The fourth edition of a classic text providing a comprehensive overview of substance misuse and dependence.
Cover Half-title Title Copyright Dedication Contents Preface Introduction Chapter 1. Drugs, addiction and behaviour What is a 'drug'? What is drug misuse? Drug abuse harmful use Drug dependence Psychological dependence Craving and drug-seeking behaviour Physical dependence and the withdrawal syndrome Tolerance Mechanisms of tolerance Relationship between tolerance and physical dependence Types of drug dependence Causes of drug dependence The drug The individual personality Society Chapter 2. The global drug problem: international perspectives Introduction Extent and nature of drug problems International audit Demand and supply of opiates for medical and scientific purposes1,2,3 Medical requirements and availability of psychotropic substances The diversion of psychotropic substances Production Trafficking Consumption Global drug problems 3-9 Africa Central America and the Caribbean East and Southeast Asia Europe North America Oceania South America South Asia West Asia Summary Sources of epidemiological information in the UK Drug seizures Persons dealt with for drug offences Drug-related crime Prescription audit Treatment demand Mortality studies Home Office Index General Mortality Registers National Database for Misuse of Volatile Solvents National Programme for Substance Abuse Deaths Surveys Accident and Emergency (A & E) departments Other epidemiological approaches Drug dependence in the UK The birth of the 'British system' The Dangerous Drugs Act 1967 Polydrug abuse The 1980s The 1990s The twenty-first century Organization of treatment services in the UK Primary healthcare Drug Dependence Treatment Units (DDTUs). Community Drug Teams (CDTs) Inpatient units Rehabilitation and after-care Arrest referral schemes Drug Treatment and Testing Orders Drug Interventions Programme (DIP) Prison medical service Drug policy in some other countries The Netherlands United States of America Switzerland Germany Sweden Australia Pakistan Summary Chapter 3. Drugs of abuse and dependence Opioids Effects Tolerance Physical dependence Opioid abstinence syndrome Psychological dependence Opioid receptors Different opioid drugs Morphine Papaveretum (Omnopon) Diamorphine (heroin) Methadone (Physeptone) Levacetylmethadol (laevo-alpha-acetylmethadol, LAAM) Pethidine (meperidine in USA) Dipipanone (with cyclizine as Diconal) dextromoramide (Palfium) Dextropropoxyphene (Doloxene) Codeine Opioid antagonists and agonist-antagonists Pentazocine (Fortral) Buprenorphine (Temgesic, Subutex) Butorphanol Nalbuphine (Nubain) & kgr1 opioid receptor agonists Sedative hypnotics Effects Tolerance Physical dependence Sedative hypnotics abstinence syndrome Chronic intoxication Psychological dependence Different sedative hypnotic drugs Barbiturates Non-barbiturate, non-benzodiazepine sedative hypnotics Benzodiazepines Flunitrazepam (Rohypnol) Cross-tolerance Stimulant drugs Amphetamine Effects Tolerance Physical dependence Psychological dependence Adverse effects Amphetamine-type stimulants Methamphetamine Methylphenidate Pemoline Cocaine Routes of administration Effects Tolerance Physical dependence Psychological dependence Mechanism of action Cocaine toxicity/psychosis Khat Effects Dependence Hallucinogens Lysergic acid diethylamide (LSD) Effects. Tolerance and dependence Adverse effects Other hallucinogenic drugs Phencyclidine (PCP) and PCP-like drugs (ketamine) Tolerance and dependence Ketamine Cannabis Preparations Absorption and fate of THC Effects Tolerance Dependence Cannabis psychosis Flashbacks Amotivational syndrome Chronic brain damage Volatile solvents Methods of administration Effects Tolerance Dependence Designer drugs Ecstasy Steroids Adverse effects Over-the-counter medicines Herbal preparations and 'natural' medicines The combined use of drugs and alcohol Chapter 4. Alcohol Introduction Definitions Unit of alcohol 'Safe' limits and sensible drinking Harmful drinking and alcohol misuse Hazardous drinking Problem drinker Alcohol dependence syndrome Extent and nature of the problem Global perspective Europe and the UK Genetics of alcohol use and dependence Alcohol metabolism Recognition of problem