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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.
Disorders of anxiety and substance use are, for some reason, rarely treated in an integrated fashion by professionals. This timely volume addresses this glaring omission with dispatches from the frontlines of research and treatment. Thirty-four international experts offer findings, theories, and intervention strategies for this common form of dual disorder, across a range of substances and of anxiety disorders, to give the reader comprehensive knowledge in a practical format.
Cognitive-behavioural principles are integrated with genetic and psychiatric factors to explain addiction's causes and consequences.
This textbook surveys the current knowledge on substance use disorders (SUD), summarizing scientific evidence from numerous fields. It uses a biopsychosocial framework to integrate the many factors that contribute to addictions, from genetic predispositions, neurological responses caused by drugs, co-occurring psychiatric disorders, personality traits, and developmental conditions to cultural influences. Real-life vignettes and first-person accounts build understanding of the lived experience of addiction. The currently accepted practices for diagnosis and treatment are presented, including the role of 12-step programmes and other mutual-assistance groups. The text also investigates the research methods that form the foundation of evidence-based knowledge. The main body text is augmented by study guideposts such as learning objectives, review exercises, highlighted key terms, and chapter summaries, which enable more efficient comprehension and retention of the book's material.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
This practical and timely book provides comprehensive, state-of-the-art guidance on how primary care clinicians can best care for patients with substance use disorders. The book covers the major drugs of abuse, as well as the more recent ones, detailing the biology of various addictions and all dimensions of clinical diagnosis and management. It is organized in four parts: (1) The Basics, (2) Psychoactive Substance Dependencies, (3) Diagnosis, Treatment, Recovery, Relapse, and the Family, and (4) Special Groups. Part I, The Basics, consists of an overview, the various definitions of substance dependence, and the pharmacology of addictive substances. Chapter 1, Overview, is an introductory chapter that covers material common to the entire field of substance dependence. Chapter 2 covers the various definitions of substance dependence, and Chapter 3 reviews the pharmacology of addictive substances. Part II, Psychoactive Substance Dependencies, explains the various drug dependencies—alcohol dependence, sedative-hypnotic dependence, opioid dependence, stimulant dependence, nicotine dependence, cannabis dependence, dissociative dependence, inhalant dependence, hallucinogen dependence, and anabolic steroid dependence. Part III addresses diagnosis, treatment, recovery, relapse, and the family. Part IV, Special Groups, discusses substance dependence in women, adolescents, the elderly, ethnic minority groups, co-occurring disorders, LGBT patients, HIV positive patients, and the impaired physician. In addition to primary care physicians, Substance Use Disorders: A Guide for the Primary Care Provider will serve as an invaluable resource to primary care nurse practitioners and physician assistants, as well as medical students, primary care residents, emergency medicine physicians, ASAM and APA certified addictionists and those studying for certification in those specialties, psychiatrists, psychologists, and alcohol/drug counselors.
No other text available today offers what The American Psychiatric Publishing Textbook of Substance Abuse Treatment can: completely updated treatment information on a broad range of substance use disorders that is consistent with the new DSM-5 classification and thus reflective of how psychiatry is practiced today. Designed for researchers and mental health professionals ranging from trainee to licensed practitioner, the book is also appropriate for a diverse array of rehabilitation settings, from inpatient to community-based treatment. Full coverage is provided on 12-step programs, as well, including the latest outcomes research. Much of the material is new to this edition: A chapter has been added on science in the treatment of substance abuse, in which the authors discuss the history of scientific intervention in substance abuse and explore what happens to the brain when addicting drugs are consumed, review animal models and imaging techniques, and discuss current progress in the science of addiction. Chapters have been added on screening and brief intervention, reflecting the development of brief screening tools and research on the efficacy of interventions, and the role of "recovery" in chronic care disease management -- specifically what the treatment models for alcohol dependence and for diabetes can effectively borrow from each other. A new chapter focuses on the treatment of alcohol intoxication and withdrawal -- the first steps in treatment of alcohol use disorder. Two chapters on marijuana -- one on the neurobiology and one addressing treatment have been added. Given the accelerating trend toward decriminalization and legalization of this substance, clinicians will find this information of increasing importance. The section on substance use issues among gay men and lesbians has been expanded to include bisexual and transgender people in recognition of increased diversity among the population. Well-structured, with topics that follow logically and many practical, treatment-oriented features, such as quick reference tables and lists of recommended readings, The American Psychiatric Publishing Textbook of Substance Abuse Treatment is a classic that will enhance the education and practice of clinicians.
Based on a decade of research and theory, Substance Use Disorders and Addictions examines co-occurring psychiatric disorders as the norm with substance use disorders and addictions. With more than 20 years of experience in the field as a clinician, a researcher, a program developer, and an instructor, Keith Morgen encourages a holistic approach to working with individuals, using a single case example throughout the text to encourage the sequential application of concepts to co-occurring disorders. With DSM-5 diagnostic criteria, the 2014 ACA code of ethics, and 2016 CACREP standards integrated throughout, readers will benefit from this applied and cutting-edge introduction to the field.