Contents
Section Editors  iv
Contributors  vi
Preface  xxiii
Acknowledgments  xxv
Tributes  xxvi
SECTION 1
BASIC SCIENCE AND CORE CONCEPTS  1
 1 Substance Use Disorders: The Neurobiology of Motivation 
Gone Awry  2
Nora D. Volkow, George F. Koob, and Ruben Baler
 2 Recommended Use of Terminology in Addiction 
Medicine  27
Shannon C. Miller, Richard N. Rosenthal, Jeanette M. Tetrault, 
Sarah E. Wakeman, Andrew J. Saxon, and Sharon Levy
 3 The Anatomy of Addiction  34
Michael J. Wesley, Colleen A. Hanlon, and Thomas J. R. Beveridge
 4 Clinical Trials in Substance-Using Populations  48
Frank Vocci
 5 Addiction Medicine Physicians and Collaborative Care 
Clinicians as Change Agents for Prevention and Public 
Health  64
Warren Yamashita, Kevin Kunz, and Omari Hodge
 6 Climate Change and Addiction Medicine  76
Shannon C. Miller and John W. Sullenbarger
 7 The Cigarette Industry’s Role in Promoting Tobacco Use 
Disorder  89
K. Michael Cummings
 8 The Impact of the Alcohol Industry on Alcohol Use 
Disorder  105
Thomas F. Babor
 9 The Impact of the Cannabis Industry on Cannabis Use 
Disorder  116
David H. Jernigan, Jih-Cheng Yeh, Connor Kubeisy, and Kevin A. Sabet
SECTION 2
PHARMACOLOGY  128
 10 Pharmacokinetic, Pharmacodynamic, and 
Pharmacogenomic Principles  129
Lori D. Karan, John G. McNutt, and Anne Zajicek
 11 The Pharmacology of Alcohol  148
John J. Woodward
 12 The Pharmacology of Nonalcohol Sedative Hypnotics  165
Carolina L. Haass-Kof? er and Elinore F. McCance-Katz
 13 The Pharmacology of Opioids  178
Daryl Shorter, Coreen B. Domingo, and Thomas R. Kosten
 14 The Pharmacology of Stimulants  191
David A. Gorelick and Michael H. Baumann
 15 The Pharmacology of Caffeine  217
Laura M. Juliano, Sergi Ferré, Darian Weaver, and Roland R. Griffi ths
 16 The Pharmacology of Nicotine and Tobacco  230
John A. Dani, Thomas R. Kosten, and Neal L. Benowitz
 17 The Pharmacology of Cannabinoids  248
Justin Matheson, Katrina Mark, Daniele Piomelli, David A. Gorelick, 
and Bernard Le Foll
 18 The Pharmacology of Hallucinogens  269
David B. Yaden, David S. Mathai, Michael P. Bogenschutz, 
and David E. Nichols
 19 The Pharmacology of Dissociatives  293
Nicholas Denomme, Hamilton Morris, Jason Wallach, 
and Shannon C. Miller
 20 The Pharmacology of Inhalants  308
Robert L. Balster and Silvia L. Cruz
 21 The Pharmacology of Anabolic-Androgenic 
Steroids  317
Scott E. Lukas
 22 Electronic Drug Delivery Devices  337
Gideon St.Helen and Shannon C. Miller
 23 Novel Psychoactive Substances  357
Kathryn Hawk, Barbara M. Kirrane, and Gail D’Onofrio
SECTION 3
EPIDEMIOLOGY AND PREVENTION  366
 24 The Epidemiology of Substance Use Disorders  367
Silvia S. Martins, Megan E. Marziali, and Pia M. Mauro
Sidebar Primary, Secondary, and Tertiary Prevention  385
James C. Anthony
 25 Preventing Substance Use Among Children and 
Adolescents  390
Kenneth W. Griffi n and Gilbert J. Botvin
 26 Environmental Approaches to Prevention: Communities 
and Contexts  399
Mallie J. Paschall, Joel W. Grube, Robert F. Saltz, and Paul J. Gruenewald
 27 Prevention of Prescription Medication Misuse  408
Beth Han, Christopher M. Jones, and Wilson M. Compton
 28 The Harm Reduction Approach to Caring for People Who 
Use Substances  423
Alexander Y. Walley, Sharon Stancliff, and India Perez-Urbano
 29 College Student Drinking  437
Lauren McClain, Frank J. Schwebel, Ursula Whiteside, Jason R. Kilmer, 
Ty W. Lostutter, and Mary E. Larimer
 30 Policy and Leadership: Impact on Primary, Secondary, 
and Tertiary Prevention of Substance Use Disorders 
in Military Personnel and Beyond  453
