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Table Of Contents
Contributors
Editors of The ASAM Principles of Addiction Medicine
Preface
A Note about Terminology
Acknowledgments
Introduction: A Public Health Approach to Prevention: The Health Professional's Role
Linda Richter, PhD, Kevin Kunz, MD, MPH, and Susan E. Foster, MSW

SECTION 1 BASIC SCIENCE AND CORE CONCEPTS
1 Drug Addiction: The Neurobiology of Behavior Gone Awry
Nora D. Volkow, MD and Ruben Baler
2 The Epidemiology of Substance Use Disorders
Faye Chao, MD
3 The Anatomy of Addiction
Thomas J.R. Beveridge, PhD
4 From Neurobiology to Treatment: Progress Against Addiction
Eric J. Nestler, MD, PhD
5 Understanding Behavioral Addictions : Insights from Research
Yvonne H.C. Yau, MSc, Sarah W. Yip, MSc, PhD, and Marc N. Potenza, MD, PhD

SECTION 2 PHARMACOLOGY
6 Pharmacokinetic and Pharmacodynamic Principles
Anne Zajicek, MD, PharmD, FAAP and Lori D. Karan, MD, FACP, FASAM
7 The Pharmacology of Alcohol
John J. Woodward, BS, MS, PhD
8 The Pharmacology of Nonalcohol Sedative Hypnotics
Reshmi Pal, MD, MPH and Gantt P. Galloway, PharmD
SIDEBAR: GHB
Reshmi Pal, MD, MPH, John Mendelson, MD, and Gantt P. Galloway, PharmD
9 The Pharmacology of Opioids
Eduardo R. Butelman, PhD, Elizabeth Ducat, ANP, Brenda M. Ray, MS, MPH, FNP-BC, and Mary Jeanne Kreek, MD
10 The Pharmacology of Cocaine, Amphetamines, and Other Stimulants
David A. Gorelick, MD, PhD and Michael H. Baumann, PhD
SIDEBAR: Psychoactive Bath Salts : A New Class of Designer Stimulants
Michael H. Baumann, PhD and Kurt R. Lehner, BS
11 The Pharmacology of Caffeine
Laura M. Juliano, PhD, Sergi Ferré, MD, PhD, and Roland R. Griffiths, PhD
12 The Pharmacology of Nicotine and Tobacco
Coreen B. Domingo, DrPH and Thomas R. Kosten, MD, PhD
13 The Pharmacology of Marijuana
Sandra P. Welch, PhD and Robert Malcolm, MD
14 The Pharmacology of Hallucinogens
Torsten Passie, MD, MA and John H. Halpern, MD
15 The Pharmacology of Dissociatives
Edward F. Domino, MS, MD and Shannon C. Miller, MD, FASAM, DFAPA
16 The Pharmacology of Inhalants
Robert L. Balster, PhD
SIDEBAR: Inhalant Abuse in the Military
Robert L. Balster, PhD
17 The Pharmacology of Anabolic Androgenic Steroids
David Lehman, MD, MS
SIDEBAR: Accessing Information on Newly Emerging Drugs of Abuse
David Lehman, MD, MS

SECTION 3 DIAGNOSIS, ASSESSMENT, AND EARLY INTERVENTION
18 Screening and Brief Intervention
Iliya P. Amaza, MD, MPH, Aleksandra Zgierska, MD, PhD and Michael F. Fleming, MD, MPH
SIDEBAR: Screening and Brief Intervention for Pregnant Women
Nicolas Bertholet, MD, MSc
SIDEBAR: Trauma Centers, Hospitals, and Emergency Departments
Richard D. Blondell, MD
SIDEBAR: Implementation of Screening and Brief Intervention in Clinical Settings Using Quality Improvement Principles
Katharine A. Bradley, MD, MPH and Emily C. Williams, PhD, MPH
SIDEBAR: Screening for Unhealthy Alcohol Use in the Elderly
James W. Campbell, MD, MS
19 Laboratory Diagnosis
Elizabeth A. Warner, MD
20 Assessment
Launette Rieb, MD, MSc, CCFP, FCFP
21 Environmental Approaches to Prevention: A Community-Based Perspective
Paul J. Gruenewald, PhD, Andrew J. Treno, PhD, Joel W. Grube, AB, MS, PhD, Robert F. Saltz, PhD, and Mallie J. Paschall, PhD

