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Loosening the Grip: A Handbook of Alcohol Information.

Loosening the Grip: A Handbook of Alcohol Information Kinney, J. (Ed.). (2006, Eighth edition) Boston: McGraw Hill [Paperback; ISBN# 0-07-313889-4]

Several textbooks are available in the field of alcohol education (DeSena, Schaler, & Gerstein, 2003; Hanson, 1996; Jacques, Lyons, & Kelsall, 2003) for undergraduate and graduate students. One such textbook is the book reviewed here. The first edition of this book appeared in 1978 and is now in its eighth edition. The book is very well organized into 14 chapters and 2 appendices and has 9 contributors. Each chapter is illustrated with excellent cartoons in the margins that add humor and convey salient points. Several important quotations are also added in the margins. Each chapter also has a list of resources and further reading at the end. These lists are current and quite relevant to the topics covered. For journal articles in the references it is also indicated how many references have been used in each reference.

The first chapter is an introduction about issues surrounding alcohol. Described in this chapter are the historical aspects of alcohol, theories that explain alcohol usage and various problematic issues associated with alcohol. A box item on drugs other than alcohol has also been presented in the chapter. The second chapter discusses the costs associated with alcohol. The drinking patterns are discussed in relation to gender, age, race, education, family income, geographical region, type of community, marital status, religion, and international comparisons. The personal costs of alcohol have been categorized into several groups. The box item in the chapter focuses on the issue of heroin.

The third chapter discusses the effects of alcohol on the body. Details of ingestion, absorption, breakdown, and removal of alcohol from the body are discussed. The concept of blood alcohol concentration is presented. The acute and chronic effects of alcohol on the body are described in this chapter. The box item of this chapter discusses the issue of routes of administration.

The fourth chapter discusses the issue of alcohol dependence. The debate on classifications of disease conditions is elaborated and the various classifications of alcohol dependence presented. The box item discusses diagnostic criteria for substance use disorders. The fifth chapter discusses the etiology of alcohol dependence using the triadic epidemiological framework of agent, host, and environment. The box item focuses on the important issue of use of alcohol usage in developing countries.

The sixth chapter deals with medical complications. The issues of contraindications to moderate use, alcohol-drug interactions, problems associated with drinking and intoxication, and medical complications of chronic heavy use are discussed. It is a long chapter and perhaps it could be made a little shorter. The box item focuses on the issue of interaction between alcohol and cocaine. The seventh chapter is about the behavior of dependence. Behavioral effects on family, friends, and work are discussed. The box item discusses the issue of buying drugs on the Internet. The eighth chapter is about effects of alcohol problems on the family. The response of family to the problem of an alcoholic in the family, and the role of family as an enabler and in co-dependency is presented. The case of children of alcoholics is described in this chapter. The box items in this chapter discuss the issue of marijuana toxicity in dogs and passive smoking.

The ninth chapter summarizes the evaluation and treatment issues. The theoretical perspectives, problems of use, screening and evaluation tests, and various treatment interventions are discussed in the chapter. The box item presents the Drug Abuse Screening Test (DAST), Michigan Alcoholism Screening Test (MAST), Alcohol Use Disorders Identification test (AUDIT), and Dartmouth Assessment of Lifestyle Instrument (DALI).

The tenth chapter is about treatment approaches and begins with individual counseling methods, then discusses group work, next self help approaches, moves on to other approaches such as spiritual counseling, meditation, activities therapy, behavioral approaches and concludes with pharmacotherapy. The box items discuss 13 principles of the new life program of women for sobriety and effects of various drugs on driving. The eleventh chapter is about special populations that discuss adolescents, college students, the elderly, and women. The box items discuss role of parents, alcohol first aid, and adolescent smoking cessation.

The twelfth chapter discusses other psychiatric considerations. Issues of suicide, mental status examination, common psychiatric disorders, and psychotropic medications are discussed. The thirteenth chapter discusses drugs of abuse other than alcohol. The box items discuss the issue of drug production in Afghanistan, club drugs and performance-enhancing drugs. The final chapter is entitled, "Odds 'n' ends." The chapter discusses issues beyond patient care and includes discussion on educational activities, training, and prevention efforts. The chapter also discusses the role of various professionals associated with alcohol prevention and treatment activities. The box item presents a profile of substance abuse workforce. The first Appendix summarizes the North American organizations in the substance abuse field and the second Appendix describes interaction effects of alcohol with other drugs.

The book is a useful resource for undergraduate and graduate students in health, education, social work, counseling, addictive behaviors, sociology and psychology who are studying about the prevention and treatment aspects of alcohol. The book has been written in a reader friendly manner and has some excellent illustrations. Several supplements for the instructors are also available such as CD-ROM, Power Web, Primis online and others. On the whole, this book will continue to serve as an important textbook in this area.

Review by Manoj Sharma, University of Cincinnati


DeSena, J., Schaler, J. A., & Gerstein, J. (2003). Overcoming your alcohol, drug & recovery habits: An empowering alternative to AA and 12-step treatment. Tucson, AZ: See Sharp Press.

Hanson, D. J. (1996). Alcohol education: What we must do. Westport, CT: Praeger Publishers.

Jacques, K. A. Lyons, T. R, & Kelsall, D. R. (2003). The alcohol textbook. (4th ed.). Nottingham, UK: Nottingham University Press.
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Author:Sharma, Manoj
Publication:Journal of Alcohol & Drug Education
Article Type:Book review
Date:Mar 1, 2006
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