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Concepts of Chemical Dependency

ISBN: 9780534537227 | 0534537227
Edition: 5th
Format: Paperback
Publisher: Cengage Learning
Pub. Date: 7/9/2001

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SummaryTable of Contents
This thoroughly revised and updated edition reflects the current explosion of information regarding the understanding, identification, and treatment of addictive disorders. Doweiko offers detailed coverage of the most commonly abused chemicals and their effects, covering a single facet of a drug or alcohol problem in each focused chapter. This text is the most thorough and comprehensive text on the market providing students with information on substances as well as clinical guidelines and strategies for working with clients. Doweiko covers topi... MORE
Why Worry about Recreational Chemical Use in the United States?
1(11)
Introduction
1(1)
Who ``Treats'' Those Who Abuse o... MORE
2(1)
The Scope of the Problem of Chemical Abuse and Addiction
3(4)
The Cost of Chemical Abuse and Addiction in the United States
7(2)
Summary
9(2)
What Do We Mean When We Say Substance Abuse and Addiction?
11(7)
Introduction
11(1)
The Continuum of Chemical Use
11(2)
Definitions of Terms to Be Used in This Book
13(2)
What Do We Really Know about the Addictive Disorders?
15(1)
The State of the Art: Unanswered Questions, Uncertain Answers
16(1)
Summary
17(1)
The Medical Model of Chemical Addiction
18(12)
Introduction
18(1)
Why Do People Abuse Chemicals?
18(3)
What Do We Mean When We Say That Someone Is ``Addicted'' to Chemicals?
21(8)
Summary
29(1)
Are People Predestined to Become Addicted to Chemicals?
30(14)
Introduction
30(1)
Multiple Models
30(1)
Reaction Against the Disease Model of Addiction
30(11)
The Final Common Pathway Theory of Addiction
41(2)
Summary
43(1)
Addiction as a Disease of the Human Spirit
44(11)
Introduction
44(1)
Diseases of the Mind and Diseases of the Spirit: The Mind-Body Question
45(1)
The Growth of Addiction: The Circle Narrows
46(1)
The Circle of Addiction: Addicted Priorities
46(1)
Some Games of Addiction
47(1)
Honesty as a Part of the Recovery Process
48(1)
False Pride: The Disease of the Spirit
49(2)
Projection, Denial, Rationalization, and Minimization: The Four Musketeers of Addiction
51(2)
Summary
53(2)
An Introduction to Pharmacology
55(14)
Introduction
55(1)
The Prime Effect and Side Effects of Chemicals
55(1)
Drug Forms and How Drugs Are Administered
56(2)
Bioavailability
58(4)
Key Considerations in Assessing the Effects of Chemicals
62(3)
Sites and Structures of Special Importance in Pharamacology
65(3)
Summary
68(1)
An Introduction to Alcohol
69(10)
Introduction
69(1)
A Brief History of Alcohol
69(1)
How Alcohol Is Produced
70(1)
Alcohol Today
70(1)
Scope of the Problem of Alcohol Use
71(1)
The Pharmacology of Alcohol
71(2)
The Blood Alcohol Level
73(1)
Subjective Effects of Alcohol on the Individual
74(2)
Medical Complications of Alcohol Use in the Average Drinker
76(2)
Alcohol Use and Accidental Injury or Death
78(1)
Summary
78(1)
Chronic Alcohol Abuse and Addiction
79(16)
Introduction
79(1)
Scope of the Problem
79(1)
The ``Typical'' Alcohol-Dependent Person
80(1)
Alcohol Tolerance, Dependency, and ``Craving'': Signposts of Alcoholism
80(2)
Complications of Chronic Alcohol Use
82(12)
Summary
94(1)
Abuse of and Addiction to the Barbiturates and Barbiturate-like Drugs
95(10)
Introduction
95(1)
Early Pharmacological Therapy for Anxiety Disorders and Insomnia
95(1)
History and Current Medical Uses of the Barbiturates
96(1)
Pharmacology of the Barbiturates
97(2)
Subjective Effects of Barbiturates at Normal Dosage Levels
99(1)
Complications of the Barbiturates at Normal Dosage Levels
99(2)
Effects of the Barbiturates at Above-normal Dosage Levels
