Rent 9780073404653 | Loosening the Grip : A Handbook of Alcohol Information

Jean Kinney is Lecturer in Community and Family Medicine at Dartmouth Medical School.

This text offers a thorough approach to understanding alcohol, its physical and psychological affects on an individual, and its emotional impact on the family. It is the only comprehensive, self-contained book intended to cover the range of psychological factors, physical complications, treatment options, and family concerns. The text is easy to read and covers a broad range of situations, making it suitable for academics, student... MORE

Preface	p. xiv
Alcohol	p. 1
Once Upon a Time...	p. 1
Fermentation and Discovery of Distillation	p. 2
Alcohol Use in America	p. 3
Why Bother?	p. 4
Theories to Explain Alcohol Use	p. 5
Myths	p. 7
Alcohol Problems: The Fly in the Ointment	p. 8
Problems as Sin or Moral Failing	p. 8
Proble... MOREms as a Legal Issue	p. 8
America's Response to Alcohol Problems	p. 9
Drunkenness versus Alcoholism	p. 11
History of Alcohol Treatment Efforts	p. 12
Public Policy and Alcohol	p. 14
Advertising	p. 18
Changing Norms	p. 22
Other Drug Use	p. 23
Tobacco	p. 23
Marijuana	p. 26
References and Suggested Reading	p. 29
Alcohol and Its Costs	p. 30
Who Drinks What, When, and Where	p. 31
Drinking Patterns	p. 32
Alcohol Problems	p. 37
Abuse and Dependence	p. 37
Economic Costs versus Economic Benefits	p. 38
Personal Costs	p. 40
Health Care and Alcohol	p. 45
References and Suggested Reading	p. 49
Alcohol and the Body	p. 51
Ingestion and Absorption	p. 51
Blood Alcohol Concentration	p. 53
Breakdown and Removal	p. 54
Alcohol's Acute Effects on the Body	p. 57
Digestive System	p. 57
Circulatory System	p. 57
Kidneys	p. 58
Liver	p. 58
Central Nervous System	p. 60
Acute Overdose and Toxicity	p. 63
Differences in Women	p. 64
Tolerance	p. 66
Alcohol as an Anesthetic	p. 67
Other Types of Alcohol	p. 67
The Influence of Expectations	p. 68
Advice for the Moderate Drinker	p. 69
Contraindications to Moderate Use	p. 69
Alcohol-Drug Interactions	p. 70
The Basis of Alcohol-Drug Interactions	p. 71
Problems Associated with Drinking and Intoxication	p. 74
Alcohol Use and Exercise	p. 75
In Conclusion	p. 76
References and Suggested Reading	p. 76
Alcohol Dependence	p. 77
Definitions	p. 77
Early Definitions	p. 79
Toward Uniformity in Terminology	p. 80
A Disease?	p. 82
Implications of Disease Classification	p. 82
Criticisms of the Disease Concept	p. 83
Natural History	p. 87
Jellinek's Phases of Alcoholism	p. 87
Types of Alcoholism: Jellinek's Species	p. 89
Current Thinking	p. 90
Guides for Diagnosis	p. 91
NCA Criteria	p. 91
Diagnostic Criteria of the American Psychiatric Association	p. 93
Natural History of Alcoholism: Jellinek Revisited	p. 96
References and Suggested Reading	p. 98
Etiology of Alcohol Dependence	p. 99
Public Health Model	p. 99
The Agent	p. 100
The Host-Genetic Factors	p. 102
Nature and Nurture	p. 103
Twin and Adoption Studies	p. 103
Studies of Nonalcoholic Blood Relatives	p. 105
Genetic Markers	p. 106
Familial versus Nonfamilial Alcohol Dependence: So What?	p. 111
The Host-Personality and Psychological Makeup	p. 111
Psychological Needs	p. 112
Early Psychological Approaches	p. 113
Personality Theories Applied to Alcohol Dependence	p. 113
Current Thinking	p. 115
The Environment-Sociological Factors	p. 119
Cultural Orientation	p. 119
Drinking Styles and Alcohol Problems	p. 125
Influence of Cultural Subgroups	p. 126
Legal Sanctions and Approaches	p. 126
Cross-Cultural Comparisons	p. 129
Cultural Influences on Recovery	p. 134
Views in the Twenty-First Century	p. 135
References and Suggested Reading	p. 138
Medical Complications	p. 140
Visible Signs and Symptoms of Chronic Heavy Drinking	p. 141
Gastrointestinal System	p. 142
Irritation, Bleeding, and Malabsorption	p. 142
Pancreatitis	p. 143
Gallbladder Disease	p. 144
Liver Disease	p. 144
Gastrointestinal Cancers	p. 147
Hematological System	p. 147
Red Blood Cells	p. 148
White Blood Cells	p. 149
Platelets	p. 150
Clotting Factors and DIC	p. 150
Immune System	p. 150
