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Concepts of Chemical Dependency

by: Doweiko, Harold E.

Concepts of Chemical Dependency

by: Doweiko, Harold E.

ISBN 13:
9780534632847
ISBN 10:
053463284X
Edition: 6th
Format: Paperback
Copyright: 07/06/2005
Publisher: Brooks Cole
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Summary

1. Why Worry About Recreational Chemical Use in the United States? 2. What Do We Mean When We Say Substance Abuse and Addiction? 3. The Medical Model of Chemical Addiction. 4. Are People Predestined to Become Addicted to Chemicals? 5. Addiction as a Disease of the Human Spirit. 6. An Introduction to Pharmacology. 7. An Introduction to Alcohol. 8. Chronic Alcohol Abuse/Addiction. 9. Abuse of and Addiction to the Barbiturates and Barbiturate-Like Drugs. 10. Abuse & Addiction to Benzodiazepines and Similar Agents. 11. Abuse and Addiction to Amphetamines and CNS Stimulants. 12. Cocaine. 13. Marijuana Abuse & Addiction. 14. Opiate Abuse & Addiction. 15. Hallucinogen Abuse & Addiction. 16. Abuse of and Addiction to the Inhalants and Aerosols. 17. The Unrecognized Problem of Steroid Abuse and Addiction. 18. The Over-the-Counter Analgesics. 19. Tobacco Products and Nicotine Addiction. 20. Chemicals and the Neonate: The Consequences of Drug Abuse During Pregnancy. 21. The Hidden Faces of Chemical Dependency. 22. The Dual Diagnosis Client: Chemical Addiction and Mental Illness. 23. Chemical Abuse by Children and Adolescents. 24. Codependency and Enabling. 25. Addiction and the Family. 26. The Evaluation of Substance Abuse Problems. 27. The Process of Intervention. 28. The Treatment of Chemical Dependency. 29. Treatment Formats for Chemical Dependency Rehabilitation. 30. The Process of Recovery. 31. Problems That Arise in Treating Chemical Dependency. 32. Pharmacological Intervention Tactics and Substance Abuse. 33. Substance Abuse/Addiction and Infectious Disease. 34. Self Help Groups. 35. Crime and Drug Use. Appendices. Glossary. References.

Preface

xix

Why Worry About Recreational Chemical Abuse?

(8)

Introduction

(1)

Who Treats Those Who Abuse or Are Addicted to Chemicals?

(1)

The Scope of the Problem of Chemical Abuse/Addiction

(2)

The Cost of Chemical Abuse/Addiction in the United States

(2)

Why Is It So Difficult to Understand the Drug Abuse Problem in the United States?

(1)

Summary

(2)

What Do We Mean When We Say Substance Abuse and Addiction?

(7)

Introduction

(1)

The Continuum of Chemical Use

(2)

Definitions of Terms Used in This Book

(1)

What Do We Really Know About the Addictive Disorders?

(1)

The State of the Art: Unanswered Questions, Uncertain Answers

(2)

Summary

(1)

The Medical Model of Chemical Addiction

(13)

Introduction

(1)

Why Do People Abuse Chemicals?

(4)

What Do We Mean When We Say That Someone Is ``Addicted'' to Chemicals?

(8)

Summary

(1)

Are People Predestined to Become Addicted to Chemicals?

(15)

Introduction

(1)

Multiple Models

(1)

Reaction Against the Disease Model of Addiction

(12)

The Final Common Pathway Theory of Addiction

(1)

Summary

(2)

Addiction as a Disease of the Human Spirit

(11)

Introduction

(1)

The Rise of Western Civilization, or How the Spirit Was Lost

(2)

Diseases of the Mind---Diseases of the Spirit: The Mind-Body Question

(1)

The Growth of Addiction: The Circle Narrows

(1)

The Circle of Addiction: Addicted Priorities

(1)

Some Games of Addiction

(1)

Honesty as a Part of the Recovery Process

(1)

False Pride: The Disease of the Spirit

(2)

Denial, Rationalization, Projection, and Minimization: The Four Horsemen of Addiction

(2)

Summary

(1)

An Introduction to Pharmacology

(15)

Introduction

(1)

The Prime Effect and Side Effects of Chemicals

(1)

