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\"In most countries, problematic drug use is dealt with primarily as a criminal justice issue, rather than a health issue. Accordingly, a large proportion of people in prison have a history of alcohol, tobacco and/or illicit drug use and, despite the best efforts of correctional authorities, some continue to use these substances in prison, often in very risky ways. After release from prison, many relapse to risky substance use, and are at high risk of poor health outcomes, preventable death, or reincarceration.In this edited volume, for the first time we bring together 40 contributors from 10 countries to review what is known about alcohol, tobacco and illicit drug use in people who cycle through prisons, and the harms associated with use of these substances. We consider some evidence-based responses to these harms - both in prison and after return to the community - and discuss their implications for policy reform.This book is international in scope and multi-disciplinary in character. It brings together and integrates the perspectives of public health and addictions researchers, criminologists and correctional leaders, epidemiologists, physicians, and human rights lawyers. Our contributors are unified in their commitment to evidence-informed policy - that is, doing what we know works. An overarching theme pervading all of the chapters is that people who cycle through prisons come from the community, and almost always return to the community. Their health problems are therefore our health problems; in other words, 'prisoner health is public health'\"--Provided by publisher.

Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.

\"Just say no\" just doesn't work for everyone. Presenting a powerful alternate to abstinence-only addictions treatments, this empathic, nonjudgmental resource has already helped thousands set and meet their own goals for gaining control over alcohol and drugs. The science of harm reduction is translated into step-by-step strategies that readers can use to figure out which aspects of their habits may be harmful, what they would like to change, and how to put their intentions into action. Updated to reflect a decade's worth of research, the fully revised second edition is even more practical and reader friendly. It features additional concrete examples, engaging graphics, new worksheets (which can be downloaded and printed for repeated use), \"Self-Reflection\" boxes, and more.-- Source other than Library of Congress.

Dealing with Substance use disorders (SUDs) in conjunction with psychopathological conditions such as Major Depressive Disorder (MDD), bipolar disorder (BD), and schizophrenia - often referred to as dual diagnosis or co-occurring disorders - poses significant challenges for both patients and clinicians, requiring integrated treatment approaches that simultaneously tackle both substance use and psychopathology. The objective of this systematic review is to analyse and summarize the existing research on the various pharmacological treatments for dual diagnosis, providing a comprehensive understanding of their effectiveness and identifying areas requiring further exploration. The systematic review was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the id number CRD 42024500114. The analysis of the available literature identified 66 articles, 29 related to SUDs & schizophrenia, 20 focused on SUDs & MDD, and 17 on SUDs & BD. Overall, most manuscripts recording SUDs concerned the following drugs: alcohol (N = 26), cannabis (N = 19), opioids (N = 10), cocaine (N = 10), and amphetamine (N = 3), while several studies described SUDs in general (N = 12). Findings were presented thematically based on the type of intervention for each of the main conditions recorded. In the case of psychotic symptoms and SUDs, aripiprazole appeared to be the most used medication in the maintenance therapy not only for its effectiveness but also for its safety profile. Alternatively, despite the side effects, clozapine showed a good efficacy in the management of symptoms and in terms of relapse prevention. Moreover, long-acting medications might be an effective option in the control of impulsivity and psychotic symptoms, but also in first-episode psychosis, reducing relapse and rehospitalization. With regard to the treatment of MDD/BD and SUDs, there are mixed findings regarding the best medication for symptom control; notably, different degrees of efficacy were recorded if added to psychological/behavioural interventions, or combined with specific SUD treatments, such as opioid receptor agonist/antagonist therapies or the anti-glutamatergic drugs acamprosate/memantine, etc. The current body of evidence includes mixed findings in terms of which medication is superior in controlling symptoms, according to the specific psychopathology, the specific SUD involved, the treatment setting, and the primary objective of care. Overall, pharmacological treatments for dual diagnosis are complex and require personalized approaches considering the heterogeneity of the population. Future research should focus on developing individualized treatment plans and understanding the biological underpinnings of dual diagnosis to create more targeted, effective pharmacological interventions. •Dual diagnosis—the co-occurrence of SUD and mental illness—poses major challenges for effective mental health treatment.•Traditional treatment models separate mental illness and SUD care, but this approach is often ineffective for dual diagnosis.•Medication management can be challenging and requires a comprehensive, individualized, and integrated approach

