Working Bibliography: Alcoholism and Addiction

Allen, John P. 1996. "Subtypes of Alcoholics Based On Psychometric Measures," Alcohol Health and Research World, v20n1 (1996): 24-9. [One approach to subtyping alcoholics is the use of psychometric tests that quantity a person's personality characteristics, psychological characteristics, and intelligence. For example, researchers have used the Personality Research Form, which measures basic personality traits, to establish alcoholism typologies. Other psychometric measures that have been employed in the classification of alcoholics, such as the Minnesota Multiphasic Personality Inventory and the Millon Clinical Multiaxial Inventory, measure the presence of co-occurring psychiatric disorders in the patients. Still other subtypes are based on tests assessing the patient's motivation for treatment. Although clinicians hope to use psychometric typologies to improve treatment planning and monitoring for their patients, several questions remain to be answered by additional research before the instruments and the typologies based on them achieve broad applicability.]

Amodeo, Maryann. ; Jones, L. Kay. 1998. "Using the AOD Cultural Framework to View Alcohol and Drug Issues Through Various Cultural Lenses," Journal of Social Work Education v34n3 (Fall 1998): 387-99. [This article elaborates a cultural framework for viewing alcohol and drug abuse which, if used as a teaching tool, can lead to increased cultural awareness among students. The framework helps educators to illustrate the powerful role of culture in shaping behaviors such as drinking and drug use and to focus on several cultures or ethnic groups simultaneously. The authors give examples of how the framework can be used to: discuss cases and clinical problems in the classroom; conduct classroom exercises comparing cultures and differences within cultures; structure student homework and paper assignments; and prepare course materials and lectures.]

Anonymous. 1990. "Korsakoff's Syndrome (editorial)," The Lancet, v336n8720 (Oct 13, 1990): 912(2). [Korsakoff's psychosis and Wernicke's encephalopathy are now giving way to a single diagnosis of "alcohol amnesic syndrome". The two conditions seem to represent different stages of the same deficiency process, starting with Wernicke's description of impaired coordination, vision and thought, and proceeding, if untreated, to Korsakoffian amnesia and the making up of stories (confabulation), and finally to a permanent amnesic defect. Frontal lobe shrinkage, among other symptoms apparent in CAT scans, suggests dual causes: thiamine deficiency and alcohol neurotoxicity. Methylphenidate and fluvoxamine have shown promise for treatment in small, uncontrolled studies, but the early use of thiamine for any confused alcoholic remains a priority. Even after the appearance of Korsakoffian symptoms, some 25 percent of patients make a complete recovery, and 50 percent make a partial recovery.]

Anonymous. 1993. "High and Hooked," Economist, v327n7811 (May 15, 1993): 105-107. [A better understanding of how addictions work might benefit science, medicine and recreation. Neuroscientists are using molecular biology to find the links between pleasure and addiction deep in the recesses of the brain.]

Anonymous. 1997. "Neuroscience: Pathways of Addiction," Alcohol Health and Research World, v21n2 (1997): 99-179. [A special issue on neuroscience and the pathways of addiction. Topics discussed include an overview of the neurobiology of addiction; alcohol and neurotransmitter interactions; exploring alcohol withdrawal syndrome; the implications of neuroscience for treatment; whether behavioral tolerance is learned; the principles of nerve cell communication; alcohol and dopamine; the role of serotonin in the effects of alcohol on the brain; alcohol and glutamate; GABA and the GABAA receptor; opioid peptides; the role of the neuromodular adenosine in alcohol's actions; and the neurobiology of alcoholism in genetically selected rat models.]

Anonymous. 2000. "Alcohol, the Brain, and Behavior: Mechanisms of Addiction," Alcohol Research & Health, v24n1 (2000): 12-15. [The actions of alcohol that cause intoxication, initiate and maintain excessive drinking behavior, and promote relapse during abstinence occur primarily in the brain. A thorough understanding of alcohol's effects on the mechanisms underlying brain function is essential to develop and improve alcoholism prevention and treatment strategies. This article is not an exhaustive overview of alcoholism neurobiology, but a sampling of the more significant recent advances in the field. Reprinted by permission of the publisher.]

