With an on-going commitment to address the challenges in assessing and treating substance abuse disorders worldwide, clinicians and researchers will undoubtedly find the 5th edition of The American Psychiatric Publishing Textbook of Substance Abuse Treatment to be the most current and comprehensive guide in the field of addiction. The editors have once again brought together a notable group of specialists to provide expertise on a range of substance abuse topics and, while appropriately following a structure similar to the last one, this edition also features thoroughly revised and new chapters and is compatible with DSM-5 classifications.
Material specifically related to the basic science of addiction is discussed in great detail throughout the first of seven parts comprising this textbook. Neurobiological, genetic and cross-cultural aspects of substance abuse are given a well-structured outline, which might, however, not be simple enough for non-experts and not detailed enough for specialists. The extensive revision of the epidemiology chapter to include data from international studies and sections on individual drugs is a welcome modification although it still feels quite outdated with research just extending to the beginning of the 2000s.
More positively, The Nature of Treatment stands out as a superior part in this textbook. Three newly added chapters expand the focus onto (i) the history of clinical interventions for substance abuse, (ii) the development of screening tools and brief interventions for the treatment of alcohol abuse and (iii) how treatment models for addiction compare to those for the management of chronic illnesses such as diabetes. Anyone interested in clinical case formulation will regard Assessment of the Patient of high value. More than just a summary of diagnostic approaches, this outstanding chapter unfolds clearly and logically and provides a wealth of advice on how to identify and assess substance-related disorders in patients and formulate interventions to overcome barriers and facilitate successful treatments.
Spanning over 200 pages, Specific Drugs of Abuse, the next and largest section, provides a clear and accessible description of individual drugs of abuse from legal substances such as nicotine to anabolic steroids and opioid antagonists. When it comes to alcohol, a revised chapter on the neurobiology of related disorders is followed by a new chapter on intoxication and withdrawal treatment presenting a complete picture in the management of alcohol use disorders. In view of the shifting attitudes towards cannabis, the two new additions on the neurobiology and treatment of cannabis-related disorders report on up-to-date knowledge of increasing importance for this controversial substance. Sadly, novel psychoactive substances receive only limited consideration.
Highlighting the progress made in the domain of non-pharmacological approaches to substance abuse disorders treatment, a series of chapters is next designed to deliver the latest in psychosocial therapies focusing on more traditional methods such as CBT to network therapy and contingency management. The role and effectiveness of in- and out-patient treatments, therapeutic communities and Alcoholics Anonymous as well research outcomes from 12-step programmes are examined rigorously. With two, instead of one, chapters now concentrating on substance use disorders in adolescence, a new chapter on addiction in pain sufferers, a revision to address HIV/AIDS and hepatitis C separately as well as an update to include transgender people, the Special Populations section reflects the urgency for substance abuse disorder care to transcend traditional treatment modalities. Similarly, but short of any further additions, the concluding part is dedicated to themes of particular interest. Steps to embed addiction education in medical training, improve preventive initiatives and address psychiatric comorbidity in substance abuse are only a few indications of the intensive approach that we must take to ensure patient-specific treatment and rehabilitation.
Key points and suggested readings at the end of each chapter provide great assistance in navigating the manual and summarizing sections of varying scope and complexity. However, those requiring a review of basic addiction concepts, more details on specific aspects of substance abuse treatment or evidence-based research beyond North America will have to supplement their reading with specialist publications. Providing a context for this textbook and laying the foundation for its aims in a preface – surprisingly omitted from this edition – would have been of benefit, too.
Undeniably, this textbook has been updated and expanded to offer knowledge on substance abuse disorders treatment that is consistent with the new DSM-5 classifications. While I am sceptical it is suitable for both health professionals and addiction researchers of varying expertise, this manual is an essential reference in the treatment of addictions. It approaches this major public health issue from a number of distinct perspectives – chapters that stand on their own – to bring together a unique source of practical theory and clinical information.
