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The American Society of Addiction Medicine Handbook on Pain and Addiction provides clinical considerations and guidelines for the clinician treating patients with pain and addiction. This book is structured in five sections that cover the core concepts of addressing pain and addiction; diagnosis and treatment; treating pain in patients with, or at risk for, co-occuring addiction; treating substance use disorders (SUD) and addiction in patients with co-occuring pain; and adapting treatment to the needs of specific populations. Each chapter ends with suggestions for further reading on the topics discussed.
In The Integration of Pharmacological and Nonpharmacological Treatments in Drug/Alcohol Addictions, you?ll discover how traditional “clean and sober” recovery methods are being combined with “drug solutions” to successfully treat patients with addictive disorders. Up-to-date and filled with practical research, its integrated approach shows how you can significantly reduce morbidity and mortality due to long-term addiction. Providing the groundwork for future developments in integrated forms of treatment, The Integrations of Pharmacological and Nonpharmacological Treatments in Drug/Alcohol Addictions combines research and practice to give you the evaluative tools you need to move from an “all or nothing” approach to a level of balanced tolerance between “good and bad” when you and your patients are searching for a successful regimen of treatment. The in-depth studies will guide you in carefully rethinking the basic tenets of addictive disorder treatment. Specifically, you?ll read about: the integration of generalized vulnerability to drug and alcohol addiction psychopharmacotherapy for addictive and comorbid disorders psychosocial perspectives on integrating treatments for methamphetamine addiction integrating pharmacotherapies in existing alcoholic treatment programs the integrations of research in pharmacotherapy Contemporary research has taught us some humbling lessons--namely, that addictive disorders are complex biopsychosocial entities and not simple “either/or” cases. The Integration of Pharmacological and Nonpharmacological Treatments in Drug/Alcohol Addictions explores the newly emerging middle ground in addictive disorder treatment. You?ll find that it gives you sharper definitions of abstinence, recovery, and therapy and helps you best serve those patients whose needs lie somewhere between prescription and detoxification.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Treating Drug Problems, Volume 2 presents a wealth of incisive and accessible information on the issue of drug abuse and treatment in America. Several papers lay bare the relationship between drug treatment and other aspects of drug policy, including a powerful overview of twentieth century narcotics use in America and a unique account of how the federal government has built and managed the drug treatment system from the 1960s to the present. Two papers focus on the criminal justice system. The remaining papers focus on Employer policies and practices toward illegal drugs. Patterns and cycles of cocaine use in subcultures and the popular culture. Drug treatment from a marketing, supply-and-demand perspective, including an analysis of policy options. Treating Drug Problems, Volume 2 provides important information to policy makers and administrators, drug treatment specialists, and researchers.
Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.
Performance Enhancing Medications and Drugs of Abuse explores various medications currently being abused by patients, from the drugs used for physical and cosmetic purposes by weekend warriors, professional athletes, and other at-risk populations, to the drugs used to enhance mood and memory.
The Australian Guidelines for the Treatment of Alcohol Problems have been periodically developed over the past 25 years. In 1993, the first version of these guidelines, titled: ‘An outline for the management of alcohol problems: Quality assurance in the treatment of drug dependence project’ was published (Mattick & Jarvis 1993). The Australian Government commissioned an update a decade later (Shand et al. 2003) and a further edition in 2009 to integrate the Guidelines with the Australian Guidelines to Reduce Health Risks from Drinking Alcohol (National Health and Medical Research Council, NHMRC 2009; Haber et al., 2009). The present version of the Guidelines was also commissioned by the Commonwealth of Australia to remain current and integrated with the updated NHMRC consumption guidelines (2020). In order to ensure that guidelines remain relevant, the next set of guidelines should be updated in 2025, consistent with NHMRC recommendation that guidelines be updated every five years. These guidelines aim to provide up-to-date, evidence-based information to clinicians on available treatments for people with alcohol problems and are largely directed towards individual clinicians in practice, such as primary care physicians (general practitioners, nursing staff), specialist medical practitioners, psychologists and other counsellors, and other health professionals. Some chapters highlight service or system level issues that impact on clinicians and their patients. These include recommendations concerning Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, stigma, and discrimination. Elsewhere, organisation capacity is implied, such as medical resources for withdrawal management where recommendations indicate use of medications. As all forms of treatment will not be readily available or suitable for all populations or settings, these guidelines may require interpretation and adaptation.
Drug abuse has emerged as the leading factor associated with transmission of HIV, and AIDS is the leading cause of mortality among drug-dependent individuals. Through Effects of Substance Abuse Treatment on AIDS Risk Behaviors, you will discover how drug treatment programs are becoming instrumental in reducing the risks of HIV/AIDS among substance abusers. Needle sharing is a major contributor to contracting HIV/AIDS but, as this book shows you, sexual risk behaviors from sex-trade workers, as well as risky behaviors due to the influence of cocaine and methamphetamines, contribute to the spread of HIV/AIDS. From Effects of Substance Abuse Treatment on AIDS Risk Behaviors, you will discover drug abuse treatment methods that will reduce the number of injection episodes and reduce injection use in higher risk settings, such as shooting galleries, thereby reducing your clients’risk of infection. Effects of Substance Abuse Treatment on AIDS Risk Behaviors reveals the stark realities regarding substance abusers and HIV risk. Through this compelling book, you will gain new insight into how you can help drug abusers avoid contracting HIV/AIDS by: discussing intervention methods that do not adhere to abstinence-based treatment models, such as reducing a stimulant binge by one day examining the dangerous effects that methadone clinics, who discharge patients for cocaine use, can have on the reduction of risk behaviors among heroine addicts discovering the correlation that exists between the fact that opioid-dependent individuals who have more drug and legal problems are at a higher risk for AIDS risk behaviors With Effects of Substance Abuse Treatment on AIDS Risk Behaviors, you will discover how stimulant drug treatment in itself represents a potentially powerful HIV prevention method by allowing the individual to make more thoughtful decisions regarding their sexual behaviors. Through this insightful volume, you will also learn essential information pertaining to different regions of the country, allowing you to effectively tailor your treatment program for your community. For example, in urban areas of the Western United States, the greatest risk of HIV infection is from non-injected stimulants. Effects of Substance Abuse Treatment on AIDS Risk Behaviors will prove to you how drug treatment programs can significantly reduce the spread of HIV/AIDS and make lower infection rates a reality.