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Part of the Oxford Psychiatry Library series, this resource is a clear and comprehensive overview of the brain science underpinning addiction that helps explain the current and future therapeutics for the range of addictions, using full colour images to enhance understanding. It focuses on the nature of addiction as a brain disorder that includes a range of different behavioural traits such as impulsivity and reward dependence, and discusses the critical role of kinetic and pharmacological factors. The also explains how the primary pharmacological targets of drugs of abuse are now understood, the relation to the variable nature of addiction to different substances, and how this may lead to new approaches to treatment.Less

Addictive disorders in older adults are underdiagnosed and undertreated. An important reason for this lack of recognition of a serious health problem is a paucity of clinical knowledge about how such disorders present in this population. The presentation for alcohol and substance use disorders in the elderly can be confusing, given the metabolic changes and concurrent conditions associated with aging, together with interactions between alcohol and prescribed psychoactive drugs. Further, screening instruments have not been validated for this population. Brief interventions may be effective but should take into account contextual needs such as medical conditions, cognitive decline, and mobility limitations. Treatment strategies, including detoxification regimens, need to be modified for older patients and - in the case of opioid dependence - must address the management of chronic pain in this population. Ironically, benzodiazepines are the most frequently prescribed psychoactive medication in the elderly, despite older individuals' greater sensitivity to side effects and toxicity. Older women are at particularly heightened vulnerability for iatrogenic dependence on sedatives and hypnotics. More clinical research data are needed to inform screening and referral strategies, behavioral therapies, and pharmacological treatment. At the same time, emerging technologies such as communication tools and monitoring devices offer important opportunities to advance addiction treatment and recovery management in older adults. Although research to date has been limited in this population, recent data suggest that treatment outcomes are equal or better to those seen in younger cohorts.Less

The American Society of Addiction Medicine Handbook of Addiction Medicine is a practical, evidence-based guide to the identification and treatment of substance use disorders. Produced by the largest medical society dedicated to the improvement of addiction care, it begins with screening and brief intervention and an overview of treatment. This is followed by substance-specific chapters covering: alcohol, sedatives, opioids, tobacco, stimulants, hallucinogens, cannabinoids, inhalants, anabolic steroids and prescription drug misuse. Substance-specific chapters cover pharmacology, acute effects and intoxication, withdrawal, medical complications and treatment. The handbook concludes with chapters on the medical care of patients with substance use disorders, psychiatric co-occurring disorders, special populations and ethical and legal considerations. Chapters include practical tools and treatment protocols that can be used in outpatient and inpatient settings. Less

The ASAM Handbook on Pain and Addiction provides clinical guidance to health care professionals who treat patients with co-occurring pain and addiction. Produced by the largest medical society dedicated to the improvement of addiction care, the handbook takes an evidence-based approach. Its advice is based on the current scientific literature and the advice of well-regarded organizations and government agencies, including NIDA, CDC, SAMHSA, PCSS-O, and ASAM itself. The ASAM Handbook is organized in five sections, which cover the core concepts of pain and addiction; diagnosis and treatment; treating pain in patients with, or at risk for, addiction; treating substance use disorders (SUD) and addiction in patients with co-occurring pain; and adapting treatment to the needs of specific populations. Each chapter concludes with suggestions for further reading on the topics discussed. The Handbook is ideal for primary care practitioners, mental health clinicians, addiction clinicians, and pain clinicians who wish to bridge the knowledge gap related to treating patients suffering from both pain and addiction.Less

This title explains the rationale for changes in the DSM-5® related to incorporating behavioral addictions alongside substance use disorders; it also illuminates the significance of including the construct of behavioral addictions in this widely used psychiatric diagnostic manual. The chapters herien describe eight behaviors often considered addictions, including gambling disorder, internet gaming disorder, internet addiction, food addiction, hypersexuality, shopping addiction, exercise addiction, and tanning addiction. Also examined are prevalence rates in epidemiological samples, risk factors, and promising treatment approaches. The result is an easy-to-use resource and guide for clinicians, students, and researchers.Less

Drug Nation provides an accessible and lucid introduction to some of the main health and social issues related to illicit drugs and their use, and reviews a range of popular drugs—including amphetamines, cannabis, cocaine, Ecstasy (MDMA), heroin and LSD—whilst considering the law related to such substances.Less

The majority of people who experience incarceration have a history of harmful alcohol, tobacco, and/or illicit drug use. Some discontinue use of these substances while in custody. Others—notably including some people who inject drugs—continue to use drugs in prison, typically in avoidably high-risk circumstances. Rapid relapse to risky substance use after release from prison is common and is associated with a range of health and social problems, and increased risk of both death and reincarceration. Effective measures to reduce the incarceration of people who use drugs, and to minimize drug-related harms both in prison and after release from custody, are urgently required. However, the evidence base to inform effective responses remains weak, and implementation of evidence-based responses remains patchy. Drawing on the expertise of 40 authors from 10 countries, this book reviews what is known about the epidemiology of substance use in people who experience incarceration. It presents what is known about the health, social, and criminal justice consequences of harmful substance use in this population and discusses key policy reforms that have the potential to achieve better health outcomes. In addition to reviewing what is known, the book identifies key knowledge gaps and makes recommendations for future research.Less

