Introduction to addictive behaviors

337 Pages·2006·4.75 MB·English

by  PhD Dennis L. Thombs PhD FAAHB

INTRODUCTION TO ADDICTIVE BEHAVIORS
The Guilford Substance Abuse Series
HowardT.BlaneandThomasR.Kosten,Editors
RECENT VOLUMES
Introduction to Addictive Behaviors, Third Edition
Dennis L. Thombs
Clinical Work with Substance-Abusing Clients, Second Edition
Shulamith Lala Ashenberg Straussner, Editor
Treating Substance Abuse: Theory and Technique, Second Edition
Frederick Rotgers, Jon Morgenstern, and Scott T. Walters, Editors
Addiction and Change: How Addicitions Develop and Addicted People Recover
Carlo C. DiClemente
Seeking Safety: A Treatment Manual for PTSD and Substance Abuse
Lisa M. Najavits
Substance Abuse Treatment and the Stages of Change:
Selecting and Planning Interventions
Gerard J. Connors, Dennis M. Donovan, and Carlo C. DiClemente
Psychological Theories of Drinking and Alcoholism, Second Edition
Kenneth E. Leonard and Howard T. Blane, Editors
New Treatments for Opiate Dependence
Susan M. Stine and Thomas R. Kosten, Editors
Couple Therapy for Alcoholism: A Cognitive-Behavioral Treatment Manual
Phylis J. Wakefield, Rebecca E. Williams, Elizabeth B. Yost,
and Kathleen M. Patterson
Clinical Guide to Alcohol Treatment: The Community Reinforcement Approach
Robert K. Meyers and Jane Ellen Smith
Psychotherapy and Substance Abuse: A Practitioner’s Handbook
Arnold M. Washton, Editor
Introduction to
Addictive Behaviors
T H I R D E D I T I O N
DENNIS L. THOMBS
THE GUILFORD PRESS
New York London
©2006TheGuilfordPress
ADivisionofGuilfordPublications,Inc.
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Thisbookisprintedonacid-freepaper.
Lastdigitisprintnumber: 9 8 7 6 5 4 3 2 1
LibraryofCongressCataloging-in-PublicationData
Thombs,DennisL.
Introductiontoaddictivebehaviors/DennisL.Thombs.—3rded.
p.cm.—(TheGuilfordsubstanceabuseseries)
Includesbibliographicalreferencesandindex.
ISBN-101-59385-278-9 ISBN-13978-1-59385-278-8(cloth)
1. Substanceabuse—Etiology. 2. Substanceabuse—
Treatment. I. Title. II. Series.
[DNLM:1.Substance-RelatedDisorders—etiology. 2.Substance-Related
Disorders—therapy. WM270T465i2006]
RC564.T552006
616.86—dc22
2005030211
About the Author
DennisL.Thombs,PhD,FAAHB,isAssociateProfessorintheDepartment
ofHealthEducationandBehaviorattheUniversityofFlorida.Thefocusof
hisscholarshipisaddictivebehavior,withspecialinterestsintheepistemol-
ogyofaddictionandinalcoholanddruguseduringtheperiodofemerging
adulthood. Dr. Thombs’s research has been supported by the National
InstituteonAlcoholAbuseandAlcoholism.HeisaFellowintheAmerican
Academy of Health Behavior.
v