drinking Questionnaires Biological markers Liver enzymes MCV Carbohydrate-deficient transferrin (CDT) Adverse effects of alcohol misuse Liver damage Neurological syndromes Chronic effects Wernicke-Korsakoff syndrome Fetal alcohol syndrome Management of problem drinking and its complications Treatment of acute intoxication Managing alcohol withdrawal Detoxification Delirium tremens Withdrawal seizures Wernicke-Korsakoff syndrome Relapse prevention Brief intervention Motivational interviewing Abstinence or controlled drinking Pharmacological approaches Disulfiram Acamprosate Additional support Treatment matching Alcohol policies Drink driving Taxation Licensing regulations National and local strategies Chapter 5. Tobacco use and addiction Introduction. The global epidemic Types of tobacco and routes of administration Tobacco addiction Neurobiology and pharmacokinetics of nicotine Dependence and withdrawal The hazards of tobacco use Mortality Physical morbidity Social morbidity Special populations of tobacco users Children and adolescent users Tobacco use by the mentally ill Tobacco use by individuals with learning disability Treatment Pharmacological interventions Nicotine replacement therapy Bupropion Varenicline Other pharmacological treatments Non-pharmacological interventions Policy and public health initiatives Conclusion Chapter 6. Assessment Introduction Drug history Life history Social work assessment Family assessment Physical examination General appearance Gait Eyes Nose Mouth Skin Cardiovascular system Respiratory system Abdomen Neuromuscular system Lymphatic system Test of physical dependence on opiates (naloxone) Mental state examination General behaviour Talk Mood Thought content Abnormal experiences and beliefs Cognitive state Psychological assessment Special investigations Haemoglobin Urea Liver function tests Wassermann reaction Hepatitis Test for HIV antibody Precautions for taking specimens from drug abusers Needle-stick injuries Chest radiography Bacteriological investigation Laboratory investigation for drugs Hair analysis Laboratory methods Near-patient testing Interpretation of results Drug-screening programmes and workplace drug testing Summary Classification of substance-use disorders ICD-10 F1x.0 acute intoxication F1x.1 harmful use F1x.2 dependence syndrome F1x.3 withdrawal state F1x.4 withdrawal state with delirium F1x.5 psychotic disorder. F1x.6 amnesic syndrome F1x.7 residual and late-onset psychotic disorder F1x.8 other mental and behavioural disorders F1x.9 unspecified mental and behavioural disorder DSM-III-R Psychoactive substance use disorders Criteria for psychoactive substance dependence Criteria for severity of psychoactive substance dependence Criteria for psychoactive substance abuse DSM-IV Criteria for substance dependence Criteria for substance abuse Criteria for substance intoxication Criteria for substance withdrawal DSM-IV classification Alcohol-related disorders Amphetamine (or amphetamine-like)-related disorders Caffeine-related disorders Cannabis-related disorders Cocaine-related disorders Hallucinogen-related disorders Inhalant-related disorders Nicotine-related disorders Opioid-related disorders Phencyclidine (or phencyclidine-like)-related disorders Sedative-, hypnotic- or anxiolytic-related disorders Polysubstance-related disorder Other (or unknown) substance-related disorders Chapter 7. General measures of intervention Introduction Psychotherapy Supportive-expressive and interpersonal psychotherapy Group psychotherapy Family therapy Multiple-family therapy Behavioural couples therapy Drug counselling Motivational interviewing Cognitive and behavioural techniques Behavioural therapies Cognitive therapy Cognitive behavioural therapy and relapse prevention Relapse prevention Skills training Contingency management Other behavioural approaches Aversive conditioning Cue exposure Vocational rehabilitation Therapeutic communities Religious communities Concept houses Selection of patients suitable for a therapeutic community Hostels Self-help groups Narcotics Anonymous and Alcoholics Anonymous. Families Anonymous.
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Print version: Ghodse, Hamid Ghodse's Drugs and Addictive Behaviour