All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

This volume reviews a range of empirically supported approaches to prevention and treatment of adolescent substance use problems. The focus is on motivationally based brief interventions that can be delivered in a variety of contexts, that address key developmental considerations, and that draw on cutting-edge knowledge on addictive behavior change. From expert contributors, coverage encompasses alcohol skills training; integrative behavioral and family therapy; motivational interviewing; interventions for dually diagnosed youth; Internet-based education, prevention, and treatment; and applications to HIV prevention. The volume is extensively referenced and includes numerous clinical illustrations and vignettes.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

This book has been replaced by Treating Alcohol and Drug Problems in Psychotherapy Practice, Second Edition, ISBN 978-1-4625-5086-9.

Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.

Alcohol, Drugs, Genes and the Clinical Laboratory provides an overview and quick reference to genetic relationships and clinical laboratory information related to the serious public health issue of alcohol and drug abuse. Written in a clear and concise manner, this book discusses the necessary information for health and safety professionals working in public health to learn about complex issues quickly to better help their patients, employees, and others affected by alcohol and drug abuse. Alcohol, Drugs, Genes and the Clinical Laboratory covers the important aspects of drugs and alcohol abuse including genetic aspects along with laboratory methods for analysis of alcohol and abused drugs with emphasis on false positive test results. The book is helpful to healthcare professionals, such as pathologists who oversee alcohol and drug testing, emergency room physicians, family practice physicians who are first healthcare professionals who identify patients susceptible to drug and alcohol abuse, and psychiatrists involved with drug and alcohol rehabilitation programs. It will also be useful to safety professionals who have to assess individuals for workplace responsibilities, ranging from police and recruitment to occupational safety and occupational medicine and public health officials. - Features accessible language for healthcare and safety professionals who are not experts in laboratory procedures - Provides examples from clinical and everyday situations - Explains how to interpret laboratory results and the latest genetic factors regarding drug and alcohol abuse

Bringing together leading experts, this book demonstrates the unique value of brief motivational interventions for addressing adolescent alcohol and other substance use in a range of clinical contexts. It presents cutting-edge knowledge on the etiology and developmental context of adolescent addictive behaviors and reviews exemplary treatment approaches. Effective strategies are described for intervening with diverse populations, such as college students, youth in the justice system and in foster care, those with co-occurring substance abuse and psychiatric problems, LGBT youth, and Latino and American Indian adolescents. This book replaces the editors' influential earlier work, Adolescents, Alcohol, and Substance Abuse, with an expanded focus on practical applications. Most of the chapters are completely new.