Drug Forms and How Drugs Are Administered

(2)

Bioavailability

(4)

The Drug Half-Life

(2)

The Effective Dose

(1)

The Lethal Dose Index

(1)

The Therapeutic Index

(1)

Peak Effects

(1)

The Site of Action

(4)

The Blood-Brain Barrier

(1)

Summary

(1)

Alcohol: Humans' Oldest Recreational Chemical

(12)

Introduction

(1)

A Brief History of Alcohol

(1)

How Alcohol Is Produced

(1)

Alcohol Today

(1)

Scope of the Problem of Alcohol Use

(1)

Pharmacology of Alcohol

(2)

The Blood Alcohol Level

(1)

Subjective Effects of Alcohol on the Individual: At Normal Doses in the Average Drinker

(1)

Effects of Alcohol at Intoxicating Doses: For the Average Drinker

(1)

Medical Complications of Alcohol Use in the Average Drinker

(2)

Alcohol Use and Accidental Injury or Death

(1)

Summary

(1)

Chronic Alcohol Abuse and Addiction

(18)

Introduction

(1)

Scope of the Problem

(1)

Is There a ``Typical'' Alcohol-Dependent Person?

(1)

Alcohol Tolerance, Dependence, and ``Craving'': Signposts of Alcoholism

(2)

Complications of Chronic Alcohol Use

(14)

Summary

(1)

Abuse and Addiction to the Barbiturates and Barbiturate-like Drugs

100

(12)

Introduction

100

(1)

Early Pharmacological Therapy of Anxiety Disorders and Insomnia

100

(1)

History and Current Medical Uses of the Barbiturates

101

(1)

Pharmacology of the Barbiturates

102

(2)

Subjective Effects of the Barbiturates at Normal Dosage Levels

104

(1)

Complications of the Barbiturates at Normal Dosage Levels

105

(2)

Effects of the Barbiturates at Above-Normal Levels

107

(1)

Neuroadaptation, Tolerance to, and Dependence on the Barbiturates

108

(1)

Barbiturate-like Drugs

109

(1)

Summary

110

(2)

Abuse of and Addiction to Benzodiazepines and Similar Agents

112

(16)

Introduction

112

(1)

Medical Uses of the Benzodiazepines

112

(2)

Pharmacology of the Benzodiazepines

114

(1)

Side Effects of the Benzodiazepines When Used at Normal Dosage Levels

115

(1)

Neuroadaptation to Benzodiazepines and Abuse/Addiction to These Agents

116

(2)

Complications Caused by Benzodiazepine Use at Normal Dosage Levels

118

(2)

Subjective Experience of Benzodiazepine Use

120

(1)

Long-Term Consequences of Chronic Benzodiazepine Use

121

(1)

Buspirone

122

(2)

Zolpidem

124

(1)

Zaleplon

125

(1)

Rohypnol

126

(1)

Summary

127

(1)

Abuse of and Addiction to Amphetamines and CNS Stimulants

128

(18)

Introduction

128

(1)

The CNS Stimulants as Used in Medical Practice

128

(1)

The Amphetamine-like Drugs

128

(4)

The Amphetamines

132

(4)

CNS Stimulant Abuse

136

(1)

Scope of the Problem of CNS Stimulant Abuse and Addiction

136

(1)

Effects of the CNS Stimulants When Abused

136

(8)

Summary

144

(2)

Cocaine

146

(15)

Introduction

146

(1)

A Brief Overview of Cocaine

146

(1)

Cocaine in Recent U.S. History

147

(1)

Cocaine Today

148

(1)

Pharmacology of Cocaine

149

(2)

How Illicit Cocaine Is Produced

151

(1)

How Cocaine Is Abused

152

(2)

Subjective Effects of Cocaine When It Is Abused

154

(1)

Complications of Cocaine Abuse/Addiction

155

(4)

Summary

159

(2)

Marijuana Abuse and Addiction

161

(13)

Introduction

161

(1)

History of Marijuana Use in the United States

161

(2)

A Question of Potency

163

(1)

A Technical Point

163

(1)

Scope of the Problem of Marijuana Abuse

164

(1)

Pharmacology of Marijuana

165

(2)

Methods of Administration

167

(1)

