Textbook of Addiction Treatment: International Perspectives PDF
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- Editors Textbook of Addiction Treatment: International Perspectives 1 3 Reference Textbook of Addiction Treatment: International Perspectives Nady el-Guebaly (cid:129) Giuseppe Carra` Marc Galanter Editors Textbook of Addiction Treatment: International Perspectives With67Figuresand117Tables Editors Nadyel-Guebaly MarcGalanter DivisionofAddiction DivisionofAlcoholismandDrugAbuse DepartmentofPsychiatry NYUSchoolofMedicine UniversityofCalgary NewYork,USA AlbertaGamblingResearchInstitute Calgary,AB,Canada GiuseppeCarra` UCLDivisionofPsychiatry FacultyofBrainSciences UniversityCollegeLondon London,UK ISBN978-88-470-5321-2 ISBN978-88-470-5322-9(eBook) ISBNBundle978-88-470-5323-6(printandelectronicbundle) DOI10.1007/978-88-470-5322-9 SpringerMilanHeidelbergNewYorkDordrechtLondon LibraryofCongressControlNumber:2014952301 #Springer-VerlagItalia2015 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartof the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionor informationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped.Exemptedfromthislegalreservationarebriefexcerpts inconnectionwithreviewsorscholarlyanalysisormaterialsuppliedspecificallyforthepurposeofbeing enteredandexecutedonacomputersystem,forexclusiveusebythepurchaserofthework.Duplication ofthispublicationorpartsthereofispermittedonlyundertheprovisionsoftheCopyrightLawofthe Publisher’s location, in its current version, and permission for use must always be obtained from Springer.PermissionsforusemaybeobtainedthroughRightsLinkattheCopyrightClearanceCenter. ViolationsareliabletoprosecutionundertherespectiveCopyrightLaw. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexempt fromtherelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. While the advice and information in this book are believed to be true and accurate at the date of publication,neithertheauthorsnortheeditorsnorthepublishercanacceptanylegalresponsibilityfor anyerrorsoromissionsthatmaybemade.Thepublishermakesnowarranty,expressorimplied,with respecttothematerialcontainedherein. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Foreword Substance use and abuse is widespread around the world. There are clear cultural differencesbetweencountriesandsometimesevenwithinthesamecountryregarding theuseandabuseofsubstances.Variousculturalandsocialfactorsplayanimportant roleindefiningandtreatingpatternsofsubstanceabuse.Reasonsforsubstanceuse andabusevaryfromgenetic,social,andpsychological.Dependinguponthedegree ofabuseandrecognitionofthepatternsofabuse,helpmaybesoughtfromanumber ofsources.Culturesandsocietiesdictatehowresourcesareallocatedandhowpeople are encouraged to use certain pathways into care. Identifying the unmet needs and mentalhealthgapinthefieldofsubstanceuseandabuseisthefirstcrucialstep. Thisreferencetext–asignificantoutputfromtheInternationalSocietyofAddic- tionMedicine–meetstheaimsoftheSociety.Theseaimsareeminentlylaudableas they recognize the role of physicians in treating and managing addictions. The key challengesremainingincludepolicydifferencesacrosscountriesandhowthesemust beaddressed.Furthermore,trainingofallhealthprofessionalsinrecognizingphysical andpsychiatricproblemsassociatedwithsubstanceabuseisamust.Dependingupon human and financial resources, perhaps a tiered approach may be indicated. Physi- cians in partnership with others have a significant role to play in a public mental health agenda. Substance abuse – varying from tobacco to drugs, prescribed or otherwise – is a major challenge in the field of public mental health. The editors have done a sterling job in bringing together over 250 authors from a rich global backgroundtohavesharedtheirexpertiseandexperiences.Thisvolumeprovidesan excellent introduction at an international level to epidemiology, biological, social, and psychological interventions and recognition of medical consequences and comorbidities.Theeditorsdeserveourcongratulationsonajobwelldone. DineshBhugra F.R.C.P.,F.R.C.P.E.,F.R.C.Psych.,F.F.P.H.,M.Phil.,Ph.D. ProfessorofMentalHealth&CulturalDiversity InstituteofPsychiatry,King’sCollegeLondon