Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It

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While knowledge on substance abuse and addictions is expanding rapidly, clinical practice still lags behind. This state-of-the-art book brings together leading experts to describe what treatment and prevention would look like if it were based on the best science available. The volume incorporates developmental, neurobiological, genetic, behavioral, and social-environmental perspectives. Tightly edited chapters summarize current thinking on the nature and causes of alcohol and other drug problems; discuss what works at the individual, family, and societal levels; and offer robust principles for developing more effective, humane treatments and services.
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Editorial Reviews

From the Publisher

"This book is an important contribution to our understanding of how to apply substance use research to treatment, prevention, and policy. Preeminent researchers have written chapters that focus on their respective areas of expertise. Each chapter provides a concise picture of the research activities currently underway in the area at hand and summarizes current findings. All of the important domains of research on substance use problems are covered. McLellan provides a compelling critique of the current treatment system, arguing that it is not capable of incorporating evidence-based practices. Miller and Carroll propose a radical restructuring of the now largely segregated substance abuse prevention and treatment system so that it becomes integrated into the health and mental health systems. All those interested in substance use policy should read this book."--Daniel Yalisove, PhD, Department of Psychology and Addiction Studies Program, John Jay College of Criminal Justice

"Two thought leaders in substance abuse have done a remarkable service for clinicians and researchers: they have put together a distillation of what research has taught about the nature of addiction and its treatment. This volume is well focused, comprehensive, and quite readable."--Marc Galanter, MD, Department of Psychiatry and Division of Alcoholism and Drug Abuse, New York University School of Medicine

"If you teach about substance use and abuse, as I do, you and your students will greatly value this book. Like other exemplary volumes that review what we know about substance abuse, it offers state-of-the-art overviews of biological, psychological, and social factors in and treatments for substance abuse. But it also does a good deal more. Above all, the book anticipates important future developments and weighs them for their impact on prevention and treatment. Since the editors and contributors are leading authorities on these matters, this is a book that can be taken seriously."--Peter E. Nathan, PhD, Department of Psychology and Department of Community and Behavioral Health, University of Iowa

"This is a rare book in the addictions field. It assembles the most up-to-date scientific knowledge in the social and biological sciences to advance the field with regard to the etiology, prevention, and treatment of substance use problems. The book provides a new understanding of how scientific principles can be utilized in addressing common human issues associated with addictions. The themes that emerge will be of interest to practitioners in pursuit of transdisciplinary research for purposes of improving interventions and services for alcohol and drug problems."--Allen Zweben, DSW, Columbia University School of Social Work

Bulletin of the Menninger Clinic

"The book does a great job of explaining the science in easy-to-understand language....The book is multiauthored, each chapter written by a researcher with expertise in a particular area of substance abuse, spanning the range from genetics of substance abuse disorders, to religion and spirituality, to systems issues in delivery of substance abuse treatment. Technical jargon is kept to a minimum, and each chapter ends with a list of general principles that summarize the key points. The gap between what is known and what is practiced is disheartening. This brave little book points out that there are effective treatments, and this is definitely not the time to give up."--Bulletin of the Menninger Clinic

"An important contribution to the field....its wide-ranging information is accessible to a broad audience....Each chapter exhibits fluidity and comprehensiveness....Both experts and novices alike will find this book to be interesting and informative....A contemporary and inclusive resource for understanding substance use from a variety of perspectives and serves an important contribution to the field of addiction."--Addiction

"Notable for its structure and noteworthy for its fresh application of recent science to the treatment and prevention of addictions....All the chapters are written by recognized experts in the field....This text provides an excellent foundation for clinicians, program administrators, policy makers, and students who want to orient themselves to the field of addiction studies. The summary of research may challenge current prevention and treatment practices by providing a fresh perspective on the field. The interdisciplinary nature of the book is one of its greatest strengths. It introduces the reader to the most salient points of research across the wide spectrum of addiction studies."--PsycCRITIQUES

"An important contribution to the field....its wide-ranging information is accessible to a broad audience....Each chapter exhibits fluidity and comprehensiveness....Both experts and novices alike will find this book to be interesting and informative....A contemporary and inclusive resource for understanding substance use from a variety of perspectives and serves an important contribution to the field of addiction."--Addiction
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Product Details

  • ISBN-13: 9781606236987
  • Publisher: Guilford Publications, Inc.
  • Publication date: 7/2/2010
  • Pages: 320
  • Sales rank: 388,922
  • Product dimensions: 5.90 (w) x 8.80 (h) x 0.90 (d)

Meet the Author

William R. Miller, PhD, is Distinguished Professor of Psychology and Psychiatry at the University of New Mexico. A recipient of the Jellinek Memorial Award for alcoholism research, he is fundamentally interested in the psychology of change, and has focused in particular on the development, testing, and dissemination of behavioral treatments for addictions. Dr. Miller's publications include more than 30 books and 300 articles and chapters spanning behavior therapies, motivation, self-regulation, and the interface of psychology with spirituality and religion. He is named by the Institute for Scientific Information as one of the "world's most cited scientists."

Kathleen M. Carroll, PhD, is Professor of Psychiatry at the Yale University School of Medicine. The author of over 180 journal articles and chapters, her research and clinical interests lie in the area of developing and evaluating behavioral therapies for substance use disorders, and combining therapies to maximize treatment outcome. Dr. Carroll is the past president of Division 50 (Addictions) of the American Psychological Association, and holds both Senior Scientist and MERIT awards from the National Institute on Drug Abuse, the latter being awarded to the top 1% of National Institute of Health investigators.

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Table of Contents

I. Introduction
1. Defining and Addressing the Problem, Kathleen M. Carroll and William R. Miller
2. The Forest and the Trees: Addiction as a Complex Self-Organizing System, Warren K. Bickel and Marc N. Potenza
II. Biological Factors
3. The Neurobiology of Addiction: A Hedonic Calvinist View, George F. Koob
4. What Can Human Brain Imaging Tell Us about Vulnerability to Addiction and to Relapse?, Anna Rose Childress
5. Genetics of Substance Use Disorders, Deborah Hasin, Mark Hatzenbuehler, and Rachel Waxman
III. Psychological Factors
6. Natural Change and the Troublesome Use of Substances: A Life-Course Perspective, Carlo C. DiClemente
7. Developmental Perspectives on the Risk for Developing Substance Abuse Problems, Victor M. Hesselbrock and Michie N. Hesselbrock
8. Comorbid Substance Use Disorders and Psychiatric Disorders, Kim T. Mueser, Robert E. Drake, Win Turner, and Mark McGovern
9. Motivational Factors in Addictive Behaviors, William R. Miller
IV. Social Factors
10. Racial and Gender Differences in Substance Abuse: What Should Communities Do about Them?, Harold D. Holder
11. Family and Other Close Relationships, Barbara S. McCrady
12. Social Contexts and Substance Use, Rudolf H. Moos
13. Ethnography and Applied Substance Misuse Research: Anthropological and Cross-Cultural Factors, Robert G. Carlson
V. Interventions
14. Behavioral Therapies: The Glass Would Be Half Full If Only We Had a Glass, Kathleen M. Carroll and Bruce J. Rounsaville
15. Pharmacotherapy of Addictive Disorders, Stephanie S. O'Malley and Thomas R. Kosten
16. Religion, Spirituality, and the Troublesome Use of Substances, Keith Humphreys and Elizabeth Gifford
17. What We Need Is a System: Creating a Responsive and Effective Substance Abuse Treatment System, A. Thomas McLellan
18. Drawing the Science Together: Ten Principles, Ten Recommendations, William R. Miller and Kathleen M. Carroll

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