Alcohol and Tobacco

Alcohol and nicotine addiction mostly occur together. Over the last ten years therapeutic aspects and motivational strategies have been considerably improved. Hence, groups and subgroups have been defined and can be treated with specific medication and tailor-made psychotherapies, leading in the long term to considerably better and more effective results than the once broadly applied, rigorous abstinence -based therapies. However, alcohol and nicotine addiction still represent major medical and social problems.

In this book, new therapeutic approaches are comprehensively described, outlining the different interactions between personality, environment and the effects of the substance.

In addition to prevention-based therapies and diagnosis, essential psychological and sociological strategies, as well as medication-based therapies, are also presented in detail. All of these therapies have realistic aims and are of global validity. In addition, the book provides a broad overview of the American and European epidemiology of alcohol and nicotine addictions. The book is written for all those who care for and offer professional therapy for alcohol and nicotine-addicted patients.

       Table of contents

       1 Information on the origination of the book

1.1   Aims of this book

1.2   Personal reasons for the first author writing this book

2 Addiction- a short overview over a widespread disease

2.1 Introduction

2.2 Prevention

2.3 Diagnosis of addiction

2.4 Aetiology of addiction

2.5 Secondary disorders and addiction

2.6 Secondary diseases and brain functions

2.7 Subgroups of addicts

2.8 Motivation of addicts

2.9 The path from motivation to therapy

2.10 Addiction and relapse

2.11 Specific groups of addicts

2.12 Addiction and the homeless

2.13 Polytoxicomania

2.14 Non-substance dependence

3   Aetiology of Addiction

3.1 The psycho-socio-biological model

3.2 Psychological theories

3.3 Socialexplanation approaches

3.4 Biological theories about the aetiology of tobacco and alcohol addiction

3.5 Aetiological aspects of tobacco and alcohol addiction from an epidemiological perspective

3.6 Aetiology of addiction from a psychiatric perspective

4 Prevention strategies

4.1 Attitude towards addictive drugs

4.2 Primary prevention of tobacco and alcohol addiction

4.3 Secondary prevention: early diagnosis and early intervention

4.4 Tertiary prevention

5 Diagnosis of abuse and addiction

5.1 Problems concerning psychiatric diagnoses

5.2 Development of the term “addiction”

5.3 Substance related diagnoses in the ICD-10

5.4 Substance related diagnosis in DSM-IV (American Psychiatric Association. 1994)

5.5 Commonalities and differences of ICD-10 and DSM-IV

5.6 Implication of these classification systems for therapy and research

6 Types, dimensions and aetiology

6.1 Alcohol addiction

6.2 Tobacco addiction
    

6.3 Alcohol addiction: Lesch’s typology

6.4 The relationship between alcohol dependent patients according to Lesch`s typology and the
     severity of tobacco addiction

7 Motives for alcohol and/or tobacco addicted patients to seek medical help

7.1 Tobacco addiction

7.2 Alcohol addiction

7.3 Sequelae that bring patients into therapy

8 Detection of alcohol and tobacco addiction

8.1 Recommendations for the first contact

8.2 Assessment of drinking behaviour using biological markers

 8.3 The clinical dialogue in tobacco addiction

9 Therapeutic strategies for alcohol and tobacco dependence

9.1 Motivation for therapy in different settings

 9.2 Pharmacotherapy of alcohol and tobacco dependence

9.3 Pharmacotherapy of alcohol withdrawal  

9.4 Alternatives to withdrawal

9.5  Pharmacotherapy of the tobacco withdrawal syndrome

9.6 Medical strategies for relapse prophylaxis

10 Sociotherapy of alcohol and tobacco dependents with regards to Lesch’s typology

10.1 Alcohol and tobacco

10.2 The sociotherapeuticmission

10.3 Classification Psychotherapy-Sociotherapy

10.4 Sociogenesis and sociotherapeutic chances

10.5 Sociotherapy in the context of therapeutic phases

10.6 State of the art: overlapping perspectives for sociotherapeutic housing and support

10.7 Motivation- a challenge for whom?

10.8 Sociotherapy as a means of promoting networking

10.9 Sociotherapy with alcohol dependents in the context of Lesch’s typology

Appendix 1 Lesch Alcoholism Typology – Questionnaire

Appendix 2 Lesch European Smoker Classification

Index

About the Authors