Posts Tagged ‘books’

Top Ten Books for Methadone Counselors

I have a fair number of methadone counselors who read my blog. I’m often asked by these counselors what books I recommend, which is like asking me what kind of dessert is good. The list is so long. But here are the ones all methadone counselors should read:

  1.  Medication-assisted Treatment for Opioid Addiction in Opioid Treatment Programs, by the Substance Abuse and Mental Health Services Administration. This is better known as “TIP 43,” because it’s the 43rd book in the series of treatment improvement protocols published by SAMHSA. You can get any book in the series for FREE! Yes, this book and several others are free resources. The website is: http://store.samhsa.gov. While you’re there, order TIP 40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, and TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment. Then browse around, and see what else interests you. This is a great website, and all addictions counselors should be very familiar with it. There’s great material for counselors and their clients.
  2.   Pain Pill Addiction: Prescription for Hope, by….me. Hey, it’s my blog, so of course I’m gonna list my book. At least I didn’t put it at number one. But seriously, I do think my book describes what opioid addiction is, why this country is having such problems with opioid addiction now, and the available treatments for this addiction. I focus on medication-assisted treatments, which means treatments with methadone or buprenorphine, better known as Suboxone. After reading my book, any substance abuse counselor should be able to talk intelligently with patients and their families about the pros and cons of medication-assisted treatment. I tried hard to base this book on available research and not my own opinions, though I do state some of my opinions in the book. My book also has summaries of the major studies done using medication-assisted treatments, so that if you need resources to prove why methadone works, you’ll have them. OK. I’m done blathering. Order it on EBay and you’ll save some money.
  3.      Motivational Interviewing by William Miller and Stephen Rollnick. This is a book all addiction counselors should have… and read. I’ve learned so much about how to interact with people as they consider if, how, and when to make changes in their lives by reading this book. The authors demonstrate how the Stages of Change model easily fits with this style of counseling. There are some solid examples of how to incorporate MI techniques.
  4.      Cognitive Therapy of Substance Abuse, by Aaron Beck et. al. This is a venerable text describing cognitive therapy as it applies to substance abuse. The book is relatively concise, but it’s still dense reading. Get out your underliner because you’ll want to find some parts to read again. The dialogues in the book that serve as examples are instructive. This book has been around for some time, as texts go, since it was published in 2001.
  5.     Narcotics Anonymous Basic Text, by Narcotics Anonymous World Service. Now in its sixth edition, this is one of the books that serve as a foundation for 12-step recovery in Narcotics Anonymous. If you are a counselor who’s in recovery, you’ve probably already read it. If you’re not, you need to get it, read it, and be able to talk intelligently about the 12-step recovery program of this 12-step group. The AA “Big Book,” which is AA’s version of a basic text, has much of the original old-time words and phrases, and speaks mostly of alcohol. For these reasons, some addicts won’t like the Big Book as well as the NA Basic Text. However, the Big Book does have a certain poetry that will appeal to others. (….trudge the road of happy destiny…) You can order it at http://na.org or go to that site and download it as a pdf.
  6.  The Treatment of Opioid Dependence, by Eric Strain and Maxine Stitzer. Written in 2005, this is an update to a similar title written in the 1990’s. This book reviews the core studies underpinning our current treatment recommendations for patients in medication-assisted treatment of opioid addiction. I don’t know why more people haven’t read this book, because it’s relatively easy to understand. Don’t make the mistake of assuming it will be too advanced for you. Get it and read it.
  7. Addiction and Change: How Addictions Develop and Addicted People Recover, by Carlo DiClemente. This book describes the paths people follow as they become addicted and as they recover. It’s focused on the transtheoretical model of the stages of change, so named because it can be used with many counseling theories. I think this is a practical book, and easier to understand than some texts.
  8.  Diagnosis Made Easier: Principles and Techniques for Mental Health Technicians, by James Morrison M.D. This is an improvement of his earlier book, DMS IV Made Easy, written in 1992. At any work site, addictions counselors will have to be familiar with the criteria used to diagnose mental illnesses. Since around 30 – 50% of addicts have another co-occurring mental illness, you need to be familiar with the criteria used to diagnose not just addiction, but these other illnesses as well. And this book makes learning relatively painless. It’s practical and easy to read, and based on common sense. It contains many case examples, which keep it interesting.
  9. The American Disease: Origins of Narcotic Control, by David Musto. This book has been updated and is on its third edition, but so much has happened since this last edition in 1999 that the author needs to write an update. This is an interesting book, and it moves fairly quickly. This information puts our present opioid problem into the context of the last century or so. As an alternative, you can read Dark Paradise: A History of Opiate Addiction in America, by David Courtwright in 2001. I included this book, but be warned it’s heavier reading. This author is an historian, so maybe his writing style didn’t resonate with me as much. Still, he has much good information. You can’t go wrong with either book. You could also read The Fix by Michael Massing, which is another book about the history of addiction and its treatment in the U.S… This last book doesn’t focus on just opioid addiction, but still gives all the pertinent history. This book is written by a journalist and will keep your interest. It was written in 2000.
  10.  Hooked: Five Addicts Challenge Our Misguided Drug Rehab System, by Lonnie Shavelson. This book, written by a journalist, follows five addicts through the labyrinth of addiction treatment. You’ll see the idiotic obstructions addicts seeking help are asked to negotiate in our present healthcare system. I was angry as I read the book, seeing obvious simple solutions that couldn’t be enacted for one administrative reason or another. Let this book make you angry enough to demand change from our system. Be an advocate for addicts seeking treatment.

