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Loosening the Grip : A Handbook of Alcohol Information

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ISBN: 9780072891065 | 0072891068
Edition: 6th
Format: Paperback
Publisher: MCGRAW HILL PUBLISHING CO
Pub. Date: 8/1/1999

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Table of ContentsAuthor Biography
... MORE
Alcohol
1(40)
Once Upon a Time
2(1)
Fermentation and Discovery of Distillation
3(1)
Alcohol Use in America
4(1)
Why Bother?
4(4)
Theories to explain alcohol use
6(2)
Myths
8(1)
Alcohol Problems: The Fly in the Ointment
8(12)
As sin or moral failing
8(1)
As a legal issue
9(1)
America's response to alcohol problems
9(2)
Drunkenness versus alcoholism
11(1)
History of alcohol treatment efforts
12(3)
Public policy and alcohol
15(5)
Alcohol Costs: Paying the Piper
20(11)
Who drinks what, when, and where
20(1)
Drinking patterns
21(3)
Economic costs versus economic benefits
24(2)
Personal costs
26(3)
Health care and alcohol
29(2)
Other Drug Use
31(5)
Social costs
31(2)
Drug use patterns
33(2)
Public perceptions and public polices
35(1)
Resources and Further Reading
36(5)
Alcohol and the body
41(25)
Digestion
42(1)
Absorption
42(1)
Blood Alcohol Concentration (BAC)
43(1)
Breakdown and Removal
44(2)
Alcohol's Acute Effects on the Body
46(5)
Digestive system
46(1)
Circulatory system
46(1)
Kidneys
47(1)
Liver
47(1)
Central nervous system
48(3)
Acute Overdose and Toxicity
51(3)
Differences in women
52(2)
Tolerance
54(1)
Alcohol As an Anesthetic
55(1)
Other Types of Alcohol
55(1)
The Influence of Expectations
56(1)
Other Drugs of Abuse
56(7)
Route of administration
57(1)
Site of action
58(1)
Solubility in fat and/or water
59(1)
Metabolism
59(1)
Acute effects of major drug classes
59(4)
In conclusion
63(1)
Resources and Further Reading
63(3)
Medical complications
66(1)
PART I. ADVICE FOR THE MODERATE DRINKER67(4)
Contraindications to moderate use
67(1)
Alcohol-drug interactions
68(1)
Problems associated with drinking and intoxication
69(1)
Alcohol use and exercise
70(1)
Other drug use
71(1)
PART II. MEDICAL COMPLICATIONS OF CHRONIC HEAVY ALCOHOL USE71(42)
Visible signs and symptoms of chronic heavy drinking
72(1)
Gastrointestinal System
73(4)
Irritation, bleeding, and malabsorption
73(1)
Pancreatitis
74(1)
Liver disease
74(3)
Hematological System
77(4)
Red blood cells
77(2)
White blood cells
79(1)
Platelets
79(1)
Clotting factors and DIC
79(1)
Alcohol and the immune system
80(1)
Cardiovascular System
81(2)
Genitourinary System
83(2)
Urinary tract
83(1)
Reproductive system
84(1)
Alcohol and Pregnancy
85(3)
Fetal alcohol syndrome
85(1)
Fetal alcohol effects
86(2)
Respiratory System
88(1)
Endocrine System
89(2)
Cancer
90(1)
Skin
91(1)
Musculoskeletal System
92(1)
Nervous System
93(6)
Dependence, tolerance, craving, and withdrawal
93(1)
Alcohol idiosyncratic intoxication (pathological intoxication)
94(1)
Organic brain disease
95(2)
Nerve and muscle tissue damage
97(1)
Subdural hematoma
98(1)
Miscellaneous CNS disturbances
98(1)
Neuropsychological Impairment
99(1)
Miscellaneous Effects
99(1)
Sleep and Sleep Disturbances in Alcoholics
100(5)
Sleep patterns
101(1)
Sleep disturbances
102(1)
Insomnia
103(1)
Alcohol's effects on sleep
104(1)
Blackouts
105(2)
Withdrawal Syndromes
107(6)
Late withdrawal phenomena
112(1)
Some cautions
112(1)
PART III. OTHER DRUG USE113(392)
Chronic Effects of Other Drug Use
113(6)
Signs and Symptoms of Acute Intoxication and Overdose
119(2)
Pregnancy and Other Drug Use
121(4)
Epidemiology
121(1)
Cocaine-exposed infants
122(1)
Opiate-exposed infants
123(2)
Resources and Further Reading
125(5)
Alcohol dependence
130(25)
Definitions
131(4)
Early definitions
132(3)
A Disease?