Subjective Effects of Marijuana

168

(1)

Adverse Effects of Occasional Marijuana Use

168

(1)

Consequences of Chronic Marijuana Abuse

169

(3)

The Addiction Potential of Marijuana

172

(1)

Summary

172

(2)

Opiate Abuse and Addiction

174

(23)

Introduction

174

(1)

The Medical Uses of Narcotic Analgesics

174

(1)

A Short History of the Narcotic Analgesics

174

(2)

The Classification of Narcotic Analgesics

176

(1)

Where Opium Is Produced

177

(1)

Current Medical Uses of the Narcotic Analgesics

177

(1)

Pharmacology of the Narcotic Analgesics

177

(3)

Neuroadaptation to Narcotic Analgesics

180

(2)

Subjective Effects of Narcotic Analgesics When Used in Medical Practice

182

(1)

Complications Caused by Narcotic Analgesics When Used in Medical Practice

182

(2)

Fentanyl

184

(1)

Buprenorphine

185

(1)

Opiates As Drugs of Abuse

186

(1)

The Mystique of Heroin

186

(2)

Other Narcotic Analgesics That Might Be Abused

188

(1)

Methods of Opiate Abuse

189

(2)

Scope of the Problem of Opiate Abuse and Addiction

191

(1)

Complications Caused by Chronic Opiate Abuse

192

(3)

Overdose of Illicit Opiates

195

(1)

Summary

196

(1)

Hallucinogen Abuse and Addiction

197

(16)

Introduction

197

(1)

History of Hallucinogens in the United States

197

(2)

Scope of the Problem

199

(1)

Pharmacology of the Hallucinogens

199

(2)

Subjective Effects of Hallucinogens

201

(2)

Phencyclidine (PCP)

203

(4)

Ecstasy: Evolution of a New Drug of Abuse

207

(5)

Summary

212

(1)

Abuse of and Addiction to the Inhalants and Aerosols

213

(8)

Introduction

213

(1)

History of Inhalant Abuse

213

(1)

Pharmacology of the Inhalants

214

(1)

Scope of the Problem

215

(1)

Method of Administration

216

(1)

Subjective Effects of Inhalants

216

(1)

Complications From Inhalant Abuse

217

(1)

Anesthetic Misuse

218

(1)

Abuse of Nitrites

219

(1)

Summary

220

(1)

The Unrecognized Problem of Steroid Abuse and Addiction

221

(8)

Introduction

221

(1)

An Introduction to the Anabolic Steroids

221

(1)

Medical Uses of Anabolic Steroids

222

(1)

The Legal Status of Anabolic Steroids

222

(1)

Scope of the Problem of Steroid Abuse

222

(1)

Sources and Methods of Steroid Abuse

222

(1)

Problems Associated With Anabolic Steroid Abuse

223

(2)

Complications of Steroid Abuse

225

(2)

Are Anabolic Steroids Addictive?

227

(1)

Summary

228

(1)

The Over-the-Counter Analgesics: Unexpected Agents of Abuse

229

(16)

Introduction

229

(1)

A Short History of the OTC Analgesics

229

(1)

Medical Uses of the OTC Analgesics

230

(2)

Pharmacology of the OTC Analgesics

232

(3)

Normal Dosage Levels of OTC Analgesics

235

(2)

Complications Caused by Use of OTC Analgesics

237

(4)

Overdose of OTC Analgesics

241

(2)

Summary

243

(2)

Tobacco Products and Nicotine Addiction

245

(15)

Introduction

245

(1)

History of Tobacco Use in the United States

245

(1)

Scope of the Problem

246

(1)

Pharmacology of Cigarette Smoking

247

(3)

The Effects of Nicotine Use

250

(1)

Nicotine Addiction

251

(1)

Complications of the Chronic Use of Tobacco

252

(7)

Summary

259

(1)

Chemicals and the Neonate: The Consequences of Drug Abuse During Pregnancy

260

(15)

Introduction

260

(1)

Scope of the Problem

260

(1)

The Fetal Alcohol Spectrum Disorder

261

(2)

Cocaine Use During Pregnancy

263

(3)

Amphetamine Use During Pregnancy

266

(1)