Kenneth Hoffman and Janet H. Lenard
Sidebar Challenges of Reintegration for Military Personnel 
and Their Families  464
Joan E. Zweben and Susan StortiSECTION 4
DIAGNOSIS, ASSESSMENT, AND EARLY 
INTERVENTION TREATMENT  471
 31 Screening and Brief Intervention  472
Kenneth W. Verbos II, Alice Zhang, Ahyeon Cho, Suena H. Massey,  
and Aleksandra E. Zgierska
Sidebar 1 Screening and Brief Intervention in 
Pregnancy  496
Nicolas Bertholet
Sidebar 2 Screening and Brief Intervention in Trauma 
Centers, Hospitals, and Emergency  
Departments  504
Arthur F. Weissman and Richard D. Blondell
Sidebar 3 Implementation of Screening and Brief 
Intervention in Clinical Settings Using Quality Improvement 
Principles  506
Emily C. Williams and Katharine A. Bradley
Sidebar 4 Screening for Unhealthy Alcohol and Drug Use  
in Older Adults  510
Jennifer McNeely and Benjamin Han
 32 Laboratory Assessment  515
Sacha N. Uljon, Eugene Lambert, and Eric Lott
 33 Assessment  526
Deirdre O’Sullivan and Abenaa Jones
Sidebar 1 Hospital-Based Addiction Care  535
Honora Englander, Jennifer McNeely, and Zoe M. Weinstein
Sidebar 2 Prevention and Early Treatment in the  
Workplace Setting  542
Marianne Cloeren, Jodi J. Frey, and Indira G. Jetton
 34 Addiction Among Physicians and Physician Health 
Programs  551
Paul H. Earley and Chris Bundy
Sidebar Health care Professional Wellness After Patient 
Overdose Death  575
Amy M. Yule and Frances Rudnick Levin
SECTION 5
OVERVIEW OF ADDICTION TREATMENT  579
 35 Addiction Medicine in America: Its Birth, Early History,  
and Current Status (1750-2022)  580
Kevin Kunz, Hoover Adger, William L. White,  Timothy K. Brennan,  
Annie Lévesque, and Jacqueline Deanna Wilson
 36 The Treatment of Substance Use Disorders: An 
Overview  594
Lawrence S. Brown Jr, Andrea G. Barthwell, and Ana Ventuneac
 37 Identification and Treatment of High-Risk Alcohol Use  
and Alcohol Use Disorder: An Overview  609
Mark Willenbring
 38 Race, Ethnicity, Gender, and Social Determinants of 
Health, Disparities, and Access to Care  621
Oluwole O. Jegede, Myra L. Mathis, Richard Youins, Kimberly Guy, 
Skylar Gross, and Ayana Jordan
 39 Cultural Issues in Addiction Medicine  627
Andrea G. Barthwell
 40 Substance Use and Co-occurring Conditions  
in Women  635
 41 Treatment of Substance Use Disorders in Older 
Adults  653
Frederic C. Blow, Kristen J. Barry, and Angela M. Tiberia
 42 Treatment Considerations for LGBTQ Patients  666
Timothy M. Hall, Maliha Khan, and Steven Shoptaw
 43 Military Sexual Trauma  680
Joan E. Zweben
 44 Traumatic Brain Injury and Substance Use Disorders  685
David L. Pennington, Amy A. Herrold, and Angela M. Mueller
 45 Integrated Care for Substance Use Disorder  701
Emma E. McGinty, Rachel H. Alinsky, and Mark McGovern
 46 Substance Use–Related Care—Interprofessional 
Collaborative Practice  713
Deborah S. Finnell, Jeffrey Bratberg, and Lisa K. Berger
 47 The ASAM Criteria and Matching Patients to 
Treatment  725
David R. Gastfriend and R. Corey Waller
 48 Linking Addiction Treatment With Other Medical and 
Psychiatric Treatment Systems  740
Alyssa F. Peterkin, Karran A. Phillips, Peter D. Friedmann,  
and Jeffrey H. Samet
 49 Reducing Inequities of Care Through Changes in 
Practice  758
Kimberly Sue, Amanda Latimore, and India Perez-Urbano
 50 Quality Improvement for Addiction Treatment  768
James H. Ford II, Kim A. Hoffman, Kimberly Johnson, and Javier Ponce 
Terashima
Sidebar Delivery of Addiction Medicine Care via Video or 
Phone  780
Christopher M. Jones and Yngvild Olsen
SECTION 6
NONSUBSTANCE ADDICTION-RELATED 
DISORDERS  787
