Cocaine and Methamphetamine Dependence: A Comprehensive Guide to Treatment and Management

By Thomas R. Kosten, a renowned expert in the field, this book delves into the complex world of stimulant dependence, providing invaluable insights for psychiatrists, primary care physicians, and residents alike.

The APA’s Textbook of Addiction Psychiatry covers the foundational knowledge necessary for general psychiatrists and primary care physicians to identify and initially manage stimulant dependence. However, Cocaine and Methamphetamine Dependence: Advances in Treatment goes beyond the basics, shedding light on the rapid evolution of understanding and treatment of stimulant abusers.

The Devastating Consequences of Stimulant Abuse

Cocaine dependence complications account for one out of every three drug-related emergency room visits. Furthermore, coroners’ reports reveal that stimulants are directly responsible for 25% of cocaine overdoses and 68% of methamphetamine overdoses. In addition, 20% of these abusers die due to cardiovascular or medical problems stemming from stimulant use.

Co-occurring mental illnesses, such as schizophrenia, major depression, and post-traumatic stress disorder, frequently accompany cocaine and methamphetamine abuse and dependence. This highlights the importance of understanding stimulant dependence within the psychiatric community to provide effective evaluation and treatment.

Key Insights and Strategies for Effective Treatment

This comprehensive guide provides:

• An overview of the DSM-5 plan to drop the distinction between abuse and dependence, adding craving as a criterion.
• An examination of the changing epidemiology of stimulant abuse, including the rise of pharmaceutical abuse due to increased availability through family and friends.
• The insight that even after long abstinence, stimulant users may remain vulnerable to amphetamine-induced psychosis, with delusions, paranoia, and compulsive behavior.
• The importance of comprehensive patient assessment, including the management of aberrant behaviors such as intoxication, violence, suicide, impaired cognitive function, and uncontrolled affective displays.
• A focus on treatment, emphasizing the crucial role of behavioral therapies, often combined with adjunctive medications.
• A review of the criminal justice system’s shift towards more human treatment, including the benefits of medical management and treatment.

In conclusion, Cocaine and Methamphetamine Dependence is an indispensable resource for residents, physicians, and psychiatrists who encounter stimulant users and abusers in their daily practice. As our understanding of stimulant abuse and dependence continues to evolve, this book serves as a beacon of hope for the millions affected by these devastating substances.