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Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
This book presents new and important information about adolescent drug use. The book is intended for human service professionals, teachers, researchers, and students interested in the issue of early adolescent drug use and its causes and pervasiveness in a multiethnic population. Today, the field of adolescent drug use research relies on integrative models that permit competing explanations of drug use. This approach promotes flexibility in testing hypotheses pertinent to adol- cents of very different social and cultural backgrounds or personal characteristics. Longitudinal studies, including the one presented in these pages, have identified many risk and protective factors or processes that are linked to adolescent drug use. We review these throughout this book and present new information from our own research. Our point of departure is to extend and elaborate descriptive research and models of adolescent drug research to cover the unique and diverse experiences of adolescents who are Hispanic, African American, and White non-Hispanic.
Although this book focuses most of its attention on ethnic minority substance abusers, considerable mention is made of their White peers, too. Thus, the authors offer cultural points and counterpoints - all of them given to achieve three objectives: (1) to make care providers aware of cultural factors that affect substance abuse and cessation; (2) to review multidisciplinary research studies in order to ascertain helpful and unhelpful health care practices; and (3) to provide practical suggestions for improving community-wide substance prevention and intervention programs. The book tries to answer three questions.
This authoritative book--now revised and expanded with important clinical and research advances--presents a proven approach for helping people meet the day-to-day challenges of recovery from addiction and maximize their well-being. Mindfulness-based relapse prevention (MBRP) integrates carefully tailored meditation practices with cognitive and behavioral skills building. In a convenient large-size format, the book includes instructions for setting up and running MBRP groups, session-by-session implementation guidelines, sample scripts, and 27 reproducible handouts and forms. Purchasers can download and print the reproducible materials at the companion website, which also features audio recordings of the guided practices. A separate website for clients provides the audio files only. New to This Edition *Reflects clinical refinements, the growing MBRP evidence base, and advances in knowledge about both addictive behaviors and mindfulness. *Section on cutting-edge topics--culturally responsive adaptations, alternative group formats and settings, dual diagnosis groups, behavioral addictions, and uses of technology. *Reproducible appendices: MBRP Fidelity Scale and quick-reference guide to the intentions of each session. *Audio recordings now available online.
For many years, addiction research focused almost exclusively on men. Yet scientific awareness of sex and gender differences in substance use disorders has grown tremendously in recent decades. This volume brings together leading authorities to review the state of the science and identify key directions for research and clinical practice. Concise, focused chapters illuminate how biological and psychosocial factors influence the etiology and epidemiology of substance use disorders in women; their clinical presentation, course, and psychiatric comorbidities; treatment access; and treatment effectiveness. Prevalent substances of abuse are examined, as are issues facing special populations.
The essential newly-expanded reference that needs to be on the desk of every health care professional who encounters substance abusers. Handbook of the Medical Consequences of Alcohol and Drug Abuse, Second Edition is the newly-updated classic reference text that provides even more detailed and expanded information on the pharmacological, toxicological, and neuropsychological consequences of alcohol and drug abuse. Eight new chapters of crucial information have been added. Written by leading experts in the fields of medical physiology, psychopharmacology, and neuropsychology, this valuable resource provides the detailed alcohol and drug information health professionals in all fields need to know. Handbook of the Medical Consequences of Alcohol and Drug Abuse, Second Edition greatly expands on the expert information provided in the first edition. This text provides reviews of the cardiovascular, neurological, pulmonary, gastrointestinal, psychological, and hepatic effects of commonly abused drugs. The book also provides in-depth explanations of the mechanisms by which these psychoactive drugs exert their biobehavioral effects as well as current thinking about—and definitions of—abuse, dependence, and alcohol/drug use. The Handbook of the Medical Consequences of Alcohol and Drug Abuse, Second Edition includes vital information on: alcohol, including definitions of alcohol use, abuse, and dependence the relationship between alcohol and accidental injuries, alcohol’s effect on skeletal and major organ systems, and its effect on risk factors for certain cancers effects of alcohol and other drugs on neuropsychological function the effects of alcohol on neuron signaling, neurotransmitter function, and alcoholic brain damage and cognitive dysfunction fetal alcohol effects chronic effects of marijuana use on psychological and physical health, including a fair and balanced discussion of the medical marijuana issue the consequences of opiate abuse and methadone pharmacotherapy, including a comparison of the effects of methadone and heroin on organ systems cocaine’s history, the various forms of the drug, and the adverse effects of cocaine on cardiovascular, neurologic, and pulmonary systems the medical consequences of inhalants ranging from benzene to xylene the prenatal effects of nicotine, cocaine, marijuana, and opiates terminology that appears in the current literature on alcohol New topics in the Handbook of the Medical Consequences of Alcohol and Drug Abuse, Second Edition include chapters discussing: chemical dependency in psychiatric patients medical consequences of steroids OTC medications hallucinogens health effects of tobacco, nicotine, and exposure to tobacco smoke interactions of alcohol with other drugs and other medications periodontal effects of alcohol and drug abuse in the oral cavity imaging studies of structural brain changes The Handbook of the Medical Consequences of Alcohol and Drug Abuse, Second Edition is an invaluable resource for physicians, scientists, nurses, psychologists, and alcohol and drug counselors.