Substance Abuse

Contents

Preface xiii

Chapter 1

The Role of the Mental Health Professional in Prevention and Treatment 1

The Need for Generalist Training 3

Philosophical Orientation 5

Attitudes and Beliefs 6

Denial, Minimization, Projection, and Rationalization 7

Helping Attitudes and Behaviors 8

Overview of the Book 10

 

Chapter 2

Classification of Drugs 12

Comprehensive Drug Abuse Prevention and Control Act 12

The Concept of Dangerousness 13

Definitions 14

Central Nervous System Depressants 15

Central Nervous System Stimulants 18

Opioids 21

Hallucinogens 23

Cannabinols 25

Inhalants and Volatile Hydrocarbons 27

Anabolic Steroids 28

Club Drugs 30

Drugs Used in the Treatment of Mental Disorders 31

Summary 33

Additional Reading 33

Internet Resources 33

Drug Use Survey 33

Further Discussion 34

 

Chapter 3

Models of Addiction 35

The Moral Model 36

Sociocultural and Psychological Models of Addiction 37

Disease Concept of Addiction 39

Biopsychosocial Model of Addiction 46

Summary 49

Internet Resources 49

Further Discussion 50

MyHelpingLab Assignment

50

 

Chapter 4

Culturally and Ethnically Diverse Groups 51

Native Americans and Alaska Natives 52

Asian Americans and Pacific Islanders 58

African Americans 63

Latino and Hispanic Populations 69

Persons with Disabilities and the Elderly 74

Helping Culturally and Ethnically Diverse Populations 75

Summary 79

Internet Resources 81

Further Discussion 81

 

Chapter 5

Confidentiality and Ethical Issues 82

Confidentiality: 42 Code of Federal Regulations, Part 2 (42 CFR) 83

Health Insurance Portability and Accountability Act (HIPAA) 89

Documentation 90

Ethics 91

Application of Confidentiality Regulations 93

Summary 95

Internet Resources 95

Further Discussion 96

MyHelpingLab Assignment 96

 

Chapter 6

Assessment and Diagnosis 97

Definitions of Use, Misuse, Abuse, and Dependence or Addiction 98

Psychosocial History 100

Signs of Adolescent Substance Abuse 106

Self-Report Inventories 107

Referral 112

Diagnosis 114

Summary 118

Internet Resources 118

Further Discussion 119

MyHelpingLab Assignments 119

 

Chapter 7

Client Engagement and Brief Interventions 120

Client Engagement 122

Motivational Interviewing 122

Brief Interventions 129

Summary 131

Internet Resources 131

Further Discussion 131

MyHelpingLab Assignments 132

 

Chapter 8

Treatment of AOD Problems 133

How Many Are in Treatment? How Many Need Treatment? 133

What Happens in Treatment? 134

Treatment Strategies and Techniques 138

Treatment Settings 144

Principles of Effective Treatment 147

Evidence-Based Treatment 149

Treatment and Special Populations 149

Treatment Effectiveness 155

Client—Treatment Matching 157

Special Problems in Treatment 158

Summary 162

Internet Resources 163

Further Discussion 163

MyHelpingLab Assignment 163

 

Chapter 9

Relapse Prevention and Recovery 164

Need for Generalist Training in Relapse Prevention 165

Definitions of Slipand Relapse 165

Frequency of Slips and Relapse 166

Is Relapse in Addiction Similar to Other Chronic Conditions? 167

Models of Relapse Prevention 167

Essential Components of Relapse Prevention 171

Preventing Slips from Escalating 178

Recovery 179

Summary 180

Internet Resources 181

Further Discussion 181

MyHelpingLab Assignment 181

 

Chapter 10

Twelve-Step and Other Types of Support Groups 182

Alcoholics Anonymous 183

Other Twelve-Step Groups 190

Advantages and Disadvantages of Twelve-Step Groups 191

Other Types of Support Groups 193

Summary 197

Internet Resources 197

Further Discussion 198

MyHelpingLab Assignments 198

 

Chapter 11

Children and Families 199

Children’s Exposure to Alcohol and Other Drugs 200

Family Exposure to Alcohol and Other Drugs 204

Intergenerational Transmission of Alcoholism 215

Women and Alcoholism 216

Stepfamilies: System and Structure 220

Helping Families 221

Summary 226

Internet Resources 227

Further Discussion 227

 

Chapter 12

Adult Children and Codependency 228

Adult Children of Alcoholics (ACOAs) 229

Assessment and Treatment Considerations 231

ACOAs and Diversity 233

Codependency 234

Implications for Mental Health Professionals 240

Relationship of ACOA, AA, Al-Anon, and Codependency 243

Codependency and Diversity 245

Summary 252

Internet Resources 253

Further Discussion 254

 

Chapter 13

HIV/AIDS 255

Incidence and Prevalence 255

Myths and Facts about HIV and AIDS 256

Risk Factors and High-Risk Populations 260

Assessment of Clients for HIV and AIDS: Signs and Symptoms 265

Helping HIV-Infected Clients 265

HIV-Related Issues Specific to the Helping Professional 272

Summary 273

Internet Resources 274

Further Discussion 275

 

Chapter 14

Gambling and Other Addictions 276

Prevalence of Gambling and Gambling Problems 277

Definitions of Gamblers and Problem Gambling 2

80

Assessment and Diagnosis 281

Treatment, Resources, and Support 284

Other Addictions 286

Food Addiction: The Eating Disorders 289

Addiction to Sex and Love 296

Internet Addiction 297

Addiction to Work: Workaholism 300

Assessment and Treatment Issues 303

Summary 308

Internet Resources 310

Further Discussion 310

 

Chapter 15

Prevention 311

Why Are Prevention Efforts Needed? 311

Policy Issues in Prevention 312

Prevention Classification Systems 317

What Works in Prevention 320

Evidence-Based Prevention 328

Prevention Resources 328

Summary 329

Internet Resources 329

Further Discussion 329

References 330

Index 330

Preface