Alcoholism is a pathological behavioural syndrome, characterised by comp- sive alcohol use, craving and relapses, even recurring after many years of abstinence. It is suggested that chronic alcohol abuse leads to persistent changes within several neurochemical pathways in the brain and furthermore that an imprinted drug and addiction memory may scarcely be extinguished. Hence, the question arises as to whether there ought to be a reasonable hope that pharmacological drugs will be developed that interfere with an addiction memory, and as a result, finally lead to a cure? In this book, leading preclinical and clinical experts in the field of alcohol relapse prevention strive to furnish an answer to this question. None of the researchers or clinicians believes in a magic bullet that will be of help to all alcoholic patients in overcoming this disease. However, there is now convi- ing evidence demonstrating that specific subpopulations of alcoholic patients experience satisfactory benefit from currently available treatments. Today we have two medications for relapse prevention on the market – acamprosate and naltrexone. Although, currently, only a minority of alcoholic patients benefit from these medications, the approval of these compounds may be considered a hallmark in the field of psychopharmacology, even comparable to the era when the first antidepressant compounds were introduced. In recent years we have been witnessing an enormous growth in the science and knowledge regarding the field of relapse prevention.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
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.
The editors of this volume have assembled recent articles discussing elements of each of the several commonly used psychosocial interventions -- including relapse prevention therapy, community reinforcement, voucher-based programs, self-help therapies, and motivational enhancement therapy--in addition to research-based articles that demonstrate the efficacy of these approaches. The selections in this book will provide the reader with a broad overview of the field as well as the specific information needed to use these therapies in a variety of clinical settings.
This important work elucidates why relapse is so common for people recovering from addictive behavior problems--and what can be done to keep treatment on track. It provides an empirically supported framework for helping people with addictive behavior problems develop the skills to maintain their treatment goals, even in high-risk situations, and deal effectively with setbacks that occur. The expert contributors clearly identify the obstacles that arise in treating specific problem behaviors, review the factors that may trigger relapse at different stages of recovery, and present procedures for teaching effective cognitive and behavioral coping strategies.
This highly valuable book provides information on the problem of relapse in alcoholism and drug addiction. Experts address conceptual issues, summarize research on relapse, and explore a variety of theoretical and clinical models of relapse prevention. Several chapters describe practical applications of relapse prevention approaches used in both inpatient and outpatient clinical settings. Rather than adhere to one particular approach, this volume presents diverse viewpoints on clinical applications of relapse prevention. Intended for all professionals in medicine, psychiatry, social work, psychology, and nursing who work with individuals who have alcohol or other drug problems. Of particular interest to clinicians who treat alcoholics and drug abusers as well as administrators or supervisors who wish to develop and implement new types of relapse prevention programs. Unique in that it addressed conceptual, research, and clinical perspectives. Contributors, many who have published extensively on the subject, include a range of individuals, from those involved in academic research to those who work on the front lines in treatment facilities. SOFT BACKCOVER COPYRelapse: Conceptual, Research, and Clinical Perspectives provides new and valuable information on the problem of relapse with alcoholics and drug addicts. Some of the most respected authorities in the field describe practical applications of relapse prevention approaches used in both inpatient and outpatient clinical settings. They also discuss important conceptual issues, review the research on relapse, and explore theoretical and clinical models of relapse prevention. In recent years, increasing attention has been paid to the problem of relapse in chemically dependent individuals. With advanced research into the causes of relapse and the effectiveness of relapse prevention treatment models and new approaches to relapse prevention, more patients and their families are receiving specialized relapse prevention education and treatment focusing on long-term maintenance. Subsequently, all professionals in medicine, psychiatry, social work, psychology, and nursing who work with individuals who have alcohol or other drug problems will find it essential to read this up-to-the-minute volume. Clinicians who treat alcoholics and drug abusers and administrators or supervisors who wish to develop and implement new types of relapse prevention programs will applaud the comprehensive insights and applications featured in Relapse: Conceptual, Research, and Clinical Perspectives. Here's what you will find: A summary of the existing research and literature on relapse and relapse prevention, providing a broad overview of the current state of knowledge A description of four clinical treatment approaches commonly used in the chemical dependency field--the cognitive-behavioral approach based on the self-efficacy theory, the Psychoeducational Model of Relapse Prevention, the Marlatt and Gordon "self-management" approach, and the CENAPS model An examination of the content and structure of relapse prevention programs and the application of various approaches in several clinical contexts, including a six-month outpatient program, an intensive nonresidential rehabilitation program, a 28-day residential program, a therapeutic community, and a program used with adult chronic marijuana users
Acamprosate is the first new anticraving agent used prophylactically to prevent relapse in alcohol-dependent patients. This book presents an overview on basic mechanisms in alcohol dependence and craving and all the preclinical and clinical results are available to date on Acamprosate's mechanisms of action and efficacy.
A fully revised and updated edition of this unique and authoritative reference The award-winning A Guide to Treatments that Work , published in 1998, was the first book to assemble the numerous advances in both clinical psychology and psychiatry into one accessible volume. It immediately established itself as an indispensable reference for all mental health practitioners. Now in a fully updated edition,A Guide to Treatments that Work, Second Edition brings together, once again, a distinguished group of psychiatrists and clinical psychologists to take stock of which treatments and interventions actually work, which don't, and what still remains beyond the scope of our current knowledge. The new edition has been extensively revised to take account of recent drug developments and advances in psychotherapeutic interventions. Incorporating a wealth of new information, these eminent researchers and clinicians thoroughly review all available outcome data and clinical trials and provide detailed specification of methods and procedures to ensure effective treatment for each major DSM-IV disorder. As an interdisciplinary work that integrates information from both clinical psychology and psychiatry, this new edition will continue to serve as an essential volume for practitioners of every kind: psychiatrists, psychologists, clinical social workers, counselors, and mental health consultants.
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.
