Community Treatment of Drug Misuse: More than Methadone

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.

About the Author :
Nicholas Seivewright is Consultant Psychiatrist in Substance Misuse, Sheffield and Nottinghamshire NHS Trusts, UK.

Review :
' ... a well-written and stimulating book by an author whose opinions are informed by evidence and considerable experience in treating drug users. It is honest in acknowledging the difficult issues faced by practitioners and these are well illustrated in the case histories that show the mixed results often achieve in the treatment of substance misuse.' The Lancet ' ... well thought out, informative and non-partisan ... Good use is made of case histories ... This book will prove to be invaluable to clinicians and policy makers both old and new to the field. For the latter particularly, this book provides the opportunity to rethink and fine tune theoretical and practical underpinnings and identify new and more effective ways forward.' Drug Link '... a comprehensive, up-to-date and pragmatic account of treatment options for drug misusers. ... I would commend it as a worthwhile and practical friend who will provide reliable, relevant and understandable advice for any workers in this field, where guidance so frequently seems inaccessible or insufficient.' Health Bulletin 'This concise text presents a candid discussion of the strengths and weakness of treatments for a variety of substance use disorders, including opioid dependence, from a clinical, research and policy perspective.' Addiction 2001 'The book combines a highly practical approach with scientific rigour, beginning from the position that the drug treatment scene has become so dominated by methadone substitution treatment that other treatment endeavours are being overlooked ... a must read for all dedicated alcohol and drug clinicians ... I would particularly recommend it to all psychiatrists and psychiatric trainees.' Doug Sellman, Australia and New Zealand Journal of Psychiatry 'The clinical dilemmas which are discussed within the book have a very real resonance with everyday clinical practice. It is obvious that Dr Seivewright deals with these dilemmas on a daily basis, not just as an academic, but as a worker at the coalface of addictions service delivery ... I strongly recommend this book, both to the experienced drug worker, as a thought provoking and challenging book which should inform their practices, and also to less experienced practitioners, as a general introduction to the field.' Chris Daly, International Journal of Geriatric Psychiatry 'This book provides psychiatrists, GPs, nursing staff and forensic practitioners, as well as specialist drug workers both new to the field and experienced, with a practical, yet readable guide to assist their understanding of drug treatment and inform service provision.' Debbie McQueirns, The British Journal of Forensic Practice