Clinical Textbook of Addictive Disorders

Fourth Edition

Edited by Avram H. Mack, Kathleen T. Brady, Sheldon I. Miller, and Richard J. Frances

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This state-of-the-science reference and text has given thousands of practitioners and students a strong foundation in understanding and treating addictive disorders. Leading experts address the neurobiology of addictions and review best practices in assessment and diagnosis. Specific substances of abuse are examined in detail, with attention to real-world clinical considerations. Issues in working with particular populations—including polysubstance abusers, culturally diverse patients, older adults, chronic pain sufferers, and others—are explored. Chapters summarize the theoretical and empirical underpinnings of widely used psychosocial and pharmacological treatments and clearly describe clinical techniques.

New to This Edition

“An important, accessible, comprehensive book; I commend the authors and editors for their work....This is a useful text for teaching about the addictive disorders in many fields, including medicine, psychology, social work, counseling, and nursing.”

PsycCRITIQUES (on the third edition)


“Excellent....The authors provide us with a textbook that is quick to read and easy to digest. I have found over the years that residents enjoy this book and can learn from it readily....The clinician will find this textbook useful and handy in a busy practice. As a certified addictions specialist, I have found it useful in my day-to-day practice. I highly recommend this book and will certainly keep a copy of it on my shelf.”

American Journal of Psychiatry (on the second edition)


“As a student in the mental-health field, this book has already been helpful in my studies....A valuable resource to anyone who works or is thinking about working in the addiction-treatment field.”

Addiction Today (on the third edition)


“This extraordinarily well-written, clinically relevant, evidence-based work provides guidance and clarity to treatment professionals. Thousands of patients and practitioners will benefit from its contents, and treatment outcomes will be greatly improved.”

—Louis E. Baxter, Sr., MD, FASAM, Executive Medical Director, Professional Assistance Program of New Jersey, Inc.; past president, American Society of Addiction Medicine


“This book is ideal for therapists and researchers, as well as students and trainees new to the field. Science and clinical practice issues are presented in a balanced and inclusive manner. Now in its fourth edition, the volume retains all of its originally positive features and adds timely and new information essential to better understanding and treating addictions.”

—Nancy M. Petry, PhD, Professor of Medicine, UConn Health


“This book is unique in providing high-quality, comprehensive, and up-to-date coverage of all major topics in addictions, with broad applicability for training psychiatrists, clinical psychologists, and other mental health professionals. It is an excellent text for graduate or other professional courses in assessment and treatment of substance use disorders.”

—Stephen A. Maisto, PhD, Department of Psychology, Syracuse University


“The book enriches the reader's understanding of drugs, their interactions, and ways to enhance screening and diagnosis, including how to overcome interview barriers when working with alcohol and drug users. There is good coverage of brain processes associated with substance use and their implications for treatment. The figures and tables contribute greatly to understanding each chapter. This would be a useful text for my graduate-level Addictions course; I would also recommend it as a supplementary reference in my undergraduate Mental Health course.”

—Cynthia Bostick, PMHCNS-BC, PhD, School of Nursing, California State University, Dominguez Hills

Table of Contents

I. Foundations of Addiction

1. Neurobiology of Substance Use Disorders: Implications for Treatment, Thomas R. Kosten & Colin N. Haile

2. Historical and Social Context of Psychoactive Substance Disorders, Joseph Westermeyer

II. Assessment of Addiction

3. Diagnostic Assessment of Substance Abusers, Deborah Hasin & Bari Kilcoyne

4. Laboratory Testing for Substances of Abuse, D. Andrew Baron & David A. Baron

III. Substances of Abuse

5. Alcohol, Ed Nace

6. Nicotine Dependence, David Kalman, Amy Harrington, Joseph DiFranza, Lori Pbert, & Douglas Ziedonis

7. Opioids, Sudie E. Back, Jenna L. McCauley, Kelly S. Barth, & Kathleen T. Brady

8. Cannabis, Alicia R. Murray & Frances R. Levin

9. Hallucinogens and Inhalants, Stephen Ross & Avram H. Mack

10. Caffeine, Laura M. Juliano & Greta Bielacyzc Raglan

11. Stimulants, Richard Rawson, Larissa Mooney, & Walter Ling

12. Cocaine, Evaristo Akerele & Niru Nahar

13. Sedatives/Hypnotics and Benzodiazepines, Robert L. DuPont, William M. Greene, & Caroline M. DuPont

IV. Special Populations

14. Polysubstance Use, Abuse, and Dependence, Richard N. Rosenthal, Petros Levounis, & Abigail J. Herron

15. Co-Occurring Substance Use Disorders and Other Psychiatric Disorders, Benjamin C. Silverman, Lisa M. Najavits, Roger D. Weiss

