Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment

ISBN-13: 9781468411782 / Angielski / Miękka / 2012 / 267 str.

Marc A. Schuckit; Marc A. Schuckit

Opis

When this series was conceived, a book on substance abuse, including alcohol and alcoholism, was to be of the highest priority. This priority was a reflection of my view that the subject is often inadequately or insufficient ly taught in many training programs. Few clinicians have had comprehen sive didactic education in this area, despite the frequency with which these problems are encountered in practice. All too often these encounters are in situations in which accurate diagnosis and rapid treatment are of critical im portance. We wanted a book that would be concise and easily readable but also comprehensive in its presentation of the basic principles underlying clinical manifestations, diagnosis, and management. It was of particular im portance that the book also serve as an easy reference guide in emergency situations. Marc Schuckit, a man with impeccable credentials as a scholar and an experienced clinician in this field, produced just such a book with his critically acclaimed first edition. That volume rapidly became a resource of great significance for psychiatrists, psychotherapists, and physicians in general. It has been adopted as a text in medical schools and residency train ing, as well as for courses in psychology, emergency medicine, social work, and nursing. The entire volume has been revised and updated to reflect changes in knowledge and clinical practice since the publication of the first edition and in order to keep the comprehensive references current. There is a new chapter on phencyclidine and another on caffeine and nicotine."