Opiate Abuse During Pregnancy

266

(2)

Marijuana Use During Pregnancy

268

(1)

Benzodiazepine Use During Pregnancy

269

(1)

Hallucinogen Use During Pregnancy

270

(1)

Buspirone Use During Pregnancy

270

(1)

Bupropion Use During Pregnancy

270

(1)

Disulfiram Use During Pregnancy

271

(1)

Cigarette Use During Pregnancy

271

(1)

Over-the-Counter Analgesic Use During Pregnancy

272

(1)

Inhalant Abuse During Pregnancy

273

(1)

Summary

273

(2)

Hidden Faces of Chemical Dependency

275

(15)

Introduction

275

(1)

Women and Addiction: An Often Unrecognized Problem

275

(5)

Addiction and the Homeless

280

(1)

Substance Use Problems and the Elderly

280

(4)

The Homosexual and Substance Abuse

284

(2)

Substance Abuse and the Disabled

286

(1)

Substance Abuse and Ethnic Minorities

287

(2)

Summary

289

(1)

The Dual-Diagnosis Client: Chemical Addiction and Mental Illness

290

(14)

Introduction

290

(1)

Definitions

290

(1)

Dual-Diagnosis Clients: A Diagnostic Challenge

291

(1)

Why Worry About the Dual-Diagnosis Client?

291

(1)

The Scope of the Problem

292

(1)

Characteristics of Dual-Diagnosis Clients

293

(1)

Psychopathology and Drug of Choice

293

(6)

Problems in Working With Dual-Diagnosis Clients

299

(1)

Treatment Approaches

300

(3)

Summary

303

(1)

Chemical Abuse by Children and Adolescents

304

(16)

Introduction

304

(1)

The Importance of Childhood and Adolescence in the Evolution of Substance-Use Problems

304

(1)

Scope of the Problem

305

(5)

Why Do Adolescents Use Chemicals?

310

(3)

The Adolescent Abuse/Addiction Dilemma: How Much Is Too Much?

313

(4)

Possible Diagnostic Criteria for Adolescent Drug/Alcohol Problems

317

(1)

The Special Needs of the Adolescent in a Substance-Abuse Rehabilitation Program

318

(1)

Summary

319

(1)

Codependency and Enabling

320

(10)

Introduction

320

(1)

Enabling

320

(1)

Codependency

321

(5)

Reactions to the Concept of Codependency

326

(3)

Summary

329

(1)

Addiction and the Family

330

(11)

Introduction

330

(1)

Scope of the Problem

330

(1)

Addiction and Marriage

330

(2)

Addiction and the Family

332

(3)

The Adult Children of Alcoholics (ACOA) Movement

335

(4)

Summary

339

(2)

The Evaluation of Substance-Use Problems

341

(15)

Introduction

341

(1)

The Theory Behind Alcohol- and Drug-Use Evaluations

341

(1)

Screening

342

(2)

Assessment

344

(1)

Diagnosis

345

(1)

The Assessor and Data Privacy

346

(1)

Diagnostic Rules

347

(1)

The Assessment Format

348

(4)

Other Sources of Information

352

(3)

The Outcome of the Evaluation Process

355

(1)

Summary

355

(1)

The Process of Intervention

356

(9)

Introduction

356

(1)

A Definition of Intervention

356

(1)

Characteristics of the Intervention Process

357

(1)

The Mechanics of Intervention

357

(1)

Family Intervention

358

(2)

Intervention With Other Forms of Chemical Addiction

360

(1)

The Ethics of Intervention

361

(1)

Intervention via the Court System

362

(2)

Other Forms of Intervention

364

(1)

Summary

364

(1)

The Treatment of Chemical Dependency

365

(9)

Introduction

365

(1)

Characteristics of the Substance-Abuse Rehabilitation Professional

365

(2)

The Minnesota Model of Chemical-Dependency Treatment

367

(1)

The Treatment Plan

368

(1)

Other Treatment Formats for Chemical Dependency

369

(4)

Aftercare Programs

373

(1)

Summary

373

(1)

Treatment Formats for Chemical-Dependency Rehabilitation

374

(12)

Introduction

374

(1)

Outpatient Treatment Programs

374

(3)

Inpatient Treatment Programs

377

(4)

Inpatient or Outpatient Treatment?

