By Darius A. Rastegar MD, Michael I. Fingerhood MD

This guide presents functional and evidence-based guidance for comparing, treating, and dealing with sufferers with substance abuse difficulties. the hole chapters offer an outline of key medical matters, recommendations for interviewing, screening, confronting, and motivating sufferers, and numerous remedy modalities. a big component of the ebook specializes in analysis, clinical issues, and remedy of particular drug addictions. Chapters on smoking and prescription drug abuse also are integrated. different chapters speak about remedy for the addicted sufferer, psychiatric disorder and habit, and substance abuse in unique populations. particular remedy protocols are supplied and every bankruptcy ends with annotated references to the literature.

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Additional info for Addiction Medicine: An Evidence-Based Handbook (Lippincott Williams & Wilkins Handbook Series)

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Fingerhood, Michael I. 32 33 Title: Addiction Medicine: An Evidence-Based Handbook, 1st Edition Copyright ©2005 Lippincott Williams & Wilkins > Table of Contents > 5 - Alcohol 5 Alcohol BACKGROUND The use of alcoholic beverages dates back thousands of years to a biblical reference to Noah drinking wine and getting drunk. 37 Distillation of alcohol into whiskey started during the Middle Ages when alcohol was first used for medicinal reasons as an anxiolytic. Not long after that, the detrimental effects of alcohol were first recognized.

The National Institute on Alcohol Abuse and Alcoholism defines â at-risk drinkingâ as more than 14 drinks per week or more than 4 drinks per occasion for men and more than 7 drinks per week or more than 3 drinks per occasion for women (15). More recently, the terms â alcohol use disorder,â â problem drinking,â â hazardous drinking,â and â unhealthy alcohol useâ have also been used in the literature. These terms aim to include individuals who do not meet DSM-IV criteria for alcohol abuse or dependence but who may be at increased risk for alcohol-related problems or have had isolated problems related to drinking alcohol, such as a DUI.

An alcohol-disulfiram reaction usually begins within 10 minutes of drinking and may last for up to several hours. Symptoms include flushing, headaches, anxiety, sweating, nausea, vomiting, dizziness, palpitations, hyperventilation, and confusion. Disulfiram at recommended dosages of 250-500 mg/day is well tolerated by most patients. 62 or a history of drinking while taking disulfiram. If alcohol-related liver disease is present, prescribing of disulfiram should be delayed until the levels of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) are less than three times the normal range.

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