Addiction Medicine

Book excerpt: Among Australians use of alcohol and other drugs is almost ubiquitous and results in 13% of total morbidity, but clinicians generally receive limited training in diagnosis and management of substance-use disorders. Written by clinical and academic specialists in their fields, and providing a comprehensive overview of the principles and practice of addiction medicine, this textbook will facilitate such training. The book’s 36 chapters, by 62 specialist contributors, are organised into 5 sections. In Section 1, how substance use can be understood and core principles of management of substance-use disorders are outlined. In Section 2, the clinical and other core skills required for practice are described: clinical assessment, therapeutic relationship, psychological interventions, screening and brief interventions, drug testing and biomarkers of consumption, responsible prescribing, and medico-legal assessment and report-writing. In Section 3, common clinical issues – intoxication and overdose, withdrawal, comorbidities, and pain management and pharmaceutical opioids – are described. Section 4, the largest section, is devoted to consideration of specific substances, legal, illegal, and emerging: tobacco, alcohol, opioids, cannabis, stimulants, hallucinogens, benzodiazepines, and volatile substances. The focus of Section 5 is special populations, adolescents, Aboriginal and Torres Strait Islanders, injecting-drug users, and others. With new clinical syndromes arising from synthesis of new substances, and with new approaches to treatment being developed, addiction medicine is a rapidly-evolving field. The book is designed to meet the specific needs of a young graduate who is starting a clinical rotation in a drug and alcohol unit. Medical students and junior medical officers will find the book valuable, as will other health professionals who care for people with substance-use problems in drug and alcohol services, nurses, counsellors, and welfare/social workers.