Drug and Alcohol Abuse Reviews – serie

A major national goal is to improve our health and advance our opportunities to pursue happiness. Simulta­ neously, there are increasing health care costs and increasing demands to accomplish more with less financial support. Treatment costs can be reduced and health improved by preventing the toxic effects of drugs. This first volume of our new series, Drug and Alcohol to reduce the use and Abuse Reviews, focuses on stategies abuse of common compounds known to cause major damage to health: alcohol, tobacco, and illicit drugs such as cocaine and heroin. With the number of deaths attributable to the consumption of alcohol in the US at about 100,000 per year, the annual cost of addictions will be $150 billion by 1995. A variety of approaches to preventing drug abuse are being applied by governmental agencies and health care providers to reduce costs. These include school-based inter­ ventions, driver education programs, media interventions, health warning labels, physician guidance, economic dis­ incentives, restricted availability, punishments and penalties, environmental protections, and social-support approaches. With such a range of options, it becomes critical to evaluate and choose the most effective systems for a given population. We feel that the present collection of critical survey articles constitutes a thorough examination of the issues and strategies associated with prevention, and trust that readers will find the book exceedingly helpful in under­ standing and planning what needs to be done.

Alcohol and other drugs of abuse are major contributing factors to liver disease and its pathology. Alcoholic cirrhosis causes thousands of deaths each year in the United States, and encourages liver replacement. A better understanding of the mechanisms of liver pathology will significantly aid basic researchers and physicians in treating and preventing liver damage. This book is designed especially for those researchers wishing to understand alcoholic liver disease. Therefore the role of alcohol in changing nutrition and its nutritional effects on liver disease are reviewed. The generation of free radicals during alcohol use has been found to be an important cause of membrane changes, of cancer development, and of lipid alterations-and thus of liver pathology. In addition to alcohol, other drugs of abuse, including morphine, cocaine, marijuana, and caffeine have also been shown to be significant contributors to liver pathology. The prevalence of drug and alcohol use and abuse today means that liver disease will continue as a major social and medical problem. The explanation of its biological origins cannot fail to help us better understand and treat the disease in the years to come.

Drug Abuse Treatment, together with its companion volume, Alcohol Abuse Treatment, critically examines the many difficult issues and complex strategies associated with the successful treatment of substance abuse today. Because of the high cost in lives, health, and dollars, the need for improved tech-niques and strategies for the treatment and reduction of substance abuse has become a critical national priority. In this volume of Drug & Alcohol Abuse Reviews, Ronald R. Watson and key researchers in the field of drug abuse treatment evaluate both old and new methods, carefully reviewing current data to determine the value of the most important treatment programs in current use.Featured topics include: cocaine and heroin addiction treatment relapse problems and treatment nicotine abuse treatment strategy for drug treatment systems psychological correlates of drug abuse outpatient drug abuse treatment pharmacotherapy for drug abuse Drug Abuse Treatment and its complementary volume on Alcohol Abuse Treatment together offer a thorough review and analysis of drug and alcohol abuse treatment options, providing researchers and clinicians with a valuable framework for understanding, planning, and delivering the effective substance abuse treatment that is so urgently needed now.

Alcohol Abuse Treatment, together with its companion volume, Drug Abuse Treatment, critically examines the many difficult issues and complex strategies associated with the successful treatment of substance abuse today. Because of the high cost in lives, health, and dollars, the need for improved techniques and strategies for the treatment and reduction of substance abuse has become a critical national priority. In this volume of Drug & Alcohol Abuse Reviews, Ronald R. Watson and key researchers in the field of alcohol abuse treatment evaluate both old and new methods, carefully reviewing current data to determine the value of the most important treatment programs in current use. Featured topics include: psychosocial factors influencing alcohol use among adults and youth pharmacotherapy for alcohol abusers promising new themes in alcohol treatment clinical use of alcoholism treatment research role of hormones in behavioral treatment theories of alcohol intoxication nicotine as a cofactor in alcohol abusers.Alcohol Abuse Treatment and its complementary volume on Drug Abuse Treatment together offer a thorough review and analysis of drug and alcohol abuse treatment options, providing researchers and clinicians with a valuable framework for understanding, planning, and delivering the effective substance abuse treatment that is so urgently needed now.