 Have I left out any? Let me know which book have helped you be a better counselor or therapist.

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Bibliotherapy: Books About the History of Addiction and Treatment

Great books about the history of addiction and its treatment have languished in obscurity, never getting the recognition that these bits of history richly deserve.  I’m going to do my small part to encourage people to read these great books.

 The Addicts Who Survived: An Oral History of Narcotic Use in America, 1923-1965, by Courtwright, Joseph, and Des Jarlais. This book, published by the University of Tennessee Press in 1989, is now out of print, so hopefully you can find a copy at your library. I’m so glad I bought one of the few copies. This amazing book is filled with interviews with intravenous heroin addicts who lived through the so called “classic era” of opioid addiction. I got a feel for how fragile life is for IV addicts, and how miraculous it is to survive addiction for 30 years. Many of the survivors went into methadone programs, and credit methadone with saving their lives. Other addicts went on methadone, but are frank about their criticisms of methadone treatment, and their regrets. As an added bonus, this book has interviews with key people who made history during the classic era of opioid addiction in the U.S.: Vincent Dole, M.D., one of the three original investigators of the efficacy of methadone maintenance as a treatment. Dr. Dole describes the harassment and interference he experienced during his work, both from law enforcement and the medical community.

 The Fix, by Michael Massing.  There’s much great history in this book. Much of the book talks about the governmental decisions regarding the treatment of addiction and addicts. The author describes effective treatments for addiction which weren’t continued, because of political pressures. It also describes how policies that didn’t work nonetheless remained in practice because of politics. This book gives us insight into dealing with the present wave of pain pill addiction. If you have to read one book on the history of addiction treatment in the U.S., make it this one. It’s interesting because the author also includes stories of real-life addicts and their struggles to find treatment and recover.

 The American Disease: Origins of Narcotic Control, by David Musto. This may be the best-known book about the history of opioid addiction and treatment in the U.S. The author gives exhaustive references, valuable in their own right. This book may be dense reading for anyone not already interested in the topic, but I loved it. He gives a painstaking history of drug addiction against the background of American culture and politics. Anyone who has input into drug policies needs to read this book.

Dark Paradise: A History of Opioid Addiction in America, by David Courtwright. Much like The American Disease, it is packed full of information, along with insights and interpretation of the information. It covers much of the same information as the other book. It differs in the interpretation of opioid addiction history.

