Loosening the Grip: A Handbook of Alcohol Information / Edition 9

Loosening the Grip: A Handbook of Alcohol Information / Edition 9

by Jean Kinney, Stuart A. Copans
     
 

ISBN-10: 0073404659

ISBN-13: 9780073404653

Pub. Date: 04/11/2008

Publisher: McGraw-Hill Companies, The

Accessible and comprehensive, Loosening the Grip remains the best resource for information about alcohol, its use, abuse, and dependence, and other drugs of abuse. This student-focused text presents the physical and psychological effects of alcohol alongside the impact of abuse and dependence on the family and society. The Ninth Edition continues to include a

Overview

Accessible and comprehensive, Loosening the Grip remains the best resource for information about alcohol, its use, abuse, and dependence, and other drugs of abuse. This student-focused text presents the physical and psychological effects of alcohol alongside the impact of abuse and dependence on the family and society. The Ninth Edition continues to include a historical foundation for the discussion of alcohol use, abuse, and dependence.

Product Details

ISBN-13:
9780073404653
Publisher:
McGraw-Hill Companies, The
Publication date:
04/11/2008
Edition description:
Older Edition
Pages:
672
Product dimensions:
7.30(w) x 9.00(h) x 1.00(d)

Table of Contents


Preface     xiv
Alcohol     1
Once Upon a Time...     1
Fermentation and Discovery of Distillation     2
Alcohol Use in America     3
Why Bother?     4
Theories to Explain Alcohol Use     5
Myths     7
Alcohol Problems: The Fly in the Ointment     8
Problems as Sin or Moral Failing     8
Problems as a Legal Issue     8
America's Response to Alcohol Problems     9
Drunkenness versus Alcoholism     11
History of Alcohol Treatment Efforts     12
Public Policy and Alcohol     14
Advertising     18
Changing Norms     22
Other Drug Use     23
Tobacco     23
Marijuana     26
References and Suggested Reading     29
Alcohol and Its Costs     30
Who Drinks What, When, and Where     31
Drinking Patterns     32
Alcohol Problems     37
Abuse and Dependence     37
Economic Costs versus Economic Benefits     38
Personal Costs     40
Health Care and Alcohol     45
References and Suggested Reading     49
Alcohol and the Body     51
Ingestion and Absorption     51
Blood Alcohol Concentration     53
Breakdown and Removal     54
Alcohol's Acute Effects on the Body     57
Digestive System     57
Circulatory System     57
Kidneys     58
Liver     58
Central Nervous System     60
Acute Overdose and Toxicity     63
Differences in Women     64
Tolerance     66
Alcohol as an Anesthetic     67
Other Types of Alcohol     67
The Influence of Expectations     68
Advice for the Moderate Drinker     69
Contraindications to Moderate Use     69
Alcohol-Drug Interactions     70
The Basis of Alcohol-Drug Interactions     71
Problems Associated with Drinking and Intoxication     74
Alcohol Use and Exercise     75
In Conclusion     76
References and Suggested Reading     76
Alcohol Dependence     77
Definitions     77
Early Definitions     79
Toward Uniformity in Terminology     80
A Disease?      82
Implications of Disease Classification     82
Criticisms of the Disease Concept     83
Natural History     87
Jellinek's Phases of Alcoholism     87
Types of Alcoholism: Jellinek's Species     89
Current Thinking     90
Guides for Diagnosis     91
NCA Criteria     91
Diagnostic Criteria of the American Psychiatric Association     93
Natural History of Alcoholism: Jellinek Revisited     96
References and Suggested Reading     98
Etiology of Alcohol Dependence     99
Public Health Model     99
The Agent     100
The Host-Genetic Factors     102
Nature and Nurture     103
Twin and Adoption Studies     103
Studies of Nonalcoholic Blood Relatives     105
Genetic Markers     106
Familial versus Nonfamilial Alcohol Dependence: So What?     111
The Host-Personality and Psychological Makeup     111
Psychological Needs     112
Early Psychological Approaches     113
Personality Theories Applied to Alcohol Dependence     113
Current Thinking     115
The Environment-Sociological Factors      119
Cultural Orientation     119
Drinking Styles and Alcohol Problems     125
Influence of Cultural Subgroups     126
Legal Sanctions and Approaches     126
Cross-Cultural Comparisons     129
Cultural Influences on Recovery     134
Views in the Twenty-First Century     135