101(1)
Neuroadaptation to, Tolerance to, and Dependency on the Barbiturates
102(1)
Barbiturate-like Drugs
103(1)
Summary
104(1)
Abuse of and Addiction to Benzodiazepines and Similar Agents
105(16)
Introduction
105(1)
Medical Uses of the Benzodiazepines
105(1)
Pharmacology of the Benzodiazepines
106(2)
Side Effects of the Benzodiazepines at Normal Dosage Levels
108(1)
Neuroadaptation to Benzodiazepines, and Their Abuse/Addiction
109(1)
Complications Caused by Benzodiazepine Use at Normal Dosage Levels
110(3)
Subjective Experience of Benzodiazepine Use
113(1)
Long-term Consequences of Chronic Benzodiazepine Use
114(1)
Buspirone
115(2)
Zolpidem
117(1)
Zaleplon
118(1)
Rohypnol
118(1)
Summary
119(2)
Abuse of and Addiction to Amphetamines and CNS Stimulants
121(15)
Introduction
121(1)
The CNS Stimulants as Used in Medical Practice
121(1)
The Amphetamine-like Drugs
121(3)
The Amphetamines
124(4)
CNS Stimulant Abuse
128(1)
Scope of the Problem of Stimulant Abuse and Addiction
128(1)
Effects of the CNS Stimulants When Abused
128(7)
Summary
135(1)
Cocaine
136(15)
Introduction
136(1)
A Brief Overview of Cocaine
136(1)
Cocaine in Recent U.S. History
137(1)
Cocaine Today
138(2)
Pharmacology of Cocaine
140(1)
How Illicit Cocaine Is Produced
141(1)
How Cocaine Is Abused
142(2)
Subjective Effects of Cocaine When It Is Abused
144(1)
Complications of Cocaine Abuse/Addiction
145(4)
Summary
149(2)
Marijuana Abuse and Addiction
151(11)
Introduction
151(1)
History of Marijuana Use in the United States
151(2)
The Potency of Marijuana Currently Being Used
153(1)
Scope of the Problem of Marijuana Abuse
153(1)
Pharmacology of Marijuana
154(1)
Methods of Administration
155(1)
Subjective Effects of Marijuana
156(1)
Adverse Effects of Occasional Marijuana Use
157(1)
Consequences of Chronic Marijuana Abuse
158(2)
The Addiction Potential of Marijuana
160(1)
Summary
160(2)
Opiate Abuse and Addiction
162(21)
Introduction
162(1)
The Medical Uses of Narcotic Analgesics
162(1)
A Short History of the Narcotic Analgesics
162(2)
The Classification of Analgesics
164(1)
Where Opium Is Produced
164(1)
Current Medical Uses of the Narcotic Analgesics
165(1)
Pharmacology of the Narcotic Analgesics
165(3)
Subjective Effects of Narcotic Analgesics When Used in Medical Practice
168(1)
Complications Caused by Narcotic Analgesics When Used in Medical Practice
169(2)
Fentanyl
171(1)
Buprenorphine
172(2)
Opiates As Drugs of Abuse
172(2)
Methods of Opiate Abuse
174(2)
Scope of the Problem of Opiate Abuse and Addiction in the United States
176(4)
Complications Caused by Chronic Opiate Abuse
180(1)
Opiate Overdose
181(1)
Summary
182(1)
Hallucinogen Abuse and Addiction
183(15)
Introduction
183(1)
History of Hallucinogens in the United States
183(1)
Scope of the Problem
184(1)
Pharmacology of the Hallucinogens
184(2)
Subjective Effects of Hallucinogens
186(3)
Phencyclidine (PCP)
189(2)
Complications of PCP Abuse
191(1)
Ecstasy: Evolution of a New Drug of Abuse
192(5)
Summary
197(1)
Abuse of and Addiction to the Inhalants and Aerosols
198(8)
Introduction
198(1)
The History of Inhalant Abuse
198(1)
The Pharmacology of the Inhalants
199(1)
Scope of the Problem
200(1)
Method of Administration
201(1)
Subjective Effects of Inhalants
202(1)
Complications from Inhalants Abuses
202(2)
Misuse of Anesthetics
204(1)
Abuse of Nitrites
205(1)
Summary
205(1)
The Unrecognized Problem of Steroid Abuse and Addiction
206(8)
Introduction
206(1)
An Introduction to the Anabolic Steroids
206(1)
Medical Uses of Anabolic Steroids
207(1)
The Legal Status of Anabolic Steroids
207(1)
Scope of the Problem of Steroid Abuse
207(1)
Sources and Methods of Steroid Abuse
207(2)
Problems Associated with Anabolic Steroid Abuse
209(1)
Complications of Steroid Abuse
209(3)
Are Anabolic Steroids Addictive?