 Hooked: Five Addicts Challenge our Misguided Drug Rehab System, by Lonnie Shavelson. The author, a physician and journalist, follows five addicts with no money through the process of accessing addiction treatment. He documents in excruciating detail the pitiful systems called “treatment” for these addicts. Gaps in care and communication breakdowns would frustrate anyone, but these people are more fragile than most. The roadblocks they face are depressing. This is a fascinating and entertaining book, and left me with a feeling of frustration. It’s a vivid description of how broken our healthcare system is for the indigent.

Slaying the Dragon: The History of Addiction Treatment and Recovery in America, by William White. Written in 1998, this book has it all. It’s probably the most comprehensive book about the history of addiction treatments. Even if you don’t work in the field, you’ll think the book is interesting. It’s a well-written and scholarly book.  Particularly interesting was the descriptions of quack cures for addiction promoted throughout the ages. Some things never change. People desperate and suffering from a disease are vulnerable to different species of snake oil treatments now, as ever in history.

Addiction: from Biology to Drug Policy, by Avram Mack. Written nearly 10 years ago, parts of this might be a little out of date, but it’s still packed with information. It covers technical material, but is accessible to the educated layperson. He has some interesting stories to illustrate his meanings.

 The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts, by Nancy Campbell, 2008. In this little-known book, the author explains how drug addiction was treated from 1935 until 1975. The Narcotic Farm was a unique facility that served both voluntary patients and prisoners who had addiction. For its time, the Farm was moderately open-minded and willing to try new treatments. Sadly, most of the addicts treated to the Farm relapsed, probably because they had no continuing treatment when the addicts returned home. The pictures in the book are great, and tell much of the story of the Narcotic Farm.

We need these books. We don’t have to keep re-inventing the wheel because we can look to the past for guidance about the treatment of the addicts in this country. Our past method of incarcerating addicts clearly did not, is not, working. Public policy makers all over the country at all levels of government need to read these books.

If you know of more such books, tell me.

Bibliotherapy for Families Affected By Addiction

It’s never just the addict (or alcoholic) who suffers.

Anyone who cares about or depends upon the addict suffers. Living with active addiction is too much for most people. Thank God there are more resources now than ever before for the families afflicted by addiction. Treatment centers have family groups and family days, and many therapists are skilled at helping family members. There are 12-step groups devoted to helping family and friends of alcoholics (Alanon) and addiction (Naranon) in nearly every area of the country. Alanon does make a distinction between alcohol and other drugs, while Naranon is for families of people addicted to any drug including alcohol. However, in practice, many people attending Alanon do so because their loved ones use drugs in addition to alcohol.

Well-written books for families of addicts can help initiate the process of understanding and healing. These books can give a starting point to desperate family members, literally worried sick about the addict in their lives.

Popularized by the TV show “Intervention,” some families hold these interventions for the addicted family member. An intervention usually contains certain elements: the addicted person’s friends and family gather together in the presence of the addict, they tell the addict how much they love him or her, they tell the addict how much their addiction hurts them, and what they want the addict to do about his/her problem. Usually this means going to an addiction treatment center. Families usually also tell the addict there will be definite consequences for non-compliance with their requests.

Other people deal with addiction in less directive ways. For example, in Alanon, the focus is kept not on the addict, but on the distressed family member or friend who is affected by the addiction. Alanon helps people deal with the dilemmas that appear with addiction, whether the addict is in or out of the home. Some people go to Alanon years after the addict is dead, because of the long-lasting emotional effects addiction can have. More about Alanon’s approach to dealing with the distress of addiction can be found at their website: http://www.al-anon.alateen.org   Alateen is not for alcoholic teens, but for teenagers who have been affected by the alcoholism of a parent or other close relative, or friend.

I’ve compiled a list of books I’ve found to be useful for family members. These books range widely in their approaches, and at times may contradict each other.

When Enough is Enough, by Candy and Sean Finnegan

            This great book clearly explains the mechanics of holding an intervention, as well as the risks and possible pitfalls. It’s 208 pages long and the paperback version is quite affordable. The authors cover much ground. They discuss all of the factors that must be considered, like financial concerns, physical and mental health issues, and legal issues. Candy is sometimes the interventionist on A&E’s “Intervention,” and has worked for treatment centers with stellar reputations. This is a top choice if you are considering holding an intervention.

