Ghodse's Drugs and Addictive Behaviour: A

This classic text provides a comprehensive, accessible overview of substance misuse and dependence with an emphasis on practical and evidence-based approaches to the assessment, management and prevention of a wide range of drug-related problems, in a variety of clinical and social settings. The book includes definitions of terms, and describes the effects and clinical characteristics of all substances of misuse. The theoretical background to these topics is clearly explained. For the fourth edition, every chapter has been revised to include the most up-to-date information, with the latest international data on the extent of the world drug problem. There is detailed emphasis on harm minimization, AIDS and hepatitis C and entirely new coverage of tobacco addiction and its management. This is an essential guide for all healthcare workers, health policy specialists, counselors and those seeking to train in areas related to addiction and substance misuse.

Hamid Ghodse CBE is Professor of psychiatry and the Director of the International centre for Drug policy, St George's University of London, London, UK. He is also a member of the Expert Advisory Panel of WHO on Alcohol and Drug Dependence and is President of the United Nations International Narcotics Control Board.

Preface	p. ix
Introduction	p. 1
Drugs, addiction and behaviour	p. 5
What is a 'drug'?	p. 5
What is drug misuse?	p. 5
Drug abuse; harmful use	p. 6
Drug dependence	p. 6
Psychological dependence	p. 7
Physical dependence and the withdrawal syndrome	p. 7
Tolerance	p. 8
Types of drug dependence	p. 9
Causes of drug dependence	p. 10
The global drug problem: international perspectives	p. 19
Introduction	p. 19
Extent and nature of drug problems	p. 20
Global drug problems	p. 32
Sources of epidemiological information in the UK	p. 45
Drug dependence in the UK	p. 60
Organization of treatment services in the UK	p. 67
Drug policy in some other countries	p. 72
Drugs of abuse and dependence	p. 76
Opioids	p. 76
Sedative hypnotics	p. 83
Stimulant drugs	p. 86
Hallucinogens	p. 93
Cannabis	p. 95
Volatile solvents	p. 98
Designer drugs	p. 100
Steroids	p. 102
Over-the-counter medicines	p. 103
Herbal preparations and 'natural' medicines	p. 103
The combined use of drugs and alcohol	p. 103
Alcohol	p. 106
Introduction	p. 106
Definitions	p. 106
Extent and nature of the problem	p. 107
Genetics of alcohol use and dependence	p. 109
Alcohol metabolism	p. 109
Recognition of problem drinking	p. 110
Adverse effects of alcohol misuse	p. 111
Management of problem drinking and its complications	p. 113
Relapse prevention	p. 115
Alcohol policies	p. 117
Tobacco use and addiction	p. 120
Introduction	p. 120
The global epidemic	p. 120
Types of tobacco and routes of administration	p. 121
Tobacco addiction	p. 122
The hazards of tobacco use	p. 124
Special populations of tobacco users	p. 125
Treatment	p. 127
Policy and public health initiatives	p. 129
Conclusion	p. 129
Assessment	p. 131
Introduction	p. 131
Drug history	p. 131
Life history	p. 132
Social work assessment	p. 133
Family assessment	p. 135
Physical examination	p. 136
Test of physical dependence on opiates (naloxone)	p. 138
Mental state examination	p. 139
Psychological assessment	p. 140
Special investigations	p. 140
Laboratory investigation for drugs	p. 142
Summary	p. 147
Classification of substance-use disorders	p. 148
ICD-10	p. 148
DSM-III-R	p. 154
DSM-IV	p. 155
General measures of intervention	p. 160
Introduction	p. 160
Psychotherapy	p. 161
Drug counselling	p. 164
Cognitive and behavioural techniques	p. 166
Vocational rehabilitation	p. 170
Therapeutic communities	p. 171
Self-help groups	p. 173
Minnesota method	p. 176
Crisis intervention	p. 176
Compulsory treatment	p. 177
Inpatient care	p. 177
Treatment matching	p. 179
Specific methods of treatment	p. 180
Opiates	p. 180
Sedative hypnotic drugs	p. 196
LSD and cannabis	p. 200
Cocaine and amphetamine	p. 200
Complications of drug abuse and their treatment	p. 203
Infective complications of injection	p. 203
Pulmonary complications	p. 214
Psychiatric complications	p. 214
Special problems	p. 223
The pregnant addict	p. 223
The child at risk	p. 226
The drug-abusing doctor: the 'professional' addict	p. 229
Comorbidity	p. 231
Drug-dependent patients on general medical and surgical wards	p. 234
Drug-dependent patients in accident and emergency departments	p. 235
Drug-dependent patients in the general practitioner's surgery	p. 238
Substance abusers detained in police custody	p. 239
Driving licences	p. 242
Travelling abroad	p. 243
Follow-up and treatment outcome	p. 244
Introduction	p. 244
Natural history of drug dependence	p. 245
Mortality	p. 247
Outcome of treatment	p. 250
Discussion	p. 252
Prevention of drug abuse	p. 255
Introduction	p. 255
Reducing the availability of drugs of abuse	p. 256
Reducing the demand for drugs of abuse	p. 260
Pharmacological approaches	p. 263
Harm reduction	p. 264
Conclusion	p. 267
The law and drug-control policies	p. 270
History of international drug control	p. 270
Current international controls	p. 272
United Nations drug abuse control organs	p. 274
Control in the UK	p. 278
Appendices	p. 283
References and further reading	p. 349
Index	p. 373
Table of Contents provided by Ingram. All Rights Reserved.

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Ghodse's Drugs and Addictive Behaviour: A Guide to Treatment

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