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.

Treating Drug Problems, Volume 2 presents a wealth of incisive and accessible information on the issue of drug abuse and treatment in America. Several papers lay bare the relationship between drug treatment and other aspects of drug policy, including a powerful overview of twentieth century narcotics use in America and a unique account of how the federal government has built and managed the drug treatment system from the 1960s to the present. Two papers focus on the criminal justice system. The remaining papers focus on Employer policies and practices toward illegal drugs. Patterns and cycles of cocaine use in subcultures and the popular culture. Drug treatment from a marketing, supply-and-demand perspective, including an analysis of policy options. Treating Drug Problems, Volume 2 provides important information to policy makers and administrators, drug treatment specialists, and researchers.

In the 1960s, as illegal drug use grew from a fringe issue to a pervasive public concern, a new industry arose to treat the addiction epidemic. Over the next five decades, the industry's leaders promised to rehabilitate the casualties of the drug culture even as incarceration rates for drug-related offenses climbed. In this history of addiction treatment, Claire D. Clark traces the political shift from the radical communitarianism of the 1960s to the conservatism of the Reagan era, uncovering the forgotten origins of today's recovery movement. Based on extensive interviews with drug-rehabilitation professionals and archival research, The Recovery Revolution locates the history of treatment activists' influence on the development of American drug policy. Synanon, a controversial drug-treatment program launched in California in 1958, emphasized a community-based approach to rehabilitation. Its associates helped develop the therapeutic community (TC) model, which encouraged peer confrontation as a path to recovery. As TC treatment pioneers made mutual aid profitable, the model attracted powerful supporters and spread rapidly throughout the country. The TC approach was supported as part of the Nixon administration's "law-and-order" policies, favored in the Reagan administration's antidrug campaigns, and remained relevant amid the turbulent drug policies of the late twentieth and early twenty-first centuries. While many contemporary critics characterize American drug policy as simply the expression of moralizing conservatism or a mask for racial oppression, Clark recounts the complicated legacy of the "ex-addict" activists who turned drug treatment into both a product and a political symbol that promoted the impossible dream of a drug-free America.

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.

An eye-opening tour of the addiction treatment industry explores the gap between what should happen and what does What happens inside drug and alcohol rehabilitation centers and how rehab works are a mystery to those outside the industry – and sometimes even to those inside it. Anne M. Fletcher is a trusted New York Times bestselling health and medical writer who visited 15 addiction treatment centers—from outpatient programs for the indigent to famous celebrity rehabs; from the sites of renowned Twelve-Step centers to several unconventional programs—to find out what really happens. What she reveals ranges from inspirational to irresponsible, and, in some cases, potentially dangerous. Real Stories: As always with her books, Fletcher gets the inside story by turning to real people who “have been there,” interviewing more than 100 individuals whose compelling stories illustrate serious issues facing people in rehab and endemic in the rehab industry today. Connected Writer and Researcher who has earned the respect (and cooperation) of experts throughout the fields she’s taken on. Inside Rehab is no exception—Fletcher has interviewed more than 100 professionals working in the field, including a mix of rehab staffers and administrators as well as leading academics. Rehab is constantly covered in the media, as celebrities battle their drug and alcohol issues in the spotlight and reality TV puts recovery in prime time. Addiction is no longer only a personal struggle—it’s a pop culture phenomenon. Myth Busting: Fletcher exposes twelve supposed facts for the falsehoods they are, including “rehab is necessary for most people to recover from addictions;” “highly trained professionals provide most of the treatment in addiction programs;” and “drugs should not be used to treat a drug addict.” Fletcher’s most important finding is the alarming discrepancy between the treatments being employed at many rehab centers and the treatments recommended by leading experts and supported by scientific research. Guidance and Practical Solutions: Inside Rehab also highlights what is working, spotlights state-of-the-art programs and practices, and offers advice and guidance for people seeking quality care and treatment for themselves or those they care about. Inside Rehab is the first book to give readers a thoughtful, sensitive, and bracingly honest insider’s view of the drug and alcohol rehab industry in America. For people seeking quality care for themselves or a loved one, Inside Rehab is essential reading, offering a wealth of accurate information and wise guidance.

Disorders of anxiety and substance use are, for some reason, rarely treated in an integrated fashion by professionals. This timely volume addresses this glaring omission with dispatches from the frontlines of research and treatment. Thirty-four international experts offer findings, theories, and intervention strategies for this common form of dual disorder, across a range of substances and of anxiety disorders, to give the reader comprehensive knowledge in a practical format.