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 . . . . . .

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.

This volume gives an overview of new insights to alcohol pharmacology using DREADDs (Designer Receptors and Unraveling the Neuropharmacology of Alcohol). It examines which pharmacological principles should be applied to understanding DREADDs taking into account some very current research. Additionally, this book covers important topics under the heading of “experimental pharmacology” and alcohol.

The definitive guide to the effect of alcohol on people, families, communities, and society, written by two of America's leading experts on alcoholism and its impact. Throughout history, and across cultures, alcohol has affected the fabric of society through abuse and addiction, contributed to violence and accidents, and caused injuries and health issues. In Alcohol: Its History, Pharmacology, and Treatment, part of Hazelden's Library of Addictive Drugs Series, Cheryl Cherpitel, DrPH, and Mark Rose, MA, examine the nature and extent of alcohol use in the United States, current treatment models and demographics, and the biology of alcohol, addiction, and treatment.In separating fact from fiction, Cherpitel and Rose give context for understanding the alcohol problem by tracing its history and different uses over time, then offer an in-depth look atthe latest scientific findings on alcohol's effects on individualsthe myths and realities of alcohol's impact on the mindthe societal impacts of alcohol abuse as a factor in violence and accidentsthe pharmacology of pharmaceutical treatments for alcoholismthe history of treatment and current therapeutic treatment modelsThoroughly researched and highly readable, Alcohol offers a comprehensive understanding of medical, social, and political issues concerning this legal, yet potentially dangerous, drug.

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.

This book presents state-of-the-art, accessible reviews of the science of alcohol treatment and guidance for the management of clinical situations.

This clinical guideline, commissioned by the National Institute for Health and Clinical Excellence (NICE) sets out clear recommendations, based on the best available evidence, for health care professionals on how to work with people with alcohol use disorders, in order to improve their treatment and care. About a quarter of the UK population drink alcohol at a level that is harmful and over 4% are dependent. Alcohol use disorders are also increasing in children and young people. This new guideline reviews the evidence for the diagnosis and assessment of alcohol use disorders, organisation and delivery of care, assisted alcohol withdrawal, and psychological and pharmacological interventions, and includes a chapter on experience of care. It comes with a free CD-ROM that contains all the data used as evidence, including: included and excluded studies, profile tables that summarise both the quality of the evidence and the results of the evidence synthesis, all meta-analytical data, presented as forest plots and detailed information about how to use and interpret forest plots.

Since the last meeting of the WHO Expert Committee on Problems Related to Alcohol Consumption WHO has undertaken a range of major initiatives to support Member States and reinforce the evidence on which policies work to develop global and regional information systems and to promote effective policies in health-care settings. These initiatives provide the background for the continuing role of WHO in supporting Member States to reduce the harm done by alcohol. In resolution WHA58.26 the Fifty-eighth World Health Assembly in 2005 requested the Director-General to report to the Sixtieth World Health Assembly on evidence-based strategies and interventions to reduce alcohol-related harm including a comprehensive assessment of public-health problems caused by harmful use of alcohol and to draw up recommendations for effective policies and interventions to reduce alcohol-related harm . To this end a WHO Expert Committee on Problems Related to Alcohol Consumption was convened with the main objectives of reviewing a range of public health problems attributable to alcohol consumption as well as scientific and empirical evidence of effectiveness of different policy options and providing technical recommendations on effective policies and interventions to reduce alcohol-related harm.

Provides clinical descriptions diagnostic guidelines and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry. The book was developed from chapter V of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The clinical descriptions and diagnostic guidelines were finalized after field testing by over 700 clinicians and researchers in 110 institutes in 40 countries making this book the product of the largest ever research effort designed to improve psychiatric diagnosis. Every effort has been made to define categories whose existence is scientifically justifiable as well as clinically useful. The classification divides disorders into ten groups according to major common themes or descriptive likeness a new feature which makes for increased convenience of use. For each disorder the book provides a full description of the main clinical features and all other important but less specific associated features. Diagnostic guidelines indicate the number balance and duration of symptoms usually required before a confident diagnosis can be made. Inclusion and exclusion criteria are also provided together with conditions to be considered in differential diagnosis. The guidelines are worded so that a degree of flexibility is retained for diagnostic decisions in clinical work particularly in the situation where provisional diagnosis may have to be made before the clinical picture is entirely clear or information is complete. ... As befitting a publication of considerable influence the amount of work that went into preparing ICD-10 has been formidable... - The International Journal of Social Psychiatry

This book focuses on the value of supervised Disulfiram therapy, highlighting the many potential and unique benefits of Disulfiram. One of the oldest drugs available for the long-term management of alcohol dependence, Disulfiram remains a viable treatment option for alcohol dependence and has been shown in recent studies to be more successful in treating patients with alcohol dependence than Naltrexone, Topiramate and Acamprosate. It is also useful in dual diagnosis patients and those with co-morbid cocaine and alcohol dependence. Although Disulfiram’s mechanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies point to potential anti-craving effects as well. In dedicated chapters, the book reviews major clinical trials of Disulfiram spanning nearly 60 years, its historical aspects and discovery, side effects, treatment protocols and uses in the context of alcohol dependence. The book also discusses the use of Disulfiram across diverse populations along with monitoring for compliance and various adverse effects that may manifest. Further topics include Disulfiram implant therapy and the role of Disulfiram in the modern long-term pharmacotherapy of alcohol dependence, as well as the role of cognitive behavior therapy in enhancing the effects of Disulfiram and the emerging role of Disulfiram in treating cocaine dependence and pathological gambling. As such, the book offers a “one-stop” comprehensive guide to all aspects of Disulfiram therapy.