risk for SUD During Pregnancy
109.4.1.1 Maternal Interview Screening
109.4.1.2 Biologic Specimens
109.5 Identification of the Individual Exposed Prenatally to Substances
109.6 Interventions for Pregnant Women with SUD and Their Children
109.6.1 Preconception and Prenatal Counseling
109.6.2 Treatment During Pregnancy
109.6.3 Postpartum Care of the Woman with an SUD
109.6.4 The Mother/Child Dyad: Postnatal Period
109.6.5 Parenting by the Mother with an SUD
109.7 Summary and Conclusions
References