References and Suggested Reading     138
Medical Complications     140
Visible Signs and Symptoms of Chronic Heavy Drinking     141
Gastrointestinal System     142
Irritation, Bleeding, and Malabsorption     142
Pancreatitis     143
Gallbladder Disease     144
Liver Disease     144
Gastrointestinal Cancers     147
Hematological System     147
Red Blood Cells     148
White Blood Cells     149
Platelets     150
Clotting Factors and DIC     150
Immune System     150
Cardiovascular System     151
Genitourinary System     154
Urinary Tract     154
Reproductive System and Pregnancy     155
Respiratory System     159
Endocrine System     160
Cancer      162
Skin     163
Skeletal System     164
Nervous System     165
Dependence, Tolerance, Craving, and Withdrawal     165
Alcohol Idiosyncratic Intoxication (Pathological Intoxication)     167
Organic Brain Disease     167
Nerve and Muscle Tissue Damage     170
Subdural Hematomas     171
Miscellaneous CNS Disturbances     172
Neuropsychological Impairment     172
Miscellaneous Effects     173
Sleep and Sleep Disturbances     175
Sleep Stages     175
Sleep Disturbances     176
Insomnia     177
Alcohol's Effects on Sleep     178
Blackouts     179
Withdrawal Syndromes     182
Hyperarousal     183
Alcoholic Hallucinosis     183
Convulsive Seizures     184
Delirium Tremens     185
Late Withdrawal Phenomenon     187
Some Cautions     187
References and Suggested Reading     188
The Behavior of Dependence     190
A Behavioral Composite     190
How, If Not Why?     191
Deteriorating Functioning      197
Family and Friends     198
Work     200
Other Drugs of Abuse     200
A Final Thought     204
References and Suggested Reading     205
Effects of Alcohol Problems on the Family     206
The "Family Illness"     206
The Family's Response     207
The Family System     210
Enabling     211
Co-dependency     212
Current Thinking     213
Children in the Family     214
Children in the Home     214
Children's Coping Styles     217
Adult Children     218
Resiliency     221
Genetic Vulnerability     222
Alcohol Dependence in Other Family Members     222
Other Substance Use and Its Impact on the Family     223
References and Suggested Reading     227
Evaluation and Treatment Overview     229
Theoretical Perspectives     230
Problems of Use     231
Chronic Disease Framework     232
Challenges of Problems Associated with Use     234
Screening and Evaluation     235
Laboratory Tests     235
Screening Instruments      236
Initial Follow-Up Questions     242
Identifying Situations Requiring Medical Attention     244
Substance Use History     247
Clinical Style     247
Motivation     247
History Taking     249
What's Next?     251
Making a Referral     251
Evaluation in a Substance Abuse Treatment Setting     254
Treatment Planning and Treatment Settings     257
Treatment of Alcohol Problems and Alcohol Abuse     260
Alcohol Incidents     260
Alcohol Abuse     265
Treatment of Alcohol Dependence     265
Obstacles to Treatment     267
Factors in Successful Treatment     268
Recovery Process     269
Common Treatment Issues     274
References and Suggested Reading     285
Treatment Techniques and Approaches     287
Individual Counseling     287
Observation     288
Feedback     290
Education     290
Self-Disclosure     292
Client Responsibility     294
Possible Mis-steps     295
Problem Identification and Problem Solving     296
The Therapeutic Relationship     297
Case Management and Administrative Tasks     299
Group Work     299
Group as Therapy     299
Types of Groups     301
Group Functions     302
Groups as a Diversion     303
Working with Families     304
Family Members Troubled by Another's Alcohol Use     305
Family Interventions     305
Family Treatment in Conjunction with Alcohol Treatment     309
Suggestions for Working with Families during Treatment     310
Family Issues     311
Couples Therapy     316
Self-Help for Families     316
Self-Help     318
Alcoholics Anonymous (AA)     318
Other Self-Help Groups     329
Which Self-Help Approach?     332
Other Approaches     333
Spiritual Counseling     333
Meditation     339
Activities Therapy     340
Behavioral Approaches     343
Pharmacotherapy     351
Disulfiram (Antabuse)     351
Anticraving Agents     353
Treatment Matching     354
References and Suggested Reading      355
Special Populations     357
Adolescents     357
Developmental Issues     358