Anonymous. 2000. "Research Refines Alcoholism Treatment Options," Alcohol Research & Health, v24n1 (2000): 53-61. [Every day, more than 700,000 people in the United States receive treatment for alcoholism. In recent years, much progress has been made in understanding how both psychological approaches and medications can help these patients achieve sobriety, including evaluation of existing treatment approaches and development of new ones. Continued research to refine therapies for alcoholism will have widespread benefits for alcohol-dependent people, for their families, and for society as a whole, which bears the weight of the enormous economic and social costs of problem drinking. This article reviews the current state of alcoholism treatment research. Reprinted by permission of the publisher.]

Anonymous. 2000. "Why Do Some People Drink Too Much? The Role of Genetic and Psychosocial Influences," Alcohol Research & Health, v. 24 no1 (2000) p. 17-26. [A sizable minority of the population abuses alcohol. Research has found that some vulnerability to developing alcohol-related problems is conveyed genetically, and animal research has indicated that inheritance can take many forms. Studies in mice have demonstrated that various individual genes or groups of genes can shape very distinct responses to alcohol. By identifying the proteins these genes encode and the mechanisms by which the genes influence an animal's biochemical response to alcohol, scientists can gain insight into the features of human alcoholism and provide a basis for developing pharmaceuticals that short-circuit these genetically defined processes. Reprinted by permission of the publisher.]

Anton, Raymond F. 1994. "Medications for Treating Alcoholism," Alcohol Health and Research World, v18n4 (1994): 265-271. [Researchers are evaluating medications to assist in treating alcoholism. Such medications may be used to treat withdrawal or co-occurring psychiatric disorders or as an adjunct to psychosocial treatment.]

Anton, Raymond F. 1999. "What Is Craving? Models and Implications for Treatment," Alcohol Research & Health, v. 23 no3 (1999) p. 165-73. [Although many alcoholics experience craving, researchers have not yet developed a common, valid definition of the phenomenon. Numerous models of the mechanisms underlying craving have been suggested, however. One of those models--the neuroadaptive model--suggests that the prolonged presence of alcohol induces changes in brain-cell function. In the absence of alcohol, those changes cause an imbalance in brain activity that results in craving. Furthermore, the adaptive changes generate memories of alcohol's pleasant effects that can be activated when alcohol-related environmental stimuli are encountered, even after prolonged abstinence, thereby leading to relapse. Similarly, stressful situations may trigger memories of the relief afforded by alcohol, which could also lead to relapse. Neurobiological and brain-imaging studies have identified numerous brain chemicals and brain regions that may be involved in craving. Psychiatric conditions that affect some of these brain regions, such as depression or anxiety, also may influence craving. A better understanding and more reliable assessment of craving may help clinicians tailor treatment to the specific needs of each patient, thereby reducing the risk of relapse.]

Ball, Samuel A. 1996. "Type A and Type B Alcoholism: Applicability Across Subpopulations and Treatment Settings," Alcohol Health and Research World, v. 20 no1 (1996) p. 30-5. [Babor's classification of alcoholism uses multiple characteristics to assign subjects to two categories, called type A and type B. Type B alcoholism appears to be consistently more severe than type A. Research findings are reviewed that support the usefulness of Babor's typology for different drugs of abuse, clinical settings, gender, and race.]

Blum, Kenneth. 1991. Alcohol and the Addictive Brain: New Hope for Alcoholics from Biogenetic Research. New York: Free Press. [Highly recommended.]

Blum, Kenneth; Cull, John G.; Braverman, Eric R.; Comings, David E. 1996. "Reward Deficiency Syndrome," American Scientist, v84n2 (Mar 1996): 132-145. [Highly recommended, for instrumental reasons. Blum et al examine evidence that the A1 allele, the same genetic variant previously found to be associated with alcoholism, is associated with a spectrum of impulsive, compulsive, and addictive behaviors. The concept of a reward deficiency syndrome unites these disorders and may explain how simple genetic anomalies give rise to complex aberrant behavior.]

Brown, Stephanie (ed.). 1995. Treating Alcoholism. San Francisco: Jossey-Bass Publishers.

