Treatment of addiction made easier | |
Management of alcohol and drug problems. Gary K Hulse, Jason M White, Gavin Cape (editors). Melbourne: Oxford University Press, 2002 (xx + 404 pp). ISBN 019551331-2. |
Drug and alcohol dependent
patients present a challenge to many doctors and medical students. Despite recent advances in medical education, there is still prejudice and fear to the extent that some medical practitioners will not treat addiction. This book goes a long way toward demystifying the treatment of drug dependence.
This book is a comprehensive manual written by leaders in the field of addiction in both Australia and New Zealand. Despite its numerous contributors, the book flows seamlessly through the history of drug use, to opioids, cannabis, psychostimulants, alcohol and tobacco use. There are well written sections on Aboriginal Australians and Mäori, explaining the particular problems of each group. A strong clinical focus is present which describes assessment, diagnosis and treatments available. Graphic case studies illustrate chapters on women and substance abuse, adolescent drug use and coexisting mental disorders. I found the chapter on professional issues particularly interesting. It addresses the difficulties doctors have in treating this group of patients, in boundary setting and maintaining appropriate limits. In addition, there is advice on drug and alcohol abuse and impairment within the medical profession. Regarding detoxification from opioids, the book does not endorse the use of buprenorphine, stating that it has not yet been fully evaluated. My understanding is that this is no longer the case and that buprenorphine is now the preferred option for detoxification in Australia. Despite having a host of contributors, this book is easy to read, well set out, and has many illustrations and useful tables. At $55.00, this is excellent value for money. Having worked in addiction for 20 years, I wish this book had been available when I first started seeing drug and alcohol dependent patients. It would have made my life easier. Raymond Seidler
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