Getting Them Sober, Volumes 1, 2, 3, and 4, by Toby Rice Drews

            Don’t let the title mislead you. These books aren’t all about forcing someone to get sober. These slender volumes, written in the 1980’s, have short chapters, written clearly and simply, and are packed with wisdom. I like that these books don’t give absolutes but rather suggestions. I don’t think there’s only one correct solution for every problem. Some people criticize the book, and say the best answer if you are married to an addict is to leave. And that might be the best answer for some people, but not all. It’s rarely so simple. Sometimes there are children involved. Sometimes the addict is your adult child, so there’s no “just leave” solution. The last volume, #4, is subtitled “Separations and Healings”

How Alanon Works For Friends and Families, by Alanon Family Groups

            This book gives a great description of what Alanon is all about. It tells about the common behaviors seen in the alcoholic and the family, and gives hope that even if the alcoholic never quits drinking, you can still have a happy life. It contains stories from other people who’ve lived with addiction, and much can be learned from their experiences. Alanon has several other great books: Paths of Recovery: Alanon’s Steps, Traditions, and Concepts; Alanon’s Twelve Steps and Twelve Traditions; From Survival to Recovery: Growing Up in an Alcoholic Home; The Dilemma of an Alcoholic Marriage. They also publish three small books containing daily meditations, or readings, on some topic connected to Alanon: One Day at a Time, Courage to Change (a bit old-fashioned, assumes the wife is the alanon member) and Hope for Healing (to me it seems this last one has more material for people who had alcoholic parents than the other two)

Codependent No More: How to Stop Controlling Others and Start Caring for Yourself, by Melody Beattie

            This is a classic. Written in the 1980’s, it still contains useful information that isn’t necessarily specific to addiction and the family, but most families with addiction of any sort do have codependent behaviors. The examples are helpful, and her writing is clear. I’m not sure anyone has come up with a great definition of codependency, but if you read this book to the end, you’ll know it when you see it. Also consider reading her daily meditation book, The Language of Letting Go.

Terry: My Daughter’s Life-and-Death Struggle with Alcoholism, by George McGovern

            This is a sad book, written by the father of an alcoholic, who died of exposure outside while drunk. The author is a famous politician, and his writing reveals how addiction is an equal opportunity destroyer. I got the feeling after reading this book that Mr. McGovern regretted not having done things differently. Though Terry went to treatment centers, she wasn’t successful at remaining sober. It sounds like the family detached with love, but now the author regrets detaching to the degree that he did.

 I think each family decides differently how much they can do for the addicted one. Should you provide free room and board to keep the addict off the street? Is that harm reduction… or enabling? Is it, “loving them to death?” Often, addicts say it was only when they had to face the unpleasant consequences of addiction, like sleeping outside in the cold, or going to jail, that they turned towards recovery. But then you read a story like this one, where Terry froze to death in a snow bank.

Beautiful Boy: A Father’s Journey Through his Son’s Addiction, by David Sheff

            This book was on one of my other lists. The book is poignant. In places it is heart-breaking. Over and over, I would think, “Ah, the kid’s finally in good recovery.” And the next sentence contained the next relapse. This author caught exactly the rollercoaster ride of emotions felt by someone who loves a person in active addicition.

From Binge to Blackout, by Toren and Chris Volkmann

            This is an unusual book because it contains the viewpoints of both the alcoholic and the mother of the alcoholic. This book hasn’t gotten the attention it deserves. Both authors are eloquent when describing their thoughts and feelings about what is happening with the son’s alcohol addiction. I believe this book would be interesting to any parent, particularly those with adolescents. From a doctor’s point of view, I was pleased to see Chris Volkmann quoted accurate information when she writes of the science of addiction to alcohol. I was impressed with her ability to convey these scientific concepts lucidly. You should get this book. Really.

Last Call, by Jack Hedblom

            This book is about alcohol addiction, but I don’t recall that it talked about other drugs. It contained a great description of why addiction is classified as a disease. The author, a psychotherapist with a PhD, goes into some detail about recovery from alcohol addiction from mostly a 12-step perspective. It’s a great book, covering all the necessary topics in a straightforward way but without “talking down” to the reader. I like that the book has end notes and references, and also an index. It’s recent – published in 2007, but kind of pricey – new book is $40 on Amazon but used copies are available &  much cheaper.