Acknowledgments
Thefollowingpublishershavegenerouslygivenpermissiontouseextended
quotations or paraphrases, and/or to reprint or adapt tables or figures,
from published works:
Beyond Freedom and Dignity by B. F. Skinner, 1975, New York: Ban-
tam. Copyright 1975 by B. F. Skinner. Used by permission of Random
House, Inc.
“TheoryinthePracticeofPsychotherapy”byM.Bowen,1976,inP.J.
Guerin (Ed.), Family Therapy: Theory and Practice, New York: Gardner
Press. Copyright 1976 by Gardner Press, Inc.
“Principles of Alcoholism Psychotherapy” by S. Zimberg, 1978, in S.
Zimberg,J.Wallace,andS.Blume(Eds.),PracticalApproachestoAlcohol-
ism Psychotherapy, New York: Plenum Press. Copyright 1978 by Springer
Science and Business Media.
“WhatMotivatesPeopletoChange?”byW.R.MillerandS.Rollnick,
1991,inMotivationalInterviewing:PreparingPeopletoChangeAddictive
Behavior, New York: Guilford Press. Copyright 1991 by The Guilford
Press.
“Drugs of Abuse: Anatomy, Pharmacology and Function of Reward
Pathways” by G. F. Koob, 1992, Trends in Pharmacological Sciences, 13,
177–184. Copyright 1992 by Elsevier Science Ltd.
“Sex and Age Effects on the Inheritance of Alcohol Problems: A Twin
Study” by M. McGue, R. W. Pickens, and D. S. Svikis, 1992, Journal of
Abnormal Psychology, 101, 3–17. Copyright 1992 by the American Psy-
chological Association.
“Dual Diagnosis: A Review of Etiological Theories” by K. T. Mueser,
R.E.Drake,andM.A.Wallach,1998,AddictiveBehaviors,23,717–734.
Copyright 1998 by Elsevier.
vii
viii Acknowledgments
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edi-
tion, Text Revision, by the American Psychiatric Association, 2000, Wash-
ington, DC: American Psychiatric Association. Copyright 2000 by the
American Psychiatric Association.
“RatesofPsychiatricComorbidityamongU.S.ResidentswithLifetime
CannabisDependence”byV.Agosti,E.Nunes,andF.Levin,2002,Ameri-
can Journal of Drug and Alcohol Dependence, 28, 643–652. Copyright
2002 by the Taylor and Francis Group.
“Nicotine Dependence and Psychiatric Disorders in the United States:
Results from the National Epidemiologic Survey on Alcohol and Related
Conditions”byB.F.Grant,D.S.Hasin,S.P.Chou,F.S.Stinson,andD.A.
Dawson, 2004, Archives of General Psychiatry, 61, 1107–1115; “Preva-
lence and Co-Occurrence of Substance Use Disorders and Independent
Mood and Anxiety Disorders: Results from the National Epidemiologic
SurveyonAlcoholandRelatedConditions”byB.F.Grant,F.S.Stinson,D.
A.Dawson,S.P.Chou,M.C.Dufour,W.Compton,R.P.Pickering,andK.
Kaplan, 2004, Archives of General Psychiatry, 61, 807–816; and “Co-
Occurrence of 12-Month Alcohol and Drug Use Disorders and Personality
Disorders in the United States: Results from the National Epidemiologic
SurveyonAlcoholandRelatedConditions”byB.F.Grant,F.S.Stinson,D.
A. Dawson, S. P. Chou, W. J. Ruan, and R. P. Pickering, 2004, Archives of
General Psychiatry, 61, 361–368. Copyright 2004 by the American Medi-
cal Association.
Preface
Thisbookwaswrittenforpracticinghealthandhumanservicesprofession-
als with no formal training in substance abuse prevention and treatment,
and for undergraduate and graduate courses on addictive behavior. The
book has two primary goals. The first is to challenge and strengthen the
reader’s understanding of addiction by exploring how others in the field
have come to know it. I hope that this will enable the reader to create a
clear and logically consistent perspective on addiction. The second goal is
toshowthereaderhowtheoryandresearchareimportanttoboththepre-
vention and the treatment of substance abuse. This should provide the
readerwithanarrayofstrategiesforaddressingsubstanceabuseproblems,
and help make him or her an effective practitioner.
There are a number of good books currently available on substance
abuse and dependence. For the most part, however, these books either are
writtenatanadvancedlevelforthesophisticatedpractitionerorresearcher
or focus on a limited set of theoretical orientations. The present text is
unique in that it attempts to present a comprehensive and thoughtful
review of theory and research with the front-line practitioner and student
inmind.Exposuretocomplexanddivergenttheoriesofaddictivebehavior
has often been neglected in the preparation and training of health and
human services professionals, including substance abuse counselors, pre-
vention specialists, social workers, psychologists, nurses, and so forth.
Some of these practitioners are familiar with one or more of the disease
models, but even here they often have not had the opportunity to examine
its propositions critically. This book assumes virtually no preexisting
knowledge in the biological and behavioral sciences, medicine, or public
health.Ineachchapter,acarefulattempthasbeenmadetoexplainthecon-
ceptual underpinnings of the theories and approaches described herein, as
well as the research supporting these frameworks.
ix
x Preface
The third edition of Introduction to Addictive Behaviors has been
revised to appeal to a broader audience of practitioners and students. The
primary focus of the first two editions was to provide a multidisciplinary
foundation for addiction treatment. The third edition has been revised to
include a theoretical and research foundation for substance abuse preven-
tion as well. The third edition also includes two new chapters. Each pre-
sents cutting-edge knowledge in two very different but important areas in
thestudyofaddictivebehavior.Thenewchaptersaretitled“PublicHealth
and Prevention Approaches” and “Toward an Understanding of Comor-
bidity.” All the chapters from the second edition have been updated and
included in the third edition.
Specialthanksareinordertothosewhohelpedmecompletethethird
edition.IamgratefultoTheGuilfordPress,andespeciallytoJimNageotte
and Jane Keislar, for their encouragement and assistance in preparing the
third edition. A number of anonymous reviewers provided feedback that
also was extremely helpful in steering the direction of the book.
DENNIS L. THOMBS
University of Florida