Book Review: Addictions: The Treatment of Drinking Problems: A Guide for the Helping Professions

The Treatment of Drinking Problems: A Guide for Helping Professions. Griffith Edwards, E Jane Marshall, Christopher CH Cook. New York: Cambridge University Press; 2003.412p. US$50.00. Reviewer rating: Very Good As I began reviewing this book, now in its fourth edition, it dawned on me that I had pleasure of reviewing third edition as well (1). Our patients commonly present a clinical picture of polysubstance abuse; teaching texts devoted exclusively to drinking problems are less common. Thus, in comparing third and fourth editions of this focused publication, I expected to gain a good sense of recent advances in field. Dr Griffith Edwards is founder of National Addiction Centre, London, England, professor emeritus at University of London, and Editor-in-Chief of Addiction. The coauthors since third edition, Dr Jane Marshall and Dr Christopher Cook, are noted for their own pioneering work. Like third edition, book is aimed at a multidisciplinary audience of professionals in field and is divided into 2 main sections. The first section has 13 chapters. A new introductory chapter on history of treatment reminds us that it was Trotter, as early as beginning of 19th century, who posited that, far from being a sin, the habit of drunkenness was a disease of mind (2). An overview of causes of drinking problems follows, integrating related sociocultural, psychological, and biological dimensions across lifespan. The next chapter focuses on drug alcohol and includes an update on its receptors' action. The book's midsection begins with a description of clinical sensitivities surrounding alcohol-dependence syndrome, masterfully covered by group who powerfully helped define it. A synopsis of consequences on family and social functioning follows. The array of neuropsychiatrie as well as psychiatric comorbidities receive expanded attention in this edition. The common comorbid use of other drugs alluded to in my introduction is reviewed in next chapters, along with physical complications. The section appropriately ends with an overview of special clinical presentations among women, as well as an overview of different age, cultural, comorbid, and social groups. However, no mention is made of affected health professionals. The challenges involved in defining and estimating long-term outcomes conclude section. The second section addresses screening, assessment, and treatment issues. The seasoned clinical skills of authors are evident in chapters on screening and assessment and management of withdrawal. (Why, however, was Canadian Clinical Institute Withdrawal Assessment Scale not mentioned?) This subject is followed by a discussion of therapeutic basic work of engagement and an essay on Alcoholics Anonymous. The next part is, in my opinion, less rewarding. In 24 pages, it reviews a series of psychological approaches (for example, motivational interviewing, cognitive-behavioural therapy, behavioural self-control, relapse prevention, and psychotherapy), along with current pharmacotherapeutic armementarium. …

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