The American Psychiatric Association Publishing Textbook of Substance Use Disorder Treatment. Sixth Edition

February 2022

BOOK REVIEWS: The American Psychiatric Association Publishing Textbook of Substance Use Disorder Treatment. Sixth Edition

Feb
2022
Vol. 34. No. 1
James Allen Wilcox, MD, PhD

Tucson, AZ, USA

This is an excellent reference book. It contains a vast amount of information on substance use disorder and its treatment. It is well researched and finely written. The text covers 53 chapters, divided into 7 major parts. The text begins with a very good introduction to the neurobiology of addiction, and various treatments (both pharmacologic and nonpharmacologic). This is followed by the public health perspective on substance use disorders. The burden of tobacco use upon society is mentioned. There are adequate sections on the substance use phenomena in special populations, including the elderly, women, and nonbinary persons. The clinical importance of substance use in people with psychiatric comorbidities is covered, with many conditions noted. There are also sections on prevention, drug testing, medical education, and addiction in the workplace.

In general, there are very few things to fault with this edition. One wishes that some areas could have been more detailed. The inclusion of a section on neurobiology was a great contribution, but should have been more thorough. It was also good that both nonmedical and medical treatment options were given a fair description. These days, we often see clinical populations of comorbid psychopathology along with substance use, which makes this section very relevant to the modern clinician. For example, my colleagues often report that more inpatient cases of paranoia are related to stimulant use than functional psychosis. Clinicians frequently report that cannabis-related psychosis is now commonly seen in vulnerable populations. This portion on comorbidity is nicely covered, with a variety of conditions and diagnoses being well described. The specific populations are well delineated and divided into diagnostic groups, which makes for easy reading. Psychiatric comorbidity in substance use disorders is particularly well handled in mood disorders, anxiety, and attention deficit disorders. The portion regarding substance use in eating disorders, trauma, and stress is quite good and very relevant to clinical settings.

The inclusion of a section on forensic issues and substance use is very interesting. The overlap of legal problems and substance use disorders is well known to most experienced clinicians. The authors should be commended for including this section, but it doesn’t cover enough material to be truly useful. Many legal paradoxes in the realm of substance use were not touched upon. The authors cover liability for the prescribers of controlled drugs, and this is an excellent addition. They provide a good review of issues regarding confidentiality and general concerns of public safety as it applies to controlled substances. This section was interesting, but it would have been wonderful to learn more on the topic. It also would have been good to see information involving the legal ramifications of the religious use of entheogenic substances.

This is a comprehensive and enjoyable textbook. I think that it is an excellent addition to any department library. The challenge of any such volume is the huge amount of material on substance use that needs to be reviewed and concisely assembled in a single volume. This is a very fine text, but can’t cover all of its topics in a mere 881 pages. One feels that the authors’ intent was to provide details on substance use disorder treatment, but then they went into a variety of related topics that overwhelmed the scope of 1 book. I hope that the next edition will be 2 volumes, and complete the monumental effort that the editors have put forth.  

CORRESPONDENCE

James Allen Wilcox, MD, PhD
University of Arizona
Tucson, Arizona, USA