SECTION 4 OVERVIEW OF ADDICTION TREATMENT
22 Addiction Medicine in America: Its Birth and Early History (1750 1935) with a Modern Postscript
William L. White, MA and James F. Callahan, DPA
23 Treatment of Heavy Drinking and Alcohol Use Disorder
Mark L. Willenbring, MD
24 The Treatment of Drug Addiction: An Overview
Andrea G. Barthwell, MD, FASAM and Lawrence S. Brown Jr., MD, MPH, FASAM
25 Moving Toward Integrated Care for Substance Use Disorders: Lessons from History and the Rest of Health Care
A. Thomas McLellan, PhD
26 Effects of Treatment Setting, Duration, and Amount on Patient Outcomes
John W. Finney, PhD, Rudolf H. Moos, PhD, and Paula L. Wilbourne, PhD
27 The ASAM Criteria and Matching Patients to Treatment
David Mee-Lee, MD and Gerald D. Shulman, MA, MAC, FACATA
28 Linking Addiction Treatment with Other Medical and Psychiatric Treatment Systems
Andrew O'Hagan, MD
29 Alternative Therapies for Alcohol and Drug Addiction
David Y-W Lee, PhD
30 The Harm Reduction Approach to Prevention and Treatment
Nayla Hariz, MD and Atika Zubera, MD
SIDEBAR: A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs
Joe Ruggiero, PhD
31 Quality Improvement for Addiction Treatment
James H. Ford II, PhD, Kim A. Hoffman, PhD, and Kimberly Johnson, MBA
32 Nursing Roles in Addressing Addiction
Marianne T. Marcus, EdD, RN, FAAN, Christine Savage, PhD, RN, CARN, FAAN, and Deborah S. Finnell, DNS, PHMHNP-BC, CARN-AP, FAAN
33 International Perspectives on Addiction Management
Nady el-Guebaly, MD, DPsych, DPH, FRCPC, DABAM, Vladimir Poznyak, MD, PhD, and Juana M. Tomás-Rosselló, MD, MPH

SECTION 5 SPECIAL ISSUES IN ADDICTION
34 Nonmedical Use, Misuse, and Abuse of Prescription Medications
Martha J. Wunsch, MD, FAAP, FASAM
35 Special Issues in Treatment: Women
Joan E. Zweben, PhD
SIDEBAR: Military Sexual Trauma
Joan E. Zweben, PhD
36 Treatment of Older Adults
Frederic C. Blow, PhD and Kristen L. Barry, PhD
37 Cultural Issues in Addiction Medicine
Joseph J. Westermeyer, MD, MPH, PhD
38 College Student Drinking
Melodie Isgro, MD
39 Pathologic Gambling: Clinical Characteristics and Treatment
Jon E. Grant, MD, JD, MPH, Brian L. Odlaug, MPH
40 Sexual Addiction
Steven J. Shoptaw, PhD and Matthew Brensilver, PhD
41 Physician Health Programs and Addiction among Physicians
Jeffrey Selzer, MD, FASAM

SECTION 6 MANAGEMENT OF INTOXICATION AND WITHDRAWAL
42 Management of Intoxication and Withdrawal: General Principles
Tara M. Wright, MD, Jeffrey S. Cluver, MD, and Hugh Myrick, MD
43 Management of Alcohol Intoxication and Withdrawal
Alan A. Wartenberg, MD, FACP, FASAM
44 Management of Sedative Hypnotic Intoxication and Withdrawal
Joseph Samuel Insler, MD
45 Management of Opioid Intoxication and Withdrawal
Aykut Ozden, MD
46 Management of Stimulant, Hallucinogen, Marijuana, Phencyclidine, and Club Drug Intoxication and Withdrawal
Based on Principles of Addiction Medicine Chapter by Jeffery N. Wilkins, MD, FASAM, DFAPA, Itai Danovitch, MD, MBA, and David A. Gorelick, MD, PhD