Carroll, Kathleen M. 1997. "New Method of Treatment Efficacy Research: Bridging Clinical Research and Clinical Practice," Alcohol Health and Research World, v. 21 no4 (1997) p. 352-9. [A variety of methodological advances are allowing alcoholism treatment researchers to develop effective new treatments and to answer more complex questions regarding the efficacy of treatments for alcohol use disorders. These advances include the use of standardized diagnostic criteria; thorough description of the study populations; standardization of treatments (e.g., through the use of manuals); training of treatment providers; quality control procedures and manipulation checks; and multidimensional, longitudinal assessments. Many of these methods can be adopted by clinicians to improve clinical care as well as to meet the challenges posed by managed care and other changes in the years ahead.]

Cloninger, C. Robert. ; Sigvardsson, Sören. ; Bohman, Michael. 1996. "Type I and Type II Alcoholism: An Update," Alcohol Health and Research World, v. 20 no1 (1996) p. 18-23. [A commonly cited alcoholism typology, the type I-type II typology, was developed from the findings of a study of Swedish adoptees and their biological and adoptive parents. Type I alcoholism affects both men and women, requires the presence of a genetic as well as an environmental predisposition, commences later in life after years of heavy drinking, and can take on either a mild or severe form. Type II alcoholism, in contrast, affects mainly sons of male alcoholics, is influenced only weakly by environmental factors, often begins during adolescence or early adulthood, is characterized by moderate severity, and usually is associated with criminal behavior. Additional studies have demonstrated that type I and type II alcoholics also differ in characteristic personality traits (e.g., harm avoidance and novelty seeking) as well as in certain neurophysiological markers. A replication study with a second group of Swedish adoptees has confirmed many of the findings of the original adoption study.]

Di Chiara, Gaetano. 1997. "Alcohol and Dopamine," Alcohol Health and Research World, v21n2 (1997): 108-14. [Dopamine is a neuromodulator that is used by neurons in several brain regions involved in motivation and reinforcement, most importantly the nucleus accumbens (NAc). Dopamine alters the sensitivity of its target neurons to other neurotransmitters, particularly glutamate. In addition, dopamine can affect the neurotransmitter release by the target neurons. Dopamine-containing neurons in the NAc are activated by motivational stimuli, which encourage a person to perform or repeat a behavior. Even low alcohol doses can increase dopamine release in part of the NAc. This dopamine release may contribute to the rewarding effects of alcohol and may thereby play a role in promoting alcohol consumption. In contrast to other stimuli, alcohol-related stimuli maintain their motivational significance even after repeated alcohol administration, which may contribute to the craving for alcohol observed in alcoholics.]

Drake, Robert E. ; Mueser, Kim T. 1996. "Alcohol-use disorder and severe mental illness,: Alcohol Health and Research World, v20n2 (1996): 87-93. [Alcohol-use disorders (AUD's) commonly occur in people with other severe mental illnesses, such as schizophrenia or bipolar disorder, and can exacerbate their psychiatric, medical, and family problems. Therefore, to improve detection of alcohol-related problems, establish correct AUD diagnoses, and develop appropriate treatment plans, it is important to thoroughly assess severely mentally ill patients for alcohol and other drug abuse. Several recent studies have indicated that integrated treatment approaches that combine AUD and mental health interventions in comprehensive, long-term, and stagewise programs may be most effective for these clients.]

Edwards, Griffith & E. Jane Marshall & Christopher C. Cook. 1997. The Treatment of Drinking Problems: A Guide for the Helping Professions. 3rd ed. Cambridge, UK; New York: Cambridge University Press.

Edwards, Martha E. ; Steinglass, Peter. 1995. "Family Therapy Treatment Outcomes for Alcoholism," Journal of Marital and Family Therapy, v21 (Oct. 1995): 475-509. [Part of a special issue on the effectiveness of marital and family therapy. The writers reviewed results from 21 studies of family-involved therapy for alcoholism. The findings indicate that family therapy is effective in motivating alcoholics to enter treatment and that once the alcoholic enters treatment, family-involved treatment is marginally more effective than individual alcoholism treatment. Three factors may mediate the impact of treatment: gender, investment in the relationship, and perceived support from the spouse for abstinence.]

