The Substance Abuse Handbook

568 Pages·2014·2.85 MB·English

by  Pedro Ruiz

The
SubSTance
abuSe
handbook
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Title: The Substance Abuse Handbook 2e Short / Normal / Long Publishing Services
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Title: The Substance Abuse Handbook 2e Short / Normal / Long Publishing Services
The
SubSTance
abuSe
handbook
Second ediTion
Pedro Ruiz, M.d.
Professor and Executive Vice-Chair
Director of Clinical Programs
Department of Psychiatry and Behavioral Sciences
Miller School of Medicine, University of Miami
Miami, Florida
eric c. Strain, M.d.
Professor
Director, Johns Hopkins Center for Substance
Abuse Treatment and Research
Medical Director, Behavioral Pharmacology Research Unit
Johns Hopkins University School of Medicine
Baltimore, Maryland
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Title: The Substance Abuse Handbook 2e Short / Normal / Long Publishing Services
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© 2014 by Lippincott Williams & Wilkins, a Wolters Kluwer business
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1st edition, © 2007 by Lippincott Williams & Wilkins
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any
form or by any means, including photocopying, or utilizing by any information storage and retrieval sys-
tem without written permission from the copyright owner, except for brief quotations embodied in critical
articles and reviews.
Printed in China
Library of Congress Cataloging-in-Publication Data
The substance abuse handbook / editor, Pedro Ruiz, Eric C. Strain. — Second edition.
p. ; cm.
Companion to: Lowinson and Ruiz’s substance abuse : a comprehensive textbook / editors, Pedro Ruiz,
Eric C. Strain. 5th ed. c2011.
Includes bibliographical references and index.
ISBN 978-1-4511-9196-7 (paperback)
I. Ruiz, Pedro, 1936- II. Strain, Eric C. III. Lowinson and Ruiz’s substance abuse.
[DNLM: 1. Substance-Related Disorders. 2. Behavior, Addictive. WM 270]
RC564.15
616.86—dc23
2013044532
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any
consequences from application of the information in this book and make no warranty, expressed or implied, with
respect to the currency, completeness, or accuracy of the contents of the publication. Application of this informa-
tion in a particular situation remains the professional responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth
in this text are in accordance with current recommendations and practice at the time of publication. However, in
view of ongoing research, changes in government regulations, and the constant flow of information relating to
drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in
indications and dosage and for added warnings and precautions. This is particularly important when the recom-
mended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of health care providers to ascertain
the FDA status of each drug or device planned for use in their clinical practice.
The publisher has made every effort to trace copyright holders for borrowed material. If they have inadver-
tently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity.
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PReFace
i
n 2007, we conceived, created, and published the first edition of The Substance Abuse
Handbook as a practical companion book to the fourth edition of Substance Abuse:
A  Comprehensive Textbook, published by Lippincott Williams and Wilkins in 2005. At that
time, it was clear to us that mental health professionals working in the field of addiction, pri-
mary care practitioners, addiction counselors, students, residents, and trainees at large needed
a clinically oriented handbook that focused on the most essential aspects of addictive disorders
and their treatment. Our goals were very ambitious. In creating and publishing the first edi-
tion of The Substance Abuse Handbook, we, together with Wolters Kluwer Health/Lippincott
Williams and Wilkins, offered the field authoritative, clinically oriented information on the
topic of substance use, abuse, and dependence, with an emphasis on diagnosis, treatment, and
prevention. Our goal was to provide short and focused reviews on the nature of substance
abuse as well as each type of drug that is abused, chapters that addressed comorbidities and
other related disorders, and also information about treatment approaches. In addition, we also
wanted to create a handbook that could be useful to all disciplines involved, directly or indi-
rectly, in the addiction field.
We were very pleased that the first edition of this Handbook was very well received
throughout the field and by a wide variety of practitioners—reflecting, in part, the multidisci-
plinary nature of those who treat persons with addictions. Over the ensuing years the addiction
