Drug and Alcohol Abuse A Clinical Guide to Diagnosis and Treatment
Mark Schuckit’s Drug and Alcohol Abuse has been a clinical mainstay for over a quarter century. Now the author’s trusted expertise is available in a new Sixth Edition, thoroughly revised for content, updated references, and streamlined for increased usefu
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Sixth Edition
Drug and Alcohol Abuse A Clinical Guide to Diagnosis and Treatment
Sixth Edition
Marc A. Schuckit University of California Medical School and Veterans Administration Hospital San Diego, CA, USA
Library of Congress Control Number: 2005924429 ISBN-10:0-387-25732-2 ISBN-13:978-0387-25732-7
0-387-25733-0 (eBook)
Printed on acid-free paper. © 2006 Springer Science+Business Media, Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed in the United States of America. 987654321 springeronline.com
(SPI/SBA)
Preface This book uses a clinically oriented approach for working with patients and clients with substance-use disorders. The material represents a blending together of my three major professional roles as a clinician, teacher, and researcher. The overall goal is to help the busy clinicians feel comfortable with their level of understanding of alcohol and other drug-related disorders, and to offer the best clinical care possible. The first edition of this text, published in 1979, grew out of my need to place the 200 or so drugs of abuse into a clinically useful perspective. There was no way I could remember each and every drug, and I faced a challenge when a new drug (or perhaps an old substance with a new name) was introduced. I learned that I can place these substances into a limited number of categories based on the usual clinical effects, thereby creating groups similar in the quality of intoxication, associated physiological changes, and patterns of problems likely to be observed in the context of intoxication and withdrawal. This clinically oriented and pragmatic approach remains the core of this book, continuing to be as useful to me today as when the first volume was published. Of course, over the years, many details have changed. First, the diagnostic criteria have evolved from DSM-II to DSM-III in 1980, DSM-III-R in 1987, and DSM-IV in 1994. I was fortunate to hold the Chair of the DSMIV Substance Use Disorders Workgroup, and to participate in one of the committees leading to DSM-V. Therefore, each edition of the text has had the opportunity to offer some perspectives on the most recent diagnostic systems. Over the years, the patterns of substance use in populations have gone up, come down, and sometimes gone up again, while our understanding of pharmacology, physiology, and genetic influences has continued to e
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