Emanuele, Nicholas. ; Emanuele, Mary Ann. 1997. "The Endocrine System: Alcohol Alters Critical Hormonal Balance," Alcohol Health and Research World, v21n1 (1997): 53-64. [Alcohol's effects on the hormonal (i.e., endocrine) system have widespread consequences for virtually the entire body. Alcohol-related hormonal disturbances can result in cardiovascular abnormalities and reproductive deficits in both males and females. Other endocrine problems stemming from excess alcohol consumption include immune dysfunction and bone disease. Researchers are exploring ways of using hormonal mechanisms to help treat alcoholics as well as to identify people predisposed to alcoholism.]

Emerson, Dan. 1995. "Taking the Cure," MPLS. St. Paul, v23n4 (Apr 1995): 52-55+. [Joan Mathews Larson of Health Recovery Center aims to prove that the revered Minnesota model of talk therapy for alcoholics is outdated with a holistic program that treats the disease's side effects. Larson's nutritional formula, which, over time, ends the side effects experienced by many recovering alcoholics, is discussed.]

Evert, Denise L. ; Oscar-Berman, Marlene. 1995. "Alcohol-related Cognitive Impairments: An Overview of How Alcoholism May Affect the Workings of the Brain," Alcohol Health and Research World, v19n2 (1995): 89-96. [People with alcoholism express cognitive deficits of varying type and severity. Theoretical models of impaired cognition are intended to explain the deficit patterns by relating them to the brain structures or brain processes that may be damaged. Although no model has thus far succeeded in defining adequately all the impairments alcoholics experience, process-oriented models are proving useful as tools for describing alcohol-related cognitive deficits.]

Flores, Philip J. (ed.) 1997. Group Psychotherapy With Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory. 2nd ed. New York: Haworth Press.

Forrest, Gary G. 1984. Intensive Psychotherapy of Alcoholism. Northvale, NJ; London: Aronson.

Fuller, Richard K. ; Hiller-Sturmhöfel, Susanne. 1999. "Alcoholism Treatment In the United States: An Overview," Alcohol Research & Health, v23n2 (1999): 69-77. [On any given day, more than 700,000 people in the United States receive alcoholism treatment in either inpatient or outpatient settings. For many of those patients, detoxification--with or without pharmacotherapy--is the first step of treatment. The major behavioral approaches currently used in alcoholism treatment include cognitive-behavioral therapy, motivational enhancement therapy, and Alcoholics Anonymous (AA) or related 12-step programs. Clinical studies, such as the Project MATCH trial, have compared the effectiveness of these approaches. Overall, that study detected no significant differences among the three treatments in patient outcome, although certain treatment methodologies may be most appropriate for patients with certain characteristics. Pharmacotherapy with aversive or anticraving medications may supplement behavioral treatment approaches. Brief interventions that are delivered by primary health care providers also have been shown to reduce drinking levels, particularly in nondependent drinkers.]

Glausiusz, Josie. 2000. "Homo Intoxicatus," Discover, v21n6 (June 2000): 17 . [According to physiologist Robert Dudley of the University of Texas at Austin, humans share a taste for alcohol with their close primate relatives. Many animals are attracted by the odors arising from the high alcohol contents of ripe or rotting rain forest fruit, and chimpanzees and gorillas will travel for miles to seek out the fruit. Dudley believes that, as modest amounts of alcohol offer health benefits, animals predisposed to alcohol consumption could be better survivors; thus, alcoholism is a by-product of our ancestral nutritional physiology.]

Gold, Mark S. 1991. The Good News About Drugs and Alcohol: Curing, Treating, and Preventing Substance Abuse In the New Age of Biopsychiatry. New York: Villard Books.

Hanson, Dorothy. "Obsessions: What Are They All About?" <http://205.186.239.2/steps/obsessions.html>

Haugen, Richard ; Lund, Thorleif 1999. "The Concept of General Expectancy In Various Personality Dispositions," Scandinavian Journal of Psychology, v40n2 (1999): 109 (6). [It is argued that the concept of general expectancy is a central common core of personality dispositions related to achievement areas. This hypothesis of common core was investigated with factor analysis and cluster analysis. 166 advanced teacher students participated, and were scored on the following relevant personality dispositions motive to seek success, motive to avoid failure, global and academic self-esteem, self-efficacy, attributional style, depression, and defensiveness. The hypothesis was supported in that factor analysis gave a general bipolar expectancy factor, and cluster analysis resulted in two clusters, one corresponding to positive expectancy and the other to negative expectancy.]

