Preface

Problems with substance use have plagued humanity for centuries. Because of the vast personal and material costs associated with these problems, society looks to public health professionals and managers of public policy for assistance. The art and science of substance abuse therapeutics have also evolved, but there is still a great need for developing our understanding of addictions and techniques to mitigate problems associated with Substance Use Disorders (SUD). As both domains (diagnosis and treatment) evolve, it remains critically important to communicate actively the findings to promote the reciprocal influence between diagnosis and intervention to augment the overall advancement of the field. In developing this book, we asked potential authors for chapters related to the diagnosis and intervention of addictions, and we had certain ideas about the topics that we might receive. As it turned out, we received many works that were unpredicted and represented high-quality contributions from a variety of viewpoints. Not only does the work include different views from the humanities but it also incorporates ideas from the cutting edge of modern science. These chapters represent biological, human, cultural, and health-based perspectives that emphasize meeting people as they really are and bringing real possibilities to the future of addiction treatment. There is an integration of the past, the present, and the likely future directions of both diagnosis and treatment. Thus, the nine chapters in this book are a tribute to the current nature of the field. From the key considerations of human diversity to the cutting-edge examination of trends across large populations, advances in the field are being realized from many perspectives. The chapters are divided into two sections, with four chapters devoted to diagnosis and five chapters that consider intervention.

The book begins with a discussion of the contributions of psychopharmacology in SUD diagnosis. This rapidly expanding area of understanding documents our evolving appreciation of how neuroplastic changes in brain anatomy and chemistry are linked with various stages of the addictive process and provides insight into the diagnosis of SUD. Chapter 2 presents a quite different perspective by examining the benefits of a grassroots religious-based intervention for problematic drinking practiced in Mexico and amongst the Mexican immigrant community in the United States. This qualitative evaluation illustrates the value of understanding how a deeply held set of beliefs within a specific culture can promote insight into the understanding and prevention of alcohol addiction.

In another look from a diverse human perspective, Chapter 3 considers sex differences and the comorbidity of addiction and depression in young adults in the Czech and Slovak Republics. This chapter serves as an important reminder that the predictive variables used to identify those at risk for developing SUD may vary by region and locale. Chapter 4 presents a new line of consideration. While once an obscure and fanciful set of ideas, artificial intelligence and machine learning represent approaches that are advancing rapidly and have demonstrated applicability. Chapter 4 illustrates how these advanced analytic procedures can be leveraged upon large data sets to understand serious health issues in our time. In particular, this chapter examines how the COVID-19 pandemic and diagnosis of SUD are related by assessing a large volume of data obtained from healthcare claims databases and state-level alcohol consumption information.

The second section of the book focuses on treatment. Chapter 5 leads by considering Alcoholics Anonymous, a long-standing approach to intervention, but in the context of modern evidence. We know about such 12-step approaches from innumerable anecdotal reports, but this modern consideration examining the foundational philosophy of the 12 steps, the key elements that support recovery, cultural considerations, empirical evidence, and suggestions for integration of this approach into clinical practice is more than overdue. Chapter 6 presents an integration of systems that commonly interact in the real world. As the law continues to provide considerable regulation of substance-related behavior, the reality of community corrections remains vital to our understanding of approaches to addiction on both system and individual levels. This chapter looks at both assessment and treatment of addictions in the community corrections model of intervention highlighting their effectiveness as well as how various forms of therapy differ in community corrections as compared to other populations.

Continuing in the consideration of multi-faceted and ecologically valid approaches, Chapter 7 adopts the biopsychosocial framework for understanding SUD and chronic pain to inform the treatment of both conditions. The efficacy of several psychotherapeutic approaches to addressing these conditions are covered as is the potential for decreasing the role of opioid analgesics for long-term pain management. Given the considerable economic pressure on any healthcare delivery system, it is important to cultivate mechanisms by which treatment can be made more effective and cost-effective. The role of supervision in promoting highquality and cost-effective interventions for addictions cannot be underestimated. In many contexts, effective supervision is a mechanism for advancing the skills of practitioners, promoting the well-being of professionals, and increasing treatment efficacy. Chapter 8 addresses the integration of two well-established models of supervision to create a form of supervision that goes beyond business as usual by creating more nuanced and individualized supervisory experiences. Chapter 9 closes the book by profiling three innovative and controversial therapeutic approaches for SUD: the use of classic serotonergic hallucinogenic drugs (LSD and psilocybin), anti-addiction vaccines, and the use of transcranial magnetic stimulation. It reviews the theoretical basis for use, history, status of the literature supporting their use, limitations, and potential applications. It is our hope that the reader will walk away from this book understanding that advances in addiction diagnosis and treatment will come through both scientific breakthroughs and an appreciation of humanity and cultural diversity.

> **William M. Meil, Ph.D. and John A. Mills, Ph.D., ABPP** Professor of Psychology, Indiana University of Pennsylvania, Indiana, Pennsylvania, USA