SECTION 7 PHARMACOLOGIC INTERVENTIONS
47 Medications for Use in Alcohol Rehabilitation
Daniel Eckroth, MD
48 Pharmacologic Intervention for Sedative Hypnotic Addiction
Jeffrey S. Cluver, MD, Tara M. Wright, MD, and Hugh Myrick, MD
49 Pharmacologic Interventions for Opioid Dependence
Xiaofan Li, MD, PhD, Daryl Shorter, MD, Susan M. Stine, MD, PhD, and Thomas R. Kosten, MD, PhD
50 Opioid Maintenance Treatment
Claudie H. Jimenez, MD, MS
51 Special Issues in Office-Based Opioid Treatment
Andrew J. Saxon, MD
52 Pharmacologic Interventions for Cocaine, Methamphetamine, and Other Stimulant Addiction
David A. Gorelick, MD, PhD
53 Pharmacologic Interventions for Tobacco Dependence
Richard D. Hurt, MD, FASAM, Jon O. Ebbert, MD, J. Taylor Hays, MD, and David D. McFadden, MD
54 Pharmacologic Interventions for Other Drug and Multiple Drug Addictions
Jeffery N. Wilkins, MD, FASAM, DFAPA, Mark Hrymoc, MD, and David A. Gorelick, MD, PhD

SECTION 8 BEHAVIORAL INTERVENTIONS
55 Enhancing Motivation to Change
Mirela Feurdean, MD, FACP
56 Group Therapies
Dennis C. Daley, PhD, Antoine Douaihy, MD, Roger D. Weiss, MD, and Delinda E. Mercer, PhD
57 Individual Treatment
Deborah L. Haller, PhD and Edward V. Nunes, MD
58 Contingency Management and the Community Reinforcement Approach
Stephen T. Higgins, PhD, Ryan Redner, PhD, and Thomas J. White, PhD
59 Behavioral Interventions in Smoking Cessation
Erika Litvin Bloom, PhD, Christopher W. Kahler, PhD, Adam M. Leventhal, PhD, and Richard A. Brown, PhD
60 Network Therapy
Dmitry Ostrovsky, MD
61 Therapeutic Communities
Joseph Ruggiero, PhD
SIDEBAR: Overview of Therapeutic Community Outcome Research
Stanley Sacks, PhD
SIDEBAR: Modified Therapeutic Community for Persons with Co-Occurring Mental and Substance Use Disorders
Stanley Sacks, PhD
62 Aversion Therapies
P. Joseph Frawley, MD and Matthew Owen Howard, MD
63 Family Involvement in Addiction, Treatment, and Recovery
Kathleen A. Gross, MD, Michael R. Liepman, MD, DFAPA, FASAM, Maritza M. Lagos, MD, DABAM, Belal Hegazy, MD, Chris Karampahtsis, MD, MPH, Priya Mahajan, MD
64 Twelve-Step Facilitation Approaches
David Dayan-Rosenman, MD, MA, MSc
65 Microprocessor Abuse and Internet Addiction
Richard N. Rosenthal, MD
66 Relapse Prevention: Clinical Models and Intervention Strategies
Antoine Douaihy, MD, Dennis C. Daley, PhD, G. Alan Marlatt, PhD, and Dennis M. Donovan, PhD
67 Medical Management Techniques and Collaborative Care: Integrating Behavioral with Pharmacologic Interventions in Addiction Treatment
Richard N. Rosenthal, MD
68 Conceptual and Treatment Issues in Behavioral Addictions
Abigail J. Herron, DO, Paul Rinaldi, PhD, and Petros Levounis, MD, MA

SECTION 9 MUTUAL HELP, TWELVE STEP, AND OTHER RECOVERY PROGRAMS
69 Twelve-Step Programs in Addiction Recovery
Edgar P. Nace, MD
70 Recent Research into Twelve-Step Programs
Atika Zubera, MD and Petros Levounis, MD, MA, FASAM
71 Spirituality in the Recovery Process
Marc Galanter, MD and Sonya Lazarevic, MD