Spis treści

1: An Overview.- 1.1. Introduction.- 1.2. Some Definitions.- 1.2.1. Drug of Abuse.- 1.2.2. Drug Abuse.- 1.2.3. Dependence.- 1.3. General Comments about Drug Mechanisms.- 1.4. One Approach to Drug Classification.- 1.4.1. General CNS Depressants.- 1.4.2. CNS Sympathomimetics or Stimulants.- 1.4.3. Opiate Analgesics.- 1.4.4. The Cannabinols, or Marijuana.- 1.4.5. Psychedelics or Hallucinogens.- 1.4.6. Solvents, Glues, and Aerosols.- 1.4.7. Over-the-Counter Drugs and Other Prescription Medications.- 1.5. Alternate Classification Schemes.- 1.6. A Classification of Drug Problems.- 1.6.1. Panic Reaction.- 1.6.2. Flashback.- 1.6.3. Toxic Reaction.- 1.6.4. Psychosis.- 1.6.5. Organic Brain Syndrome.- 1.6.6. Withdrawal or Abstinence Syndrome.- 1.7. A General Introduction to Emergency and Crisis Treatment.- 1.7.1. Acute Emergency Care.- 1.7.2. Evaluation.- 1.7.3. Subacute Care.- 1.8. Onward.- References.- 2: The CNS Depressants.- 2.1. Introduction.- 2.1.1 Pharmacology.- 2.1.2 Epidemiology and Pattern of Abuse.- 2.1.3 Establishing the Diagnosis.- 2.2 Emergency Problems.- 2.2.1 Panic Reaction.- 2.2.2 Flashbacks.- 2.2.3 Toxic Reactions.- 2.2.4 Psychosis.- 2.2.5 Organic Brain Syndrome.- 2.2.6 Drug Withdrawal Syndrome.- 2.2.7 Medical Problems.- References.- 3: Alcoholism: An Introduction.- 3.1 Introduction.- 3.1.1 General Comments.- 3.1.2 Some Definitions.- 3.2 Pharmacology of Alcohol.- 3.2.1. General Comments.- 3.2.2. Effects on the Body.- 3.2.3. Effects on Mental Processes.- 3.2.4. Alcohol Metabolism.- 3.2.5. Tolerance and Physical Dependence.- 3.3 Epidemiology of Drinking and Alcoholism.- 3.3.1. Drinking Patterns.- 3.3.2. Alcoholism.- 3.4 Natural History of Alcoholism.- 3.4.1. General Comments.- 3.5 Etiology.- 3.5.1. Psychological Theories.- 3.5.2. Sociocultural Theories.- 3.5.3. Biological Theories.- 3.5.4. Genetic Factors.- References.- 4: Alcoholism: Acute Treatment.- 4.1 Introduction.- 4.1.1 Identification of the Alcoholic.- 4.1.2 Obtaining a History.- 4.2 Emergency Situations.- 4.2.1 Panic Reaction.- 4.2.2 Flashbacks.- 4.2.3 Toxic Reactions.- 4.2.4 Psychosis.- 4.2.5 Organic Brain Syndrome.- 4.2.6 Alcoholic Withdrawal.- 4.2.7 Medical Problems.- 4.2.8 Other Problems.- References.- 5: Stimulants.- 5.1 Introduction.- 5.1.1 Pharmacology.- 5.1.2 Epidemiology and Patterns of Abuse.- 5.1.3 Establishing the Diagnosis.- 5.2 Emergency Problems.- 5.2.1 Panic Reaction.- 5.2.2 Flashbacks.- 5.2.3 Toxic Reaction.- 5.2.4 Psychosis.- 4.2.5 Organic Brain Syndrome.- 5.2.6 Withdrawal.- 5.2.7 Medical Problems.- References.- 6: Opiates and Other Analgesics.- 6.1 Introduction.- 6.1.1 Pharmacology.- 6.1.2 Epidemiology and Pattern of Abuse.- 6.1.3 Establishing the Diagnosis.- 6.2 Emergency Problems.- 6.2.1. Panic Reactions.- 6.2.2. Flashbacks.- 6.2.3 Toxic Reactions.- 6.2.4 Psychosis and Depression 1ll.- 6.2.5 Organic Brain Syndrome.- 6.2.6 Opiate Withdrawal in the Adult.- 6.2.7 Opiate Withdrawal in the Neonate.- 6.2.8 Medical Problems.- 6.3. Rehabilitation.- References.- 7: Cannabinols.- 7.1 Introduction.- 7.1.1 Pharmacology.- 7.1.2 Epidemiology and Pattern of Abuse.- 7.1.3 Medical Uses.- 7.1.4 Establishing the Diagnosis.- 7.2 Emergency Problems.- 7.2.1 Panic Reaction.- 7.2.2 Flashbacks.- 7.2.3 Toxic Reactions.- 7.2.4 Psychosis and Other Related Symptoms.- 7.2.5 Organic Brain Syndrome.- 7.2.6 Withdrawal.- 7.2.7 Medical Problems.- 7.2.8 Other Emergency Problems.- References.- 8: The Hallucinogens and Related Drugs.- 8.1 Introduction.- 8.1.1 Pharmacology.- 8.1.2 Epidemiology and Patterns of Abuse.- 8.2 Emergency Problems for LSD-Type Drugs.- 8.2.1 Panic Reaction.- 8.2.2 Flashbacks.- 8.2.3 Toxic Reactions.- 8.2.4 Psychosis.- 8.2.5 Organic Brain Syndrome.- 8.2.6 Withdrawal.- 8.2.7 Medical Problems.- 8.3 Related Drugs.- 8.3.1 Nutmeg.- 8.3.2 Morning Glory Seeds.- 8.3.3 Catnip and Locoweed.- 8.3.4 Nitrous Oxide (N20).- 8.4.5 Amyl or Butyl Nitrite.- References.- 9: Phencyclidine (PCP).- 9.1 Introduction.- 9.1.1 Pharmacology.