Treating alcohol and drug abuse : an evidence-based review / edited by Mats Berglund, Sten Thelander, Egon Jonsson.

Format:

Book

Contributor:

Berglund, Mats.

Thelander, Sten.

Jonsson, Egon.

Language:

English

Swedish

Subjects (All):

Alcoholism--Treatment.

Alcoholism.

Substance abuse--Treatment.

Substance abuse.

Alcoholism--therapy.

Substance-Related Disorders--therapy.

Medical Subjects:

Alcoholism--therapy.

Substance-Related Disorders--therapy.

Genre:

Dictionaries.

Physical Description:

xix, 631 p ; 25 cm + 1 CD-ROM (4 3/4 in.)

Place of Publication:

Weinheim : Wiley-VCH, 2003.

Summary:

With a foreword by Henry R. Kranzler, University of Connecticut, USA.

Contents:

1 Intervention against Hazardous Alcohol Consumption-Secondary Prevention of Alcohol Problems 1

1.3.1 Selection of Studies, Inclusion and Exclusion Criteria 2

1.3.2 Search Strategy 2

1.3.3 Outcome Measures 3

1.3.4 Rating Scientific Quality 3

1.3.5 Analyzing the Results 3

1.4 Results 4

1.4.1 Literature Search 4

1.4.2 Previous Reviews and Meta-Analysis 4

1.4.3 Randomized and Controlled Studies 5

1.4.4 Studies with Positive Outcome (Measures) Presented in Order of Quality 16

1.4.5 Studies without Significant Effects, Presented in Order of Quality 23

1.5 Analysis of the Overall Results of the Reviewed Studies 26

1.5.1 Studies with a Positive Outcome 26

1.5.2 Studies which Showed No Effects 36

1.6 Important Aspects of Brief Intervention 36

1.6.1 Analysis of Special Groups 36

1.7 Problems with Dropout in Studies 37

1.8 Problems with Implementation 37

2 Psychosocial Treatment for Alcohol Dependence 43

2.1.1 Earlier Reviews 43

2.1.2 Assessing the Effects of Different Methods 43

2.1.3 Methodological Deficiencies and Problems 45

2.1.4 Treatment Methods 45

2.1.5 Treatment Effects 47

2.1.6 Questions Addressed 48

2.1.7 Intensity and Aftercare 49

2.1.8 Subgroups of Alcohol Dependence 49

2.2 Method and Material 50

2.2.1 Search Strategies 50

2.2.2 Result Protocol 50

2.2.3 Meta-analysis 51

2.3 Results 51

2.3.1 Does psychosocial treatment have any effect? Comparisons with no treatment 51

2.3.2 Are some methods superior to others? 54

2.4 Motivational Methodology 54

2.5 Methods Specifically Aimed at Changing the Drinking Problem Itself 56

2.5.1 Cognitive Behavioral Therapy (CBT) 56

2.5.2 Broad Spectrum Treatment with CBT Focus 57

2.5.3 CRA Treatment

Community Reinforcement Approach 59

2.5.4 Self-control Training 61

2.5.5 Cue Exposure 62

2.5.7 Twelve-Step Treatment 63

2.6 Methods Aimed at the Factors Behind Alcohol Dependence 65

2.6.1 Dynamically Oriented Treatments 65

2.7 Standard Treatment 67

2.8 Marital Therapies and Interventions Focused on Family Members 69

2.9 Studies Showing Matching Results 70

2.10 Comparing the Intensity of Treatment and Aftercare 73

2.11 Subgroups of Alcohol-Dependent Patients 75

2.12 Therapist Factors 78

2.13 Gender-related Effects 79

2.14 Renewed Literature Search 82

3 Pharmacotherapy for Alcohol Withdrawal Syndrome 189

3.2 Methods 190

3.2.1 Selection Criteria 190

3.2.2 Diagnostic Criteria and Outcome Measures 190

3.2.3 Search Strategy 190

3.3 Included Studies 191

3.3.1 Treatment of Alcohol Withdrawal 191

3.3.1.1 Benzodiazepines 191

3.3.1.2 Chlormethiazole and Anti-Epileptics 204

3.3.1.3 Imidazoline Agonists 214

3.3.1.4 Beta-Receptor Antagonists 220

3.3.1.5 Nitrous Oxide 221

3.3.1.6 Thiamine 221

3.3.1.7 Psychological Treatment 228

3.3.1.8 Other Treatment 228

3.3.1.9 Meta-analyses and Reviews 229

3.3.2 Treatment of Delirium Tremens 229

3.3.2.1 Barbiturates 229

3.3.2.2 Benzodiazepines 234

3.3.2.3 Chlormethiazole 234

3.3.2.4 Imidazoline Agonists 234

3.3.2.5 Other Treatment 235

3.3.2.6 Meta-analyses 235

4 Pharmacotherapy for Alcohol Dependence 247

4.2 Methods 248

4.2.1 Search Strategies 248

4.2.2 Complementary Search 248

4.2.3 Unpublished Studies 249

4.3 Analytical Principles 249

4.3.1 Categorization 249

