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.

Sets out clear recommendations, based on the best available evidence, for healthcare staff on how to work with people who misuse drugs (specifically opioids, stimulants and cannabis) to significantly improve their treatment and care.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Evidence-Based Treatments for Alcohol and Drug Abuse encompasses the developments in the field over the last decade, blending theory, techniques and clinical flexibility. Research in the past decade has shown that substance abuse and substance dependence are treatable. The field has witnessed the introduction of evidence-based psychological and specific pharmacological treatments. Unfortunately, many of the empirical supported therapies for addictions are still not widely applied by practitioners. The third volume in the Practical Clinical Guidebooks Series (PCG), Evidence-Based Treatments for Alcohol and Drug Abuse, defines the characteristics, classification, and prevalence of substance use disorders, and provides the clinician with practical guidelines applicable across a variety of treatment settings and patient groups. Drawing on the recent research in the field, the authors provide the practicing clinician and student with an up-to-date understanding of the epidemiology, etiology, course and prognosis of substance abuse disorders that would be relevant to clinical practice. In addition to describing phenomenology and etiology, the book provides a comprehensive guide to the assessment and treatment of DSM-IV-TR substance abuse disorders (SUDs), including abuse and dependence of alcohol, stimulants, opiates, hallucinogens, cannabis/marijuana, sedative, and party drugs.

Neuropathology of Drug Addictions and Substance Misuse, Volume One: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids, Opioids and Emerging Addictions provides the latest research in an area that shows that the neuropathological features of one addiction are often applicable to those of others. The book also details how a further understanding of these commonalties can provide a platform for the study of specific addictions in greater depth, all in an effort to create new modes of understanding, causation, prevention, and treatment. The three volumes in this series address new research and challenges, offering comprehensive coverage on the adverse consequences of the most common drugs of abuse, with each volume serving to update the reader's knowledge on the broader field of addiction, while also deepening our understanding of specific addictive substances. Volume One addresses tobacco, alcohol, cannabinoids, and opioids, with each section providing data on the general, molecular/cellular, and structural/functional neurological aspects of a given substance, along with a focus on the adverse consequences of addictions. - Provides a modern approach on the pathology of substances of abuse, offering an evidence based ethos for understanding the neurology of addictions - Fills an existing gap in the literature by proving a one-stop-shopping synopsis of everything to do with the neuropathology of drugs of addiction and substance misuse - Includes a list of abbreviations, abstracts, applications to other addictions and substance misuse, mini-dictionary of terms, summary points, 6+ figures and tables, and full references in each chapter - Offers coverage of preclinical, clinical, and population studies, from the cell to whole organs, and the genome to whole body

This volume reviews a range of empirically supported approaches to prevention and treatment of adolescent substance use problems. The focus is on motivationally based brief interventions that can be delivered in a variety of contexts, that address key developmental considerations, and that draw on cutting-edge knowledge on addictive behavior change. From expert contributors, coverage encompasses alcohol skills training; integrative behavioral and family therapy; motivational interviewing; interventions for dually diagnosed youth; Internet-based education, prevention, and treatment; and applications to HIV prevention. The volume is extensively referenced and includes numerous clinical illustrations and vignettes.

The leading clinical expert on substance misuse and abuse, Dr. Harry Haroutunian of the Hazelden Betty Ford Foundation, provides caregivers and loved ones with vital information needed to understand and address addiction issues in older adults. Drug and alcohol problems are booming in older adults. Dramatic lifestyle changes, along with growing health problems, have led many to turn to alcohol, prescription painkillers, and marijuana to medicate their physical and psychological pain. You may think, Dad is just enjoying cocktails and retirement, or Mom still has pain and needs her pills. Maybe so, but consider that an estimated 17 percent of people age sixty and older struggle with misuse of alcohol and prescription drugs alone. Older adults are now hospitalized as often for alcohol-related problems as they are for heart attacks. In this book, Dr. Haroutunian, physician director of the Professionals Program at the Betty Ford Center, provides you with the information needed to understand the dynamics of addiction in older adults. You’ll learn to; clearly distinguish between the signs of aging and the signs of addiction, many of which overlap; identify the indications of drug misuse and its progression to addiction; understand the unique treatment needs of older adults; and get the help you—as a caregiver or loved one—need to cope with your loved one’s addiction. This essential guide can help you transform stress and chaos into understanding and compassion.

Critical Issues in Alcohol and Drugs of Abuse Testing, Second Edition, addresses the general principles and technological advances for measuring drugs and alcohol, along with the pitfalls of drugs of abuse testing. Many designer drugs, for example, are not routinely tested in drugs of abuse panels and may go undetected in a drug test. This updated edition is a must-have for clinical pathologists, toxicologists, clinicians, and medical review officers and regulators, bridging the gap between technical and clinical information. Topics of note include the monitoring of pain management drugs, bath salts, spices (synthetic marijuana), designer drugs and date rape drugs, and more. - Serves as a ready resource of information for alcohol and drug testing - Ideal resource for making decisions related to the monitoring and interpretation of results - Includes concise content for clinical laboratory scientists, toxicologists and clinicians

Written by an experienced academic author, lecturer and practitioner, this comprehensive textbook provides an introduction to alcohol and drug misuse. It presents: the context of alcohol and drug misuse, and the nature and theories of addiction, including a historical overview and policy initiatives in contemporary society an overview of the problems associated with psychoactive substances and their impact on groups such as culturally and linguistically diverse communities, young people, women, older people and the homeless an understanding of the generic role responses to substance misuse in a variety of different settings and contexts, including primary care, the community and hospitals a framework for assessment, care planning, harm reduction approaches, dealing with overdose, intoxication and withdrawals, and psychological and pharmacological interventions an accessible and skills-oriented approach to assist students and practitioners in dealing with alcohol and drug misuse. This new edition is fully updated and includes new material on: evidence-based pharmacological interventions; recent global strategies in alcohol and drug; dual diagnosis and women; shisha smoking; and current statistics on prevalence of alcohol and drug misuse Alcohol and Drug Misuse takes into account current policy and practice for substance use and misuse and includes a range of pedagogical features to enhance learning. It is essential reading for nursing, health and social work students taking substance misuse modules, as well as related CPD courses for health and social care professionals.

This volume is intended for clinicians, researchers, residents, and students. The range is wide and the depth considerable for all the topics covered in the treatment of this timely and relevant subject. This book may serve equally well as a general introduction and a scholarly reference. Ultimately, it is designed to serve those patients suffering from abuse of and addiction to drugs and alcohol. The content and organization of the book flow from general concepts of abuse and addiction to specific details of the pharmacology of alcohol and drugs. Special chapters on topics not found in most other books, such as pharmacology of drug-drug interactions, abstinence, and prevention, are included. This book is written especially for the clinician interested in the pharma cology of alcohol and drugs of abuse and addiction. The pharmacology is integrated into a conceptual approach to diagnosis and treatment of alcohol and drug abuse and addiction. The form and style are didactic, critical as well as straightforward in presentation. Literature references from recent clinical research and basic research provide the foundation for the chapters throughout the book. Be cause the book is written by a clinician-researcher, the information is readily adaptable to clinical problems and research ideas. I would like to express my deep appreciation to Susan Newsom and Darlene Tucci for their invaluable technical assistance. Norman S. Miller vii Contents Preface ....................................................... vii CHAPTER 1 Introduction to the Pharmacological Effects of Alcohol and Drugs and Addiction on the Brain and Behavior .... . . . . . . . . . . . . . . . . . .. . . 1 . . . . . .