Community Treatment of Drug Misuse: More Than Methadone

Nicholas Seivewright,Ebooks Corporation.9780511533884, 0511533888

Table of contents :
Cover……Page 1
Half-title……Page 4
Title……Page 6
Copyright……Page 7
Contents……Page 8
Preface and acknowledgements……Page 10
Introduction: community treatment in context……Page 14
Drug misuse as a social problem……Page 15
Risk factors for drug misuse……Page 16
The role of treatment……Page 17
Inpatient treatment……Page 19
General observations……Page 20
Introduction……Page 23
Formal methadone maintenance programmes……Page 25
Other long-term methadone prescribing……Page 26
Specific treatment or heroin substitute?……Page 27
A classic example of different approaches……Page 29
Case history……Page 30
Individual treatment or public health policy?……Page 31
Effectiveness of methadone……Page 32
Associated counselling……Page 36
Treatment contracts……Page 37
Methods……Page 38
Safety issues……Page 39
Additional medication……Page 41
Adverse effects……Page 42
Case history……Page 44
Injectable ampoules……Page 45
Case history……Page 47
Introduction……Page 48
Diamorphine……Page 49
Case history……Page 52
Morphine……Page 53
Case history……Page 54
Issues in prescribing euphoriant opioids……Page 55
Rationale……Page 56
Use……Page 57
Some study evidence……Page 58
Particular practicalities……Page 59
Dihydrocodeine……Page 60
Amphetamines……Page 61
Case history……Page 64
Benzodiazepines……Page 65
Detoxification from benzodiazepine misuse……Page 66
Case history……Page 67
Prescribing benzodiazepines to opioid substitution patients……Page 68
Alternatives to benzodiazepines……Page 71
Assessment, preparation and level of support required……Page 73
Method 2 – Lofexidine plus symptomatic medication……Page 75
Method 3 – Dihydrocodeine plus symptomatic medication……Page 76
Clonidine……Page 77
Suitability as a detoxification medication……Page 78
Evidence from studies……Page 80
Starting dose……Page 81
Rate of reduction……Page 82
Partial detoxifications……Page 83
Buprenorphine……Page 84
Inpatient treatment……Page 86
Naltrexone……Page 87
Case history……Page 90
General methods……Page 91
Other observations……Page 93
Introduction……Page 94
Cocaine……Page 95
Pharmacological treatments……Page 96
Nonpharmacological treatments……Page 97
Practical management……Page 98
Case history……Page 99
Cocaine misuse by opioid substitution patients……Page 100
Amphetamine……Page 103
Methylenedioxymethamphetamine (MDMA, ‘ecstasy’)……Page 105
Methamphetamine (‘crystal meth’, ‘ice’)……Page 107
Benzodiazepines……Page 108
Hallucinogens……Page 110
Volatile substances……Page 111
Cannabis……Page 112
Alcohol……Page 114
Case history……Page 116
Brief therapies……Page 117
Other medications……Page 118
Historical development……Page 119
Changes in emphasis……Page 120
Some further developments……Page 123
Organization within teams……Page 124
Drug counselling……Page 125
Levels of interest……Page 127
Effectiveness……Page 129
Some characteristics of primary care treatment……Page 130
Introduction……Page 133
Mental disorders in drug misusers……Page 134
Personality disorder……Page 135
Drug-induced psychosis……Page 139
Drug misuse in the severely mentally ill……Page 141
Principles of treatment……Page 143
Ultra-specialist treatment units……Page 144
Other treatment models……Page 145
The general hospital……Page 147
Treatment in pregnancy……Page 148
Young drug users……Page 149
Pain management……Page 151
HIV and hepatitis……Page 152
Treatment in prisons……Page 154
Lomotil (2.5mg tablets) (reduces diarrhoea)……Page 156
Dihydrocodeine (30 mg tablets)……Page 157
Glossary……Page 159
References……Page 162
Index……Page 188