Substance abuse and dependence

Important outcome indicators to evaluate postintoxication and/or postwithdrawal treatment of substance abuse and dependence can be divided into three major groups decreased consumption of substances, decreased problems associated with substance use, and increased psychosocial functioning. Although it is less commonly employed, a quality-of-life scale can help determine how substance abuse/dependence treatment has affected your patients lives. If you are involved in the cost-justification of services, a cost-benefit analysis could also become important, although this is more often used at the administrative level,... 

This chapter is organized somewhat differently than previous chapters. Because there are so many aspects of the clinical course and treatment that are conunon to all substances of abuse, we will first review the features of substance abuse and dependence that are common to all substances. This will include a general description of risk factors, clinical course, evaluation, and treatment recommendations. What follows is a review of treatment recommendations specific to each substance of abuse. 

The good news is that treatment can have a profound impact on the clinical course of substance dependence. Most patients who have been treated are eventually able to stop their pattern of compulsive misuse. Some abstain altogether while others are able to manage long periods of sobriety with only brief episodes of substance use. Those who are able to maintain periods of sustained abstinence from substance abuse and dependence also find improvement in job performance and social functioning. Those who do the best had little comorbid psychiatric illness, were able to... 

NEUROBIOLOGY OF SUBSTANCE ABUSE AND DEPENDENCE ANIMAL MODELS... 

Henggeler, S., Pickrel, S., and Brondino, M. (1999) Multisystemtic treatment of substance-abusing and dependent delinquents outcomes, treatment, fidelity and transportability. Mental Health Services Research 1 171-184. 

Personality disorders can complicate management (e.g., borderline disorder with a superimposed MDD). Dual depression occurs in patients who have chronic dysthymic disorder and then experience a superimposed MDD. Substance abuse and dependence are frequently co-morbid with mood disorders and substantially increase depression-related morbidity and mortality rates (see Drug-Induced Syndromes ). 

Clients with bipolar disorders can present with other existing problems that may exacerbate manic, hypomanic, or depressive symptoms. Some of these include anxiety disorders, substance abuse and dependence, and... 

Imlah, N., Addiction-Substance Abuse and Dependency, Sigman Press, Wilmslow, 1989. O Brien, C. P., Drug Addiction and Drug Abuse. In Goodman and Gilman s The Pharmacological Basis of Therapeutics, 9th ed. 

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