Addiction Medicine

Science and Practice

2nd Edition - December 12, 2019
Author: Bankole Johnson
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 4 4 0 - 8
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 6 7 2 3 9 - 9

Integrating scientific knowledge with today’s most effective treatment options, Addiction Medicine: Science and Practice, 2nd Edition, provides a wealth of information on addiction… Read more

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Integrating scientific knowledge with today’s most effective treatment options, Addiction Medicine: Science and Practice, 2nd Edition, provides a wealth of information on addictions to substances and behavioral addictions. It discusses the concrete research on how the brain and body are affected by addictions, improving your understanding of how patients develop addictions and how best to personalize treatment and improve outcomes. This essential text is ideal for anyone who deals with patients with addictions in clinical practice, including psychiatrists, health psychologists, pharmacologists, social workers, drug counselors, trainees, and general physicians/family practitioners.

Cover image
Title page
Table of Contents
Copyright
Dedication
About the Editor
Contributors
Preface
Part 1. History, Perspectives, Epidemiology, Diagnosis, and Classification
1. Emerging Health Perspectives
Introduction
Alcohol Use
Illicit Drug Use
Age Variations
Nonmedical Use of Prescription Drugs
Opioid Overdose Deaths
Naloxone and Opioid Overdose
Legislative, Regulatory, and Community Controls Over Opioid Prescribing
Medication-Assisted Treatment Prescription Drug and Opioid Addiction Grant Program
Comprehensive Addiction and Recovery Act
Medication-Assisted Treatment
Social Determinants of Health
Perceived Risk of Harm With Substance Use
Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health
Screening, Brief Intervention, and Referral to Treatment
Recovery as a Holistic System
Health Insurance
2. The Epidemiology of Alcohol and Drug Disorders
What Is Epidemiology?
Substance Use in the United States: Historical Overview and Recent Prevalence Trends
Substance Use in the United States: A Public Health Problem
When Does Use Become Pathological? Substance Abuse and Dependence
Descriptive Epidemiology: The Incidence and Prevalence of Substance Disorders
Analytic Epidemiology: The Etiology of Substance Disorders
Conclusion
3. United States Federal Drug Policy
Introduction
History
Federal Drug-Control Operations
Policymaking and Budgeting
Law Enforcement
Prevention
Treatment
Research
Issues in Policymaking
Appendix
4. Historical Perspectives of Addiction
Histories of Addiction
Brain Disease Redux
Alcohol and Other Drugs
Alcohol: Predisposed or Culturally Determined
Opiates and Other Illicit Drugs
Licit Mind-Altering Drugs
Smoking and Nicotine
Rhetoric and Reality
Taking History Seriously
5. Diagnosis and Classification of Substance Use Disorders
Introduction
The Nature of Substance Use Disorders
Substance Use Diagnoses in the DSM and ICD Systems
Practical Approaches to Diagnosis
Part 2. Behavioral Theories for Substance Use Disorder
6. Drug Reinforcement in Animals
Introduction
Assessing Reinforcing Efficacy
Progressive-Ratio Schedule
Threshold Procedure
Second-Order Schedules
Choice Procedures
Modeling Phases of Substance Use Disorder
Animal Models of Drug Use Initiation
Animal Models of Substance Use Disorder
Animal Models of Relapse
Conclusions
7. Role of Human Laboratory Studies in the Development of Medications for Alcohol and Substance Use Disorders
Introduction
Role of the Human Laboratory in Evaluating the Abuse Liability of New Medications
Issues in Human Laboratory Studies of Abuse Liability
Human Laboratory Studies of Pharmacological Agonist and Antagonist Treatments
Role of Human Laboratory Studies in Developing Medications for Alcohol Dependence
Role of the Human Laboratory in Evaluating Medications for Cocaine Dependence
Human Laboratory Studies of Medications for Amphetamine or Methamphetamine
General Conclusions Regarding Human Laboratory Studies
8. Conditioning of Addiction
Introduction
Methods for Assessing the Conditioned Effects of Drugs of Abuse in Laboratory Animals
Neural Substrates of Drug Conditioning: General Neurochemical Circuitry
Neural Substrates of Drug Conditioning: Recent Key Findings
Conclusions
9. Overlapping Striatal Circuits and Molecular Mechanisms in Rodent Models of Addiction and Depression
Overview of Striatal Circuits
Striatal Circuit Activity in Animal Models of Addiction and Depression
Molecular Mechanisms in Striatal Circuits in Addiction
Molecular Mechanisms in Striatal Circuits in Stress and Depression-Like Behavior
Conclusions
10. The Role of Endocannabinoids in Amphetamine-Driven Actions in Dopamine Neurons: Implications for Understanding and Treating Dysfunction in the Mesolimbic Circuit
Introduction
Mesolimbic Dopamine
Endocannabinoid Modulation of DA
Amphetamine
Amphetamine at Dopamine Terminals
Amphetamine at the Cell Body
Endocannabinoids and Amphetamine
Conclusions
11. Pain and Negative Affect
Pain Is a Multidimensional Experience
Chronic Pain and Negative Affect
The Vicious Cycle of Pain and Negative Affect
Comorbidity
Pain as a Negative Reward
Shared Brain Circuits
The Amygdala
Descending Pain Modulation
Corticotrigeminal Pathways
Thalamus and Cortex
A Brighter Future?
12. Genetic Vulnerability to Substance Use Disorders
Introduction
Heritability (h 2) of SUDs
Genetic Architecture of Addiction Vulnerability
An Evolutionary Perspective on Genetic Architecture of Addiction
The Genetic Architecture for Substance Dependence in Individuals
Epigenetics and Individual Differences in SUDs
Ethical Issues in High-Density Genotyping of Individuals With Substance Use Disorders
Summary and Conclusions
Glossary
13. The Assessment and Treatment of Addiction: Best Practices in a Direct-to-Consumer Age
Introduction
The Assessment
The Stages of Addiction
The Domains
The Treatment
New Frontiers
14. Metabolomics in Drug Response and Addiction
What Is Metabolomics?
Substance Abuse and Its Effect on Health and Economy
Substance Abuse Leads to Addiction
Metabolomics: The Beginning
Metabolomics in Addiction Research: Current Approach
Transcription Regulatory Network in Drug Metabolomics
Application of Metabolomics in Solving Addiction Disorders
Integration of Systems Biology to Medication Discovery
Part 3. Visualizations and Workings of the Addicted Brain
15. Neuroimaging Findings in Substance Use Disorders
Introduction
Structural Alterations
Summary of Structural Brain Findings
Dopamine and Other Neurotransmitter Systems
Summary of Neurotransmitter Findings
Functional Imaging Findings
Alcohol and Other Drug-Cue Reactivity
Conclusion
16. Neurobiological Basis of Drug Reward and Reinforcement
Introduction
Experimental Psychology Concepts of Reward and Reinforcement
Neurotransmitters and Neural Circuitry: Involvement in Different Aspects of Reward, Reinforcement, and Addiction
Models of Drug Use and Drug Addiction
Actions of Addictive Drugs Within the Reinforcement and Reward Circuitry
What Drives Drug Use, Abuse, and Addiction: The Direction of Future Research
17. Neurobehavioral Toxicology of Substances of Abuse
Ethanol (Alcohol)
Cocaine
Amphetamine and Amphetamine-Analogs
Cathinone and Synthetic Cathinone Derivatives
Opiates
Hallucinogens
Cannabis
Nicotine
Inhalants
Barbiturates
Benzodiazepines
18. Animal Models of Substance Use Disorders: Motivational Perspective
Definitions Relevant to Animal Models
Animal Models of Withdrawal
Animal Models of Increased Drug Taking With Prolonged Access or Dependence
Protracted Abstinence
Animal Models of Dependence: Validity and Relevance to Treatment
19. Novel Methodologies: Proteomic Approaches in Substance Abuse Research
Introduction
Technology and Methods for Expression Proteomics
Implementation for Drug Abuse Studies
Conclusion
20. Neuroinflammatory Processes in Drug Addiction
Innate Immune Signaling in the Brain
Pattern Recognition Receptors and Their Ligands
Addiction as a Neuroimmune Disease
Future Immune Therapies for Addiction
Part IV. Clinical Aspects of Alcohol and Drug Addiction
21. Alcohol: Clinical Aspects
Introduction
Alcohol-Related Disorders
Age at Onset of Drinking Behavior
Effects of Ethnicity, Gender, Place of Residence, and Religion on Alcohol Consumption
Clinical Picture
Signs and Symptoms
Psychological and Psychiatric Complications of Alcohol
Conclusions
22. Cocaine
Introduction
Cocaine Use Disorder
Intoxication
Withdrawal
Craving and Relapse
Intoxication Delirium
Cocaine-Induced Psychotic Disorder
Cocaine-Induced Anxiety Disorder
Cocaine-Induced Mood Disorder
Cocaine-Induced Sexual Dysfunction
Cocaine-Induced Sleep Disorder
23. Nicotine
Epidemiology
Biological, Behavioral, and Cognitive Aspects of Nicotine Dependence
Development of Nicotine Dependence Risk, and the Effect on Other Substance Use Disorders
Genetics
Diagnosis
Smoking and Psychiatric Comorbidities
Prevention Science
Treatment
Summary
24. Cannabis: An Overview of the Empirical Literature
Introduction
Prevalence
Nature of Cannabis Use: Pharmacokinetics and Acute Intoxication Features
Classification of Cannabis Use Disorder
Motivational Bases of Cannabis Use
Negative Correlates of Cannabis Use and Its Disorders
Cannabis: Motivation to Quit, Reasons for Quitting, and Success in Quitting
Cannabis: Overview of Clinical Issues Relevant to Practitioners
Summary
25. Opiates and Prescription Drugs
Classification
Etiology
Epidemiology
Neurobiology
Biological Effects of Use
Psychological Effects of Use
Diagnosis
Clinical Management
Opiate Pharmacotherapy
Psychosocial Treatment
Co-occurring Psychiatric Disorders
Primary Prevention
Conclusion
26. Clinical Aspects of Methamphetamine
Introduction
Neurobiological Impact of Methamphetamine Use
Effects of Methamphetamine Use and Methamphetamine Use Disorder
Specific Populations
Reducing Harms Associated With Methamphetamine Use
Acute Management of Methamphetamine Problems
Treatment for People Who Use Methamphetamine
Future Directions in Research and Practice
27. Sedative-Hypnotics and Anxiolytics
Introduction
Intoxication and Overdose
Tolerance and Withdrawal
Substance Use Disorder
Mood and Anxiety Disorders
Cognitive Disorders
Psychotic Manifestations
Sleep Disorders
Sexual Dysfunction
Summary
Acknowledgments
28. Clinical Aspects of Inhalant Addiction
Types of Inhalants Being Abused
Epidemiology
Mechanisms of Action
Morbidity and Mortality
Psychiatric Disorders in Inhalant Users
Prevention and Management Considerations
29. Anabolic-Androgenic Steroids
Introduction
Epidemiology
Pharmacology
Patterns of Illicit Use
Adverse Medical Effects
Psychiatric Aspects and Effects
Neurobiology
Addiction
Screening and Assessment
Conclusions
30. Caffeine
Introduction
Main Sources of Caffeine and Patterns of Consumption
Pharmacology of Caffeine
Psychopharmacology of Caffeine: The Critical Processes of Caffeine Withdrawal and Withdrawal Reversal
Mental Health and Well-Being
Dietary Caffeine and Physical Health: Cardiovascular Disease
Dietary Caffeine and Physical Health: Noncardiovascular Disease
Is Caffeine Addictive and Is There a Safe Level of Consumption?
Does Caffeine Have Health Benefits?
Other Active Compounds in Caffeine Beverages
Threats to the Integrity of Caffeine Science
Public Policy and Regulation of Caffeine Exposure
Conclusions
31. Serotonergic Hallucinogens
Introduction
History
Epidemiology
Classification
Mechanism of Action
Serotonin Receptor
Indolealkylamine Hallucinogens
Phenethylamine Hallucinogens
Conclusions
32. Ketamine and Phencyclidine
Introduction
Pharmacology
Epidemiology
Use Disorders
Intoxication
Chronic Use
Addiction Treatment
part V. Behavioral Addictions and Treatment
33. The Biology and Treatment of Gambling Disorder
Introduction
The Psychiatric Nosology of Gambling Disorder
Cognitive Distortions
Prevalence Estimates and Characteristics
The Biochemistry of Gambling Disorder
The Genetics of Gambling Disorder
The Neuropsychology of Gambling Disorder
Neuroimaging Studies
Treatment
Natural Recovery
Prevention Efforts
Research Challenges and Future Directions
34. Implications of Food Addiction for Understanding and Treating Binge Eating Disorder
Introduction
History and Background
Risk Factor Similarities
Summary and Conclusions
35. Compulsive Buying
Introduction
Diagnosis and Classification
Prevalence Rates and Subject Characteristics
Economics and Consumerism
Etiology and Course
Comorbidity
Cultural Considerations
Assessment
Treatment
Future Research
36. Sexual Behavior as an Addictive or Compulsive Phenomenon
Introduction
History of Sexual Addiction and Sexually Compulsive Behavior
Sex Outside the Norm
Clinical Criteria
Etiology
Measurement
Implications for Clinical Practice
Implications for Future Research
Summary
37. New Era of Internet Addiction Research in China
Introduction
Internet and Smartphone Penetration in China
Recent Internet Addiction Research in China
National Internet Addiction Research in China
Regional Internet Addiction Research in China
Cross-Cultural Internet Addiction Research
Mediating Effects Studies in Internet Addiction Research
Internet Addiction Research in Special Groups
Methodological Approaches in Internet Addiction Research
Conclusion
38. Hoarding as a Behavioral Addiction
Overview
Classification and Comorbidity
Hoarding and Impulse Control Disorders
Hoarding and Compulsive Acquisition
Etiology/Biobehavioral Underpinnings of Hoarding
Cognitive-Behavioral Theory and Evidence
Information-Processing Deficits
Emotional Attachment to Possessions
Assessment of Compulsive Hoarding
Treatment of Compulsive Hoarding
Biological Treatments
Psychological Treatments
Conclusions
Part VI. Treatment and Application: Behavioral Treatments
39. Motivational Interviewing: Emerging Theory, Research, and Practice
What Is Motivational Interviewing?
A Brief History of MI
Theoretical Concepts and Emerging Models of MI
Defining MI
MI as an Activator of Autonomous Motivations and Growth
MI as a Method to Move People Through Stages of Change
MI as an Activator of Emotions and Openness
MI as an Interpersonal Intervention
MI as a Method to Resolve Ambivalence in the Direction of Change
MI and an Approach to Align Behavior and Values
Summary: Emerging Relational and Technical Components in a Model or Theory of MI
Evidence About MI
Evidence About MI Processes and Their Relationships With Outcomes
Other Developments in MI
Preparing Clinicians to Use MI
Summary
40. Cognitive Behavioral Therapy for Addiction
Introduction
Overview of Cognitive Behavioral Therapy
Review of Cognitive Behavioral Therapy for Stimulant Drugs
Review of Treatment for Depressant Drugs
Future Directions
41. Community Reinforcement Approach and Contingency Management Therapies
Introduction
Community Reinforcement Approach Therapy
Contingency Management Interventions
Issues Hindering the Implementation of the Community Reinforcement Approach in Practice
Issues Associated With Implementation of Contingency Management in Practice
Prize-Based Contingency Management
Cost-Effectiveness
Challenges to Dissemination
Conclusion
42. Relapse Prevention and Recycling in Addiction
Introduction
Understanding the Concept of Relapse and Its Role in Recovery
Relapse Prevention
Cognitive-Behavioral Models
Strategies for Relapse Prevention
When Relapse Prevention Fails
Treatment Recommendations
43. Brief and e-Health Interventions for the Treatment of Alcohol or Other Drug Addiction
Drug Use and Problems
Drug Treatment in Primary Care and Nonspecialist Settings
What Is Screening and Brief Intervention?
Screening and Brief Intervention—Effectiveness and Delivery
Conclusions—Screening and Brief Interventions
Improving Compliance/Adherence to Therapies
Conclusions—Compliance Enhancement
Future Research
Resources
44. Self-Help Approaches for Addictions
Defining Self-Help
Why Use Self-Help?
Can Individuals Help Themselves?
Self-Help Drug Replacement
Bibliotherapy
Expressive Writing
Helplines
Religion, Spirituality, and Meditation
Internet Resources
Conclusions
Part VII. Treatment and Application: Group Treatments and Specific Settings
45. Community Clinics
Introduction
Literature Review Methods
History of Community Substance Abuse Treatment
A New Era Begins
Impact of the Community Mental Health Movement
Effectiveness of Community Clinic Approaches 1935–1980
Community Responses to the 1980s Cocaine Epidemic
Categories of Community Clinics
Types of Community Clinics
Interventions for Specific Populations
Use of Evidence-Based Services in Community Clinic Substance Abuse Treatment
The National Institute on Drug Abuse’s National Drug Abuse Treatment Clinical Trials Network
Drug Abuse Reporting Program Studies
Additional Treatment Models
Challenges to Community-Based Clinics
Opportunities to Expand Evidence-Based Substance Use Disorder Interventions
46. Unhealthy Alcohol and Other Drug Use in Primary Care
Introduction
Screening
Assessment
Management of Unhealthy Alcohol and Other Drug Use
Pharmacotherapy
Treatment of Psychiatric Comorbidity
Management of Withdrawal From Alcohol and Other Drugs
Medical Management (Including Preventive Care) of People With Unhealthy Alcohol and Other Drug Use
Confidentiality
Summary and Conclusions
47. Criminal Justice System and Addiction Treatment
Introduction
Prevalence of Substance Abuse and Dependence
Substance Abuse Comorbidities
Pharmacotherapies for Substance Use
Community Corrections
Institutional Corrections
Conclusion
48. Adolescent Neurocognitive Development and School-Based Drug Abuse Prevention and Treatment
Introduction
Brief Overview: Neuroscience and Adolescents
Negative Consequences of Drug Use on Teen Cognitive Function
Brain Development and School-Based Drug Use Prevention and Treatment
Schools as a Modality for Implementation of Cessation Programming
Conclusions and Future Directions
49. The Therapeutic Community for Drug Abuse Treatment: A Journey Yet Unfolding in the Recovery Movement
Introduction
Origins
Early Expansion
The Formative Years
The Therapeutic Community’s Coming of Age
To the 21st Century
Conclusion
50. Substance Use–Focused Mutual-Help Groups: Processes and Outcomes
Acknowledgments
Introduction
Major Types of Substance Use-Focused Mutual-Help Groups
Participation in Mutual-Help Groups and Substance Use Outcomes
Connections Between Mutual-Help Groups and Treatment
Personal Factors, Participation, and Mutual-Help Group Outcomes
Active Ingredients of Mutual-Help Groups
Conclusions
Part VIII. Treatment and Application Pharmacotherapy
51. Pharmacotherapy for Alcoholism and Some Related Psychiatric and Addictive Disorders: Scientific Basis and Clinical Findings
Introduction
Opioids: Mu Receptor Antagonist—Naltrexone
Glutamate
GABA Synthesis and Glutamate Synthesis Modulator—Gabapentin
Serotonin
Acetylcholine: Cholinergic Receptor Antagonist—Varenicline
Dopamine
Alcohol Metabolism Disruptor: Disulfiram
Potential Treatments on the Horizon
Combination Treatments
Conclusions
52. Alcohol Withdrawal: Treatment and Application
Introduction
Anticonvulsants in the Treatment of Alcohol Withdrawal
Other Anticonvulsant Agents
Alpha-2 Adrenergic Agonists
Summary and Conclusions
53. Pharmacotherapy of Cocaine Addiction
Strategies for Selecting Candidate Medications for Testing
Clinical Trials in Cocaine Addiction
Summary
54. Opioid Overdose
History
Definitions
Epidemiology
Pathophysiology
Risk Factors
Prevention
Management
Supports Following an Overdose
Conclusion
55. Methamphetamine
Mechanism of Action
Clinical Use of Methamphetamine
Diagnosis of Methamphetamine Use Disorder
Escalation of Methamphetamine Use
Pharmacokinetics of Methamphetamine
Mechanisms of Methamphetamine Reward
Human Studies in the Treatment of Methamphetamine Use Disorder
Conclusions
56. Potential Pharmacotherapies for Cannabis Dependence
Introduction
Detoxification and Relapse Prevention or Maintenance Phase
Cannabinoid Neuropharmacology
Abstinence Symptoms Treatment Medications
Relapse Prevention Medications
Future Directions in Medication Development for Cannabis Dependence
57. Hallucinogens
Historical Perspectives
Epidemiology
Basic Pharmacology
Psychological and Biological Effects
Hallucinogen Use Disorders
Hallucinogens as Treatment Tools for Addiction?
Part IX. Molecular Genetics, Alternative Therapies, and Other Topics in the Treatment of Addiction
58. Molecular Genetics and the Treatment of Addiction
Overview
Genetics and the Treatment of Addictions
Pharmacogenetics and Pharmacogenomics
Nicotine
Alcohol
Cocaine
Opiates
An Intermediate Phenotype-Driven Pharmacogenetics Approach
Optimizing Psychosocial Treatments Through Genetics
Translating Pharmacogenetic Approaches Into Practice
Future Directions of Molecular Genetics and Addiction Treatment
Summary and Conclusions
59. Physical Considerations for Treatment Complications of Alcohol and Drug Use and Misuse
Introduction
Liver
Gut and Pancreas
Nervous System
Cardiovascular System
Oncology
Endocrinology
Nutrition and Body Composition
60. Quadruple Diagnosis: Substance Use Disorder, Comorbid Psychopathology, Human Immunodeficiency Virus Infection, and Hepatitis C Virus Infection
Introduction
Scope of the Problem
Substance Use Disorders (SUDs)
Psychiatric Disorders Other Than SUDs
Psychiatric Disorders in Human Immunodeficiency Virus Infection
Psychosocial Issues in Persons Living With HIV
Hepatitis C Virus (HCV) Infection
Stigma, HIV Infection, Hepatitis C Virus Infection, Substance Misuse and SUDs, and Other Psychiatric Disorders
Role of SUDs and Other Psychiatric Disorders in the Treatment With and Adherence to Effective ART for HIV Infection and DAAs for HCV Infection
Risk-Taking Behaviors
Assessment of the Quadruply Diagnosed
SUD Treatment of the Quadruply Diagnosed
Summary and Conclusions
61. Substance Use Stigma As a Barrier to Treatment and Recovery
Introduction
What Is Stigma?
