Substance Use Disorders, Second Edition

by Stuart Gitlow
Philadelphia: Lippincott Williams & Wilkins, 2007
352 pages • $39.95 (softcover)

The highly readable and informative second edition of Substance Use Disorders, by Stuart Gitlow, is a valuable handbook for treatment providers of all specialties. The book's tone reflects Dr Gitlow's extensive experience as a physician treating addictions and shows a clear understanding of the challenges of treating persons with substance use disorders.

Perhaps the book's greatest strength is the undeniable care and compassion with which Dr Gitlow approaches the treatment of patients with substance-related problems. The author begins with a series of exercises that help the reader empathize with persons who have substance use disorders. Although the harm created by substance abuse is never de-emphasized, the book effectively aids readers in understanding the motivations and challenges faced by patients with problematic substance use disorders.

Substance Use Disorders is intended as a general overview of substance use disorders so it is far-reaching in its scope with chapters on specific addictive substances and classes of substances (eg, alcohol, nicotine, stimulants) as well as chapters focused on treatment protocols and other aspects of treatment (eg, opioid detoxification, patient placement criteria, 12-step programs).

Dr Gitlow's guide is useful in its breadth and it presents many details providers need to treat a patient with a substance use disorder. For example, the appendices include several alcohol-screening measures and the text provides links to resources such as the American Society of Addiction Medicine Web site, where one can access more detailed practice guidelines. The text not only functions nicely as a guidebook that covers many topics but also provides ways to learn more about specific questions.

The attention paid to prescription medication addiction, such as sedatives or prescription opioids, is unique. As Dr Gitlow notes, dependence on these substances is quite common and presents a real challenge to treatment providers who are motivated to effectively manage their patients' medical symptoms while curtailing access to addictive substances. The author cautions against the long-term use of these medications and gives specific suggestions for how to work with patients to decrease their depedence.

Dr Gitlow does not hesitate to give his opinion on several controversial topics within the addictions treatment field. For example, he expresses a lack of faith in research that uses any outcome other than complete abstinence as a measure of treatment effectiveness. Readers should be aware that there is substantial controversy on this and other related topics and the approach in Substance Use Disorders represents just one perspective.

Substance Use Disorders is an enjoyable and informative resource for all types of treatment providers. Within this guidebook, clinicians will find a great deal of information on how to identify and treat persons who have substance use disorders.