 This is barely scratching the surface. I have many more recent books that are still in my ever-towering “to read” pile.

 Please tell me about your favorites.

Books for Addiction Counselors and other interested parties:

Here’s my list of favorite addiction-related books. Some are more traditional textbooks, and some were written more for entertainment, but all of these have helped me understand addiction and its treatment better. I highly recommend them all.

Principles of Addiction Medicine, ed. by Ries et. al.,  for the American Society of Addiction Medicine

            It’s expensive, but worth it. It contains comprehensive information about the whole field. If you’re going to work in this field for any length of time, you should buy it. And read it. It’s a mighty tome, and big enough to cause hernias if you lift it the wrong way, at 1408 pages. Get the 2009 4th edition.

Substance Abuse : A Comprehensive Textbook, by Lowinson et. al.

 Published by the American Psychiatric Association, it gives information about addiction from the psychiatrist’s perspective. More heavy lifting, at 1200 pages. This book may function better as a reference. Obviously, the information covered overlaps with information in Principles of Addiction Medicine. (But the latter is the better book, in my opinion) There’s also a distillation of information contained in a paperback version: Substance Abuse Handbook, by Ruiz, which is half the size at 500+ pages.

Addiction Treatment: Science and Policy for the Twenty-first Century, edited by Henningfield et.al.

            This is a small book packed with up-to-date information. If you don’t have much time to read (and I pity you) then this is one of the best books to stay informed. The book is divided into small chapters, written by different people who are experts on the given topic. It even gives space to minority opinions, like the chapter written by Stanton Peele. Once again, he describes in detail how apples are different than oranges. Yeah, I know, doesn’t seem worth discussing to me either. But that’s a short chapter.

High Society: How Substance Abuse Ravages American and What to Do About It, by Joseph Califano

            This book is packed with information and well-written enough to hold anyone’s attention. The book does a great job of describing the current U.S. situation with drug abuse and addiction. Critics of the book may say the book overstates the severity of addiction in the U.S., but sadly, I don’t it does. He cites extensive references, so go check them out yourself if you doubt what you read.

Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It, edited by William Miller and Kathleen Carroll

            This book gives the latest update on which treatments are evidence-based, and discusses why these treatments aren’t being used to their fullest.  In this country, there is a gap between what we know to be the best kinds of treatments for addiction, and the treatments that are actually delivered. If you read this book, you’ll be better able to recognize which treatments we should be using. Some might find this book a little dry. The sections are written by people who know what they’re talking about.           

Addiction and Grace, by Gerald May

            This is still my all-time favorite. A small book, it talks about the nature of addiction, and the spiritual aspects of addiction and recovery. It describes the behaviors addictions can cause. It points out how all of us have addictions to varying degrees, which the author calls attachments. These attachments may not be to drugs, but they can be to activities, people, or behaviors.

Motivational Interviewing, by William Miller

            This book, along with Stages of Change by Prochaska and DiClemente describe the nuts & bolts of the motivational interviewing techniques. It goes into great detail about how MI is done, and points out the underlying reasons why this method works. Many people think they already “do” motivational interviewing, and they may – but reading this book will help you do it better. This method really works well with chronically angry clients.

Women Under the Influence, by the National Center on Addiction and Substance Abuse (CASA)

            Probably the most extensively researched and annotated book describing addiction in women. Not only is the book itself interesting and educational, it has dozens of useful references. Be sure and check out CASA’s other books, most of which can be downloaded for free from their website: “You’ve Got Drugs,” about controlled substances access via the internet, “Shoveling Up,” about the cost of addiction to society, and “Under the rug” about how addiction is under diagnosed in some groups.

 I could go on and on, but this is a start….

Oh. Of course. I need to mention my all-time, number one favorite book of all time: Pain Pill Addiction: A Prescription for Hope, by me. It’s at the publisher’s now, and I am hoping it will be out by early September.