HealthService&PopulationResearchDepartment London,UK President,WorldPsychiatricAssociation v vi Foreword Thepastdecadehaswitnesseddisturbinggrowthintheprevalenceanddiversityof substanceuseproblemsthroughouttheworld.Firstconsidereda“USproblem”and later a problem “of the Western world,” substance abuse and addiction are now clearlyworld-wideproblemsproducingdramaticallygreaterlossoflife,morbidity, andcoststhanvirtuallyanyotherhealthcondition. Perhaps because addictions have been so prevalent and serious in the USA for thepast40years,over80%ofpublishedclinicalresearchonaddictiontoalcohol and other drugs of abuse has been done by the USA and other English-speaking investigators. But this body of work has at best only partially informed our understanding of how to prevent and treat addiction. This is because so many factors that contribute to susceptibility to initial substance use; transition from voluntary use to uncontrolled addiction; and to treatment entry, adherence, and effectiveness are determined as much by environmental, family, and interpersonal forces as they are by genetics and metabolism. These factors vary substantially across countries and cultures. Thus, world understanding about how to prevent, intervene early, and treat addiction will require far more diversestudy. In this context, the ISAM Textbook of Addiction Treatment, with its broad and diverse contributions representing 265 scientists and 30 countries, is a timely and welcome addition to worldwide understanding on how to intervene and treat addictions.Inparticular,theTextbookintroducesawiderangeofnewperspectives on the development of substance use disorders and a number of previously unreported interventions to reduce the prevalence, severity, and associated harms fromsubstanceabuseandaddiction. To be sure this Textbook will not resolve decades-long controversies in optimal prevention, intervention, and treatment responses, there is still too little information and too many preexisting views to yet achieve consensus. But this Textbook signals something that has frankly been lacking in US-dominated research and treatment of addiction: a willingness to incorporate, evaluate, and includeeffectivenewapproaches,methods,andtools.Itisclearthatnocountry, profession,ortheorycanclaimadequatesuccessinpreventingortreatingaddic- tion to justify the all-too-common political, financial, and even scientific resis- tance to new methods. If there is a need to reduce diversity, it is in our methods of diagnosing substance use disorders, in articulating common goals of treatment, and in adoptingcommonmeasuresandmethodsforevaluatingtreatmentaccess,adher- ence,andeffectiveness.Thesekindsofconsensusstandardsshouldhelpthisstill- developingfieldofpublicandclinicalhealthtoidentifyandagreeuponeffective Foreword vii new interventions. This is an obvious and needed role for the International Society of Addiction Medicine and should be a natural outgrowth of continued international collaboration and sharing of results through venues such as this Textbook. A.ThomasMcLellan CEO,TreatmentResearchInstitute Philadelphia,PA,USA FormerDeputyDirector OfficeofNationalDrugControlPolicy USA Theinitiativetowriteatextbookaddressingtheglobalaspectsofaddiction,whether prevalence, types, and methods of abuse or different management approaches, is unique and welcome. The chapters are comprehensive to deal with all psychoso- cial–biological aspects of addiction. Psychoactive substance use poses a significant threat to the health, social, and economic fabric of families, communities, and nations.Theextentofworldwidepsychoactivesubstanceuseisestimatedat2billion alcoholusers,1.3billionsmokers,and185milliondrugusers. In an initial estimate of factors responsible for the global burden of disease, tobacco,alcohol,andillicitdrugscontributedtogether12.4%ofalldeathsworld- wide in the year 2000. Looking at the percentage of total years of life lost due to thesesubstances,ithasbeenestimatedthattheyaccountfor8.9%. The level of economic development in countries also plays an important role. Theburdenfrompsychoactivesubstanceuseishigherindevelopedcountriesthan especiallyinhigh-mortalitydevelopingcountries.Thesexratiofortheattributable