The Addiction Casebook

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edited by Petros Levounis, MD, MA, and Abigail J. Herron, DO. American Psychiatric Publishing, Inc, Washington, DC, 2014, 230 pages, $65.00 (paper).

The opening sentences of the preface of The Addiction Casebook, edited by Levounis and Herron, articulate some of the major challenges confronting this complex patient population. They identify the barrier of stigma along with inadequate diagnosis and treatment as still having a significant impact on many patients with substance use disorders. The response of this text as stated is to “provide the fundamental tools for working with the substance-using patient in the hospital, the clinic and the community” (p xi).

The book is subdivided into 4 sections, with the first section (chapter 1) addressing the rationale for the transition from DSM-IV to DSM-5 criteria for substance use disorders. In that first chapter, there is a brief, but excellent, discussion of the evidence-based changes that resulted in the merger of substance abuse and substance dependence diagnoses into 1 category, along with other modifications in both the diagnostic criteria and diagnostic thresholds for these disorders. Also included is commentary on the novel introduction of gambling disorder in DSM-5, which previously resided in the Impulse-Control Disorders Not Elsewhere Classified section of DSM-IV, and a discussion of Internet addiction as a topic for potential future inclusion as a DSM diagnosis.

The second section represents the majority of the content of the text and addresses 10 substance-related disorders in chapters 2 through 11. The chapters in this section are not meant to be encyclopedic in their coverage, but foremost in importance is the outstanding structure and consistency of the material presented to the reader in every chapter. Each chapter in this section begins with a brief narrative describing the clinical significance of the featured substance use disorder, followed by a listing of the DSM-5 diagnostic criteria associated with that specific substance.

As the title of this text implies, a detailed clinical case is included in each chapter to demonstrate the diagnostic and treatment issues associated with each substance, often combined with 1 or more co-occurring psychiatric disorders. The follow-up case discussions in each chapter are a particular strength given the effort made by the authors to be empathic in their illustration of the personal and environment-based struggles faced by each patient and how those elements are critical to understanding their addiction and the dilemmas associated with recovery. A nice section titled “Key Points” serves to review the focus of each chapter and is immediately followed by a short list of relatively current references that provide additional information for further exploration of the topic. The conclusion of each chapter contains thoughtful questions with answers to assist the reader in consolidating the information presented.

The subject of “behavioral addictions” is included in the third section, titled Non-Substance-Related Disorders (chapter 12, “Gambling”), and the fourth section, Conditions for Further Study (chapter 13, “Internet”). These 2 sections follow the same excellent format as the chapters described above in the second section but are more limited in clinical content due to their topics’ relative youth as subjects of formal investigation in Psychiatry.

In summary, I must congratulate both editors and all of the chapter authors of The Addiction Casebook for producing a text that provides an excellent introduction to the field of Addiction Psychiatry and emphasizes the importance of anxiety disorders, mood disorders, and other co-occurring psychiatric illnesses that are often present in this patient population. This book should be a valuable addition to the reading lists of primary care physicians, psychiatry residents, and psychiatrists seeking a current and user-friendly introduction to the DSM-5 substance use disorder diagnoses anchored upon a foundation of evidence-based knowledge, wisdom, compassion, and humor.

David D. Weinstein, MD

weinsted1@kernmedctr.com

Author affiliation: David Geffen School of Medicine at UCLA, Los Angeles, California.

Potential conflicts of interest: None reported.

J Clin Psychiatry 2015;76(9):e1144

dx.doi.org/10.4088/JCP.15bk10008

© Copyright 2015 Physicians Postgraduate Press, Inc.