135(4)
Implications of disease classification
136(1)
Criticisms of the disease concept
137(2)
Natural History
139(4)
Jellinek's phases of alcoholism
139(3)
Types of alcoholism: Jellinek's species
142(1)
Species reexamined
143(1)
Guides for Diagnosis
143(6)
NCA criteria
143(2)
DSM-III criteria
145(1)
DSM-IV criteria
146(3)
Natural History of Alcoholism: Jellinek Revisited
149(1)
Other Drugs of Abuse
150(1)
Resources and Further Reading
151(4)
Etiology of alcohol dependence
155(40)
Public Health Model
156(1)
The Agent
157(2)
The Host---Genetic Factors
159(7)
Nature versus nurture
159(1)
Twin and adoption studies
160(1)
Studies of nonalcoholic blood relatives
161(2)
Genetic markers
163(2)
Familial versus nonfamilial alcoholism: So what?
165(1)
The Host---Personality and Psychological Makeup
166(6)
Psychological needs
166(1)
Early psychological approaches
167(1)
Personality theories applied to alcoholism
168(2)
Learning theories
170(1)
Current thinking
170(2)
The Environment---Sociological Factors
172(16)
Cultural orientation
172(4)
Drinking styles and alcohol problems
176(1)
The influence of cultural subgroups
176(1)
Legal sanctions and approaches
177(1)
Cross-cultural comparisons
178(4)
Another perspective on cultural influence
182(1)
The 1990s: A decade of change
183(5)
Resources and Further Reading
188(7)
The behavior of dependence
195(14)
A Behavioral Composite
196(2)
How, If Not Why
198(5)
Deteriorating Functioning
203(1)
Family and Friends
204(2)
Work
206(1)
Resources and Further Reading
207(2)
Effects of alcohol problems on the family
209(21)
The ``Family Illness''
210(4)
The family's response
211(3)
The Family System
214(3)
Enabling
215(1)
Co-dependency
215(1)
Current thinking
216(1)
Children of Alcoholics
217(7)
Children in the home
217(3)
Children's coping styles
220(1)
Adult children of alcoholics
221(1)
An insight from PT Barnum
222(1)
Resiliency
223(1)
Genetic vulnerability
224(1)
Alcoholism in Other Family Members
224(1)
Problems of Other Drug Abuse and the Family
225(1)
Resources and Further Reading
225(5)
Evaluation and treatment overview
230(58)
Theoretical Perspectives
232(1)
Problems of Use
233(3)
Chronic disease framework
233(3)
Screening and Evaluation
236(13)
Screening instruments
238(8)
Initial follow-up questions
246(1)
Identifying situations requiring medical attention
246(3)
Substance Use History
249(3)
Clinical style
249(1)
Motivation
249(2)
When to ask
251(1)
What to ask
251(1)
How to ask
252(1)
Recording the data in the record
252(1)
What Next?
