Ghodse's Drugs and Addictive Behaviour: A Guide to Treatment

Cover......Page 1
Frontmatter......Page 2
Contents......Page 8
Preface......Page 10
Introduction......Page 12
What is drug misuse?......Page 16
Drug dependence......Page 17
Physical dependence and the withdrawal syndrome......Page 18
Tolerance......Page 19
Types of drug dependence......Page 20
Causes of drug dependence......Page 21
Introduction......Page 30
Extent and nature of drug problems......Page 31
Global drug problems......Page 43
Sources of epidemiological information in the UK......Page 56
Drug dependence in the UK......Page 71
Organization of treatment services in the UK......Page 78
Drug policy in some other countries......Page 83
Opioids......Page 87
Sedative hypnotics......Page 94
Stimulant drugs......Page 97
Hallucinogens......Page 104
Cannabis......Page 106
Volatile solvents......Page 109
Designer drugs......Page 111
Steroids......Page 113
The combined use of drugs and alcohol......Page 114
Definitions......Page 117
Extent and nature of the problem......Page 118
Alcohol metabolism......Page 120
Recognition of problem drinking......Page 121
Adverse effects of alcohol misuse......Page 122
Management of problem drinking and its complications......Page 124
Relapse prevention......Page 126
Alcohol policies......Page 128
The global epidemic......Page 131
Types of tobacco and routes of administration......Page 132
Tobacco addiction......Page 133
The hazards of tobacco use......Page 135
Special populations of tobacco users......Page 136
Treatment......Page 138
Conclusion......Page 140
Drug history......Page 142
Life history......Page 143
Social work assessment......Page 144
Family assessment......Page 146
Physical examination......Page 147
Test of physical dependence on opiates (naloxone)......Page 149
Mental state examination......Page 150
Special investigations......Page 151
Laboratory investigation for drugs......Page 153
Summary......Page 158
ICD-10......Page 159
DSM-III-R......Page 165
DSM-IV......Page 166
Introduction......Page 171
Psychotherapy......Page 172
Drug counselling......Page 175
Cognitive and behavioural techniques......Page 177
Vocational rehabilitation......Page 181
Therapeutic communities......Page 182
Self-help groups......Page 184
Crisis intervention......Page 187
Inpatient care......Page 188
Treatment matching......Page 190
Opiates......Page 191
Sedative hypnotic drugs......Page 207
Cocaine and amphetamine......Page 211
Infective complications of injection......Page 214
Psychiatric complications......Page 225
The pregnant addict......Page 234
The child at risk......Page 237
The drug-abusing doctor: the `professional\' addict......Page 240
Comorbidity......Page 242
Drug-dependent patients on general medical and surgical wards......Page 245
Drug-dependent patients in accident and emergency departments......Page 246
Drug-dependent patients in the general practitioner\'s surgery......Page 249
Substance abusers detained in police custody......Page 250
Driving licences......Page 253
Travelling abroad......Page 254
Introduction......Page 255
Natural history of drug dependence......Page 256
Mortality......Page 258
Outcome of treatment......Page 261
Discussion......Page 263
Introduction......Page 266
Reducing the availability of drugs of abuse......Page 267
Reducing the demand for drugs of abuse......Page 271
Pharmacological approaches......Page 274
Harm reduction......Page 275
Conclusion......Page 278
History of international drug control......Page 281
Current international controls......Page 283
United Nations drug abuse control organs......Page 285
Control in the UK......Page 289
Appendices......Page 294
References and further reading......Page 360
Index......Page 384