This resource shows that the social circumstances that spread addiction in a conquered tribe or a falling civilisation are also built into today's globalizing free-market society, and argues that the most effective response to a growing addiction problem is a social and political one, rather than an individual one. Less

Integrative Addiction and Recovery is a book discussing the epidemic of addiction that is consuming our friends, family, and community nationwide. In 2016, there were 64,000 drug overdoses, and addiction became the top cause of accidental death in America in 2015. We are in a crisis and in need of a robust and integrated solution. We begin with the definition of addiction, neurobiology of addiction, and the epidemiology of varying substances of abuse and treatment guidelines. Section II reviews different types of addiction such as food, alcohol, sedative-hypnotics, cannabis, stimulants (such as cocaine and methamphetamine), opiates (including prescription and illicit opiates), and tobacco, and evidence-based approaches for their treatment using psychotherapy, pharmacotherapy, as well as holistic treatments including acupuncture, nutraceuticals, exercise, yoga, and meditation. We also have chapters on behavioral addictions and hallucinogens. Section III reviews co-occurring disorders and their evidence-based integrative treatment and also overviews the holistic therapeutic techniques such as acupuncture and TCM, Ayurveda, homeopathy, nutrition, nutraceuticals, art and aroma therapy, and equine therapy as tools for recovery. We have unique chapters on shamanism and ibogaine, as well as spirituality and group support (12 steps included). The final section deals with challenges facing recovery such as trauma, acute/chronic pain, and post acute withdrawal. Integrative Addiction and Recovery is an innovative and progressive textbook, navigating this complex disease with the most comprehensive approach.Less

This book addresses (1) candidate mechanisms across addictive behaviors, including impulsivity (Chapters 1–5); reward sensitivity (Chapter 2); behavioral sensitization and cross-sensitization to addictive, stressful, or endogenous illness-related stimuli (Chapters 1, 5–8, 13); and genetics (Chapter 11). Addictions frequently combine with other psychiatric disorders; each increases severity of the other (Chapters 1, 7, 13). Genetic or epigenetic mechanisms underlying addictive processes may overlap with those involved in predisposing illnesses (Chapters 5, 11, 13). Addressed are (2) resilience to addictions despite substance use (Chapters 1, 3–5, 7, 13); (3) clinical contexts of addictive behavior, including nicotine (Chapter 3, early onset), opiates (Chapter 4; resilience and impulsivity), alcohol (Chapter 5; stimulant-like effects), stimulants (Chapter 9), marijuana and cannabinoids (Chapter 10; endocannabinoid systems strategic role in motivation and reward), nonpharmacological addictions (Chapter 8; sexual addictions), and interactions between addictions and other recurrent/progressive brain diseases (Chapters 1, 13). Topics include (4) strategies for addiction prevention and treatment, including targets related to impulsivity (Chapters 1, 2, 4, 5), decision-making (Chapter 2), sensitization (Chapters 1, 13), and prevention (Chapters 5, 13); nonpharmacological treatments for impulsivity (Chapters 2, 4), decision-making (Chapter 2), and sensitization prevention (Chapter 13), pharmacogenetics (Chapter 11), and study design and analysis strategies that account for complex neurobehavioral interactions underlying addiction treatment (Chapter 12). Chapter 13 integrates addictive and other psychiatric diseases, especially regarding progression and sensitization, in a clinically oriented manner. Understanding the basic neurobehavioral mechanisms and sources of resilience against them will lead to more effective prevention, diagnosis, and treatment.Less

Prescription Drug Diversion and Pain provides an interdisciplinary overview of medications used to treat chronic pain, and the benefits and risks that are posed by long-term use of opioids. Use of these life-saving medications must be carefully managed to prevent serious side effects, which may include physical dependence, addiction, and even death. In recent years, the risk of these side effects has led to increased attention on the development of alternative treatments for chronic pain. This book not only offers a single, comprehensive source for understanding the specialized nature of the opioid crisis, but also addresses provocative topics including how pain drugs came to be regulated by the US government and the rarely discussed aggressive marketing behind the spread of these drugs. Chapters are written by expert contributors from diverse backgrounds in medicine, psychiatry, pharmacy, nursing, law, and bioethics. Prescription Drug Diversion and Pain is a must-read for healthcare professionals, chronic pain patients and caregivers, policymakers and regulatory officials, drug treatment providers, and those in the pharmaceutical industry seeking to address the current opioid crisis.Less