 51 Understanding Nonsubstance  
Addictions  788
Luis C. Farhat, Sarah W. Yip, and Marc N. Potenza
 52 Gambling Disorder: Clinical Characteristics and 
Treatment  812
Jon E. Grant and Brian L. Odlaug
 53 Compulsive Sexual Behaviors  826
Timothy M. Hall, Anya Bershad, and Steven Shoptaw
 54 Disorders Associated With Technology and Social  
Media  842
Richard N. Rosenthal and Jon E. Grant
SECTION 7
MANAGEMENT OF INTOXICATION AND 
WITHDRAWAL  859
 55 Management of Intoxication and Withdrawal: General 
Principles  860
Tara M. Wright, Jeffrey S. Cluver, and Hugh Myrick
 56 Management of Alcohol Intoxication and Withdrawal  868
Alan A. Wartenberg, Hannan M. Braun, and Cara Zimmerman
 57 Management of Sedative-Hypnotic Intoxication and 
Withdrawal  888 58 Management of Opioid Intoxication and Withdrawal  908
Kenneth L. Morford, Julia M. Shi, Patrick G. O’Connor, and  
Jeanette M. Tetrault
 59 Management of Stimulant, Hallucinogen, Cannabis, 
Phencyclidine, and Other Drug Intoxication and 
Withdrawal  923
Jeffery N. Wilkins, David A. Gorelick, Itai Danovitch, Nicholas  
Athanasiou, and Steven Allen
SECTION 8
PHARMACOLOGICAL INTERVENTIONS AND 
OTHER SOMATIC THERAPIES  945
 60 Pharmacological Interventions for Alcohol Use 
Disorder  946
Norah Essali, Hugh Myrick, and Andrew J. Saxon
 61 Pharmacological Interventions for Sedative-Hypnotic Use 
Disorder  961
Alyssa Braxton, Jeffrey S. Cluver, Tara M. Wright, and Hugh Myrick
 62 Pharmacological Treatment for Opioid Use Disorder  969
David Kan and Joan E. Zweben
Sidebar Medical Director Stewardship of Opioid Treatment 
Programs  994
Kenneth B. Stoller
 63 Special Issues in Office-Based Opioid Treatment 
(OBOT)  999
Amy J. Kennedy and Andrew J. Saxon
 64 Pharmacological Treatment of Stimulant Use 
Disorders  1014
David A. Gorelick and Jeffery N. Wilkins
 65 Pharmacological Interventions for Nicotine and Tobacco 
Use  1030
Randi M. Williams, Frank T. Leone, and Robert Schnoll
 66 Pharmacological Interventions for Other Substances and 
Multiple Substance Use Disorders  1045
Jeffery N. Wilkins, Mark Hrymoc, Manjit Bhandal, and David A. Gorelick
 67 Complementary and Integrative Interventions for Substance 
Use Disorders  1052
Ripal Shah and David Spiegel
  68 Neuromodulation for Substance Use Disorders  1064
Colleen A. Hanlon, Kaitlin R. Kinney, Miranda P. Ramirez,  
and Michael J. Wesley
SECTION 9
PSYCHOLOGICALLY BASED 
INTERVENTIONS  1073
 69 Enhancing Motivation to Change  1074
James O. Prochaska and Janice M. Prochaska
 70 Motivational Interviewing  1085
Cassandra L. Boness, Antoine Douaihy, and Karen S. Ingersoll
 71 Group Therapies  1094
Dennis C. Daley, Antoine Douaihy, and Roger D. Weiss
 72 Individual Treatment  1107
Edward V. Nunes and Kenneth M. Carpenter
 73 Contingency Management and the Community 
Reinforcement Approach  1128
Sarah H. Heil, Tyler G. Erath, Roxanne F. Harfmann, and  
Stephen T. Higgins
 74 Behavioral Interventions for Tobacco Use Disorder  1143
Joanna M. Streck, Angela Wangari Walter, Rachel L. Rosen,  
and Elyse R. Park
 75 Network Therapy  1164
Marc Galanter
 76 Therapeutic Communities and Modified Therapeutic 
Communities for Co-occurring Mental and Substance  
Use Disorders  1175
George De Leon and Stanley Sacks
 77 Aversion Therapies  1189
Hanne Tonnesen, P. Joseph Frawley, and Richard Montgomery
 78 Family Involvement in Addiction, Treatment,  
and Recovery  1198
Julianne C. Flanagan and Brandi C. Fink
 79 Twelve-Step Facilitation Approaches  1213
Antoine Douaihy, Dennis M. Donovan, and Dennis C. Daley
 80 Relapse Prevention: Clinical Models and Intervention 
