Preface
About the editors
About the contributors
PART 1 PRINCIPLES
Section Editor: Carolyn Day
Part Introduction
Chapter 1 The history of psychoactive substance use and problems and of social responses to them
Robin Room
References
Chapter 2 The epidemiology of tobacco, alcohol, and illicit drug use and their contribution to the burden of disease
Louisa Degenhardt, Carol Gartner, and Wayne D Hall
Introduction
Why do people use drugs?
How do we estimate the number of people who use drugs?
Estimates of the prevalence of substance use in Australia
Epidemiology of drug use
Substance abuse and dependence
Prevalence of substance abuse and dependence
Correlates of substance abuse and dependence
The natural history of drug use
The burden of disease attributable to alcohol, tobacco, and illicit drugs
Summary and implications
References
Chapter 3 Behavioural science and addiction
Robert West and Michael Farrell
Introduction
Understanding behaviour
Understanding motivation
Addiction and the motivational system
Identity and self-control
Behavioural science and its constituent disciplines
Lessons for prevention and recovery
Evaluating interventions to combat addiction
Conclusions
References
Chapter 4 Public health responses to drug and alcohol use
Carolyn Day
Evidence for public health interventions
Drug and alcohol policy
Demand reduction strategies
Harm reduction initiatives
Supply reduction
Conclusion
References
Chapter 5 Legal framework
Sascha Callaghan
Overview
Illegal drugs
Alcohol
Tobacco
Medicines and therapeutic drugs
Control of illegal substances
Harm minimisation
Intoxication and dependence
Compulsory drug treatment and human rights
References
Chapter 6 Ethical issues in the addiction medicine and bioscience
Adrian Carter and Wayne D Hall
Introduction
Major ethical frameworks
Ethical issues in addiction treatment
Entering pharmacological treatment for addiction
Relapse prevention with slow-release medications
Coerced treatment of addiction
Ethical issues in addiction research
Conclusion
References
Chapter 7 Pathways of care
Lynda Berends
Components of alcohol and other drug treatment pathways
Beyond treatment modalities
Accessing AOD treatment
Barriers clients face
Supporting the care pathway
Strategies that enhance access
Conclusion
References
Chapter 8 Substance use in global context: drugs and conflict
Nadine Ezard
Armed conflict and drug trade
Conflict, displacement, and drug use
Conclusion
References
PART 2 CLINICAL AND OTHER CORE SKILLS
Section Editor: Paul Haber
Part Introduction
Chapter 9 Clinical assessment
Alan Gijsbers
Purpose of history taking
Why did the patient come now?
Pattern of AOD use: quantity, frequency, and variability
Withdrawal
Chronology of the last few months of AOD use
Narrative history
Readiness to change
Relapse
Harm reduction
What social supports are there to enable the patient to maintain a new lifestyle?
Spirituality
What other dimensions need to be addressed to sustain recovery?
What are the hidden values within this discussion?
Legal issues
Risk assessment
Formulation
References
Chapter 10 Therapeutic relationship
Adrian J Dunlop, Natasha L Perry, and Maryanne Robinson
Introduction
Elements of a ‘good’ therapeutic relationship
Patient engagement in treatment
Communication skills
The role of an addiction clinician
Establishing limits
Conclusion
References
Chapter 11 Dancing in step – using psychological interventions throughout substance use disorder treatment
Danielle Florida and Lisa Juckes
Introduction
Assessment and brief interventions
Motivational interviewing: framework and techniques
Cognitive behavioural relapse prevention
Contingency management
Mindfulness-based relapse prevention
Acceptance and commitment therapy for addiction
Dialectical behaviour therapy for substance use disorder
Mutual aid programs
Psychodynamic psychotherapy
References
Chapter 12 Screening and brief interventions
Robert Ali, Linda Gowing, and Jennifer Harland
Why screen for substance use?
Why screen in primary healthcare settings?
Methods of screening for substance use
Choice of approach
Alcohol, Smoking, and Substance Involvement Screening test (ASSIST)
Brief intervention
ASSIST-linked Brief Intervention
Referral to treatment
Key points
References
Chapter 13 Drug testing and biomarkers of alcohol consumption
Philip Paull, Paul Haber, and Devanshi Seth
Introduction to drug testing
Drug testing technologies
Pharmacokinetics and metabolism
Use of drug testing in drug treatment programs
Biomarkers of alcohol consumption
References
Chapter 14 Responsible prescribing
Bridin Murnion
Information gathering
Drug/drug and drug/disease interactions
Writing a prescription
Communication of a treatment plan
Monitoring efficacy and safety
Treatment cessation/withdrawal
Prescribing drugs of addiction in the non-addiction setting
Prescription and doctor shopping monitoring
References
Chapter 15 Medico-legal assessment and report writing in addiction medicine
Matthew Frei
Introduction
The nature of the assessor-patient relationship
Collection of information for assessment
The assessment
Treatment of substance use disorder
Opinion writing tips
Conclusion
References
PART 3 COMMON CLINICAL ISSUES
Section Editor: Michael Farrell
Part Introduction
Chapter 16 Intoxication and overdose
Jonathan Brett and Andrew Dawson
Introduction
Brief pharmacological principles
Core assessment
Approaches to treatment
Specific toxins
References
Chapter 17 Withdrawal
Ken Curry and Gary Reynolds
Introduction
Clinical settings
Management of WS
Monitoring of WS
Conclusion
References
Chapter 18 Mental health comorbidities
