Drug and Alcohol Abuse - Springer

1 drug and Alcohol Abuse A clinical guide to Diagnosis and Treatment Second Edition CRITICAL ISSUES IN PSYCHIATRY An Educational Series for Residents and Clinicians Series Editor: Sherwyn M. Woods, , University of Southern California School of Medicine Los Angeles, California Recent volumes in the series: LAW IN THE PRACTICE OF PSYCHIATRY Seymour L. Halleck, NEUROPSYCHIATRIC FEATURES OF MEDICAL DISORDERS James W. Jefferson, , and John R. Marshall, ADULT DEVELOPMENT: A New Dimension in Psychodynamic Theory and Practice Calvin A.

2 Colarusso, , and Robert A. Nemiroff, SCHIZOPHRENIA John S. Strauss, , and William T. Carpenter, Jr., EXTRAORDINARY DISORDERS OF HUMAN BEHAVIOR Edited by Claude T. H. Friedmann, , and Robert A. Faguet, MARITAL THERAPY: A Combined Psychodynamic-Behavioral Approach R. Taylor Segraves, , TREATMENT INTERVENTIONS IN HUMAN SEXUALITY Edited by Carol C. Nadelson, , and David B. Marcotte, clinical PERSPECTIVES ON THE SUPERVISION OF PSYCHOANALYSIS AND PSYCHOTHERAPY Edited by Leopold Caligor, , Philip M.

3 Bromberg, , and James D. Meltzer, MOOD DISORDERS: Toward a New Psychobiology Peter C. Whybrow, M. D., Hagop S. Akiskal, , and William T. McKinney, Jr., EMERGENCY PSYCHIATRY: Concepts, Methods, and Practice Edited by Ellen Bassuk, , and Ann W. Birk, drug AND Alcohol Abuse : A clinical guide to Diagnosis and Treatment, Second Edition Marc A. Schuckit, A Continuatiol' Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication.

4 Volumes are billed only upon adual shipment. For further information please con tad the publisher. drug and Alcohol Abuse A clinical guide to Diagnosis and Treatment Second Edition Marc A. Schuckit, University of California, San Diego School of Medicine Veterans Administration Hospital San Diego, California Plenum Press New York and London Library of Congress Cataloging in Publieation Data Sehukit, Mare A. drug and Alcohol Abuse . Includes bibliographical referenees and index. 1. drug Abuse . 2.

5 Alcoholism. I. Title. 1983 83-13815 ISBN 978-1-4684-1178-2 ISBN 978-1-4684-1176-8 (eBook) 001 First Printing-April 1984 Second Printing-October 1985 1984 Plenum Press, New York Softcover reprint of the hardcover I st edition 1984 A Division of Plenum Publishing Corporation 233 Spring Street, New York, 10013 All rights reserved No part of this book may be reprodueed, stored in a retrieval system, or transmitted, in any form or by any means, electronie, meehanical, photocopying, microfilming, reeording, or otherwise.

6 Without written permission from the Publisher To Sam who taught me how to laugh, Lil who showed me how to love those close to me, and to Judy, Dena, and Jordan who keep me doing both. Foreword When this series was conceived, a book on substance Abuse , including Alcohol and alcoholism, was to be of the highest priority. This priority was a reflection of my view that the subject is often inadequately or insufficient-ly taught in many training programs. Few clinicians have had comprehen-sive didactic education in this area, despite the frequency with which these problems are encountered in practice.

7 All too often these encounters are in situations in which accurate diagnosis and rapid treatment are of critical im-portance. We wanted a book that would be concise and easily readable but also comprehensive in its presentation of the basic principles underlying clinical manifestations, diagnosis, and management. It was of particular im-portance that the book also serve as an easy reference guide in emergency situations. Marc Schuckit, a man with impeccable credentials as a scholar and an experienced clinician in this field, produced just such a book with his critically acclaimed first edition.

8 That volume rapidly became a resource of great significance for psychiatrists, psychotherapists, and physicians in general. It has been adopted as a text in medical schools and residency train-ing, as well as for courses in psychology, emergency medicine, social work, and nursing. The entire volume has been revised and updated to reflect changes in knowledge and clinical practice since the publication of the first edition and in order to keep the comprehensive references current. There is a new chapter on phencyclidine and another on caffeine and nicotine.

9 There are chapters on eNS depressants; Alcohol and alcoholism; stimulants; opiates and other analgesics; cannabinols; hallucinogens; glues, solvents, and aerosols; and over-the-counter drugs. Multidrug use is dealt with thoroughly, and there is an extensively revised chapter on rehabilitation. The rapid guide to emergency problems will continue to be of great relevance to all practitioners. Whether one's goal is an understanding of each drug class and its associated clinical problems or the need to diagnose vii viii FOREWORD rapidly and treat a specific drug emergency, the reader is led step by step through all the elements underlying the mechanism of action, the clinical and laboratory findings, and the specifics of treatment.

10 Since substance Abuse is such a complicated and prevasive problem, and one that has resisted our attempts at primary prevention, Dr. Schuckit's revised and expanded book will undoubtedly make an even greater con-tribution to clinical practice in medicine, psychiatry, and all the mental health disciplines. SHERWYNM. WOODS, , Series Editor Preface to the Second Edition In the intervening years between the publication of the first and second edi-tions, this book has been used as a text for teaching in medical schools, psychology and social work courses, nursing curricula, and so on.