Alcohol and Other Drug Use     364
Associated Problems     367
Working with Adolescents     374
A Framework for Addressing Adolescent Substance Use/Problems     378
Further Assessment and Treatment     381
College Students     391
Patterns of Alcohol and Other Drug Use     391
Problems Associated with Substance Use     395
Perceived Benefits Associated with Drinking     398
Students at Risk     399
Natural History of Collegians' Alcohol Use     403
Impetus to Institutional Action     409
Impediments to Campus Programs     410
Campus Initiatives     411
Intervention and Treatment     414
Antismoking Efforts     418
Closing Thoughts     418
The Elderly     419
Stresses of Aging     420
Patterns of Alcohol and Other Drug Use     427
Alcohol Use and Health Status     431
Alcohol Problems     431
Prevention     438
Working with Elderly People     438
Women      441
Gender Differences     441
Differences among Women     443
Natural History of Alcohol and Other Drug Problems in Women     446
Assessment     450
Treatment Approaches     451
Treatment Themes     451
Treatment Issues for Pregnant Women     455
The Workplace     456
Some Basic Statistics     456
High-Risk Factors     461
The Workplace Response     461
Workplace Interventions     462
Implications for Treatment     463
Other Special Populations     464
References and Suggested Reading     466
Other Psychiatric Considerations     472
Suicide Evaluation and Prevention     472
Statistics and High-Risk Factors     473
How to Ask about Suicide     474
Responding to Suicidal Patients     475
Mental Status Examination     478
Major Categories of Co-occurring Psychiatric Illness     478
Mood Disorders     479
Disorders Involving Psychosis     483
Anxiety Disorders     485
Personality Disorders     487
Attention-Deficit/Hyperactivity Disorder      488
Psychiatric Disorders Due to a General Medical Condition     489
Other Drug Dependence and Alcohol Abuse/Dependence     490
Other Addictive Behaviors     491
Clinical Considerations     491
Homelessness, Alcohol Use, and Chronic Mental Illness     492
Psychotropic Medications     493
Antipsychotic Medications     495
Antidepressant Medications     497
Mood Stabilizers     499
Anti-Anxiety Agents     500
References and Suggested Reading     502
Drugs of Abuse Other Than Alcohol     504
Drug Use Patterns     504
Age     505
Gender     506
Education     506
Employment     507
Geographic Region     507
Social Costs     507
Public Perceptions and Public Policies     508
Legal Status     508
Early Control Efforts     509
Sources of Illicit Drugs     514
Reducing Drug Diversion     515
Basic Pharmacological Concepts     517
How to Think about Drug Use     517
Route of Administration     517
Site of Action     518
Solubility in Fat and/or Water     519
Metabolism     520
Withdrawal     520
Abuse Potential     520
Problems     522
Toxicity and Overdose     523
Classification Schemas for Substances of Abuse     523
Licit versus Illicit     524
DEA Schedule     525
Pharmacological Effects     526
Major Classes of Commonly Abused Drugs     527
Nicotine     527
Opiates     533
Sedative-Hypnotics (Central Nervous System Depressants)     539
Stimulants     541
Hallucinogens and Dissociatives     545
Cannabinoids     549
Inhalants     552
Anabolic Androgenic Steroids     555
Caffeine     561
Other Psychoactive Drugs Used Worldwide     566
Clinical Issues     568
Assessment     568
Treatment Goals     568
Harm Reduction     569
Pharmacological Treatment     571
Pregnancy and the Use of Drugs Other Than Alcohol     573
International Comparisons     578
References and Suggested Reading     580
Odds 'n' Ends      583
Beyond Counseling     583
Educational Activities     583
Training Others     585
Prevention     587
The Real World     598
Being a Professional Colleague     598
Selecting a Professional Position     604
Being a Professional     606
Certification and Licensure     607
Ethics     609
Basic Principles     609
Confidentiality     611
Setting Boundaries     613
Counselors with "Two Hats"     617
Clinician Impairment and Relapse     618
References and Suggested Reading     621
Organizations and Resources in the Substance Abuse Field     623
The Interaction Effects of Alcohol with Other Drugs     634
Diagnostic Criteria: Substance Use Disorders     638
Index     642

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