Table Of ContentCLINICAL TEXTBOOK OF ADDICTIVE DISORDERS
Clinical Textbook
of Addictive Disorders
THIRD EDITION
Editedby
RICHARD J. FRANCES
SHELDON I. MILLER
AVRAM H. MACK
THE GUILFORD PRESS
New York London
©2005TheGuilfordPress
ADivisionofGuilfordPublications,Inc.
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Library of Congress Cataloging-in-Publication Data
Clinicaltextbookofaddictivedisorders/editedbyRichardJ.Frances,SheldonI.
Miller,AvramH.Mack.—3rded.
p.cm.
Includesbibliographicalreferencesandindex.
ISBN1-59385-174-X(hardcover)
1. Substanceabuse. 2. Alcoholism. I. Frances,RichardJ. II. Miller,SheldonI.
III. Mack,AvramH.
RC564.C552005
616.86—dc22
2004026092
About the Editors
Richard J. Frances, MD,isClinicalProfessorintheDepartmentofPsychiatry
atNewYorkUniversitySchoolofMedicineandDirectorofPublicandProfes-
sional Education at Silver Hill Hospital in New Canaan, Connecticut. He is
alsoinprivatepracticeinNewYorkCity.Dr.FranceswasformerPresidentand
MedicalDirectoratSilverHillHospital;wasfoundingpresidentoftheAmeri-
can Academy of Addiction Psychiatry; and helped found and chaired the
CouncilofAddictionPsychiatryfortheAmericanPsychiatricAssociation.He
istheauthorofseveralhundredarticlesandseveralbooks,andisonnumerous
editorialboardsofjournals.Dr.Francesfrequentlylecturesonaddictionpsychi-
atry and has appeared numerous times as a guest on Court TV.
SheldonI.Miller,MD,istheLizzieGilmanProfessorofPsychiatryandformer
Chairman of the Department of Psychiatry and Behavioral Sciences at North-
westernUniversity.Duringhiscareer,hehasservedonmanyboardsandcom-
mittees of many national and local organizations. Dr. Miller has authored or
coauthored over 60 scientific articles, chapters, and books. He is Editor-in-
ChiefoftheAmericanJournalonAddictionsandwasafounderoftheAmerican
AcademyofAddictionPsychiatry.Dr.MillerisontheBoardofDirectorsofthe
Accreditation Council for Graduate Medical Education and the American
Board of Emergency Medicine. He also currently serves as Vice Chair of the
American Psychiatric Association’s Council on Medical Education and Life-
long Learning.
Avram H. Mack, MD, is Assistant Professor of Psychiatry at the Institute of
Psychiatry of the Medical University of South Carolina in Charleston. He is a
graduate of the University of Michigan–Ann Arbor and of Cornell University
v
vi About the Editors
MedicalCollege.Dr.Mackhasextensiveexperienceinorganizedmedicineand
psychiatry.Hisotherareasofinterestinpsychiatryhaveincludeddevelopment,
thepsychiatricpresentationofmedicaldisorders,andthehistoryofpsychiatric
classification. As a child and forensic psychiatrist, he has treated or evaluated
individuals with addictions in many different settings, including general inpa-
tient, outpatient, correctional, juvenile justice, and community. Dr. Mack has
lectured to medical groups, bar associations, patient groups, and other mental
health professionals as well.
Contributors
Michelle C. Acosta, PhD, Department of Psychiatry, St. Luke’s–Roosevelt Hospital
Center, New York, New York
D. Andrew Baron, PhD, Department of Psychiatry and Behavioral Medicine,
Temple University, Philadelphia, Pennsylvania
David A. Baron, DO, MSEd, Department of Psychiatry and Behavioral Medicine,
Temple University, Philadelphia, Pennsylvania
Steven H. Baron, PhD, Department of Social Sciences, Montgomery County
Community College, Blue Bell, Pennsylvania
Judith S. Beck, PhD, Beck Institute for Cognitive Therapy, Bala Cynwyd,
Pennsylvania
Sheila B. Blume, MD, Department of Psychiatry, State University of New York at
Stony Brook School of Medicine, Stony Brook, New York
Oscar G. Bukstein, MD, MPH, Department of Psychiatry, Western Psychiatric
Institute and Clinic, Pittsburgh, Pennsylvania
Alisa B. Busch, MD, Department of Psychiatry, Harvard Medical School,
Cambridge, Massachusetts; Alcohol and Drug Abuse Treatment Program, McLean
Hospital, Belmont, Massachusetts
Kathleen M. Carroll, PhD, Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut; Department of Psychiatry, VA Connecticut
Healthcare System, West Haven, Connecticut
Ricardo Castañeda, MD, Department of Psychiatry, New York University School of
Medicine, New York, New York
Stephen L. Dilts, Jr., MD, MBA, Department of Psychiatry, Penn State College of
Medicine, University Park, Pennsylvania; Department of Behavioral Health,
WellSpan Health, York, Pennsylvania
vii
viii Contributors
Stephen L. Dilts, MD, PhD, Department of Psychiatry, University of Colorado
