Alcohol and Tobacco

Alcohol and nicotine addiction mostly occur together. Over the last ten years therapeutic aspects and motivational strategies have been considerably improved. Hence, groups and subgroups have been defined and can be treated with specific medication and tailor-made psychotherapies, leading in the long term to considerably better and more effective results than the once broadly applied, rigorous abstinence -based therapies. However, alcohol and nicotine addiction still represent major medical and social problems.

In this book, new therapeutic approaches are comprehensively described, outlining the different interactions between personality, environment and the effects of the substance.

In addition to prevention-based therapies and diagnosis, essential psychological and sociological strategies, as well as medication-based therapies, are also presented in detail. All of these therapies have realistic aims and are of global validity. In addition, the book provides a broad overview of the American and European epidemiology of alcohol and nicotine addictions. The book is written for all those who care for and offer professional therapy for alcohol and nicotine-addicted patients.

Comprehensive guide for detection and therapy of acohol and nicotine abuse Classification of disease into groups and subgroups Description of tailor-made therapies of global validity Interdisciplinary approach

Auteur

Otto Michael Lesch, MD is currently President of the Austrian Society of Addiction Medicine, Head of the Alcohol Research Group of the Medical University of Vienna, Department of Psychiatry and Psychotherapy. Since 1972 he is responsible for longterm studies in alcohol dependence. He organized many international clinical trials and basic research in alcohol and tobacco dependence. He served 12 years as secretary of ESBRA and organized European networks for alcohol research. He always bridged the gap between basic and clinical research and developed clinical used tools to define subgroups of addiction for better treatment approaches. His assessment tools are now available in many different languages (www.LAT-online.at).

Henriette Walter, MD, is University Professor at the Dept. of Psychiatry and Psychotherapy. She is a member of the Senate and of many commissions of the Medical University, Vienna. Dr. Walter is working in the field of alcoholism since more than 20 years, both, practically and scientifically, with over 200 publications. She is secretary of the 'AUSAM, the Austrian Society of Addiction Medicine and an ESBRA board member. She is associate editor of the Journal Hypnose, a field in which she takes an active scientific interest since 1982. With the theory of frontalisation as the neuro-equivalent for the hypnotic state, she contributed to the neuroimaging research in this field. She gives regular training courses in medical hypnosis.

Christian Wetschka, PhD.is socialpedagogue, working in diverse socialtherapeutic and pastoral fields, supervisor, founder of Verein Struktur, which provides commune-flats for alcohol dependent persons

Michie N Hesselbrock, PhD is Professor Emeritus at the School of Social Work, and Professor of Psychiatry at the School of Medicine, University of Connecticut. She held the Zach's Chair, and was the founderand director of the PhD program at the School of Social Work before her retirement. She has served on several NIH study sections and VA Merit review committees as a regular member and as an ad hoc reviewer. Her research interests include epidemiology, behavior genetics, and health disparities of alcoholism and treatment

Victor Hesselbrock, PhD is currently Professor and Interim Chairman, Department of Psychiatry, University of Connecticut School of Medicine. He holds the Physicians Health Services endowed chair in Addiction Studies. Dr. Hesselbrock is the Principal Investigator and Scientific Director of the University of Connecticut's NIH/NIAAA funded Alcohol Research Center and is co-PI of the NIH funded national Collaborative Study on the Genetics of Alcoholism (COGA). He is a past President of the Research Society on Alcoholism (RSA). Dr. Hesselbrock is Associate Editor of Alcoholism: Clinical and Experimental Research, a Review Editor for Addiction, and a member of the editorial board of the Journal of Studies on Alcohol and Drugs. His research interests include: the genetic epidemiology of alcoholism; co-morbid psychiatric conditions and substance dependence; and psychosocial, cognitive, and genetic risk factors for developing alcohol dependence and alcohol-related problems.

Contenu
Table of contents 1 Information on the origination of the book1.1 Aims of this book1.2 Personal reasons for the first author writing this book 2 Addiction- a short overview over a widespread disease2.1 Introduction2.2 Prevention2.3 Diagnosis of addiction2.4 Aetiology of addiction2.5 Secondary disorders and addiction2.6 Secondary diseases and brain functions2.7 Subgroups of addicts2.8 Motivation of addicts2.9 The path from motivation to therapy2.10 Addiction and relapse2.11 Specific groups of addicts2.12 Addiction and the homeless2.13 Polytoxicomania2.14 Non-substance dependence 3 Aetiology of Addiction3.1 The psycho-socio-biological model3.2 Psychological theories3.3 Socialexplanation approaches3.4 Biological theories about the aetiology of tobacco and alcohol addiction3.5 Aetiological aspects of tobacco and alcohol addiction from an epidemiological perspective3.6 Aetiology of addiction from a psychiatric perspective 4 Prevention strategies 4.1 Attitude towards addictive drugs4.2 Primary prevention of tobacco and alcohol addiction4.3 Secondary prevention: early diagnosis and early intervention4.4 Tertiary prevention 5 Diagnosis of abuse and addiction 5.1 Problems concerning psychiatric diagnoses5.2 Development of the term addiction5.3 Substance related diagnoses in the ICD-105.4 Substance related diagnosis in DSM-IV (American Psychiatric Association. 1994)5.5 Commonalities and differences of ICD-10 and DSM-IV5.6 Implication of these classification systems for therapy and research 6 Types, dimensions and aetiology6.1 Alcohol addiction6.2 Tobacco addiction 6.3 Alcohol addiction: Lesch's typology6.4 The relationship between alcohol dependent patients according to Lesch`s typology and the severity of tobacco addiction 7 Motives for alcohol and/or tobacco addicted patients to seek medical help 7.1 Tobacco addiction7.2 Alcohol addiction7.3 Sequelae that bring patients into therapy 8 Detection of alcohol and tobacco addiction 8.1 Recommendations for the first contact8.2 Assessment of drinking behaviour using biological markers 8.3 The clinical dialogue in tobacco addiction 9 Therapeutic strategies for alcohol and tobacco dependence9.1 Motivation for therapy in different settings 9.2 Pharmacotherapy of alcohol and tobacco dependence9.3 Pharmacotherapy of alcohol withdrawal 9.4 Alternatives to withdrawal9.5 Pharmacotherapy of the tobacco withdrawal syndrome9.6 Medical strategies for relapse prophylaxis 10 Sociotherapy of alcohol and tobacco dependents with regards to Lesch's typology10.1 Alcohol and tobacco10.2 The sociotherapeuticmission10.3 Classification Psychotherapy-Sociotherapy 10.4 Sociogenesis and sociotherapeutic chances10.5 Sociotherapy in the context of therapeutic phases10.6 State of the art: overlapping perspectives for sociotherapeutic housing and support 10.7 Motivation- a challenge for whom?10.8 Sociotherapy as a means of promoting networking10.9 Sociotherapy with alcohol dependents in the context of Lesch's typologyAppendix 1 Lesch Alcoholism Typology QuestionnaireAppendix 2 Lesch European Smoker ClassificationIndexAbout the Authors