16. Gambling Disorder and Other "Behavioral" Addictions, Liana R. N. Schreiber, Marc N. Potenza, & Jon E. Grant

17. Substance Abuse in Minority Populations, John Franklin

18. Addiction in the Workplace, Laurence Westreich

19. Forensic Approaches to Substances of Abuse, Avram H. Mack

20. Patients with Chronic Pain and Opioid Misuse, Deborah L. Haller & Sidney H. Schnoll

21. Substance Use among Older Adults, Steve Koh, Robert Gorney, Nicolas Badre, & Dilip Jeste

22. HIV/AIDS and Substance Use Disorders, Cheryl Ann Kennedy & Steven J. Schleifer

23. Women and Substance Abuse, Dawn E. Sugarman, Christina Brezing, & Shelly F. Greenfield

24. Substance Use Disorders in Adolescence, Oscar G. Bukstein & Yifrah Kaminer

V. Treatments for Addictions

25. Matching and Differential Therapies: Providing Substance Abusers with Appropriate Treatment, Kathleen M. Carroll & Brian D. Kiluk

26. Individual Psychodynamic Psychotherapy, Lance M. Dodes & Edward J. Khantzian

27. Cognitive Therapy, Judith S. Beck, Bruce S. Liese, & Lisa M. Najavits

28. Group Therapy, Self-Help Groups, and Network Therapy, Marc Galanter

29. Family Therapy Approaches, Edward Kaufman

30. Motivational Interviewing, Jennifer L. Smith, Kenneth M. Carpenter, R. Morgan Wain, & Edward V. Nunes

31. Dialectical Behavior Therapy for Individuals with Borderline Personality Disorder and Substance Use Disorders, Dorian Hunter, M. Zachary Rosenthal, Thomas R. Lynch, and Marsha M. Linehan

32. Psychopharmacological Treatments, Larissa J. Mooney & Elinore F. McCance-Katz

Index


About the Editors

Avram H. Mack, MD, is Associate Chair for Quality and Safety at the Children’s Hospital of Philadelphia, where he is a practicing psychiatrist with a focus on substance use disorders and forensic, child, adult, and consultation–liaison psychiatry. Dr. Mack leads efforts on quality and patient safety and has had extensive experience as a teacher and administrator in undergraduate and graduate medical education for trainees and staff at the University of Pennsylvania, the Children’s Hospital of Philadelphia, and previously at Georgetown University. He is board-certified in general psychiatry, child and adolescent psychiatry, forensic psychiatry, and addiction medicine and presents, publishes, and testifies extensively regarding substance abuse. A past president of the Washington Psychiatric Society, he served on the board of directors of the American Psychiatric Association and on the Impaired Physicians Committee of the Medical Society of the District of Columbia. A distinguished Fellow of the American Psychiatric Association and a Fellow of the American College of Psychiatrists, Dr. Mack is a recipient of the Education Award presented by the Association for Academic Psychiatry in recognition of his efforts in advancing the patient safety movement within psychiatry.

Kathleen T. Brady, MD, PhD, is Distinguished University Professor and Associate Provost for Clinical and Translational Science at the Medical University of South Carolina. Her interests include drug and alcohol abuse/addiction and comorbid conditions. A board-certified psychiatrist, Dr. Brady leads numerous research projects and served as president of the American Academy of Addiction Psychiatry, a member of the Scientific Advisory Council of the National Institute on Drug Abuse, and a board member of the College on Problems of Drug Dependence. She has authored over 300 publications; presented at conferences, grand rounds, and symposia; and received numerous awards.