Hester,Reid K. & William R. Miller (eds.). 1995. Handbook of Alcoholism Treatment Approaches : Effective Alternatives. 2nd ed. Boston: Allyn and Bacon.

Hiller-Sturmhöfel, Susanne. 1996. "Jellinek's Typology Revisited," Alcohol Health and Research World, v20n1 (1996): 16-17. [Part of a special section on the classification of alcoholism. The writer considers E.M. Jellinek's 1960 concept of an alcoholism typology. Although American and European clinicians and scientists had already developed alcoholism typologies for over a century, Jellinek's system soon became broadly accepted as a scientific and comprehensive theory of alcoholism. Jellinek distinguished five subtypes, or species, of alcoholism--alpha, beta, gamma, delta, and epsilon. The opinions of several leading researchers and clinicians on the way in which alcohol researchers currently judge Jellinek's typology and its effect on the alcohol field, the extent to which Jellinek's classification is valid after 35 additional years of alcoholism typology research, and the future of alcoholism typology theory are provided.]

John P. Allen, Megan Columbus (eds.). 1995. Assessing Alcohol Problems: A Guide for Clinicians and Researchers. Bethesda, MD: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism.

Kinney, Jean & Gwen Leaton. 1995. Loosening the Grip: A Handbook of Alcohol Information. 5th ed. St. Louis: Mosby.

Krestan, Jo-Ann (ed.). 2000. Bridges To Recovery: Addiction, Family Therapy, and Multicultural Treatment. New York: Free Press.

Kurtzweil, Paula. 1996. "Medications Can Aid Recovery from Alcoholism," FDA Consumer, v30 (May 1996): 22-5. [Alcoholism is a complex disease that has physical, social, and psychological effects on alcoholics and on the people that have close relationships with them. According to the most recent estimates from the federal government's National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 1992 there were nearly 8 million alcoholics in the United States. Up to 1.5 million of them seek treatment annually. For some alcoholics, treatment begins with "detoxification." The FDA has approved two antianxiety drugs, Valium and Librium, for treating the effects of withdrawal. Alcoholics may also be helped in their recovery with one of two drugs approved for discouraging alcohol intake--Antabuse (disulfiram) and ReVia (naltrexone). Even though treatments are making the control of alcoholism easier, a cure for the disease is more elusive.]

Lawson, Ann W. & Gary Lawson (eds.). 1998. Alcoholism and the Family: A Guide To Treatment and Prevention. 2nd ed. Gaithersburg, MD: Aspen Publishers.

Levin, Jerome D. (ed.). 1995. Introduction To Alcoholism Counseling: A Bio-Psycho-Social Approach. 2nd ed. Washington, D.C.: Taylor & Francis.

Levin, Jerome D.. 1991. Recovery from Alcoholism: Beyond Your Wildest Dreams. Northvale, NJ: J. Aronson.

Littrell, Jill. 1991. Understanding and Treating Alcoholism. Hillsdale, NJ: L. Erlbaum.

Lovinger, David M. 1997. "Serotonin's Role In Alcohol's Effects of the Brain," Alcohol Health and Research World, v21n2 (1997): 114-20. [Serotonin is an important brain chemical that acts as a neurotransmitter to communicate information among nerve cells. Serotonin's actions have been linked to alcohol's effects on the brain and to alcohol abuse. Alcoholics and experimental animals that consume large quantities of alcohol show evidence of differences in brain serotonin levels compared with nonalcoholics. Both short- and long-term alcohol exposure also affect the serotonin receptors that convert the chemical signal produced by serotonin into functional changes in the signal-receiving cell. Drugs that act on these receptors alter alcohol consumption in both humans and animals. Serotonin, along with other neurotransmitters, also may contribute to alcohol's intoxicating and rewarding effects, and abnormalities in the brain's serotonin system appear to play an important role in the brain processes underlying alcohol abuse.]