SECTION 10 MEDICAL DISORDERS AND COMPLICATIONS OF ADDICTION
72 Medical and Surgical Complications of Addiction
Karsten Lunze, MD, MPH, DrPH, FAAP
73 Cardiovascular Consequences of Alcohol and Other Drug Use
Shaojie Han, MD, MS and Rashi Aggarwal, MD
74 Liver Disorders Related to Alcohol and Other Drug Use
Sara E. Mgaieth, MBBS, FRACP, Robert G. Batey, MD, FRACP, FRCP(UK), FAChAM, and Paul S. Haber, MD, FRACP, FAChAM
75 Renal and Metabolic Disorders Related to Alcohol and Other Drug Use
Susana Sanchez, MD and Erin Zerbo, MD
76 Gastrointestinal Disorders Related to Alcohol and Other Drug Use
Guang Chen, MBBS and Paul S. Haber, MD, FRACP, FAChAM
77 Respiratory Tract Disorders Related to Alcohol and Other Drug Use
Timothy Koehler Brennan, MD, MPH
78 Neurologic Disorders Related to Alcohol and Other Drug Use
Jason J. Sico, MD
79 Human Immunodeficiency Virus, Tuberculosis, and Other Infectious Diseases Related to Alcohol and Other Drug Use
Carol A. Sulis, MD
80 Sleep Disorders Related to Alcohol and Other Drug Use
Sanford Auerbach, MD
81 Traumatic Injuries Related to Alcohol and Other Drug Use: Epidemiology, Screening, and Prevention
Stephen Van Ooteghem, MD, MSW, Gail D'Onofrio, MD, MS, and Federico E. Vaca, MD, MPH
82 Endocrine and Reproductive Disorders Related to Alcohol and Other Drug Use
Nicole Guanci, MD and Rashi Aggarwal, MD
83 Alcohol and Other Drug Use during Pregnancy: Management of the Mother and Child
Michael F. Weaver, MD, FASAM, Hendrée E. Jones, PhD, and Martha J. Wunsch, MD, FAAP, FASAM
84 Surgical Interventions in the Alcohol- or Drug-Using Patient
Daniel P. Alford, MD, MPH, FACP, FASAM

SECTION 11 CO-OCCURRING ADDICTION AND PSYCHIATRIC DISORDERS
85 Substance-Induced Mental Disorders
Christine Yuodelis-Flores, MD, R. Jeffrey Goldsmith, MD, and Richard K. Ries, MD, FAPA, FASAM
86 Co-Occurring Addictive and Mood Disorders
Edward V. Nunes, MD, Roger D. Weiss, MD, and Carrie A. Davies
87 Co-Occurring Addiction and Anxiety Disorders
Karen J. Hartwell, MDand Kathleen T. Brady, MD, PhD
88 Co-Occurring Addiction and Psychotic Disorders
Douglas Ziedonis, MD, MPH, Xiaoduo Fan, MD, MPH, MS, Aurelia N. Bizamcer, MD, PhD, Stephen A. Wyatt, DO, Makenzie E. Tonelli, BA, and David A. Smelson, PsyD
89 Co-Occurring Addictive Disorder and Attention Deficit Hyperactivity Disorder
Frances Rudnick Levin, MD and John J. Mariani, MD
90 Co-Occurring Personality Disorders and Addiction
Stephen Ross, MD
91 Posttraumatic Stress Disorder and Substance Use Disorder Comorbidity
Colette L. Haward, MD
92 Co-Occurring Addiction and Eating Disorders
Lisa J. Merlo, PhD, MPE and Mark S. Gold, MD, FASAM

SECTION 12 PAIN AND ADDICTION
93 The Pathophysiology of Chronic Pain and Clinical Interfaces with Addiction
Mahreen Raza, MD and Petros Levounis, MD, MA
94 Psychological Issues in the Management of Pain
Sean Sullivan, DO and Mirela Fuerdean, MD, FACP
95 Rehabilitation Approaches to Pain Management
Steven Stanos, DO and Randy L. Calisoff, MD
96 Nonopioid Pharmacotherapy of Pain
James A.D. Otis, MD, Michael Perloff, MD, and Gina Deck, MD
97 Opioid Therapy of Pain
Shaojie Han, MS, MD and Petros Levounis, MD, MA, FASAM
98 Comorbid Pain and Addiction
Noam Koenigsberg, MD
99 Legal and Regulatory Considerations in Opioid Prescribing
David J. Copenhaver, MD MPH, Wesley Prickett, MD, and Scott M. Fishman, MD