252(9)
Making a referral
252(3)
Evaluation in a substance abuse treatment setting
255(3)
Treatment planning and treatment settings
258(3)
Treatment
261(4)
Alcohol incidents
261(1)
Other drug incidents
262(1)
Alcohol abuse
263(1)
Marijuana: incidents and abuse
264(1)
Alcohol Dependence
265(19)
Obstacles to treatment
266(1)
Factors in successful treatment
267(2)
Recovery process
269(5)
Common themes in treatment
274(10)
Resources and Further Reading
284(4)
Screening
284(1)
Assessment
284(1)
Motivation
285(1)
Clinical care
286(2)
Treatment techniques and approaches
288(70)
Individual Counseling
289(9)
Observation
289(2)
Feedback
291(1)
Education
292(1)
Self-disclosure
293(1)
Client responsibility
294(1)
A word of caution
294(1)
Problem identification and problem solving
295(1)
The therapeutic relationship
296(1)
Case management and administrative tasks
297(1)
Group Work
298(5)
Group as therapy
299(1)
Group work with those with alcohol problems
300(1)
Group functions
301(1)
Groups as a diversion
302(1)
Working with Families
303(12)
Family assessment
304(1)
Family intervention
305(1)
The ingredients of intervention
306(1)
Family treatment in conjunction with alcohol treatment
306(2)
Family issues
308(1)
Suggestions for working with families during treatment
308(1)
Things to keep in mind when working with families
309(4)
Self-help for families
313(2)
Self-Helf
315(11)
Alcoholics Anonymous
315(10)
Other self-help groups
325(1)
Other Approaches
326(14)
Spiritual counseling
326(5)
Activities therapy
331(3)
Behavioral approaches
334(5)
Meditation
339(1)
Pharmacotherapy
340(6)
Drugs used in alcohol treatment
340(5)
Pharmacologic treatment of other drug dependence
345(1)
Resources and Further Reading
346(12)
Technical assistance protocols
347(1)
Treatment improvement protocols
348(10)
Special populations
358(77)
Adolescents
359(17)
Physical changes
359(2)
Characteristics
361(4)
Alcohol and other drug use
365(1)
Adolescent alcohol and drug problems
366(9)
Prevention
375(1)
Minority youth
376(1)
College Students
376(14)
Patterns of use
376(3)
Problems associated with substance use
379(2)
Students at risk for acute problems
381(2)
Campus initiatives
383(6)
Closing thoughts
389(1)
The Elderly
390(19)
Stresses of aging
391(6)
Patterns of alcohol and other drug use
397(4)
Alcohol problems
401(5)
Drug use problems
406(1)
Prevention
406(1)
General suggestions for working with elderly people
406(3)
Women
409(13)
Gender differences
409(1)
Differences among women
410(4)
Natural history
414(3)
Treatment issues
417(3)
Treatment issues for pregnant women
420(2)
The Workplace
422(6)
Some basic statistics
422(2)
Occupational high-risk factors
424(1)
The workplace cover-up
424(1)
Workplace interventions
425(2)
Implications for treatment
427(1)
Other Special Populations
428(2)
Becoming acquainted with a different culture
429(1)
Resources and Further Reading
430(5)
Adolescents
430(1)
College students
431(1)
The elderly
432(1)
Women
432(1)
The workplace
433(2)
Other psychiatric considerations
435(34)
Suicide Evaluation and Prevention
436(5)
Statistics and high-risk factors
437(1)
How to ask
438(1)
What to do
439(2)
Mental Status Examination
441(1)
Co-Occurring Psychiatric Illness
442(11)
Mood disorders
442(3)
Disorders involving psychosis
445(2)
Anxiety disorders
447(1)
Personality disorders
448(1)
Attention-deficit/hyperactivity disorders
449(1)
Organic mental disorders
450(1)
Polysubstance dependence
451(1)
Other addictive behaviors
452(1)
Clinical considerations
452(1)
Homelessness, alcohol use, and chronic mental illness
452(1)
Psychotropic Medications
453(8)
Antipsychotic medications
455(2)
Antidepressant medications
457(1)
Mood stabilizers
457(2)
Antianxiety medications
459(2)
Resources and Further Reading
461(8)
Odds 'n ends
469(36)
Beyond Counseling
470(8)
Educational activities
470(2)
Training others
472(1)
Prevention efforts
473(5)
The Real World
478(6)
Being a professional colleague
478(2)
Selecting a professional position
480(1)
Being a professional
481(1)
Professional development
482(1)
Certification and licensure
483(1)
Ethics
484(6)
Basic principles
484(2)
Confidentiality
486(1)
Setting boundaries
486(4)
Counselors with ``Two Hats''
490(4)
Clinician impairment and relapse
491(3)
Resources and Further Reading
494(11)
Issues of the profession
494(1)
Ethics
495(1)
Clinical care
496(4)
Prevention
500(5)
Appendix A. World Wide Web (WWW) sites505(4)
Appendix B. Organizations in the substance abuse field509(26)
Appendix C. The interaction effects of alcohol with other drugs535(4)
Index539
Jean Kinney, Assistant Professor of Psychiatry at Dartmouth Medical School, was the Associate Director of the Alcohol Counselor Training Program at Dartmouth from 1972-1978, the program that was the impetus for this text. She is currently employed at Project Cork managing program administration and development for medical education and clinical care for substance abuse.

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