Strategies  1219
Antoine Douaihy, Dennis C. Daley, and Dennis M. Donovan
 81 Mindfulness-Based Treatment of Addiction  1236
Eric L. Garland and Anna Parisi
 82 Digital Health Interventions for Substance Use Disorders: 
The State of the Science  1250
Smita Das
 83 Medical Management Techniques and Collaborative 
Care: Integrating Behavioral With Pharmacological 
Interventions  1261
Richard N. Rosenthal, Richard K. Ries, and Joan E. Zweben
SECTION 10
MUTUAL HELP: TWELVE STEP AND OTHER 
PROGRAMS IN ADDICTION RECOVERY  1278
 84 Twelve-Step and Other Programs in Addiction 
Recovery  1279
Edgar P. Nace
 85 Recent Research Into Twelve-Step Programs  1289
John F. Kelly
 86 Spirituality in the Recovery Process  1308
Marc Galanter
SECTION  11
MEDICAL DISORDERS AND COMPLICATIONS  
OF ADDICTION  1313
 87 Medical Care of Patients With Unhealthy Substance 
Use  1314
Darius A. Rastegar
 88 Cardiovascular Disorders Related to Substance  
Use  1335
Andi Shahu, Steven E. Pfau, and Samit M. Shah
 89 Liver Disorders Related to Substance Use  1355
Paul S. Haber and Emily Nash
 90 Renal and Metabolic Disorders Related to Substance 
Use  1376
Sarah Gilligan and Naveen Rathi 91 Gastrointestinal Disorders Related to Substance Use  1389
Paul S. Haber and Nicholas C. Kortt
 92 Pulmonary Disorders Related to Substance Use  1402
Tessa L. Steel, Corey Sadd, and Majid Afshar
 93 Neurological Disorders Related to Substance Use  1420
Emmanuelle A. D. Schindler, Mona Al Banna, Brian B. Koo,  
Darren C. Volpe, Hamada Hamid Altalib, and Jason J. Sico
 94 Human Immunodeficiency Virus, Tuberculosis, and Other 
Infectious Diseases Related to Substance Use  1444
Carol A. Sulis, Ayesha Appa, and Simeon D. Kimmel
 95 Sleep Disorders Related to Substance Use  1463
Sanford Auerbach
 96 Traumatic Injuries Related to Alcohol and Other Drug 
Use  1482
Edouard Coupet Jr, Deepa R. Camenga, Gail D’Onofrio, and Federico E. Vaca
 97 Endocrine and Reproductive Disorders Related to 
Substance Use  1490
Priya Jaisinghani and Gwendolyne Anyanate Jack
 98 Substance Use During Pregnancy  1509
Michael F. Weaver, Hendrée E. Jones, and Martha J. Wunsch
 99 Perioperative Management of Patients With Substance 
Use  1530
Zoe M. Weinstein, Megan E. Buresh, and Daniel P. Alford
SECTION 12
CO-OCCURRING ADDICTION AND OTHER 
PSYCHIATRIC DISORDERS  1544
 100 Substance-Induced Mental Disorders  1545
Mark H. Duncan, R. Jeffrey Goldsmith, Matthew Iles-Shih,  
and Richard K. Ries
 101 Co-occurring Mood Disorders and Substance 
Use Disorders  1559
Edward V. Nunes and Jungjin Kim
 102 Co-occurring Substance Use, Anxiety Disorders,  
and Obsessive-Compulsive Disorders  1589
Alyssa Braxton, Eric T. Dobson, and Karen J. Hartwell
 103 Co-occurring Psychosis and Substance Use Disorders  1601
Douglas Ziedonis, Xiaoduo Fan, Snehal Bhatt, and Stephen A. Wyatt
 104 Co-occurring Attention Deficit Hyperactivity Disorder  
and Substance Use Disorders  1622
David Saunders and Frances Rudnick Levin
 105 Co-occurring Personality Disorders  
and Substance Use Disorders  1643
Stephen Ross, Adam Demner, Daniel Roberts, Petros Petridis,  
and Michael Torres
 106 Co-occurring Posttraumatic Stress Disorder and Substance 
Use Disorders  1658
Tanya C. Saraiya, Sudie E. Back, Michael E. Saladin,  
Therese K. Killeen, and Kathleen T. Brady
 107 Co-occurring Eating Disorders and Substance Use 
Disorders  1678
Lisa J. Merlo, Nicole Avena, Ashley N. Gearhardt, and Mark S. Gold
SECTION 13
PAIN AND ADDICTION  1690
 108 The Pathophysiology of Chronic Pain and Clinical Interfaces 
With Substance Use Disorder  1691
Laura Morgan Frankart and Michael F. Weaver