deathsofpsychoactivesubstanceusevariesfrom80%malefortobaccoandillicit druguseto90%foralcohol.WithregardtoDALYs,itisbetween77%and85% for all substances. The largest proportion of DALYs is on males in developed countries, where psychoactive substance use accounts for 33.4 % of all DALYs (WHOWebsite). WHO seeks to promote the concept of health for all through its strategy of reducingtheincidenceandprevalenceofpsychoactivesubstanceuseandproviding the best available evidence on the management of substance-related problems. The achievement of this goal is designed to lead to reductions in the demand for psychoactive substances and to reduce the health and social problems associated withsuchuse. viii Foreword The debate that we are criminalizing cannabis while decriminalizing alcohol and tobacco in spite of their higher disease burden is controversial (Okasha 2008). The use of replacement therapy in addiction in developed countries may be unavailable in emerging countries. What are the alternatives? We have contradictory feedback from different countries. I believe this book will enlighten those working in the mental health of addiction in different devel- oped, emerging, or developing countries to comprehend the complexity of the problemofaddictionandthenecessitytouseflexibleprogramsaccordingtothe norms, culture, and economy of the country. References OkashaA(2008)Introductiontotheforum:iscannabisconsumptionalifestyleor braindisease?CurrOpinPsychiatry21(2):114–115 WHOWebsite.http://www.who.int/substance_abuse/facts/global_burden/en/ Prof.AhmedOkasha M.D.,Ph.D.,F.R.C.P.,F.R.C.,Psych.,F.A.C.P(Hon.) DirectorofWHOCollaboratingCenter ForResearchandTraininginMentalHealth InstituteofPsychiatry,AinShamsUniversity,Cairo,Egypt PastPresident,WorldPsychiatricAssociation Preface: What Does an International Perspective Bring? The International Society of Addiction Medicine (ISAM) was founded in Palm Springsin1999.Fromtheonset,theelementsofitsmainmissionwere • Advancementoftheknowledgeofaddictionasatreatabledisease • Recognition that physicians worldwide have a major role to play in the man- agementofaddiction • Enhancementofthecredibilityofthephysician’srole • Emphasisoftheimportanceofeducationalactivities • Establishmentofconsensusdocumentsandpracticeguidelines To implement this mission, the Society has organized an annual meeting ever since. This major gathering has also been supplemented on a few occasions with regional meetings. The Society also cosponsors the journal Substance Abuse. To pursue the mission, an International Certification in Addiction Medicine was createdin2005andhasbeenadministeredannuallyonatotalof15occasions. InseekingreferencetextstocreatetheexaminationquestionsfortheCertifica- tion, it became evident that the three or four excellent multiauthored textbooks available in English all originated from the USA, with an occasional contribution from an author from another country. These books are heavily centered on data arising from an American context and culture. We decided that a textbook with a broader authorship representation was required as well as a search for data originatingfromacrosstheworld.Mindfulofthefactthatauthorswouldpotentially havedifferentdegreesofEnglishproficiency,wedividedthescopeofourchapters into overview, focused, and sidebar chapters for case studies. International strate- gies to address substance abuse have traditionally favored control of the supply of drugs rather than reduction of the demand for their use. This textbook aims to describe the multifaceted options available for culturally sensitive strategies prioritizingdemandreduction. This international textbook is divided into 12 sections, resulting from the collaborative efforts over 3 years of some 265 contributors from 30 countries. Thesesectionsoutlinethecomponentsofaninternationalperspective. Abroaderunderstandingofepidemiology,etiology,andprevention Theprevalenceofdrugintakeisdeterminednotonlybyindividualstressfactorsbut also regional and larger-scale cultural patterns of drug consumption, social role models,aswellaslegalrequirementsandprohibitions. ix
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