Meyers, Robert J. & Jane Ellen Smith. 1995. Clinical Guide to Alcohol Treatment: The Community Reinforcement Approach. New York: Guilford Press.

Milam, James R. 1992. " The Alcoholism Revolution," Professional Counselor Magazine, (8/92). <http://hookomo.aloha.net/~bobalex/two.htm>

Milam, James R. 1993. "More On 'The Alcoholism Revolution,'" Professional Counselor Magazine, (10/93). <http://hookomo.aloha.net/~bobalex/four.htm>

Milkman, Harvey & Lloyd I. Sederer (eds.). 1990. Treatment Choices for Alcoholism and Substance Abuse. Lexington, Mass.: Lexington Books.

Miller, Norman S. 1994. "Psychiatric Comorbidity: Occurrence and Treatment," Alcohol Health and Research World, v18n4 (1994): 261-264. [Alcoholics with psychiatric disorders often fail to receive adequate treatment. Integrated treatment programs show promise for helping these patients]

Miller, William R. ; Meyers, Robert J. ; Hiller-Sturmhöfel, Susanne. 1999. "The Community-Reinforcement Approach," Alcohol Research & Health, v23n2 (1999): 116-21. [The community-reinforcement approach (CRA) is an alcoholism treatment approach that aims to achieve abstinence by eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. CRA integrates several treatment components, including building the client's motivation to quit drinking, helping the client initiate sobriety, analyzing the client's drinking pattern, increasing positive reinforcement, learning new coping behaviors, and involving significant others in the recovery process. These components can be adjusted to the individual client's needs to achieve optimal treatment outcome. In addition, treatment outcome can be influenced by factors such as therapist style and initial treatment intensity. Several studies have provided evidence for CRA's effectiveness in achieving abstinence. Furthermore, CRA has been successfully integrated with a variety of other treatment approaches, such as family therapy and motivational interviewing, and has been tested in the treatment of other drug abuse.]

Modesto-Lowe, Vania. ; Kranzler, Henry R. 1999. "Diagnosis and Treatment of Alcohol-Dependent Patients with Comorbid Psychiatric Disorders," Alcohol Research & Health, v23n2 (1999): 144-9. [Psychiatric disorders occur more often among alcoholics than among the general population. The psychiatric disorders that alcoholics most frequently experience include mood disorders (e.g., depression), anxiety disorders, and antisocial personality disorder. The evaluation of psychiatric symptoms in alcoholic patients is complicated by the multiple relationships that exist among heavy drinking, psychiatric symptoms, and personality factors. For example, alcoholics with co-occurring depression may be at greater risk of psychosocial problems, relapse, and suicide. Conversely, heavy drinking may produce or worsen symptoms of depression or anxiety. Although clinical experience provides general guidance for treating these patients, further research is needed to develop effective psychosocial and pharmacological therapies aimed at specific combinations of psychiatric and addictive disorders.]

Moos, Rudolf H. & John W. Finney, Ruth C. Cronkite (eds.) 1990. Alcoholism Treatment: Context, Process, and Outcome. New York: Oxford University Press.

Nestler, Eric J. & Robert C. Malenka. 2004. “The Addicted Brain”, Scientific American (March 2004). [Drug abuse produces long-term changes in the reward circuitry of the brain. Knowledge of the cellular and molecular details of these adaptations could lead to new treatments for the compulsive behaviors that underlie addiction.]

O'Farrell, Timothy J. (ed.). 1993. Treating Alcohol Problems: Marital and Family Interventions. New York: Guilford Press.

Oscar-Berman, Marlene. ; Shagrin, Barbara. ; Evert, Denise L. 1997. "Impairments of Brain and Behavior: The Neurological Effects of Alcohol" ,Alcohol Health and Research World v21n1 (1997): 65-75. [Chronic heavy drinking and alcoholism can have serious repercussions for the functioning of the entire nervous system, particularly the brain. These effects include changes in emotions and personality as well as impaired perception, learning, and memory. Neuropathological and imaging techniques have provided evidence of physical brain abnormalities in alcoholics, such as atrophy of nerve cells and brain shrinkage. At the cellular level, alcohol appears to directly affect brain function in a variety of ways, primarily by interfering with the action of glutamate, gamma-aminobutyric acid, and other neurotransmitters. Neurological disorders also can result from vitamin deficiency and liver disease, two health problems that commonly occur with alcoholism. Other hypotheses, based on factors such as aging, gender, and genetics, have been developed to explain various alcohol-related neurological consequences. Many pharmacological treatments to improve neuropsychological functioning in alcoholics have been tested, but none has proved entirely successful. With prolonged abstinence, however, slow recovery of cognitive functioning can occur in some cases.]