 109 Psychological Issues in the Management of Pain  1708
Martin D. Cheatle
 110 Assessing and Mitigating Risk of Suicide in Patients  
With Pain and Substance Use Disorders  1726
Martin D. Cheatle
 111 Rehabilitation Approaches to Pain Management  1734
Steven Stanos and Randy L. Calisoff
  112 Nonopioid Pharmacotherapy of Pain  1747
Emily R. Casey and Tanya J. Uritsky
 113 Opioid Therapy of Pain  1761
Peggy Compton and Friedhelm Sandbrink
 114 Co-occurring Pain and Substance Use Disorders  1791
William C. Becker and Declan T. Barry
 115 Legal and Regulatory Considerations in Opioid 
Prescribing  1800
David J. Copenhaver, Rohit Nalamasu, Wesley R. Prickett, Julia Megan 
Webb, and Scott M. Fishman
SECTION 14
CHILDREN AND ADOLESCENTS  1810
 116 Screening and Brief Intervention for  
Adolescents  1811
Jessica B. Calihan and Lydia A. Shrier
Sidebar 1 Neurobiological Determinants of Addiction  
in Children and Adolescents  1822
Marisa M. Silveri, Andie Stallman, and Jennifer T. Sneider
Sidebar 2 Governmental Policy on Cannabis Legalization  
and Use: Impact on Youth   1827
Ziming Xuan, Lynsie Ranker, and Sion Kim Harris
 117 Assessing Adolescent Substance Use  1833
Ken C. Winters, Randy Stinchfield, and Shelby Franklin
 118 Placement Criteria and Strategies for Adolescent Treatment 
Matching  1838
Marc Fishman
Sidebar 1 Confidentiality in Caring for  
Adolescents  1850
Connor J. Buchholz  and Scott E. Hadland
Sidebar 2 Drug Testing Adolescents in School  1853
J. Wesley Boyd and John R. Knight
 119 Treating Substance Use Disorders in Carceral-Involved 
Youth  1855
Kevin M. Simon 120 Treatment of Addiction-Related Disorders in 
Adolescents  1862
Steven L. Jaffe, Justine Welsh, and Peter R. Cohen
 121 Pharmacotherapy for Adolescents  
With Substance Use Disorders  1871
Jacqueline Deanna Wilson and Paula Goldman
 122 Co-occurring Psychiatric Disorders in Adolescents With 
Addiction-Related Issues  1883
Martha J. Ignaszewski and Oscar Bukstein
SECTION 15
ETHICAL, LEGAL, AND LIABILITY ISSUES  
IN ADDICTION PRACTICE  1895
 123 Ethical Issues in Addiction Practice  1896
Timothy K. Brennan and H. Westley Clark
 124 Consent and Confidentiality Issues in Addiction 
Practice  1904
Louis E. Baxter Sr and Nan Gallagher
 125 Clinical, Ethical, and Legal Considerations in Prescribing 
Medications With Potential for Nonmedical Use and 
Addiction  1911
James W. Finch, Theodore V. Parran Jr, and Steven Prakken
Sidebar 1 Drug Control Policy: History and Future 
Directions  1927
John J. Coleman and Robert L. DuPont
Sidebar 2 Guidance on the Use of Opioids to Treat  
Chronic Pain  1933
Steven Prakken and James W. Finch
 126 Therapeutic Effectiveness of Cannabis and 
Cannabinoids  1937
Jag H. Khalsa, Gregory C. Bunt, Marc Galanter, Mahmoud A. El-Sohly,  
and Shyam Kottilil
Sidebar Legal and Ethical Considerations for  
Clinicians Recommending Cannabis Used as 
Treatment  1954
Nassima Ait-Daoud Tiouririne and Jeffrey Katra
 127 Practical Considerations in Drug Testing  1957
Jennifer A. Collins
Sidebar Workplace Drug Testing and the Role of the Medical 
Review Officer  1969
James L. Ferguson and Robert L. DuPont
 128 Reducing Substance Use in Court-Leveraged 
Treatment  1975
Douglas B. Marlowe
Sidebar Reducing Disparities in Substance Use Services 
in Legal System Settings Among BIPOC and Minority 
Groups  1982
Fred Rottnek
Index  1989
APPENDICES (ONLINE ONLY)
Appendix 1: Changes to ASAM Criteria Levels of Care
Martha J. Wunsch
Appendix 2: Consolidated Appropriations Act of 2023 and 
Buprenorphine Prescribing Requirements
Martha J. Wunsch