4.3.2 Target Group and Treatment Goals 249

4.4 Overview of Tables 250

4.5 Overview of Included Studies 252

4.6 Results 252

4.6.1 Aversive Agents 252

4.6.2 Antipsychotic Drugs 260

4.6.3 Dopamine Agonists 260

4.6.4 SSRI Agents 261

4.6.5 Other Agents with Effect on the 5-HT System 268

4.6.6 Acamprosate 268

4.6.7 Naltrexone and Nalmefene 269

4.6.8 Other Agents 289

4.6.9 Lithium 289

4.7 Comorbidity 294

4.7.1 Anti-Depressive Treatment and Psychiatric Comorbidity (Depression) 294

4.8.1 Acamprosate and Naltrexone 295

4.8.2 Aversive Agents 295

4.8.3 Other Agents 302

4.8.4 Treatment of Comorbid Conditions 302

5 The Long-Term Course in Alcohol and Drug Dependence 313

5.2 Methods 314

5.2.1 Search Strategies 314

5.2.2 Inclusion Criteria 314

5.2.3 Search Results 314

5.3 Epidemiological Studies 315

5.4 Longitudinal Clinical Trials 317

5.4.1 Long-Term Course in Alcohol Dependence 317

5.5 Long-Term Course in Heroin Dependence 319

5.6 Alcohol and Drug Abuse as a Chronic Condition 321

6 Psychosocial Treatment for Drug Dependence 325

6.2 Psychosocial Methods - a Review 326

6.2.1 Supportive Treatment Methods 326

6.2.1.1 Institutional Treatment 327

6.2.1.2 Structure-Enhancing Interventions 328

6.2.1.3 Other Supportive Intervention and Treatment Methods 328

6.2.2 Re-educative Methods 329

6.2.3 More Extensive Psychotherapy 331

6.2.4 Reconstructive Therapy 333

6.3 Research Considerations 335

6.3.1 Observational Studies 335

6.3.3 Theoretical Approach 335

6.4 Methods 336

6.4.1 Search Strategies 336

6.4.2 Representativity 336

6.4.3 Publication Bias 337

6.4.4 Quality Rating 338

6.4.5 Classifying and Synthesizing the Material 338

6.4.6 Data Analysis 339

6.5 Results 340

6.5.1 Meta-analysis of Treatment for Opiate Dependence 340

6.5.1.1 Reduction of Heroin Abuse 341

6.5.1.2 Retention in Opiate Studies 344

6.5.2 Meta-analysis of Interventions in Cocaine Dependence 344

6.5.2.1 Reduction of Cocaine Abuse 345

6.5.2.2 Retention in Cocaine Studies 350

6.5.3 Limitations in Interpreting the Results of Meta-analyses 351

6.5.3.1 Combination Therapy with Antidepressants and Cognitive Therapy in Cocaine Dependence 351

6.5.3.2 Meta-analysis of Interventions in Cannabis Dependence 354

6.5.4 Randomized Studies of Institutional Treatment 355

6.5.4.1 Meta-analysis of Institutional Treatment with Opiate Abuse as Outcome Measure 355

6.5.4.2 Meta-analysis of Institutional Treatment with Reduced Opiate and Cocaine Abuse as Outcome Measure 355

6.5.4.3 Retention in Institutional Treatment 358

6.5.5 Structure-enhancing Interventions 359

6.5.5.1 Treating Mentally Ill and Homeless Abusers 362

6.5.6 Before-and-After Changes in Treatment 363

6.5.6.1 Studies of Opiate Abuse 363

6.5.6.2 Studies of Cocaine Abuse 363

6.5.6.3 Studies of Institutional Treatment 368

6.5.7 Effects on Factors other than Abuse 369

6.5.7.1 Treatment Focus 369

6.5.7.2 Limitations of Randomized Treatment Studies 369

7 Pharmacotherapy for Opioid Withdrawal 415

7.2 Principles of Withdrawal Treatment 416

7.3 Non-Rapid 417

7.3.1 Adrenergic Agonists Clonidine (unless otherwise stated) versus 417

7.3.1.1 Placebo 417

7.3.1.2 Methadone 417

7.3.1.3 Bubrenorphine 418

7.3.1.4 Doxepin 418

7.3.1.5 Other Adrenergic Agonists 418

7.3.2 Opioid Agonists Methadone versus 420

7.3.2.1 Placebo 420

7.3.2.2 Bubrenoprhine 420

7.3.2.3 Propoxyphene 420

7.3.2.4 Chlordiazepoxide 420

7.4 Rapid 438

7.4.1 Adrenergic Agonist + Opioid Antagonists Clonidine versus Clonidine + naltrexone/naloxone versus 438

7.4.1.1 Placebo 438

7.4.1.2 Buprenorphine 438

7.4.1.3 Methadone 438

7.4.2 Partial opioid agonist + opioid antagonist + adrenergic agonist 439

7.4.2.1 Summary (Rapid) 439

7.5 Ultra-Rapid (Adrenergic agonist) + opioid antagonist under anesthesia, or under different levels of sedation 448

7.5.1 Naloxone versus Placebo 449

7.5.2 (Clonidine) + Naloxone/Naltrexone under Light Sedation versus Deep Sedation 448