212(1)
Summary
213(1)
The Over-the-Counter Analgesics: Unexpected Agents of Abuse
214(15)
Introduction
214(1)
A Short History of the OTC Analgesics
214(1)
Medical Uses of the OTC Analgesics
215(2)
Pharmacology of the OTC Analgesics
217(2)
Normal Dosage Levels of OTC Analgesics
219(2)
Complications Caused by the Use of OTC Analgesics
221(4)
Overdose of OTC Analgesics
225(2)
Summary
227(2)
Tobacco Products and Nicotine Addiction
229(14)
Introduction
229(1)
History of Tobacco Use in the United States
229(1)
Scope of the Problem
230(1)
Pharmacology of Cigarette Smoking
231(3)
Subjective Effects of Nicotine Use
234(1)
Nicotine Addiction
235(2)
Complications of the Chronic Use of Tobacco
237(5)
Summary
242(1)
Chemicals and the Neonate: The Consequences of Drug Abuse During Pregnancy
243(14)
Introduction
243(1)
Scope of the Problem
243(13)
Summary
256(1)
The Hidden Faces of Chemical Dependency
257(14)
Introduction
257(1)
Women and Addiction: An Often Unrecognized Problem
257(5)
Addiction and the Homeless
262(1)
Substance Use Problems and the Elderly
262(4)
The Homosexual and Substance Abuse
266(2)
Substance Abuse and the Disabled
268(1)
Substance Abuse and Ethnic Minorities
268(2)
Summary
270(1)
The Dual-Diagnosis Client: Chemical Addiction and Mental Illness
271(12)
Introduction
271(1)
Definitions
271(1)
Dual-Diagnosis Clients: A Diagnostic Challenge
271(1)
Why Worry About the Dual-Diagnosis Client?
272(1)
The Scope of the Problem
273(1)
Characteristics of Dual-Problem Clients
274(4)
Problems in Working with Dual-Diagnosis Clients
278(1)
Treatment Approaches
279(3)
Summary
282(1)
Chemical Abuse by Children and Adolescents
283(16)
Introduction
283(1)
The Importance of Childhood and Adolescence in the Evolution of Substance Use Problems
283(1)
Scope of the Problem
284(5)
Why Do Adolescents Use Chemicals?
289(2)
The Adolescent Abuse/Addiction Dilemma: How Much Is Too Much?
291(4)
Possible Diagnostic Criteria for Adolescent Drug/Alcohol Problems
295(2)
The Special Needs of the Adolescent in a Substance Abuse Rehabilitation Program
297(1)
Summary
298(1)
Codependency and Enabling
299(10)
Introduction
299(1)
Enabling
299(2)
Codependency
301(3)
Reactions to the Concept of Codependency
304(4)
Summary
308(1)
Addiction and the Family
309(10)
Introduction
309(1)
Scope of the Problem
309(1)
Addiction and Marriage
309(2)
Addiction and the Family
311(2)
The Adult Children of Alcoholics (ACOA) Movement
313(5)
Summary
318(1)
The Evaluation of Substance Abuse Problems
319(15)
Introduction
319(1)
The Theory Behind Alcohol and Drug Use Evaluations
319(1)
Screening
320(2)
Assessment
322(1)
Diagnosis
323(1)
The Assessor and Data Privacy
324(1)
Diagnostic Rules
325(1)
The Assessment Format
326(4)
Other Sources of Information
330(1)
The Outcome of the Evaluation Process
331(1)
Summary
331(3)
The Process of Intervention
334(8)
Introduction
334(1)
A Definition of Intervention
334(1)
Characteristics of the Intervention Process
335(1)
The Mechanics of Intervention
335(3)
Intervention with Other Forms of Chemical Addiction
338(1)
The Ethics of Intervention
338(1)
Intervention via the Court System
339(1)
Other Forms of Intervention
340(1)
Summary
341(1)
The Treatment of Chemical Dependency
342(10)
Introduction
342(1)
The Substance Abuse Rehabilitation Professional
342(2)
The Minnesota Model of Chemical Dependency Treatment
344(2)
The Treatment Plan
346(1)
Other Treatment Formats for Chemical Dependency
347(4)
Aftercare Programs
351(1)
Summary
351(1)
Treatment Formats for Chemical Dependency Rehabilitation
352(12)
Introduction
352(1)
Outpatient Treatment
352(3)
Inpatient Treatment
355(2)
Is There a Legitimate Need for Inpatient Treatment?