Petrakis, Ismene. ; Krystal, John. 1997. "Neuroscience: Implications for Treatment," Alcohol Health and Research World, v21n2 (1997): 157-60. [Medications can be used to treat alcoholism by decreasing craving for alcohol or by blocking the development of processes that lead to addiction. Medications also can enable alcoholic patients to participate more effectively in treatment by decreasing psychiatric symptoms associated with alcoholism or by improving alcohol-related intellectual impairment. Many promising medications for treating alcoholism appear to play a role in normalizing communication among nerve cells. Such medications include naltrexone and acamprosate, which help prevent relapse in patients undergoing psychotherapy for alcoholism. Medications that affect the neurotransmitter serotonin, however, may alleviate symptoms of anxiety and depression in alcoholics without affecting the alcoholism itself.]

Plant, Martin & Eric Single & Tim Stockwell (eds.). 1997. Alcohol: Minimising the Harm: What Works? London; New York: Free Association Books.

Pluymen, Bert. 1999. The Thinking Person's Guide To Sobriety. New York: St. Martin's Press.

Potter-Efron, Ronald T. & Patricia S. Potter- Efron. 1991. Anger, Alcoholism, and Addiction: Treating Individuals, Couples, and Families. New York: W.W. Norton & Co.

Ries, Richard et al. 1994. Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.

Roberts, Amanda J. ; Koob, George F. 1997. "The Neurobiology of Addiction: An Overview," Alcohol Health and Research World, v21n2 (1997): 101-6. [Addiction can be defined in part as a compulsion to use alcohol or other drugs and the occurrence of withdrawal symptoms when long-term consumption ceases. In addition to physical symptoms related to nervous system hyperexcitability, withdrawal includes changes in mental state that may motivate renewed AOD consumption. The manifestations of addiction are associated with changes in nerve cell function by which the brain attempts to adapt to a drug's presence. These functional changes modulate a person's initial response to a drug, the establishment of long-term craving for the drug (i.e., addiction), and the persistent sense of discomfort that leads to relapse after abstinence has been achieved. Research is beginning to reveal how specific brain regions may be integrated to form neural circuits that modulate aspects of addiction.]

Rodgers, Joann E. 1994. "Addiction: A Whole New View," Psychology Today, v27n5 (Sep 1994): 32-38+. [Popular theories on addictive behaviors are reviewed, and several reasons why they are woefully outdated are presented. The new concept of addiction is in sharp contrast to the conventional, frustrating and cynical view that everything causes addiction. Common characteristics of addictions are explored.]

Rosenbloom, Margaret J. ; Pfefferbaum, Adolf. ; Sullivan, Edith V. 1995. "Structural Brain Alterations Associated with Alcoholism," Alcohol Health and Research World, v19n4 (1995): 266-72. [Structural changes in the brains of chronic heavy drinkers that were first observed in pathological studies have been supported and expanded upon using computed tomography (CT) and magnetic resonance imaging (MRI) techniques. In general, the volume of brain tissue appears decreased in chronic drinkers, and this finding may be affected by a person's age, gender, and other factors. MRI studies also demonstrate some increase in brain tissue volume after a chronic drinker has been abstinent for a period of months. Whether this tissue increase can be linked with recovery of brain functioning remains unanswered.]

Schuckit, Marc A. "Alcohol, Anxiety, and Depressive Disorders," 1996. Alcohol Health and Research World, v20n2 (1996): 81-6. [Alcoholics frequently experience episodes of intense depression and/or severe anxiety. Depressed or anxious alcohol-dependent people often believe that they drink to relieve symptoms of sadness or nervousness. However, research does not unanimously support the prior existence of severe depressive or anxiety disorders as a usual cause of alcoholism. A review of recent literature (from family studies, prospective investigations, and studies of children of alcoholics) on the complex interaction between alcohol dependence and independent anxiety/depressive disorders reveals that if an association between alcoholism and anxiety/depressive disorders does exist, it likely operates in a relatively small subgroup of alcoholics at the same time. Psychological symptoms may carry a worse prognosis for alcohol-related problems, and these symptoms must be addressed early in alcoholism treatment.]