- 9.1.2 Epidemiology and Pattern of Abuse.- 9.2 Emergency Situations for PCP.- 9.2.1 Panic and Violence.- 9.2.2 Flashbacks.- 9.2.3 Toxic Reactions.- 9.2.4 Psychosis.- 9.2.5 Organic Brain Syndrome.- References.- 10: Glues, Solvents, and Aerosols.- 10.1 Introduction.- 10.1.1 General Comments.- 10.1.2 Pharmacology.- 10.1.3 Epidemiology and Patterns of Abuse.- 10.2 Emergency Problems.- 10.2.1 Panic Reactions.- 10.2.2 Flashbacks.- 10.2.3 Toxic Reactions.- 10.2.4 Psychosis.- 10.2.5 Organic Brain Syndrome.- 10.2.6 Withdrawal.- 10.2.7 Medical Problems.- References.- 11: Over-the-Counter (O/C) and Some Prescription Drugs.- 11.1 Introduction.- 11.1.1 General Comments.- 11.1.2 Epidemiology and Pattern of Misuse.- 11.2 Antihistamine Drugs (Sedatives/Hypnotics).- 11.2.1. General Comments.- 11.2.2 Pharmacology.- 11.2.3 Epidemiology.- 11.2.4 Emergency Situations.- 11.3 Cold and Allergy Products.- 11.4 Bromides.- 11.4.1 General Comments.- 11.4.2 Pharmacology.- 11.4.3 Emergency Problems.- 11.5 O/C Analgesics.- 11.5.1 General Comments.- 11.5.2 Pharmacology.- 11.5.3 Epidemiology and Pattern of Misuse.- 11.5.4 Emergency Situations.- 11.6 Laxative Abuse.- 11.6.1 General Comments.- 11.6.2 Pharmacology.- 11.6.3 Epidemiology and Pattern of Misuse.- 11.6.4 Emergency Situations—Medical Disorders.- 11.7 Stimulants.- 11.7.1 General Comments.- 11.7.2 Pharmacology.- 11.7.3 Epidemiology and Pattern of Misuse.- 11.7.4 Emergency Situations.- 11.8 Weight Control Products.- 11.8.1 General Comments.- 11.8.2 Pharmacology.- 11.8.3 Epidemiology and Pattern of Misuse.- 11.8.4 Emergency Situations.- 11.9 Abuse of Some Prescription Drugs.- 11.9.1 Antiparkinsonian Drugs.- 11.9.2 Other Prescription Drugs.- 11.10 General Conclusions.- References.- 12: The Xanthines (Caffeine) and Nicotine.- 12.1 General Comments.- 12.2 Xanthines (Caffeine).- 12.2.1. General Comments.- 12.2.2. Emergency Problems.- 12.3 Nicotine.- 12.3.1. General Comments.- 12.3.2 Emergency Problems.- 12.3.3 Treatment and Prevention.- References.- 13: Multidrug Misuse.- 13.1 Introduction.- 13.1.1 General Comments.- 13.1.2 Problems of Definition and Classification.- 13.1.3 The Natural History of Multidrug Misuse.- 13.1.4 Pharmacology.- 13.1.5 Epidemiology and Patterns of Abuse.- 13.4.6 Establishing a Diagnosis.- 13.2 Emergency Room Situations.- 13.2.1 Panic Reactions.- 13.2.2 Flashbacks.- 13.2.3 Toxic Reactions.- 13.2.4 Psychoses.- 13.2.5 Organic Brain Syndrome.- 13.2.6 Withdrawal from Multiple Drugs.- 13.2.7 Medical Problems.- References.- 14: Emergency Problems: A Rapid Overview.- 14.1 Introduction.- 14.1.1 Comments.- 14.1.2 Some General Rules.- 14.1.3 An Overview of Relevant Laboratory Tests.- 14.1.4 An Introduction to Specific Emergency Problems.- 14.2 Panic Reactions.- 14.2.1 Clinical Picture.- 14.2.2 Differential Diagnosis.- 14.2.3 Treatment.- 14.3 Flashbacks.- 14.3.1 Clinical Picture.- 14.3.2 Differential Diagnosis.- 14.3.3 Treatment.- 14.4 Toxic Reactions.- 14.4.1 Clinical Picture.- 14.4.2 Differential Diagnosis.- 14.4.3. Treatment.- 14.5. Psychosis.- 14.5.1. Clinical Picture.- 14.5.2. Differential Diagnosis.- 14.5.3. Treatment.- 14.6. Organic Brain Syndrome.- 14.6.1. Clinical Picture.- 14.6.2. Differential Diagnosis.- 14.6.3. Treatment.- 14.7. Drug Withdrawal States.- 14.7.1. Clinical Picture.- 14.7.2. Differential Diagnosis.- 14.7.3. Treatment.- References.- 15: Rehabilitation.- 15.1. Introduction.- 15.1.1. Some General Rules.- 15.1.2. A “General” Substance-Abuse Treatment Program.- 15.2. A Special Case: Alcoholism.- 15.2.1. Confrontation of the Alcoholic.- 15.2.2. Enhancing Motivation.- 15.2.3. Helping Patients to Readjust to a Life without Alcohol.- 15.2.4. Treatment Programs.- 15.3. A Special Case: Opiates.- 15.3.1. Methadone and Methadyl Acetate Maintenance.- 15.3.2. Opiate Antagonists.- 15.3.3. Other Drugs Used in Treatment.- 15.3.4. Drug-Free Programs.- 15.3.5. The Medical Abuser.- 15.4. A Special Case: Hallucinogens, Stimulants, Depressants, and Multidrug Misuse.- References.