We examine the effect of Medicaid expansion under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization and financing. We combine data on admissions to specialty facilities and Medicaid-reimbursed prescriptions for medications commonly used to treat SUDs in nonspecialty outpatient settings with an event-study design. Several findings emerge from our study. First, among patients receiving specialty care, Medicaid coverage and payments increased. Second, the share of patients who were uninsured and who had treatment paid for by state and local government payments declined. Third, private insurance coverage and payments increased. Fourth, expansion also increased prescriptions for SUD medications reimbursed by Medicaid. Fifth, we find suggestive evidence that admissions to specialty treatment may have increased one or more years post-expansion. However, this finding is sensitive to specification and we observe differential pretrends between the treatment and comparison groups. Thus, our finding for admissions should be interpreted with caution.

This brief provides an overview of the emerging field of Electronic Therapy, E-Therapy, with a specific focus on alcohol and substance abuse. Understanding barriers that prevent individuals from seeking necessary mental health treatment is at the center of the development and analysis of practice models of care. Geographic location, transportation, language barriers and other situations contribute to difficulties in obtaining adequate treatment for mental illness. E-Therapy eliminates these barriers by administering counseling and mental health services through audio or audiovisual means. This brief examines E-Therapy best practices as they apply to alcohol and substance abuse intervention and prevention.

Purpose of Review We apply the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria for substance use disorders (SUDs) to the herbal product kratom. Similarities and differences between kratom use disorder (KUD) and other SUDs are explored, along with assessment, diagnostic, and therapeutic recommendations for KUD. Recent Findings Literature reports of “kratom addiction” or KUD rarely specify the criteria by which patients were diagnosed. Individuals meeting DSM-5 KUD criteria typically do so via tolerance and withdrawal, using more than intended, and craving, not functional or ​psychosocial disruption, which occur rarely. Most clinicians who use medication to treat patients with isolated KUD select buprenorphine formulations, although there are no controlled studies showing that buprenorphine is safe or efficacious in this patient population. Summary Diagnosis and treatment decisions for KUD should be systematic. We propose an algorithm that takes into consideration whether KUD occurs with comorbid opioid use disorder.

\"Heroin is a worldwide scourge and a seemingly intractable one. The Life of the Heroin User: Typical Beginnings, Trajectories and Outcomes is the first book to apply a biographical approach to the lifecycle of the heroin user from birth until death. Chapters address each stage of the user's life, including childhood, routes to use, the development of dependence, problems arising from addiction, death and options for treatment and prevention. Drawing on over two decades of experience in the field of opium research, Shane Darke examines major theoretical approaches to the development of opiate dependence and the efficacy of treatment options for opiate dependence. Key points are presented at the end of each chapter. The most detailed review available of what is likely to happen to the dependent heroin user, this is an important book for clinicians, researchers and students in the fields of drug and alcohol studies and public health\"-- Provided by publisher.

About 17 million people worldwide engage in heroin and non-medical prescription opioid use, resulting in a public health emergency with substantial morbidity and mortality.1 In parts of North America and western Europe, overdose deaths have surpassed motor vehicle crash fatalities,2,3 and even the US presidential campaign has pivoted to addressing the opioid crisis as a national issue. Recognising young people commonly receive care from a paediatrician or general practitioner during adolescence and young adulthood--precisely when the incidence of opioid use disorder sharply increases4--the American Academy of Pediatrics has released a policy statement that calls for expanded access to medication-assisted treatment (MAT) for youth.5 This is the first time a major paediatric professional organisation has explicitly supported extending MAT to young people for opioid maintenance therapy.