Glenys Dore
Comorbidity
Alcohol and psychiatric symptoms
Benzodiazepines and psychiatric symptoms
Opioids and psychiatric symptoms
Cannabis and psychiatric symptoms
Stimulants and psychiatric symptoms
Ecstasy and psychiatric symptoms
Hallucinogens and psychiatric symptoms
Ketamine and psychiatric symptoms
References
Chapter 19 Physical comorbidities
Robert G Batey and Sara E Mgaieth
Introduction
Classifying physical comorbidities linked to alcohol/drug use
Neurological comorbidities
Musculoskeletal comorbidities
Gastrointestinal comorbidities
Viral hepatitis in alcohol/drug users
Respiratory comorbidities
Cardiovascular comorbidities
Renal comorbidities
Haematological comorbidities
Endocrine comorbidities
Dermatological comorbidities
Drug use and malignancy
Other physical syndromes associated with drug use
Chapter 20 Pain management and pharmacological opioids
Milton Cohen
The complexity of the experience of pain
The public health problem of the burden of pain
Management of patients with chronic non-cancer pain
The public health problem on increasing use of prescription opioids
Quality use of opioids in patients with chronic non-cancer pain
Conclusion
References
Chapter 21 Pregnancy, infant, and parenting
Ju-lee Oei, Adrienne Gordon, Natasha Perry, Joanne Ludlow, Lucinda Burns, Lucy Harvey-Dodds, and Adrian Dunlop
Epidemiology
Substance use patterns in pregnancy and adverse effects
Management of substance use disorders in pregnancy
Obstetric issues
Neonatal abstinence syndrome
Effects of drug use on the infant
References
PART 4 SUBSTANCE SPECIFICS
Section Editor: Paul Haber
Introduction
Chapter 22 Tobacco
Matthew Peters
The history of tobacco use – why we are where we are?
The evolution of the modern cigarette
Can tobacco smoking be considered an addiction?
Assessment of dependence
Withdrawal symptoms
Population strategies to achieve smoking cessation
Strategies to address smoking at an individual level
Relapse prevention
Snus, e-cigarettes, and alternative delivery systems
Summary and the future
References
Chapter 23 Alcohol use disorders
John B Saunders
Introduction
Alcohol use and harm
The biology of alcohol
Assessment
Management of alcohol dependence and its consequences
References
Chapter 24 Opioids
Nickolas Lintzeris
Introduction
Pharmacology
Chronic opioid use: neuroadaptation
Morbidity, mortality, and natural history of opioid dependence
Management of opioid dependence
Overview of treatment interventions
References
Chapter 25 Cannabis
Shalini Arunogiri, Matthew Frei, and Dan I Lubman
Epidemiology
Neuropharmacology
Acute effects
Long-term effects
Clinical features
Management of cannabis use disorders
Synthetic cannabinoids
References
Chapter 26 Stimulants, hallucinogens, and related drugs
Apo Demirkol
Epidemiology
Drug use patterns
Harms associated with use of psychostimulant and hallucinogenic drugs
Assessment
Management of acute intoxication
Management of withdrawal
Chronic sequelae
Harm reduction
References
Chapter 27 Benzodiazepines
M Mofizul Islam and Paul Haber
Epidemiology
Classification based on elimination half-life
Immediate effects
Long-term effects
Therapeutic indications
Dependence and withdrawal
Contraindications
Benzodiazepines, pregnancy, and the newborn child
Benzodiazepine abuse
Treatment for benzodiazepine dependence
Benzodiazepine overdose
Conclusion
References
Chapter 28 Volatile substance use
Paul Haber
Epidemiology
Effects
Management
References
PART 5 SPECIAL POPULATIONS
Section Editor: Michael Farrell
Part Introduction
Chapter 29 Men and drugs
Craig Rodgers
References
Chapter 30 Women and drugs
Sharon Reid and Carolyn Day
Epidemiology of female drug use
Why do women use drugs?
Specific consequences for women who use drugs
Healthcare for women who use drugs
Conclusion
References
Chapter 31 Adolescents
Yvonne Bonomo and Jennifer Sloane
Epidemiology
Substance use and adolescent development
Assessing the young person’s alcohol and other drug use
Intervention in adolescent substance use disorders
References
Chapter 32 There’s a tear in my beer: issues for the older patient with alcohol and substance abuse
Carly Johnco, Adrienne Withall, and Brian Draper
Prevalence and effects of alcohol misuse
Prevalence and effects of prescription medication abuse
Screening and detection of late-life alcohol and substance misuse
Management issues
References
Chapter 33 Drugs, alcohol, and prisoners
Michael H Levy
Prevalence of drug and alcohol issues in prisons
The role of prisons in managing drug and alcohol problems
Harms associated with incarceration of people who use drugs and alcohol
Prevention, treatment, and management of drug and alcohol problems in prisoners
Clinical issues
Conclusion
References
Chapter 34 Aboriginal and Torres Strait Islander Australians
Kate Conigrave, Kylie Lee, and Bradley Freeburn
Introduction
Epidemiology
Indigenous Australian efforts to tackle substance use issues
Ways of working with Aboriginal or Torres Strait Islander patients
The assessment
Brief intervention
Treatment
Prevention: what health professionals can do
Summary
References
Chapter 35 Culturally and linguistically diverse groups
Nick Walsh
Definition
Epidemiology
Determinants of AOD in CaLD
Management of AOD problems in CaLD populations
Cultural competence – bringing patients and clinicians together in a common space
References
Chapter 36 People who inject drugs
Ingrid van Beek and Mihaela Ivan
Background
The prevalence of injecting
Factors associated with injecting drug use
Health issues associated with injecting drug use
References
Index
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