Sheldon I. Miller, MD, until his death in 2011, was Emeritus Professor of Psychiatry and former Chairman of the Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. Recognized as a national leader in addiction psychiatry, he was a cofounder of the American Academy of Addiction Psychiatry. Dr. Miller was the author of more than 100 publications and Editor-in-Chief of the American Journal on Addictions. He served on the Board of Directors of the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine and was a Distinguished Fellow of the American Psychiatric Association and a member of the Group for the Advancement of Psychiatry.

Richard J. Frances, MD, is Clinical Professor of Psychiatry at New York University School of Medicine and Adjunct Professor at Rutgers New Jersey Medical School. He maintains a private practice in New York and was instrumental in the recognition of addiction psychiatry as a medical subspecialty. Board-certified in psychiatry and addiction psychiatry, Dr. Frances was a cofounder and first president of the American Academy of Addiction Psychiatry, Director of Education at the University of Medicine and Dentistry of New Jersey (now part of Rutgers Biomedical and Health Sciences), Chair of the Department of Psychiatry at Hackensack University Medical Center, and President and Medical Director of Silver Hill Hospital. He has also held leadership positions at New York Hospital–Cornell Medical Center and has a special interest in addiction, with a focus on impaired professionals.

Contributors

Evaristo Akerele, MD, MPH, DFAPA, Department of Psychiatry, Columbia University Medical Center, New York, New York; Interfaith Medical Center, Brooklyn, New York

Sudie E. Back, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina

Nicolas Badre, MD, San Diego Central Jail, San Diego, California

D. Andrew Baron, MS, Pasadena, California

David A. Baron, DO, Department of Psychiatry, University of Southern California, Los Angeles, California

Kelly S. Barth, DO, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina

Judith S. Beck, PhD, Beck Institute for Cognitive Behavior Therapy, and Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Kathleen T. Brady, MD, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, and Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina

Christina Brezing, MD, Department of Psychiatry, Columbia University Medical Center, and Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Oscar G. Bukstein, MD, Department of Psychiatry, Boston Children’s Hospital, Boston, Massachusetts

Kenneth M. Carpenter, PhD, Department of Psychiatry, Columbia University Medical Center, and Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Kathleen M. Carroll, PhD, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut

Joseph DiFranza, MD, Department of Community Medicine and Family Health, University of Massachusetts Medical School, Worcester, Massachusetts

Lance M. Dodes, MD (retired), Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

Caroline M. DuPont, MD, The Institute for Behavior and Health, Inc., Rockville, Maryland

Robert L. DuPont, MD, The Institute for Behavior and Health, Inc., Rockville, Maryland

John Franklin, MD, MSc, Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois

Marc Galanter, MD, Division of Alcoholism and Drug Abuse, Department of Psychiatry, NYU School of Medicine, NYU Langone Medical Center, New York, New York

Robert Gorney, MD, Richard J. Donovan Correctional Facility, California Department of Corrections and Rehabilitation, San Diego, California

Jon E. Grant, MD, Department of Psychiatry and Behavioral Neurosciences, University of Chicago, Chicago, Illinois

William M. Greene, MD, Division of Addiction Medicine, Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida

Shelly F. Greenfield, MD, MPH, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Alcohol and Drug Abuse and Division of Women’s Mental Health, McLean Hospital, Belmont, Massachusetts

Colin N. Haile, MD, PhD, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, and Michael E. DeBakey VA Medical Center, Houston, Texas

Deborah L. Haller, PhD, ABPP, Department of Public Health Sciences, University of Miami Miller Medical School, Miami, Florida

Amy Harrington, MD, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts

Deborah Hasin, PhD, Department of Psychiatry, Columbia University Medical Center, New York, New York

Abigail J. Herron, DO, The Institute for Family Health and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York

Dorian Hunter, PhD, private practice, Seattle, Washington

Dilip V. Jeste, MD, Department of Psychiatry and the Stein Institute for Research on Aging, UC San Diego Health Sciences, San Diego, California

Laura M. Juliano, PhD, Department of Psychology, American University, Washington, DC

David Kalman, PhD, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts

Yifrah Kaminer, MD, Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut

Edward Kaufman, MD, Northbound Treatment Services, Newport Beach, California

Cheryl Ann Kennedy MD, DFAPA, Department of Psychiatry and Department of Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, New Jersey