SECTION 13 CHILDREN AND ADOLESCENTS
100 Epidemiology of Adolescent Substance Use
Kirstin A.M. Nackers, MD, Melissa Weddle, MD, MPH, and Patricia K. Kokotailo, MD, MPH
SIDEBAR: Adolescents' Attitudes toward Alcohol and Other Drugs
Kirstin A.M. Nackers, MD, Melissa Weddle, MD, MPH, and Patricia K. Kokotailo, MD, MPH
SIDEBAR: Medical Marijuana Policy and Youth
Sion K. Harris, PhD, CPH, Julie K. Johnson, MA, and John R. Knight, MD
101 Preventing Substance Use among Children and Adolescents
Kenneth W. Griffin, PhD, MPH and Gilbert J. Botvin, PhD
102 Neurobiology of Addiction from a Developmental Perspective
Deborah R. Simkin, MD
103 Screening and Brief Intervention for Adolescents
Traci L. Brooks, MD and John R. Knight, MD
104 Assessing Adolescent Substance Use
Ken C. Winters, PhD, Tamara Fahnhorst, MPH, Andria Botzet, MA, Ali Nicholson, BS, Randy Stinchfield, PhD, and Walker Krepps, BA
105 Placement Criteria and Strategies for Adolescent Treatment Matching
Marc Fishman, MD
SIDEBAR: Confidentiality in Dealing with Adolescents
Margaret R. Moon, MD, MPH
SIDEBAR: Drug Testing Adolescents in School
J. Wesley Boyd, MD, PhD
106 Adolescent Treatment and Relapse Prevention
Steven L. Jaffe, MD, Ashraf Attalla, MD, and Diana I. Simeonova, Dipl-Psych, PhD
107 Pharmacotherapy for Adolescents with Substance Use Disorders
Geetha A. Subramaniam, MD, FAPA and Lisa A. Marsch, PhD
108 Co-Occurring Psychiatric Disorders in Adolescents
Ramon Solhkhah, MD and Muhammad Abbas, MD

SECTION 14 ETHICAL, LEGAL, AND LIABILITY ISSUES IN ADDICTION PRACTICE
109 Ethical Issues in Addiction Practice
Timothy Koehler Brennan, MD, MPH
110 Consent and Confidentiality Issues in Addiction Practice
R. Corey Waller, MD, MS, FACEP, ABAM
111 Clinical, Ethical, and Legal Considerations in Prescribing Drugs with Abuse Potential
Andrew O'Hagan, MD
SIDEBAR: Drug Control Policy: History and Future Directions
Robert L. DuPont, MD, FASAM and John J. Coleman, PhD
112 The Science and Clinical Uses of Drug Testing
Robert L. DuPont, MD, FASAM, Bruce A. Goldberger, PhD, DABFT, and Mark S. Gold, MD, FASAM
SIDEBAR: Workplace Drug Testing and the Role of the Medical Review Officer
Robert L. Dupont, MD, FASAM and James L. Ferguson, DO, FASAM
113 Drug Treatment Courts and the Treatment of Persons in the Criminal Justice System
The Hon. Peggy Fulton Hora, JD (Ret.)
SIDEBAR: Therapeutic Jurisprudence
Daniel Pulcherio Fensterseifer
SIDEBAR: Treatment of Individuals in the Criminal Justice Population
Lori D. Karan, MD, FACP, FASAM and Randall T. Brown, MD, PhD, FASAM
114 Preventing and Treating Substance Use Disorders in Military Personnel
Saadiq J. Bey, MSW, CASAC, ICADC
SIDEBAR: Risk Factors for Military Families
Joan E. Zweben, PhD and Susan Storti, PhD, RN, CARN-AP