Management of the Addicted Patient in Primary Care

ISBN-13: 9780387359618 / Angielski / Miękka / 2007 / 172 str.

Raymond M. Pomm; Heidi Allespach Pomm

Opis

Tobacco, alcohol, illicit drugs, and secondhand exposure are the nation s leading health problems. These acquired problems cause more than half of all deaths per year. First use, as well as some subsequent use, may be voluntary, but after loss of control, continued use is to be expected in an addict. So, prevention is the treatment of choice and also the treatment with the greatest ef? cacy. When prevention fails, early intervention and prompt treatment are critical; oth- wise, abuse becomes dependence and with it comes a chronic life-long disease without a speci? c cure. This places a great deal of responsibility on the already overburdened primary care physicians, who must identify a disease fraught with denial and whose patients are generally the last ones to know and accept the fact that they are hopelessly addicted and need help. Physician education and competency make early diagnosis more likely, but most practicing phy- cians do not have addiction education or treatment training as part of their undergraduate medical education. Among physicians, tobacco competency has improved, and a smoking history is now a part of almost every new patient assessment. A patient s attempts to quit and pharmacologic treatments have been incorporated into most practices in which the physician emphasizes we- ness. Most physicians have prescribed and followed patients treated with ni- tine replacement and Zyban. Progress in the treatment of alcohol abuse and dependence, cocaine and prescription misuse and dependence, and other drugs of abuse has been much slower."

Spis treści

Spectrum of addiction.- The addicted patient.- Clinical assessment.- Pharmacologic office-based interventions.- Nonpharmacologic office-based interventions: cognitive-behavioral therapy and motivational interviewing.- Case presentations and algorithms for management.- Appendix 1: into action: putting cognitive-behavioral therapy and motivational interviewing into practice.- Appendix 2: sample informed consent and medication management and treatment agreements

O autorze

Authors are leading authorities on the topic. Have published extensively on the topic in the medical literature.

Blurb

This invaluable book assists primary care physicians in managing patients with addictive illness. Written by experts in the field, the text is logically organized and key information is easily accessible. The introductory section offers the reader important background and rationale for evaluating and treating addiction in primary care. Following a useful presentation of addiction "basics" (i.e., definitions, neurobiology, genetics, and the disease model), the majority of the book focuses on helping the physician gain insight and develop practical skills that can be readily implemented. A wealth of clinical assessment tools is provided, and the underlying psychosocial processes common to all forms of addiction are discussed. Both pharmacologic interventions and nonpharmalogic modalities are clearly outlined. Of particular note are specific cognitive-behavioral and motivational strategies that can be administered in an office-based setting. The role of community-based recovery support systems is considered as well. Since a complete understanding of why and when to refer is critical to the management of this often life-threatening condition, criteria for referral are detailed. Bulleted clinical "pearls" further aid the reader in gaining insight into treating this difficult patient population. Case presentations complete the book by reinforcing management concepts and illustrating the most frequently encountered types of addicted patients found in primary care.