Edward J. Khantzian, MD, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

Bari Kilcoyne, MPH, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York

Brian D. Kiluk, PhD, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut

Steve Koh, MD, MPH, MBA, Department of Psychiatry, UC San Diego Health Sciences, San Diego, California

Thomas R. Kosten, MD, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas

Frances R. Levin, PhD, Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Petros Levounis, MD, Department of Psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey

Bruce S. Liese, PhD, Department of Psychology, University of Kansas, Lawrence, Kansas

Marsha M. Linehan, PhD, Behavioral Research and Therapy Clinics, University of Washington, Seattle, Washington

Walter Ling, MD, UCLA Integrated Substance Abuse Programs, Los Angeles, California

Thomas R. Lynch, PhD FBPsS, School of Psychology, University of Southampton, Southampton, United Kingdom

Avram H. Mack, MD, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Elinore F. McCance-Katz, MD, State of Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, Providence, Rhode Island

Jenna L. McCauley, PhD, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina

Larissa J. Mooney, MD, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, and UCLA Integrated Substance Abuse Programs, Los Angeles, California

Alicia R. Murray, DO, private practice, White Plains, New York

Ed Nace, MD, Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas

Niru Nahar, MD, Department of Psychiatry, Harlem Hospital, Columbia University Medical Center, New York, New York

Lisa M. Najavits, PhD, Department of Psychiatry, Boston University School of Medicine, and Veterans Affairs Healthcare System, Boston, Massachusetts

Edward V. Nunes, MD, Department of Psychiatry, Columbia University Medical Center, and Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Lori Pbert, PhD, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

Marc N. Potenza, MD, PhD, Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, Connecticut

Greta Bielaczyc Raglan, MA, Department of Psychology, American University, Washington DC

Richard Rawson, PhD, UCLA Integrated Substance Abuse Programs, Los Angeles, California

M. Zachary Rosenthal, PhD, Department of Psychiatry and Behavioral Sciences and Department of Psychology and Neuroscience, Duke University, Durham, North Carolina

Richard N. Rosenthal, MD, Center for Addictive Disorders, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York

Stephen Ross, MD, Department of Psychiatry, NYU School of Medicine, NYU Langone Medical Center, New York, New York

Steven J. Schleifer, MD, Department of Psychiatry, Rutgers New Jersey Medical School, Newark, New Jersey

Sidney H. Schnoll, MD, PhD, Pinney Associates, Inc., Bethesda, Maryland

Liana R. N. Schreiber, MPH, Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota

Benjamin C. Silverman, MD, Department of Psychiatry, Harvard Medical School, and Partners Human Research Committee, Partners HealthCare, Boston, Massachusetts

Jennifer L. Smith, PhD, Department of Psychiatry, Columbia University Medical Center, and Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Dawn E. Sugarman, PhD, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Alcohol and Drug Abuse and Division of Women’s Mental Health, McLean Hospital, Belmont, Massachusetts

R. Morgan Wain, PhD, Division on Substance Abuse, New York State Psychiatric Institute, New York, New York

Roger D. Weiss, MD, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Division of Alcohol and Drug Abuse, McLean Hospital,Belmont, Massachusetts

Joseph Westermeyer, MD, PhD, Department of Psychiatry, University of Minnesota, and Minneapolis VA Medical Center, Minneapolis, Minnesota

Laurence Westreich, MD, Department of Psychiatry, NYU School of Medicine, NYU Langone Medical Center, New York, New York

Douglas Ziedonis, MD, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts

Audience

Psychiatrists, clinical psychologists, social workers, substance abuse and mental health counselors, and psychiatric nurses; graduate students and residents.

Course Use

Serves as a text in such courses as Addiction and Substance Abuse, Addiction Medicine, Addiction Treatment, Treating Substance Use Disorders, and Drugs and Behavior.
Previous editions published by Guilford:

Third Edition, © 2005
ISBN: 9781609182052

Second Edition, © 1998
ISBN: 9781572303836

First Edition, © 1991
ISBN: 9780898625523
New to this edition: