Cocaine and Methamphetamine Dependence
Advances in Treatment
While the APA's Textbook of Addiction Psychiatry covers material that a general psychiatrist or primary care physician needs for the appropriate referral and initial management of stimulant dependence, Cocaine and Methamphetamine Dependence: Advances in Treatment goes beyond this basic knowledge and addresses the rapid evolution of both the understanding and the treatment of stimulant abusers. It also sheds light on how the epidemiology of cocaine, amphetamine and methamphetamine abuse and dependence have substantial differences in geographic distribution both here and abroad, and how treatments are evolving to help these complex patients benefit from emerging pharmacological and behavioral therapies.
Cocaine dependence complications account for one out of every three drug-related emergency room visits. Coroners' reports relate stimulants to the direct cause of death in 25% of cocaine overdoses and 68% of methamphetamine overdoses or as antecedents causing cardiovascular or medical problems leading to death in 20% of these abusers. Additionally, cocaine and methamphetamine abuse and dependence frequently co-occur with other major mental illnesses such as schizophrenia, major depression, and posttraumatic stress disorder. This makes a greater understanding of stimulant dependence among the psychiatric community an integral part of providing effective evaluation and treatment. Cocaine and Methamphetamine Dependence provides:
- An introduction of the DSM-5 plan to drop the distinction between abuse and dependence and add craving as a criterion.
- An overview of how the epidemiology of stimulant abuse is changing and pharmaceutical abuse is rising due to factors such as greater availability through family and friends who are increasingly being prescribed stimulants for conditions like weight loss or attention deficit disorder.
- The insight that even after long abstinence, stimulant users may remain vulnerable to amphetamine-induced psychosis, with delusions, paranoia and compulsive behavior.
- The insight that a comprehensive assessment of the patient involves the management of aberrant behaviors such as intoxication, violence, suicide, impaired cognitive function, and uncontrolled affective displays.
- A focus on treatment, emphasizing that the most important component of stimulant treatment involves behavioral therapies, often in combination with adjunctive medications.
- A review of the criminal justice system's shift away from punitive action and towards more human treatment, including the far-reaching benefits of medical management and treatment.
Fortunately, our understanding of stimulant abuse and dependence is growing at a time when a steady stream of new users and casualties is still accumulating. Constant vigilance regarding changes in epidemiology, fluctuations in drug availability, and changes in drug trafficking patterns are essential to recognition of new drug abuse patterns and their identification and treatment. Cocaine and Methamphetamine Dependence should be on the bookshelf of residents, physicians and psychiatrists who are highly likely to come into contact with one of the millions using and abusing stimulants today.
- Chapter 1. Epidemiology and Psychiatric Comorbidity
- Chapter 2. History, Use, and Basic Pharmacology of Stimulants
- Chapter 3. Diagnoses, Symptoms, and Assessment
- Chapter 4. Behavioral Interventions
- Chapter 5. Pharmacotherapy
- Chapter 6. Polydrug Abuse
- Chapter 7. HIV and Other Medical Comorbidity
- Chapter 8. Summary and Future Directions
- Richard De La Garza II, Ph.D.
Carrie L. Dodrill, Ph.D.
Rachel Fintzy, M.A.
Valerie A. Gruber, Ph.D., M.P.H.
Colin N. Haile, M.D., Ph.D.
Ari D. Kalechstein, Ph.D.
Herbert D. Kleber, M.D.
Thomas R. Kosten, M.D.
Elinore F. McCance-Katz, M.D., Ph.D.
Thomas F. Newton, M.D.
Jin H. Yoon, Ph.D.
About the Authors
Thomas R. Kosten, M.D., is J.H. Waggoner Chair and Professor of Psychiatry, Pharmacology and Neuroscience and Associate Vice President and Dean for Clinical Research at the Baylor College of Medicine, Houston, Texas. He is also Professor of Psychiatry and Epidemiology at the M.D. Anderson Cancer Center, and Director, VA National Substance Use Disorders, Quality Enhancement Research Initiative (QUERI).
Thomas F. Newton, M.D., is Professor of Psychiatry and Pharmacology at the Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, Texas.
Richard De la Garza II, Ph.D., is Associate Professor of Psychiatry, Neuroscience, and Pharmacology at the Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, Texas. He is also Research Director and Associate Professor, Departments of Psychiatric Oncology and Behavioral Science, at the University of Texas M.D. Anderson Cancer Center.
Colin N. Haile, M.D., Ph.D., is Assistant Professor of Psychiatry and Behavioral Sciences at the Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, Texas.
This is one of the rare multi-authored volumes that is well-edited, with a coherent connection between chapters that conveys the complexity and clinical challenges involved in the treatment and prevention of stimulant dependence (addiction). The book is thorough in its coverage of the full range of science, from epidemiology to clinical research, animal models and neuroscience. The state of the science is presented in a way that is both accessible and informative to the generalist and to the specialist in the field. Moreover, it is both objective and clinically relevant in its coverage of the state of treatment: including contingency management, pharmacotherapy, cognitive behaviorally-based therapies, and the delivery of services within the context of the criminal justice system. If there is one book to buy on the topic of stimulant dependence, this book is the one!—Roger E. Meyer, M.D., Professor of Psychiatry, Penn State Hershey Medical Center, Hershey, PA
In the past 30 years, dependence upon cocaine and amphetamines has adversely affected the lives of millions of people around the world. Cocaine and Methamphetamine Dependence helps general medical and mental health professionals as well as addiction specialists to understand these drugs, their pharmacological and clinical effects, and treatment strategies for people who become dependent upon them. The authors of this wonderful book have done a masterful job summarizing the most current information about stimulant dependence and its treatment.—Roger D. Weiss, M.D., Professor of Psychiatry, Harvard Medical School, Chief, Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA
This book illustrates our dramatic increase in knowledge about all aspects of stimulants, and also helps us to see those areas in which we need to further our understanding and research. It provides a comprehensive and highly useful review of all features of stimulant use, and should be of great value to clinicians, researchers, and policy makers who care about the patients who suffer from use of these drugs.—Eric C. Strain, M.D., Director, Johns Hopkins Center for Substance Abuse Treatment and Research Medical Director, Behavioral Pharmacology Research Unit Johns Hopkins University School of Medicine
This book provides a comprehensive summary of stimulant dependence and treatment for stimulant use disorders in a clearly written and well-organized manner. It is an excellent resource for clinicians interested in more in-depth information about the history, pharmacology, and management of stimulant dependence than the information found in general psychiatry or general substance use disorders textbooks. This is a well-organized book that provides practical and useful information for anyone involved in the treatment of individuals with stimulant dependence. The authors have done an excellent job of synthesizing the most current information in a manner that is both compelling and a pleasure to read.—Kathleen Brady, M.D., Ph.D., The American Journal of Psychiatry, 6/1/2012
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