381

(2)

Partial Hospitalization Options

383

(2)

Summary

385

(1)

The Process of Recovery

386

(11)

Introduction

386

(1)

The Decision to Seek Treatment

386

(1)

The Stages of Recovery

386

(4)

Specific Points to Address in the Treatment of Addiction to Common Drugs of Abuse

390

(6)

Summary

396

(1)

Problems Frequently Encountered in the Treatment of Chemical Dependency

397

(19)

Introduction

397

(1)

Limit Testing by Clients in Treatment

397

(1)

Treatment Noncompliance

397

(2)

Relapse and Relapse Prevention

399

(3)

``Cravings'' and ``Urges''

402

(1)

The ``Using'' Dream

403

(1)

Controlled Drinking

404

(1)

The Uncooperative Client

404

(2)

Toxicology Testing

406

(6)

The Addicted Patient With Chronic Pain Issues

412

(1)

Insurance Reimbursement Policies

412

(2)

D.A.R.E. and Psychoeducational Intervention Programs

414

(1)

Summary

415

(1)

Pharmacological Intervention Tactics and Substance Abuse

416

(16)

Introduction

416

(1)

Pharmacological Treatment of Alcohol Abuse and Dependence

416

(5)

Pharmacological Treatment of Opiate Addiction

421

(6)

Pharmacological Treatment of Cocaine Addiction

427

(1)

Pharmacological Treatment of Amphetamine Abuse/Dependence

428

(1)

Pharmacological Treatment of Nicotine Dependence

428

(3)

Summary

431

(1)

Substance Abuse/Addiction and Infectious Disease

432

(14)

Introduction

432

(1)

Why Is Infectious Disease Such a Common Complication of Alcohol/Drug Abuse?

432

(1)

The Pneumonias

433

(1)

Acquired Immune Deficiency Syndrome (AIDS)

434

(6)

Tuberculosis (TB)

440

(1)

Viral Hepatitis

441

(4)

Summary

445

(1)

Self-Help Groups

446

(16)

The Twelve Steps of Alcoholics Anonymous

446

(1)

Introduction

446

(1)

The History of AA

446

(1)

Elements of AA

447

(2)

AA and Religion

449

(1)

One ``A'' Is for Anonymous

450

(1)

AA and Outside Organizations

450

(1)

The Primary Purpose of AA

450

(2)

Of AA and Recovery

452

(1)

Sponsorship

452

(1)

AA and Psychological Theory

453

(1)

How Does AA Work?

453

(1)

Outcome Studies: The Effectiveness of AA

454

(2)

Narcotics Anonymous

456

(1)

Al-Anon and Alateen

456

(1)

Support Groups Other Than AA

457

(2)

Criticism of the AA/12-Step Movement

459

(1)

Summary

460

(2)

The Debate Around Legalization

462

(12)

Introduction

462

(1)

The Debate Over Medicalization

462

(1)

The ``War on Drugs'': The Making of a National Disaster

463

(10)

Summary

473

(1)

Crime and Drug Use

474

(13)

Introduction

474

(1)

Criminal Activity and Drug Use: Partners in a Dance?

474

(2)

Urine Toxicology Testing in the Workplace

476

(1)

Unseen Victims of Street Drug Chemistry

477

(1)

Drug Analogs: The ``Designer'' Drugs

478

(6)

Adulterants

484

(1)

Drug Use and Violence: The Unseen Connection

485

(1)

Summary

486

(1)

Appendix One: Alcohol Abuse Situation Sample Assessment

487

(3)

Appendix Two: Chemical Dependency Situation Sample Assessment

490

(3)

Appendix Three: The ``Jellinek'' Chart for Alcoholism

493

(2)

Appendix Four: Drug Classification Schedule

495

(1)

Glossary

496

(9)

References

505

(66)

Index

571

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Concepts of Chemical Dependency

Concepts of Chemical Dependency

9780534632847

053463284X

Summary

Table of Contents

Supplemental Materials

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Amazon no longer offers textbook rentals. We do!

Concepts of Chemical Dependency

Concepts of Chemical Dependency

9780534632847

053463284X

Summary

Table of Contents

Supplemental Materials

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