Cardiovascular System	p. 151
Genitourinary System	p. 154
Urinary Tract	p. 154
Reproductive System and Pregnancy	p. 155
Respiratory System	p. 159
Endocrine System	p. 160
Cancer	p. 162
Skin	p. 163
Skeletal System	p. 164
Nervous System	p. 165
Dependence, Tolerance, Craving, and Withdrawal	p. 165
Alcohol Idiosyncratic Intoxication (Pathological Intoxication)	p. 167
Organic Brain Disease	p. 167
Nerve and Muscle Tissue Damage	p. 170
Subdural Hematomas	p. 171
Miscellaneous CNS Disturbances	p. 172
Neuropsychological Impairment	p. 172
Miscellaneous Effects	p. 173
Sleep and Sleep Disturbances	p. 175
Sleep Stages	p. 175
Sleep Disturbances	p. 176
Insomnia	p. 177
Alcohol's Effects on Sleep	p. 178
Blackouts	p. 179
Withdrawal Syndromes	p. 182
Hyperarousal	p. 183
Alcoholic Hallucinosis	p. 183
Convulsive Seizures	p. 184
Delirium Tremens	p. 185
Late Withdrawal Phenomenon	p. 187
Some Cautions	p. 187
References and Suggested Reading	p. 188
The Behavior of Dependence	p. 190
A Behavioral Composite	p. 190
How, If Not Why?	p. 191
Deteriorating Functioning	p. 197
Family and Friends	p. 198
Work	p. 200
Other Drugs of Abuse	p. 200
A Final Thought	p. 204
References and Suggested Reading	p. 205
Effects of Alcohol Problems on the Family	p. 206
The "Family Illness"	p. 206
The Family's Response	p. 207
The Family System	p. 210
Enabling	p. 211
Co-dependency	p. 212
Current Thinking	p. 213
Children in the Family	p. 214
Children in the Home	p. 214
Children's Coping Styles	p. 217
Adult Children	p. 218
Resiliency	p. 221
Genetic Vulnerability	p. 222
Alcohol Dependence in Other Family Members	p. 222
Other Substance Use and Its Impact on the Family	p. 223
References and Suggested Reading	p. 227
Evaluation and Treatment Overview	p. 229
Theoretical Perspectives	p. 230
Problems of Use	p. 231
Chronic Disease Framework	p. 232
Challenges of Problems Associated with Use	p. 234
Screening and Evaluation	p. 235
Laboratory Tests	p. 235
Screening Instruments	p. 236
Initial Follow-Up Questions	p. 242
Identifying Situations Requiring Medical Attention	p. 244
Substance Use History	p. 247
Clinical Style	p. 247
Motivation	p. 247
History Taking	p. 249
What's Next?	p. 251
Making a Referral	p. 251
Evaluation in a Substance Abuse Treatment Setting	p. 254
Treatment Planning and Treatment Settings	p. 257
Treatment of Alcohol Problems and Alcohol Abuse	p. 260
Alcohol Incidents	p. 260
Alcohol Abuse	p. 265
Treatment of Alcohol Dependence	p. 265
Obstacles to Treatment	p. 267
Factors in Successful Treatment	p. 268
Recovery Process	p. 269
Common Treatment Issues	p. 274
References and Suggested Reading	p. 285
Treatment Techniques and Approaches	p. 287
Individual Counseling	p. 287
Observation	p. 288
Feedback	p. 290
Education	p. 290
Self-Disclosure	p. 292
Client Responsibility	p. 294
Possible Mis-steps	p. 295
Problem Identification and Problem Solving	p. 296
The Therapeutic Relationship	p. 297
Case Management and Administrative Tasks	p. 299
Group Work	p. 299
Group as Therapy	p. 299
Types of Groups	p. 301
Group Functions	p. 302
Groups as a Diversion	p. 303
Working with Families	p. 304
Family Members Troubled by Another's Alcohol Use	p. 305
Family Interventions	p. 305
Family Treatment in Conjunction with Alcohol Treatment	p. 309
Suggestions for Working with Families during Treatment	p. 310
Family Issues	p. 311
Couples Therapy	p. 316
Self-Help for Families	p. 316
Self-Help	p. 318
Alcoholics Anonymous (AA)	p. 318
Other Self-Help Groups	p. 329
Which Self-Help Approach?	p. 332
Other Approaches	p. 333
Spiritual Counseling	p. 333
Meditation	p. 339
Activities Therapy	p. 340
Behavioral Approaches	p. 343
Pharmacotherapy	p. 351
Disulfiram (Antabuse)	p. 351
Anticraving Agents	p. 353
Treatment Matching	p. 354
References and Suggested Reading	p. 355
Special Populations	p. 357
Adolescents	p. 357
Developmental Issues	p. 358
Alcohol and Other Drug Use	p. 364
Associated Problems	p. 367
Working with Adolescents	p. 374
A Framework for Addressing Adolescent Substance Use/Problems	p. 378
Further Assessment and Treatment	p. 381
College Students	p. 391
Patterns of Alcohol and Other Drug Use	p. 391