7.8.1 Non-Rapid 455

7.8.1.1 Adrenergic Agonists 455

7.8.1.2 Opioid agonists 458

7.8.1.3 Dopamine agonists 458

7.8.2 Rapid Adrenergic agonist + opioid antagonists 458

7.8.3 Ultra-Rapid (Adrenergic agonists) + opioid antagonists under anesthesia 460

8 Pharmacotherapy for Opioid Dependence 465

8.2 Agonists 467

8.2.1 Agonists (Including Partial) Versus

Control 467

8.2.2 Agonists versus Other Agonists 469

8.2.3 Agonists versus Antagonists 472

8.2.4 Agonists versus the Same Agonists 472

8.2.4.1 Distribution Studies 472

8.2.4.2 Dose Level Studies 473

8.3 Antagonists 498

8.3.1 Antagonists versus Control 498

8.3.2 Antagonists versus the Same Antagonists 499

8.3.2.1 Distribution Studies 499

8.4 Adjunctive Treatment with Antidepressants for Depressive Disorders 506

8.4.1 Antidepressants versus Control 506

8.5 Meta-Analysis 506

8.7.1 Agonists, Including Partial 512

8.7.2 Antagonists 513

8.7.3 Antidepressants 513

8.7.4 Other Illegal Drugs 513

8.8.1 Agonists 519

8.8.1.1 Agonists (Including Partial) versus Control 519

8.8.1.2 Agonists versus Other Agonists 519

8.8.1.3 Agonists versus the Same Agonists 519

8.8.2 Antagonists 526

8.8.2.1 Antagonists versus Control 526

8.8.2.2 Antagonists versus the Same Antagonists 528

8.8.2.3 Meta-Analysis 528

9 Pharmacotherapy for Cocaine Dependence 533

9.1 Background and Pharmacological Principles 533

9.2 Long-term Pharmacotherapy in Cocaine Dependence 535

9.2.1 Antidepressants 535

9.2.1.1 Tricyclic antidepressants 535

9.2.1.2 SSRI 536

9.2.1.3 Other antidepressants 536

9.2.1.4 Meta-analysis 537

9.2.2 Dopamine Agonists 538

9.2.3 Other Dopamine Agonists 538

9.2.4 Antiepileptics 539

9.3 Withdrawal Treatment in Cocaine Dependence 541

9.3.1 Dopamine Agonist 541

9.3.2 Partial Serotonin Agonist 541

9.4 Interaction Studies 554

9.4.1 Antidepressants 554

9.4.2 Dopamine Agonists 554

9.4.3 Antiepileptics 554

9.4.4 Partial Opioid Agonist 554

9.5 Review Articles 554

9.6 Long-term Pharmacotherapy in Methamphetamine Dependence 554

9.6.1 Antidepressants 555

9.6.1.1 Tricyclic Antidepressants 555

9.7.1 Long-term Pharmacological Treatment in Cocaine Dependence 555

9.7.2 Withdrawal Treatment in Cocaine Dependence 558

9.7.3 Interactions 558

9.7.4 Long-term Pharmacological Treatment in Methamphetamine Dependence 558

9.8.1 Long-term Pharmacotherapy in Cocaine Dependence 563

9.8.1.1 Antidepressants 563

9.8.1.2 Dopamine Agonists 563

9.8.1.3 Antiepileptics 563

9.8.1.4 Disulfiram 563

9.8.1.5 Neuroleptics 570

9.8.1.6 Serotonin Antagonists 570

9.8.1.7 Opioid Antagonist 570

9.8.1.8 Stimulants 570

9.8.1.9 [beta]-Blockers 570

10 Pregnancy, Neonatal Period, and Substance Abuse 573

10.2 Search Strategy and Methods 574

10.3 Incidence and Prevalence of Alcohol and Drug Use in Pregnant Women 574

10.4 Treatment Research

Alcohol and Pregnancy 575

10.5 Narcotics and Pregnancy 576

10.5.1 Cannabis and Pregnancy 577

10.5.2 Amphetamine, Other Central Stimulants, and Pregnancy 577

10.5.3 Cocaine and Pregnancy 577

10.5.4 Opiates and Pregnancy 578

10.5.5 Benzodiazepines and Pregnancy 578

10.5.6 Other Narcotics and Pregnancy 578

10.6 Studies of the Treatment of Drug Abuse in Pregnancy 578

10.7 Staff Training 579

Appendix 3. Guidelines for Estimating Effect Size 586.

Notes:

Includes bibliographical references, glossary and index.

ISBN:

352730682X

OCLC:

51437897