Relapse and Recovery in Addictions - Hardcover

Hardcover

ISBN 10: 0300083831 ISBN 13: 9780300083835

Publisher: Yale University Press, 2001

Synopsis

In this book leading experts in the field of addictions report on key aspects of addictive disorders. They focus particularly on relapse, the long-term course of addiction to drugs or alcohol, and interventions to prevent relapse and promote recovery. A critical and highly complex public health problem, addiction is seen today as having biological, psychological, social, and cultural aspects. This important volume brings together the major perspectives on addiction, treatment, and recovery along with the current findings of clinical and scientific research.

For those working with addicted patients and those making policy decisions that affect treatment and its availability, this book is an essential reference.

About this title

About the Author

Frank M. Tims is professor in the department of psychiatry and behavioral medicine, University of South Florida, science advisor to Operation PAR, Inc., and former chief of the Services Research Branch, National Institute on Drug Abuse, National Institutes of Health. Carl G. Leukefeld is professor of psychiatry and behavioral science and director of the Center on Drug and Alcohol Research at the University of Kentucky, and former deputy director, Division of Clinical Research, National Institute on Drug Abuse, NIH. Jerome J. Platt is former director of the Institute for Addictive Disorders, Allegheny University of the Health Sciences.

Reviews

Relapse is a persistent feature of addiction. Relapse seems so self-destructive that persons who are not addicted have difficulty understanding it, whereas those who are addicted know it all too well. Clinicians struggle with the problem of relapse and associated antisocial behavior without complete understanding and without effective means to treat it. Understanding relapse and the processes underlying recovery is essential to understanding and treating addictions. This book was originally conceived as an opportunity to revise and update the National Institute of Drug Abuse research monograph Relapse and Recovery in Drug Abuse (written by two of the current editors, Tims and Leukefeld, and published in 1986). The revision grew into a full-length book, which covers not only illicit drugs but also alcohol and nicotine. A central theme of this book is that relapse may be part of a learning process that ultimately leads to recovery. Because relapse can have a variety of features, it may be difficult to define. It can entail resumption of use of a specific drug that was used before treatment, nonmedical use of a drug as a substitute for the drug that was abused before treatment, resumption of a previous pattern of use of multiple drugs, or development of new patterns of use. Moreover, the definition of recovery varies according to the type of drug, the treatments available, and the sources of social support. Abstinence is the goal, but periods of reduced, controlled use may be part of the recovery pattern. Although relapse rates are high, treatment has a critical role in recovery. The decision to begin treatment often marks a major change in motivational level and constitutes an essential part of recovery. Treatment strategies vary in their underlying assumptions about the addicted person and the nature of the disorder. This book adopts the view that substance abuse is a chronic, relapsing disease -- a view that allows relapse to be expected as a normal part of recovery and that considers treatment successful if the disease is managed, not cured. The management of substance abuse and dependence includes methods to help the client cope with the emotional states and craving that can precipitate relapse. The book considers pharmacologic strategies for preventing relapse, including short-term treatment to reduce the adverse effects of withdrawal, long-term drug substitution (e.g., with methadone), use of antagonists to block the reinforcing effects of drugs, and strategies to provide aversive consequences after drug use. The book also emphasizes that pharmacotherapy is only an adjunct to social support and points out the need for coordination of social services so that the client may pass seamlessly from one level of care and treatment to another, without unsupervised interim periods. This book describes well the history of our understanding of drug abuse and treatment through 1997. Very few works published after 1997 are cited. Thus, the book is already somewhat dated. Furthermore, although it emphasizes that drug abuse and dependence constitute a complex, multidimensional problem, it does not deal with the neurobiology of craving or addiction, and it does not address the issue of genetic susceptibility. The nearly complete absence of coverage of the biology of addiction results in a work that may be helpful to clinicians and treatment-center personnel but that does not fully summarize our current understanding of addiction. This book exemplifies the current lack of integration of insights from neuroscience, behavioral science, and clinical science into a broad perspective on craving. It is probable that until the gaps that separate biologic, psychobiologic, and psychosocial models of craving are bridged, we will not understand relapse and will continue to struggle with treatment and recovery. Carol A. Shively, Ph.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

A sequel to Relapse and Recovery in Drug Abuse (National Inst. on Drug Abuse, 1986. o.p.), this volume reflects the considerable expansion of the addiction disorder field. Editors Tims (psychiatry and behavioral medicine, Univ. of South Florida), Carl G. Leukefeld (psychiatry and behavioral science, Univ. of Kentucky), and Jerome J. Platt (former director, Inst. for Addictive Disorders) have here amassed 50 authors who have contributed 17 chapters, mostly concerning research and interventions. Although many work in departments of psychiatry, only three authors are physicians; most are psychologists. The editors provide an opening overview and closing forecast. This is primarily a resource and reference for professionals, and some of the writing will even daunt them. But chapters on European approaches, self-help groups, and pharmacotherapy (for alcohol, nicotine, cocaine, and opiates) are accessible and valuable to all. Recommended for academic libraries. E. James Lieberman, George Washington Univ., Sch. of Medicine, Washington, DC
Copyright 2001 Reed Business Information, Inc.

Edition details

• Publisher: Yale University Press
• Publication date: 2001
• Language: English
• ISBN 10: 0300083831
• ISBN 13: 9780300083835
• Binding: Hardcover
• Edition number: 1
• Number of pages: 432
• Editor: Tims Frank M., Leukefeld Carl G., Platt Jerome J.