There is constant pressure for clinicians to practise evidence-based medicine. Cochrane Reviews are an important source of the evidence which informs clinical decisions but can still require considerable time to read and digest. This Cochrane Handbook of Alcohol and Drug Misuse serves as a concise guide to the evidence base for relevant interventions, highlighting the key points of Cochrane reviews for the busy practitioner.

Each review is analysed in a structured format, starting with the question, a brief background and a summary answer, followed by the results presented in comprehensive and concise way. The authors then illustrate the value that the review adds to the current knowledge, the main methodological limitations of the included studies and finally the implications of the review’s conclusions for future research.

Addiction to drugs and alcohol is an increasing problem that all clinicians have to deal with. This is especially true for medical and family specialists but more so for those dealing with psychiatric, psychological and social problems. The benefit of having the evidence underpinning the clinical approach to all aspects of this topic cannot be underestimated.

The book’s comprehensive coverage of interventions provides an authoritative reference for all physicians working with these patients, from family practitioners to clinical specialists and psychiatric specialists. With addiction to drugs and alcohol an increasingly serious morbidity and public health issue, this book from the Cochrane Collaboration will find a wide audience.
Foreword, ix

Preface, xi

Acknowledgements, xii

Part 1: Alcohol

Psychosocial interventions

Chapter 1: Effectiveness of brief alcohol interventions in primary care

populations, 1

Chapter 2: Brief interventions for heavy alcohol users admitted to general hospital wards, 5

Chapter 3: Alcoholics Anonymous and other 12-step programmes for alcohol dependence, 8

Chapter 4: Mentoring adolescents to prevent substance use disorders, 10

Chapter 5: Universal school-based prevention programmes for alcohol misuse in young people, 12

Chapter 6: Universal multicomponent prevention programmes for alcohol misuse in young people, 15

Chapter 7: Universal family-based prevention programmes for alcohol misuse in young people, 17

Chapter 8: Social norms interventions to reduce alcohol misuse in university or college students, 19

Chapter 9: Psychosocial interventions for women enrolled in alcohol treatment during pregnancy, 22

Pharmacological interventions

Chapter 10: Benzodiazepines for alcohol withdrawal, 24

Chapter 11: Anticonvulsants for alcohol withdrawal, 27

Chapter 12: Acamprosate for alcohol dependence, 31

Chapter 13: Baclofen for alcohol withdrawal, 34

Chapter 14: Gamma-hydroxybutyrate for treatment of alcohol withdrawal and prevention of relapse, 36

Chapter 15: Psychotropic analgesic nitrous oxide for alcohol withdrawal, 40

Chapter 16: Efficacy and safety of pharmacological interventions for the treatment of alcohol withdrawal, 43

Chapter 17: Opioid antagonists for alcohol dependence, 46

Chapter 18: Pharmacologic interventions for pregnant women enrolled in alcohol treatment, 49

Part 2: Drugs

Psychosocial interventions

Chapter 19: School-based prevention for illicit substance use disorders, 51

Chapter 20: Interventions for prevention of substance use disorders by young people delivered in non-school settings, 54

Chapter 21: Case management for persons with substance use disorders, 56

Chapter 22: Motivational interviewing for substance use disorders, 59

Chapter 23: Therapeutic communities for substance use disorders, 62

Chapter 24: Interventions for drug-using offenders in the courts, secure establishments and the community, 64

Chapter 25: Psychosocial interventions for pregnant women in outpatient illicit drug treatment programmes compared to other interventions, 67

Cocaine dependence

Chapter 26 Psychosocial interventions for cocaine and psychostimulant amphetamine related disorders, 69

Chapter 27: Antidepressants for cocaine dependence, 71

Chapter 28: Antipsychotic medications for cocaine dependence, 74

Chapter 29: Anticonvulsants for cocaine dependence, 76

Chapter 30: Dopamine agonists for cocaine dependence, 78

Chapter 31: Disulfiram for the treatment of cocaine dependence, 82

Chapter 32: Efficacy of psychostimulant drugs for cocaine dependence, 84

Chapter 33: Auricular acupuncture for cocaine dependence, 87

Chapter 34: Psychosocial treatment for opiate dependence, 89

Chapter 35: Psychosocial and pharmacological treatments versus

pharmacological treatments for opioid detoxification, 91

Chapter 36: Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence, 94

Chapter 37: Alpha withdrawal, 96

Chapter 38: Buprenorphine for the management of opioid withdrawal, 99

Chapter 39: Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence, 102

Chapter 40: Methadone at tapered doses for the management of opioid withdrawal, 105

Chapter 41: Methadone maintenance at different dosages for opioid dependence, 108

Chapter 42: Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence, 110

Chapter 43: Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal, 113

Chapter 44: Opioid antagonists with minimal sedation for opioid withdrawal, 115

Chapter 45: Oral naltrexone maintenance treatment for opioid dependence, 118

Chapter 46: Sustained-release naltrexone for opioid dependence, 121

Chapter 47: Heroin maintenance for chronic heroin-dependent individuals, 123

Chapter 48: LAAM maintenance versus methadone maintenance for heroin dependence, 126

Chapter 49: Detoxification treatments for opiate-dependent adolescents, 129

Chapter 50: Maintenance treatments for opiate-dependent adolescents, 131

Chapter 51: Maintenance agonist treatments for opiate-dependent pregnant women, 133

Chapter 52: Pharmacological treatment for depression during opioid agonist treatment for opioid dependence, 135

Chapter 53: Inpatient versus other settings for detoxification for opioid dependence, 138

Chapter 54: Psychotherapeutic interventions for cannabis use or

dependence in outpatient settings, 140

Chapter 55: Pharmacological interventions for benzodiazepine mono-dependence management in outpatient settings, 142

Chapter 56: Treatment for amphetamine dependence, 145

Chapter 57: Treatment for amphetamine withdrawal, 147

Chapter 58: Treatment for amphetamine psychosis, 149

Chapter 59: Treatment for methaqualone dependence in adults, 151

Index, 153
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