Types and Levels of Stigma Toward Substance Abuse
The Need to Study Stigma in Context
The Impact of Stigma on Individuals With Substance Abuse Problems
Stigmatizing Attitudes and Behavior of Friends and Family
Stigma in Treatment Settings
Interventions to Reduce Stigma
Conclusions
62. Religiousness, Spirituality, and Addiction: An Evidence-Based Review
Introduction
Section I
Section II
Section III
Summary and Future Directions
Part X. Computer Modeling
63. In Silico Models of Alcohol Kinetics: A Deterministic Approach
Introduction
Mechanisms of Alcohol Intoxication
Mathematical Modeling of the Pharmacokinetics of Ethanol
In Silico Studies of Blood Ethanol Time-Concentration
Conclusion
64. In Silico Models of Alcohol Dependence Treatment: A Stochastic Approach
Introduction
Methods
Results
Conclusions
65. Dynamic and Systems-Based Models for Evaluating Hypotheses Related to Predicting Treatment Response
Introduction
Personalized Alcoholism Treatment
Pharmacogenetics
The Johnson Model
A Dynamic Systems-Based Model
Modeling and the Personalized Treatment of Alcoholism
Conclusions
Part XI. Dependence in Specific Populations
66. Enhancing Positive Outcomes for Children of Substance-Abusing Parents
Introduction
Higher Risk for Addictions
Genetic Risks
Fetal Alcohol and Drug Exposure
The Family
Effective Prevention Programs
Programs That Increase Behavioral Control and Social Competency
Programs to Increase Emotional Resilience, Happiness, Self-Esteem, and Humor
Programs for Educational Interventions, Screening, and Referral
Summary of Recommendations for Future Research and Policy Improvements
67. Alcohol and Substance Abuse in African Americans
Introduction
Epidemiology
Preventive and Risk Factors
Impact on the Individual
Comorbidity
Treatment
Conclusions
68. Substance Use Disorders in Health Care Professionals
Introduction
Epidemiology of Alcohol and Other Drug Use by Health Care Professionals
Etiology of Substance Use Disorders in Health Care Professionals
Drug Access
Alcohol, Tobacco, and Other Drug Use in the Health Care Professions
The Intervention of Health Care Professionals
69. Identification and Treatment of Alcohol or Drug Dependence in the Elderly
Introduction
Prevalence and Impact of Substance Use Among Older Adults
Identifying Alcohol and Drug Use Problems in Older Adults
Use of Brief Alcohol Interventions With Older Adults With Substance Dependence
70. Alcohol and Drugs of Abuse in Pregnant Women: Effects on the Fetus and Newborn, Mode of Action, and Maternal Treatment
Introduction
Effects of Maternal Alcohol (Ethanol) Consumption During Pregnancy
Heroin-Dependent Mothers in Pregnancy
Effects on Postnatal Development
Mothers Using Cannabis (Marijuana, Hashish) During Pregnancy
Mothers Using Cocaine in Pregnancy
Part XII. Legal, Disability, and Rehabilitative Issues
71. Forensic Issues
Introduction
The Forensic Evaluation Process
Medical and Legal Terminology and Reports of Evaluation
Working With Attorneys: Testimony
Compulsion and Responsibility
Civil Matters
Criminal Matters
Regulatory Matters
Conclusions
72. Disability and Addiction
Introduction
Discrimination Protections for Persons With Disabilities
Key Case Law for the Americans With Disabilities Act, 1990
Americans With Disabilities Act Amendments Act of 2008
History of Entitlements for People With Disabilities and the Place for People With Substance Use Disorders
Policy, Treatment, and Medical Coverage
Substance Use Disorders and Comorbid Disability
Conclusions
73. The Homeless
Introduction
Homelessness
Substance Use Disorders
Alcohol Use Disorder
Other Drug Use Disorders
Nonsubstance Psychiatric Disorders
Services for the Homeless
Conclusions
74. Opening New Vistas in Basic and Preclinical Addiction Research
A Retrospective View on the Hallmarks of Neurobiological Alcohol and Drug Abuse Research
New Vistas in Neurobiological Alcohol and Drug Abuse Research
New Vistas on the Genetic Level
New Vistas on the Molecular Level
New Vistas in Alcohol- and Drug-Induced Synaptic Plasticity
New Vistas on Neuronal Network Activity
Animal Brain Imaging to Identify the Neuroanatomical and Neurochemical Substrates of Addictive Behavior
New Vistas on Studying Alcohol- and Drug-Related Behaviors
Summary
75. Therapeutic Use of Noninvasive Neuromodulation for Addictions
Introduction
Neurobiology of Addiction
Noninvasive Brain Stimulation Techniques: An Overview
tES and TMS in Addictive Disorders
Safety and Tolerability
Summary and Future Directions
Part XIII: National Guidelines
Appendix 1. National Institute on Drug Abuse (NIDA): Medications to Treat Opioid Use Disorder
Appendix 2. TIP 63: Medications for Opioid Use Disorder
Appendix 3. The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use
Index

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