Ghodse's Drugs and Addictive Behaviour: A Guide to Treatment

by Hamid Ghodse

Overview

This classic text provides a comprehensive, accessible overview of substance misuse and dependence with an emphasis on practical and evidence-based approaches to the assessment, management and prevention of a wide range of drug-related problems, in a variety of clinical and social settings. The book includes definitions of terms, and describes the effects and clinical characteristics of all substances of misuse. The theoretical background to these topics is clearly explained. For the fourth edition, every chapter has been revised to include the most up-to-date information, with the latest international data on the extent of the world drug problem. There is detailed emphasis on harm minimization, AIDS and hepatitis C and entirely new coverage of tobacco addiction and its management. This is an essential guide for all healthcare workers, health policy specialists, counselors and those seeking to train in areas related to addiction and substance misuse.

Product Details

ISBN-13:	9780521727556
Publisher:	Cambridge University Press
Publication date:	02/11/2010
Edition description:	4th ed.
Pages:	390
Product dimensions:	7.40(w) x 9.60(h) x 0.70(d)

About the Author

Hamid Ghodse CBE is President of the United Nations International Narcotics Control Board and Professor and Director of Psychiatry at the International Centre for Drug Policy, St George's, University of London, UK.

Table of Contents

Preface ix

Introduction 1

1 Drugs, addiction and behaviour 5

What is a 'drug'? 5

What is drug misuse? 5

Drug abuse; harmful use 6

Drug dependence 6

Psychological dependence 7

Physical dependence and the withdrawal syndrome 7

Tolerance 8

Types of drug dependence 9

Causes of drug dependence 10

2 The global drug problem: international perspectives 19

Introduction 19

Extent and nature of drug problems 20

Global drug problems 32

Sources of epidemiological information in the UK 45

Drug dependence in the UK 60

Organization of treatment services in the UK 67

Drug policy in some other countries 72

3 Drugs of abuse and dependence 76

Opioids 76

Sedative hypnotics 83

Stimulant drugs 86

Hallucinogens 93

Cannabis 95

Volatile solvents 98

Designer drugs 100

Steroids 102

Over-the-counter medicines 103

Herbal preparations and 'natural' medicines 103

The combined use of drugs and alcohol 103

4 Alcohol 106

Introduction 106

Definitions 106

Extent and nature of the problem 107

Genetics of alcohol use and dependence 109

Alcohol metabolism 109

Recognition of problem drinking 110

Adverse effects of alcohol misuse 111

Management of problem drinking and its complications 113

Relapse prevention 115

Alcohol policies 117

5 Tobacco use and addiction 120

Introduction 120

The global epidemic 120

Types of tobacco and routes of administration 121

Tobacco addiction 122

The hazards of tobacco use 124

Special populations of tobacco users 125

Treatment 127

Policy and public health initiatives 129

Conclusion 129

6 Assessment 131

Introduction 131

Drug history 131

Life history 132

Social work assessment 133

Family assessment 135

Physical examination 136

Test of physical dependence on opiates (naloxone) 138

Mental state examination 139

Psychological assessment 140

Special investigations 140

Laboratory investigation for drugs 142

Summary 147

Classification of substance-use disorders 148

ICD-10 148

DSM-III-R 154

DSM-IV 155

7 General measures of intervention 160

Introduction 160

Psychotherapy 161

Drug counselling 164

Cognitive and behavioural techniques 166

Vocational rehabilitation 170

Therapeutic communities 171

Self-help groups 173

Minnesota method 176

Crisis intervention 176

Compulsory treatment 177

Inpatient care 177

Treatment matching 179

8 Specific methods of treatment 180

Opiates 180

Sedative hypnotic drugs 196

LSD and cannabis 200

Cocaine and amphetamine 200

9 Complications of drug abuse and their treatment 203

Infective complications of injection 203

Pulmonary complications 214

Psychiatric complications 214

10 Special problems 223

The pregnant addict 223

The child at risk 226

The drug-abusing doctor: the 'professional' addict 229

Comorbidity 231

Drug-dependent patients on general medical and surgical wards 234

Drug-dependent patients in accident and emergency departments 235

Drug-dependent patients in the general practitioner's surgery 238

Substance abusers detained in police custody 239

Driving licences 242

Travelling abroad 243

11 Follow-up and treatment outcome 244

Introduction 244

Natural history of drug dependence 245

Mortality 247

Outcome of treatment 250

Discussion 252

12 Prevention of drug abuse 255

Introduction 255

Reducing the availability of drugs of abuse 256

Reducing the demand for drugs of abuse 260

Pharmacological approaches 263

Harm reduction 264

Conclusion 267

13 The law and drug-control policies 270

History of international drug control 270

Current international controls 272

United Nations drug abuse control organs 274

Control in the UK 278

Appendices 283

References and further reading 349

Index 373

Editorial Reviews

'… when it comes to applying the evidence of the real-life clinical situations that face a psychiatrist working with people who use illegal drugs, this book reaches the parts that a systematic review-driven approach cannot always reach …' British Journal of Psychiatry

'… every psychiatrist should have access to a copy for reference.' Journal of Psychosomatic Research

'… well researched, thorough and logically ordered.' Drug and Alcohol Review

'Not only does it provide a comprehensive overview of the subject but it is also written in a clear, lucid style that communicates easily with broad readership. Professor Ghodse's text will remain a comprehensive guide and essential reading for a new generation of professionals working in the field of addictions.' Psychological Medicine

'Highly readable, and including illuminating sections on historical and cultural aspects of substance use … a comprehensive tool that will be invaluable to occupational physicians, particularly the Hamid Ghodse substance abuse assessment questionnaire in Appendix 4.' Occupational Medicine

From the Publisher