357(2)
Inpatient or Outpatient Treatment?
359(3)
Summary
362(2)
The Process of Recovery
364(10)
Introduction
364(1)
The Stages of Recovery
364(5)
Specific Points to Address with Common Drugs of Abuse
369(4)
Summary
373(1)
Problems That Can Arise in Treating Chemical Dependency
374(15)
Introduction
374(1)
Limit Testing by Clients in Treatment
374(1)
Treatment Noncompliance
375(1)
Relapse and Relapse Prevention
376(2)
``Cravings'' and ``Urges''
378(2)
Controlled Drinking
380(1)
Clients Who Appear for Their Appointment While Under the Influence of Chemicals
380(1)
Toxicology Testing as a Measure of Treatment Compliance and Drug Use
381(5)
Insurance Reimbursement Policies
386(2)
Summary
388(1)
Pharmacological Intervention Tactics and Substance Abuse
389(15)
Introduction
389(1)
Pharmacological Treatment of Alcohol Abuse and Dependency
389(5)
Pharmacological Treatment of Opiate Addiction
394(4)
Pharmacological Treatment of Cocaine Addiction
398(2)
Pharmacological Treatment of Nicotine Dependency
400(3)
Summary
403(1)
Substance Abuse/Addiction and Infectious Disease
404(14)
Introduction
404(1)
Why Is Infectious Disease Such a Common Complication of Alcohol/Drug Abuse?
404(1)
The Pneumonias
405(1)
Acquired Immune Deficiency Syndrome (AIDS)
406(6)
Tuberculosis (TB)
412(1)
Viral Hepatitis
413(4)
Summary
417(1)
Self-Help Groups
418(15)
The Twelve Steps of Alcoholics Anonymous
418(1)
Introduction
418(1)
The History of AA
419(1)
Elements of AA
419(2)
AA and Religion
421(1)
One ``A'' Is for Anonymous
422(1)
AA and Outside Organizations
422(1)
The Primary Purpose of AA
423(1)
Of AA and Recovery
424(1)
Sponsorship
425(1)
AA and Psychological Theory
425(1)
How Does AA Work?
425(1)
Outcome Studies: The Effectiveness of AA
426(2)
Narcotics Anonymous
428(1)
Al-Anon and Alateen
428(1)
Support Groups Other Than AA
429(2)
Criticism of the AA/Twelve-Step Movement
431(1)
Summary
432(1)
Crime and Drug Use
433(15)
Introduction
433(1)
Drug Abuse and Criminal Behavior
433(1)
The ``War on Drugs'': The Making of a National Disaster
434(7)
Drug Use and Violence: The Unseen Connection
441(1)
Unseen Victims of Street-Drug Chemistry
441(2)
Drug Analogues: The ``Designer'' Drugs
443(4)
Summary
447(1)
Appendix 1 Sample Assessment: Alcohol Abuse Situation448(3)
Appendix 2 Sample Assessment: Chemical Dependency Situation451(4)
Appendix 3 The ``Jellinek'' Chart for Alcoholism455(1)
Appendix 4 Drug Classification Schedules456(2)
Glossary458(7)
References465(54)
Index519

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