Swift, Robert M. 1999. "Medications and Alcohol Craving," Alcohol Research & Health, v23n3 (1999): 207-13. [The use of medications as an adjunct to alcoholism treatment is based on the premise that craving and other manifestations of alcoholism are mediated by neurobiological mechanisms. Three of the four medications approved in the United States or Europe for treating alcoholism are reported to reduce craving; these include naltrexone (ReVia(trademark)), acamprosate, and tiapride. The remaining medication, disulfiram (Antabuse(r)), may also possess some anticraving activity. Additional medications that have been investigated include ritanserin, which has not been shown to decrease craving or drinking levels in humans, and ondansetron, which shows promise for treating early onset alcoholics, who generally respond poorly to psychosocial treatment alone. Use of anticraving medications in combination (e.g., naltrexone plus acamprosate) may enhance their effectiveness. Future studies should address such issues as optimal dosing regimens and the development of strategies to enhance patient compliance.]

Szpir, Michael. 1995. "Alcoholism, Personality and Dopamine," American Scientist, v83 (Sept./Oct. 1995): 425-6. [The results of a new study by scientists at the University of Kuopio in Finland suggest that people with certain types of "alcoholic personalities" have a presynaptic alteration associated with dopaminergic activity in the brain. The results indicate that violent alcoholics and nonviolent alcoholics differ from each other and from non-alcoholics in the distribution of the molecular transport systems that take up dopamine in the striatum, which is a part of the brain that plays a part in rewarding behavior.]

Todd, Richard D.; Barbara Geller; Rosalind Neuman; Louis W. Fox; Janice Hickok. 1996. "Increased Prevalence of Alcoholism In Relatives of Depressed and Bipolar Children," Journal of the American Academy of Child and Adolescent Psychiatry, v35 n6 (June 1996):716(9)

Vaillant, George E. ; Hiller-Sturmhöfel, Susanne. 1996. The Natural History of Alcoholism," Alcohol Health and Research World, v20n3 (1996): 152-61. [Part of a special section on alcohol drinking behavior over the life cycle. Findings from two longitudinal prospective studies that have following two groups of men from about 1940 to the present are presented. The questions of whether alcoholism is an independent disease or the symptom of an underlying disorder, whether certain characteristics distinguish people who eventually become alcoholics from those who do not, whether alcoholism is always a progressive disorder, how alcoholism treatment or participation in self-help groups influences the disease process, and whether abstinence is the only reasonable treatment goal are addressed.]

Valenzuela, C. Fernando. 1997. Alcohol and Neurotransmitter Interactions," Alcohol Health and Research World, v21n2 (1997): 144-8. [Evidence suggests that alcohol affects brain function by interacting with multiple neurotransmitter systems, thereby disrupting the delicate balance between inhibitory and excitatory neurotransmitters. Short-term alcohol exposure tilts this balance in favor of inhibitory influences. After long-term alcohol exposure, however, the brain attempts to compensate by tilting the balance back toward equilibrium. These neurological changes occur as the development of tolerance to alcohol's effects. When alcohol consumption is abruptly discontinued or reduced, these compensatory changes are no longer opposed by the presence of alcohol, thereby leading to the excitation of neurotransmitter systems and the development of alcohol withdrawal syndrome. Long-term alcohol intake also induces changes in many neurotransmitter systems that ultimately lead to the development of craving and alcohol-seeking behavior.]

Wakefield, Phylis, et al. 1996. Couple Therapy for Alcoholism: A Cognitive-Behavioral Treatment Manual. New York: Guilford Press.

Wallen, Jacqueline. 1993. Addiction in Human Development: Developmental Perspectives on Addiction and Recovery. Binghamton, NY: The Haworth Press. Pp. 170. $25.95.

Ashwani Vasishth <ashwani@csun.edu> Last Update: February 24, 2004