Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Cognitive-behavioural principles are integrated with genetic and psychiatric factors to explain addiction's causes and consequences.

No other text available today offers what The American Psychiatric Publishing Textbook of Substance Abuse Treatment can: completely updated treatment information on a broad range of substance use disorders that is consistent with the new DSM-5 classification and thus reflective of how psychiatry is practiced today. Designed for researchers and mental health professionals ranging from trainee to licensed practitioner, the book is also appropriate for a diverse array of rehabilitation settings, from inpatient to community-based treatment. Full coverage is provided on 12-step programs, as well, including the latest outcomes research. Much of the material is new to this edition: A chapter has been added on science in the treatment of substance abuse, in which the authors discuss the history of scientific intervention in substance abuse and explore what happens to the brain when addicting drugs are consumed, review animal models and imaging techniques, and discuss current progress in the science of addiction. Chapters have been added on screening and brief intervention, reflecting the development of brief screening tools and research on the efficacy of interventions, and the role of "recovery" in chronic care disease management -- specifically what the treatment models for alcohol dependence and for diabetes can effectively borrow from each other. A new chapter focuses on the treatment of alcohol intoxication and withdrawal -- the first steps in treatment of alcohol use disorder. Two chapters on marijuana -- one on the neurobiology and one addressing treatment have been added. Given the accelerating trend toward decriminalization and legalization of this substance, clinicians will find this information of increasing importance. The section on substance use issues among gay men and lesbians has been expanded to include bisexual and transgender people in recognition of increased diversity among the population. Well-structured, with topics that follow logically and many practical, treatment-oriented features, such as quick reference tables and lists of recommended readings, The American Psychiatric Publishing Textbook of Substance Abuse Treatment is a classic that will enhance the education and practice of clinicians.

Leading researchers and people with lived experience explain the stigma of substance use disorders, and develop solutions for overcoming it.

This practical and timely book provides comprehensive, state-of-the-art guidance on how primary care clinicians can best care for patients with substance use disorders. The book covers the major drugs of abuse, as well as the more recent ones, detailing the biology of various addictions and all dimensions of clinical diagnosis and management. It is organized in four parts: (1) The Basics, (2) Psychoactive Substance Dependencies, (3) Diagnosis, Treatment, Recovery, Relapse, and the Family, and (4) Special Groups. Part I, The Basics, consists of an overview, the various definitions of substance dependence, and the pharmacology of addictive substances. Chapter 1, Overview, is an introductory chapter that covers material common to the entire field of substance dependence. Chapter 2 covers the various definitions of substance dependence, and Chapter 3 reviews the pharmacology of addictive substances. Part II, Psychoactive Substance Dependencies, explains the various drug dependencies—alcohol dependence, sedative-hypnotic dependence, opioid dependence, stimulant dependence, nicotine dependence, cannabis dependence, dissociative dependence, inhalant dependence, hallucinogen dependence, and anabolic steroid dependence. Part III addresses diagnosis, treatment, recovery, relapse, and the family. Part IV, Special Groups, discusses substance dependence in women, adolescents, the elderly, ethnic minority groups, co-occurring disorders, LGBT patients, HIV positive patients, and the impaired physician. In addition to primary care physicians, Substance Use Disorders: A Guide for the Primary Care Provider will serve as an invaluable resource to primary care nurse practitioners and physician assistants, as well as medical students, primary care residents, emergency medicine physicians, ASAM and APA certified addictionists and those studying for certification in those specialties, psychiatrists, psychologists, and alcohol/drug counselors.

Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

The Sixth Edition has been completely revised and restructured and represents the cutting edge of research, practice, and policy in substance use disorder (SUD) treatment. A one-stop reference for evidence-based information on neurobiology, assessment, treatment, and research trends in SUDs, the book is an indispensable resource for trainees and