Health Sciences Center, Denver, Colorado
Lance M. Dodes, MD, Department of Psychiatry, Harvard Medical School,
Cambridge, Massachusetts
Caroline M. DuPont, MD, DuPont Clinical Research, Rockville, Maryland;
Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland
Robert L. DuPont, MD, Institute for Behavior and Health, Rockville, Maryland;
Department of Psychiatry, Georgetown University, Washington, DC
Richard J. Frances, MD, Silver Hill Hospital, New Canaan, Connecticut;
Department of Psychiatry, New York University School of Medicine, New York,
New York; private practice, New York, New York
Hugo Franco, MD, Dual Diagnosis Unit, New York University Hospital, New York,
New York; private practice, Eatontown, New Jersey
John Franklin, MD, Department of Psychiatry and Behavioral Sciences, Feinberg
School of Medicine, Northwestern University, Chicago, Illinois
Marc Galanter, MD, Department of Psychiatry, New York University School of
Medicine, New York, New York
Tony P. George, MD, Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut
Jon E. Grant, JD, MD, Department of Psychiatry and Human Behavior, Brown
University, Providence, Rhode Island
Deborah L. Haller, PhD, Department of Psychiatry, St. Luke’s–Roosevelt Hospital
Center, New York, New York
Francis Hayden, MD, Department of Psychiatry, New York University School of
Medicine, New York, New York
Anthony W. Heath, PhD, United Behavioral Health, Schaumburg, Illinois
James M. Hill, PhD, Department of Psychiatry, University of Medicine and
Dentistry of New Jersey, Newark, New Jersey
Norman Hymowitz, MD, Department of Psychiatry, University of Medicine and
Dentistry of New Jersey, Newark, New Jersey
Jeffrey P. Kahn, MD, Department of Psychiatry, Weill Medical College of Cornell
University, New York, New York
Yifrah Kaminer, MD, Department of Psychiatry, University of Connecticut Health
Center, Farmington, Connecticut
Cheryl Ann Kennedy, MD, Department of Psychiatry, University of Medicine and
Dentistry of New Jersey, Newark, New Jersey
Contributors ix
Edward J. Khantzian, MD, Department of Psychiatry, Harvard Medical School,
Cambridge, Massachusetts
Kenneth L. Kirsh, PhD, Symptom Management and Palliative Care Program,
Markey Cancer Center, University of Kentucky, Lexington, Kentucky
Herbert D. Kleber, MD, Department of Psychiatry, College of Physicians and
Surgeons, Columbia University, New York, New York
Thomas R. Kosten, MD, Department of Psychiatry, Yale University School of
Medicine, New Haven, Connecticut; Department of Psychiatry, VA Connecticut
Healthcare System, West Haven, Connecticut
Petros Levounis, MD, The Addiction Institute of New York, St. Luke’s–Roosevelt
Hospital Center, and Department of Psychiatry, College of Physicians and Surgeons,
Columbia University, New York, NY
Bruce S. Liese, PhD, Department of Family Medicine, University of Kansas Medical
Center, Kansas City, Kansas
Marsha M. Linehan, PhD, Department of Psychology, University of Washington,
Seattle, Washington
David Lussier, MD, Division of Geriatric Medicine, Montreal General Hospital,
McGill University, Montreal, Quebec, Canada
Thomas R. Lynch, PhD, Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, and Department of Psychology, Duke University,
Durham, North Carolina
Avram H. Mack, MD, Institute of Psychiatry, Medical University of South
Carolina, Charleston, South Carolina
Marylinn Markarian, MD, FEGS Continuing Day Program, Brooklyn, New York
Elinore F. McCance-Katz, MD, Department of Psychiatry, Virginia Commonwealth
University, Richmond, Virginia
David McDowell, MD, Department of Psychiatry, Columbia University, New York,
New York
Sheldon I. Miller, MD, Department of Psychiatry and Behavioral Sciences, Feinberg
School of Medicine, Northwestern University, Chicago, Illinois
Edgar P. Nace, MD, Department of Psychiatry, University of Texas Southwestern
Medical School, Dallas, Texas
Lisa M. Najavits, PhD, Department of Psychiatry, Harvard Medical School,
Cambridge, Massachusetts; Trauma Research Program, McLean Hospital, Belmont,
Massachusetts
Steven D. Passik, PhD, Symptom Management and Palliative Care Program,
Markey Cancer Center, University of Kentucky, Lexington, Kentucky
Description:Now in a revised and expanded third edition, this authoritative clinical reference and text presents state-of-the-science knowledge about all aspects of addictive disorders and their treatment. Leading researchers and practitioners describe best practices in assessment and diagnosis and provide the