field has continued to change and evolve. At the present time, we are better able to under-
stand the biological, psychological, behavioral, and sociocultural aspects of addictive disorders
and conditions associated with substance use. New treatment approaches and different modes
of intervention have continued to be tested, shown to be effective, and brought into clinical
practice—helping people who suffer from addictive disorders. These advances in our under-
standing of addictions, as well as new methods of intervention and treatment, have stimulated
us to produce the second edition of The Substance Abuse Handbook as a practical and relevant
companion to the fifth edition of Lowinson and Ruiz’s Substance Abuse: A Comprehensive
Textbook, also published by Wolters Kluwer Health/Lippincott Williams and Wilkins in 2011.
This second edition of The Substance Abuse Handbook follows the general outline and
format of the latest edition of the Comprehensive Textbook, and addresses those topic areas
that we thought were particularly useful in a more abbreviated version of that larger book. As is
always the case, the interested reader should be aware that the field is constantly evolving, and
that the current Handbook’s material should be balanced by familiarity with timely literature
on the nature of addictive disorders and their treatment. That said, our hope is that this book
will provide a useful resource that provides more condensed information about substance use
disorders. Our target audience continues to be all who treat persons with substance abuse dis-
order. We hope you will find this book a useful resource in your daily practice.
v
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vi Preface
Finally, we want to take this opportunity to thank and express our appreciation to the per-
sons who assisted us and made possible the publication of the second edition of The Substance
Abuse Handbook. We first thank the expert authors and colleagues who helped and collabo-
rated with us in the production of the fifth edition of Lowinson and Ruiz’s Substance Abuse:
A Comprehensive Textbook; second, we thank the editorial staff of Wolters Kluwer Health/
Lippincott Williams and Wilkins. Third, we recognize our staff who worked very hard in
making this handbook a reality. Fourth, we show appreciation for our family members who
supported us during this academic and clinical project: our spouses, Angela Ruiz and Grace
Serafini, as well as our children and grandchildren. Finally, and most important, we extend our
deepest gratitude to the patients who have suffered from addictive disorders and conditions;
these patients stimulated us to work harder in this area of the medical field. They certainly de-
serve the best outcomes of our efforts.
Pedro Ruiz, M.D.
Eric C. Strain, M.D.
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conTenTS
Preface v
SECTION 1 • Etiologic Factors 1
1 Etiology 2
2 Epidemiology 14
3 Evaluation and Diagnosis 24
SECTION 2 • Substances of Abuse 35
4 Alcohol 36
5 Opioids 48
6 Cocaine and Crack 58
7 Cannabis 71
8 Amphetamines and Other Stimulants 82
9 Sedative–Hypnotics 92
10 Hallucinogens 102
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11 PCP, MDMA, and Designer Drugs 112
12 Inhalants 118
13 Nicotine 129
14 Caffeine 139
15 Anabolic–Androgenic Steroids 150
SECTION 3 • Compulsive and Addictive
Behaviors 161
16 Eating Disorders 162
17 Pathologic Gambling 172
18 Sexual Addiction 182
19 Internet Addiction 192
SECTION 4 • Treatment Modalities 203
20 Methadone Maintenance Treatment 204
21 Buprenorphine Treatment 215
22 Naltrexone and Other Pharmacotherapies for Opioid
Dependence 225
23 Alcohol Abstinence Pharmacotherapy Treatment 234
24 Vaccines for Substance Use Disorders 244
25 Acupuncture 254
26 Nicotine Treatment 265
27 Psychosocial Treatments 276
28 The Therapeutic Community 293
29 Individual Psychotherapy 298
30 Group Therapy 306
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31 Family/Couples Therapy 317
32 Cognitive–Behavioral Therapy 326
33 Contingency Management 336
34 Motivational Interviewing and Enhancement 343
35 Relapse Prevention 355
36 Management of Associated Medical Conditions 368
37 Medical Complications of Drug Use/Dependence 379
38 Psychiatric Complications of HIV-1 Infection and Drug
Abuse 392
39 Acute and Chronic Pain 404
40 Psychiatric Comorbidity 415
41 Medication Interactions 424
42 Models of Prevention 435
43 Substance Abuse among Adolescents and the
Elderly 450
44 Women and Addiction 461
45 Special Populations 475
46 Incarcerated Populations 492
47 Substance Use Disorders among Health-Care
Professionals 500
48 The Homeless 508
49 Training and Education 515
50 Forensics 529
Index 541
ix
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Title: The Substance Abuse Handbook 2e Short / Normal / Long Publishing Services