Rethinking Substance Abuse

While knowledge on substance abuse and addictions is expanding rapidly, clinical practice still lags behind. This book brings together leading experts to describe what treatment and prevention would look like if it were based on the best science available. The volume incorporates developmental, neurobiological, genetic, behavioral, and social–environmental perspectives. Tightly edited chapters summarize current thinking on the nature and causes of alcohol and other drug problems; discuss what works at the individual, family, and societal levels; and offer robust principles for developing more effective treatments and services.

Blowing Smoke argues that we are losing the drug war because of our devotion to the disease model of substance abuse. That model has become the driving force for our two main strategies in the war: prohibition laws and drug rehab. The book traces the history and science behind each to show how they paradoxically enable drug use.

Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the “disease model” of addiction is wrong and illuminates the path to recovery. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease, based on evidence that brains change with drug use. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it’s supposed to do—seek pleasure and relief—in a world that’s not cooperating. Brains are designed to restructure themselves with normal learning and development, but this process is accelerated in addiction when highly attractive rewards are pursued repeatedly. Lewis shows why treatment based on the disease model so often fails, and how treatment can be retooled to achieve lasting recovery, given the realities of brain plasticity. Combining intimate human stories with clearly rendered scientific explanation, The Biology of Desire is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.

Views on addiction are often polarised - either addiction is a matter of choice, or addicts simply can't help themselves. But perhaps addiction falls between the two? This book contains views from philosophy, neuroscience, psychiatry, psychology, and the law exploring this middle ground between free choice and no choice.

This collection provides authoritative coverage of neurobiology of addiction, models of addiction, sociocultural perspectives on drug use, family and community factors, prevention theories and techniques, professional issues, the criminal justice system and substance abuse, assessment and diagnosis, and more.

Although there is a strong and growing literature in the two areas of desistance and addiction recovery, they have developed along parallel pathways with little systematic assessment of the empirical evidence about the co-occurrence of the relationship or how one area can learn from the other. This book aims to fill that gap by bringing together emerging literature on the relationship between offending and substance use. Instead of focusing on the active period of its onset and persistence, this book examines the mechanisms that support desistance, addiction recovery, and the common themes of reintegration and rehabilitation. With contributions from a wide range of international experts in the fields of desistance and addiction recovery, the book focuses on a strengths-based, relational and community-focused approach to long-term change in offending and drug-using populations, as well as the shared barriers to effective reintegration for both. This book will be highly informative for a wide audience, from academics and students interested in studying desistance and recovery to those working in addiction services and the criminal justice system as well as policy makers and the people undertaking their own journeys to desistance and recovery.

The National Drug Control Policy has failed its two major functions (supply reduction and demand reduction) due to faulty assumptions regarding nearly every aspect of the alcohol and drug fields, charges author Fisher. Yet in spite of overwhelming evidence of this failure policy makers have strongly resisted discussing major changes to the assumptions that underly current policy, because of political pressure, bias and philosophical intransigence, he adds. Fisher discusses controversial topics and defends uncommon approaches in chapters focused on subjects including legalization, harm reduction, the futility of supply reduction, the problem of underage drinking and effectiveness of treatment and prevention. He proposes a new national policy for drug control, including elimination of the war metaphor, inclusion of alcohol in the mandate, conceptualization of addiction as a public health problem, utilization of harm reduction principles to guide policy and discontinuation of approaches that isolate drug and alcohol problems from their connection to broader social issues such as poverty. In this work, the premises of the current National Drug Control Strategy are challenged, and both Democratic and Republican administrations across the last 10 years are critically examined. Statements of the Director of the Office of National Drug Control Strategy are critiqued. Major points include that there is no evidence the NDCS has achieved any of its goals, that harm reduction should be its guiding principle, and supply reduction should not be part of the national strategy.

Out of control sexual behavior ñ referred to variously as "sex addiction", "sexual compulsivity", and "hypersexuality", among other terms, has been a controversial and attention-getting issue since it first captured both public and professional attention over 30 years ago. Previous discussions of this behavior have been grounded in conceptualizing it as a pathologized, medical issue on par with substance abuse addictions, or, in backlash, as simply irresponsible behavior indicating weakness in the individual. In keeping with the call from many leaders in the mental health and sexual health areas to move beyond these two polarized conceptualizations of these sexual behavior problems, the authors present a model for working with clients in both group and individual treatment settings. Based on their experience with hundreds of clients, this book provides a comprehensive and practical conceptualization of out of control sexual behavior framed as a sexual health problem within a larger model of human behavior, not a psychiatric or addictive disorder. The book includes step-by-step tools for assessment, treatment planning as well as treatment implementation. It describes a process for professionals to guide clients to define and be accountable for their own personal vision of sexual health as the foundation on which they regain sexual behavior control. The authors provide rich and varied composite case examples based on 20 years of clinical experience that demonstrate clinician sexual health treatment conversations and tools, as well as stories of hope and guidance so essential to individuals wanting to understand how sexual health can be the essential ally in changing their sexual behavior.