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.

Drug Abuse Treatment: A National Study of Effectiveness

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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.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

This eminently practical guide presents an empirically supported approach for treating people with substance abuse problems and their spouses or domestic partners. Behavioral couples therapy (BCT) explicitly focuses on both substance use and relationship issues, and is readily compatible with 12-step approaches. In a convenient large-size format, the book provides all the materials needed to introduce BCT; implement a recovery contract to support abstinence; work with clients to increase positive activities, improve communication, and reduce relapse risks; and deal with special treatment challenges. Appendices include a session-by-session treatment manual and 70 reproducible checklists, forms, and client education posters.

In Psychotherapy for the Treatment of Substance Abuse, leading authorities on substance abuse treatment techniques review and illustrate the most common interventions for opioid-related and alcohol-related substance abuse disorders, as well as crucial methodologies for testing and patient placement. Methods reviewed include self-help fellowships such as Alcoholics Anonymous, cognitive-behavioral and psychodynamic treatments, motivational enhancement, group and family therapy, contingency management, and the multimodal approach called Network Therapy, which recruits the support of friends and family to prompt abstinence and prevent relapse. Each chapter includes vivid case studies to illustrate the approach described, as well as a review of the key clinical concepts and a list of essential readings. Adapting a new, clinically focused manual from their popular American Psychiatric Publishing Textbook of Substance Abuse Treatment, now in its fourth edition, Dr. Galanter and Dr. Kleber have designed Psychotherapy for the Treatment of Substance Abuse to be of practical application to both experienced clinicians and those new to the field. The accompanying DVD demonstrates Network Therapy in practice and includes enlightening commentary on key issues that are relevant across the many modalities of substance abuse treatment discussed in the book.