Problems Associated with Substance Use	p. 395
Perceived Benefits Associated with Drinking	p. 398
Students at Risk	p. 399
Natural History of Collegians' Alcohol Use	p. 403
Impetus to Institutional Action	p. 409
Impediments to Campus Programs	p. 410
Campus Initiatives	p. 411
Intervention and Treatment	p. 414
Antismoking Efforts	p. 418
Closing Thoughts	p. 418
The Elderly	p. 419
Stresses of Aging	p. 420
Patterns of Alcohol and Other Drug Use	p. 427
Alcohol Use and Health Status	p. 431
Alcohol Problems	p. 431
Prevention	p. 438
Working with Elderly People	p. 438
Women	p. 441
Gender Differences	p. 441
Differences among Women	p. 443
Natural History of Alcohol and Other Drug Problems in Women	p. 446
Assessment	p. 450
Treatment Approaches	p. 451
Treatment Themes	p. 451
Treatment Issues for Pregnant Women	p. 455
The Workplace	p. 456
Some Basic Statistics	p. 456
High-Risk Factors	p. 461
The Workplace Response	p. 461
Workplace Interventions	p. 462
Implications for Treatment	p. 463
Other Special Populations	p. 464
References and Suggested Reading	p. 466
Other Psychiatric Considerations	p. 472
Suicide Evaluation and Prevention	p. 472
Statistics and High-Risk Factors	p. 473
How to Ask about Suicide	p. 474
Responding to Suicidal Patients	p. 475
Mental Status Examination	p. 478
Major Categories of Co-occurring Psychiatric Illness	p. 478
Mood Disorders	p. 479
Disorders Involving Psychosis	p. 483
Anxiety Disorders	p. 485
Personality Disorders	p. 487
Attention-Deficit/Hyperactivity Disorder	p. 488
Psychiatric Disorders Due to a General Medical Condition	p. 489
Other Drug Dependence and Alcohol Abuse/Dependence	p. 490
Other Addictive Behaviors	p. 491
Clinical Considerations	p. 491
Homelessness, Alcohol Use, and Chronic Mental Illness	p. 492
Psychotropic Medications	p. 493
Antipsychotic Medications	p. 495
Antidepressant Medications	p. 497
Mood Stabilizers	p. 499
Anti-Anxiety Agents	p. 500
References and Suggested Reading	p. 502
Drugs of Abuse Other Than Alcohol	p. 504
Drug Use Patterns	p. 504
Age	p. 505
Gender	p. 506
Education	p. 506
Employment	p. 507
Geographic Region	p. 507
Social Costs	p. 507
Public Perceptions and Public Policies	p. 508
Legal Status	p. 508
Early Control Efforts	p. 509
Sources of Illicit Drugs	p. 514
Reducing Drug Diversion	p. 515
Basic Pharmacological Concepts	p. 517
How to Think about Drug Use	p. 517
Route of Administration	p. 517
Site of Action	p. 518
Solubility in Fat and/or Water	p. 519
Metabolism	p. 520
Withdrawal	p. 520
Abuse Potential	p. 520
Problems	p. 522
Toxicity and Overdose	p. 523
Classification Schemas for Substances of Abuse	p. 523
Licit versus Illicit	p. 524
DEA Schedule	p. 525
Pharmacological Effects	p. 526
Major Classes of Commonly Abused Drugs	p. 527
Nicotine	p. 527
Opiates	p. 533
Sedative-Hypnotics (Central Nervous System Depressants)	p. 539
Stimulants	p. 541
Hallucinogens and Dissociatives	p. 545
Cannabinoids	p. 549
Inhalants	p. 552
Anabolic Androgenic Steroids	p. 555
Caffeine	p. 561
Other Psychoactive Drugs Used Worldwide	p. 566
Clinical Issues	p. 568
Assessment	p. 568
Treatment Goals	p. 568
Harm Reduction	p. 569
Pharmacological Treatment	p. 571
Pregnancy and the Use of Drugs Other Than Alcohol	p. 573
International Comparisons	p. 578
References and Suggested Reading	p. 580
Odds 'n' Ends	p. 583
Beyond Counseling	p. 583
Educational Activities	p. 583
Training Others	p. 585
Prevention	p. 587
The Real World	p. 598
Being a Professional Colleague	p. 598
Selecting a Professional Position	p. 604
Being a Professional	p. 606
Certification and Licensure	p. 607
Ethics	p. 609
Basic Principles	p. 609
Confidentiality	p. 611
Setting Boundaries	p. 613
Counselors with "Two Hats"	p. 617
Clinician Impairment and Relapse	p. 618
References and Suggested Reading	p. 621
Organizations and Resources in the Substance Abuse Field	p. 623
The Interaction Effects of Alcohol with Other Drugs	p. 634
Diagnostic Criteria: Substance Use Disorders	p. 638
Index	p. 642
Table of Contents provided by Ingram. All Rights Reserved.

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