Alcoholism and Other Drug Problems

James E. Royce, S.J., Ph.D., is Professor Emeritus of Psychology and Addiction Studies at Seattle University. He is the author of Alcohol Problems and Alcoholism and coauthor of Ethics for Addiction Professionals.

Contents

Preface

Acknowledgments

PART ONE

ALCOHOL AND OTHER DRUGS

1. Alcohol and Alcohol Problems

Drinking, drunkenness, alcoholism. Alcohol as a drug. Defining alcoholism. Alcoholic versus problem drinker. Alcohol causes more problems than alcoholism: statistics, estimates, and methodology.

2. Drugs Other Than Alcohol

Comonly used prescription and illegal drugs. Opiates, stimulants, nicotine, marijuana, hallucinogens, sedative-hypnotics, inhalants.

3. Sociocultural Aspects

Alcohol in various cultures. Alcohol in America. Prohibition.

4. Alcohol: Physiology and Pharmacology

A. What the body does with alcohol. Ingestion, absorption, excretion, metabolism.

B. What alcohol does to behavior. Stimulant or depressant? Tolerance. Polydrug, synergism. Effects of blood levels. How many drinks?

C. What alcohol does to the body. Short- and long-term effects on health. Action of alcohol on each major organ and system. Fetal alcohol effects.

5. Other Drugs: Physiology and Pharmacology

Drug interactions. Effects on behavior. Effects on health.

PART TWO

ADDICTION

6. Patterns and Symptoms

Types of alcoholics. Common characteristics. Symptoms. Progression.

7. Causality of Addiction

Sociocultural, psychological, physiological causes. Role of heredity as part-cause. Learning (habit).

8. Addiction as a Disease

Is there an alcoholic personality? Pros and cons of calling addiction a disease. Implications for prevention, treatment, counseling, rehabilitation. Can alcoholics be conditioned to drink socially?

9. The Spouse and Family of the Addict

Cause or reaction? Adjustment of the family to the crisis of alcoholism. Reversal of roles. Effects of other drugs on the family.

10. Children of Dysfunctional Families

Typical roles: Hero (Responsible One), Scapegoat (Acting Out), Adjuster (Lost Child), Placater (Mascot). Adult Children of Alcoholics (ACoA): a high-risk group.

11. Special Groups

Women. Youth. The elderly. Minority races. The military. Skid road. Professionals, dual diagnosed, other groups.

PART THREE

PREVENTION AND INTERVENTION

12. Prevention

Primary, secondary, tertiary prevention. Information versus attitudes and values. Decision-making skills.

13. Eap -- Occupational Programs

Alcohol and other drugs in business and industry. Policy versus program. Roles of labor and management. Training of supervisors.

14. Referral and Intervention

Diagnosis. Counseling into treatment. Knowing and using various facilities.

PART FOUR

TREATMENT AND REHABILITATION

15. Overview of Treatments

Continuum of care. Variety of therapies. Detoxification. Intensive treatment. Therapies for other drug addictions.

16. Rehabilitation

After intensive care: importance of long-term followup. Phases of recovery, relapses, the dry drunk.

17. Alcoholics Anonymous and Other Twelve-Step Groups

Development of AA philosophy. The Twelve Steps and Twelve Traditions. The three legacies. Twelve-Step groups for other addicts: NA, CA, and others.

18. Al-Anon and Alateen

The Twelve Steps as used by spouse and children of the alcoholic. Special traditions and problems.

19. Spiritual and Moral Aspects

Progression of addiction as a spiritual disease. Spiritual recovery. False guilt. Moralistic attitudes. Responsibility for drug-related behavior.

20. Drugs and the Law

Liability. Discrimination. Regulation of sale. Alcohol and traffic laws. The Uniform Act: drunk in public no longer a crime, legal responsibility not eliminated, problems of implementation.

21. The New Profession

Ethics: confidentiality, education, certification. The addiction professional. Dual role of AA member. Staff burnout.

Appendix: Sources for Literature on Alcoholism and Other Addictions

General Bibliography

Index