Treatment for drug misuse has been dominated in recent years by the use of methadone as a substitution agent in heroin dependency. This approach has had considerable success, but as a result other treatment options have been neglected. This book draws on the author's direct clinical experience and makes use of international research findings to provide a comprehensive and detailed guide to service provision and treatment for drug misuse, including methadone and alternative opiate substitutes, detoxification methods, naltrexone and relapse prevention, and possible approaches with non-opiate users. There is a particular emphasis on social factors in drug misuse and dependency, and the consequent treatment issues and practical difficulties, and case studies are used throughout. Combining a highly practical approach with a strong research base, this book will be an essential resource for psychiatrists and other professionals involved in the management of drug misuse.
Table of Contents
Introduction: Community treatment in context; Part I. Treatments: 1. Methadone maintenance: a medical treatment for social reasons? 2. More than methadone: the case for other substitute drugs; 3. Achieving detoxification and abstinence; 4. Treatment of non-opiate misuse; Part II. Providing Clinical Services: 5. Community drug services; 6. Treatment of drug misuse in primary care; 7. Balancing security and accessibility; 8. Dual diagnosis - drug misuse and psychiatric disorder; Epilogue: Future directions; Glossary; Appendix 1: Protocols for quick detoxification from heroin; Appendix 2: Opioid equivalent dosages.
Nicholas Seivewright is Consultant Psychiatrist in Substance Misuse, Sheffield and Nottinghamshire NHS Trusts, UK.