In Addictive Behaviors in Women, leading experts from psychiatry, psychology, sociology, and social work concisely review the addictive process and the characteristic behaviors of women who are dependent on alcohol and/or drugs. Topics include why women smoke, the role of personality in female addiction, sexuality issues in chemically dependent women, dieting and alcohol use in women, alcohol's role in sexual assault, and the impact of drug abuse on the family and pregnancy. Addictive Behaviors in Women illuminates the causes and effects of the many lifestyle decisions women make that lead to addiction to drugs, work, sex, gambling, or to any of the many other elective aspects of our lives. It shows how addictive decisions can be avoided and/or treated, thereby making women's lives safer, more productive, and healthier.

In Alcohol and Hormones, leading researchers concisely review what is known about each human hormone system and how these systems are affected by alcohol use, to a lesser extent, other drugs of abuse. The contributors show clearly just how the body is regulated and how its normal functioning can be changed by alcohol. Major topics covered range from alcohol stress interactions and the effects of alcohol on vitamin A metabolism (fetal alcohol syndrome and neural tube development) to how alcohol blocks the release of various peptide hormones, to its effects on puberty-related events in the female. There are also articles about how alcohol affects the control of body temperature, the impact of alcohol on male sexual development during puberty, the role of TRH in alcohol use disorders, and the possibility for a neuroendocrinological component in alcoholism. Alcohol and Hormones will be of interest to biomedical and alcohol researchers, neurobiologists, endocrinologists, pharmacologists, psychiatrists, and some clinicians interested in a deeper understanding of the effects of alcohol on the body.

In Alcohol, Cocaine, and Accidents leading experts provide concise yet focused scientific reviews of the role of alcohol and cocaine in automotive, aviation, and aquatic accidents. The authoritative contributors present both applied research and epidemiological studies, with emphasis on the prevention of injuries through an increased use of appropriate educational labels, law enforcement, and personal and community based prevention programs. In addition to detailed topical coverage, the articles suggest prevention strategies and provide supporting data for the role of treatment in reducing accidents. Alcohol, Cocaine, and Accidents will be of interest to substance abuse researchers, law enforcement officials, treatment providers, policy makers, and legislators responsible for regulating alcohol and drug use, as well as safety issues in all areas of transportation.

Alcohol and other drugs of abuse cause significant physi­ ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi­ tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi­ fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi­ fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

In Alcohol, Cocaine, and Accidents leading experts provide concise yet focused scientific reviews of the role of alcohol and cocaine in automotive, aviation, and aquatic accidents. The authoritative contributors present both applied research and epidemiological studies, with emphasis on the prevention of injuries through an increased use of appropriate educational labels, law enforcement, and personal and community-based prevention programs. In addition to detailed topical coverage, the articles suggest prevention strategies and provide supporting data for the role of treatment in reducing accidents.Alcohol, Cocaine, and Accidents will be of interest to substance abuse researchers, law enforcement officials, treatment providers, policy makers, and legislators responsible for regulating alcohol and drug use, as well as safety issues in all areas of transportation.

Alcohol and other drugs of abuse cause significant physi­ ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi­ tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi­ fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi­ fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

Alcoholism, the oldest addictive illness, remains a serious problem because of its major modifications of many physiological systems. The genetic and neurological origins and mechanisms are complex and only partly understood. However, it is clear that alcohol use modifies the production of most hormones, directly and indirectly modulating the systems that hormones regulate. Acute and chronic alcohol consumption affects virtually all cellular functions of tissues like brain, liver, immune system, and reproductive and endocrine organs. The latter have major regula­ tory roles, affecting many functions from development to repro­ duction. Although stress can further modify alcohol's effects on hormone production, it significantly causes most of alcohol's modi­ fications of the body to occur via changes in hormone production and secretion. Ronald R. Watson vii Contributors Michael L. Adams • Department of Psychiatry, Washington University School of Medicine, St. Louis, MO Robert A. Anderson, Jr .• Ob/Gyn Research, Rush-Presbyterian-St. Luke's Medical Center, Chicago,IL Kasibhatla Bhavani • Molecular Heptology Laboratory, Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA Theodore J. Cicero • Department of Psychiatry, Washington University School of Medicine, St.

In Addictive Behaviors in Women, leading experts from psychiatry, psychology, sociology, and social work concisely review the addictive process and the characteristic behaviors of women who are dependent on alcohol and/or drugs. Topics include why women smoke, the role of personality in female addiction, sexuality issues in chemically dependent women, dieting and alcohol use in women, alcohol's role in sexual assault, and the impact of drug abuse on the family and pregnancy. Addictive Behaviors in Women illuminates the causes and effects of the many lifestyle decisions women make that lead to addiction to drugs, work, sex, gambling, or to any of the many other elective aspects of our lives. It shows how addictive decisions can be avoided and/or treated, thereby making women's lives safer, more productive, and healthier.

A major national goal is to improve the health of the populace while advancing our opportunities to pursue happiness. Simulta­ neously, there are both increasing health costs and increasing demands that more be accomplished with less financial support. With the number of deaths attributable to drug abuse, especially of tobacco, in the US at about 250,000 per year, the annual cost of drug addiction is over $150 billion. Improved treatment methods can both reduce these costs and improve health by preventing the continued exposure of abusers to the toxic effects of alcohol and other drugs. This fourth volume of Drug and Alcohol Abuse Reviews focuses on the strategies currently thought best for the treatment of drugs of abuse. A variety of approaches to drug abuse treatment employ those psychosocial factors that are known to influence drug use in youth and adults. Although the main emphasis is on the treatment of illicit drug use, a major cofactor in damaging the health of drug users is nicotine (tobacco) addiction, whose treatment is also reviewed. And the roles of learning and outpatient services are shown to affect treatment significantly. Thus, the problems confronted and solutions used in drug abuse treatment have here been analyzed in concise reviews that deal with the evidence for today' s best hypotheses and conclusions. Some emphasis is also placed on reviewing new compounds used to prevent cocaine and opioid dependence.

A major national goal is to improve the health of the populace while advancing our opportunities to pursue happiness. Simulta­ neously, there are both increasing health costs and increasing demands that more be accomplished with less financial support. The number of deaths attributable to the consumption of alcohol in the US is about 100,000 per year, and the annual cost of this addiction is over $100 billion. Improved treatment methods can both reduce these costs and improve health by preventing the continued exposure of abusers to the toxic effects of alcohol. This third volume of Drug and Alcohol Abuse Reviews focuses on the strategies currently thought best for the treatment of alcohol and tobacco abuse. A variety of approaches to treating alcohol abuse employ those psychosocial factors that are known to influence alcohol use in youth and adults. Pharmacotherapy has also been evaluated at the National Institute of Alcohol Abuse and Alcoholism by leaders in alcohol treatment research. One key review investigates forming a developmental framework for the treatment of adolescent alcohol abusers, a major challenge. Although the main emphasis is on the treatment of alcoholism, a major cofactor for many drug users is nicotine (tobacco) addiction, whose treatment is also reviewed. And the roles of learning and outpatient services are shown to affect treatment significantly. Thus, the problems confronted and solutions used in alcohol abuse treatment have here been analyzed in concise reviews that provide evidence for today's best hypoth­ eses and conclusions.

Alcohol and other drugs of abuse are major contributing factors to liver disease and its pathology. Alcoholic cirrhosis causes thousands of deaths each year in the United States, and encourages liver replacement. A better understanding of the mechanisms of liver pathology will significantly aid basic researchers and physicians in treating and preventing liver damage. This book is designed especially for those researchers wishing to understand alcoholic liver disease. Therefore the role of alcohol in changing nutrition and its nutritional effects on liver disease are reviewed. The generation of free radicals during alcohol use has been found to be an important cause of membrane changes, of cancer development, and of lipid alterations-and thus of liver pathology. In addition to alcohol, other drugs of abuse, including morphine, cocaine, marijuana, and caffeine have also been shown to be significant contributors to liver pathology. The prevalence of drug and alcohol use and abuse today means that liver disease will continue as a major social and medical problem. The explanation of its biological origins cannot fail to help us better understand and treat the disease in the years to come.