Miller-The ASAM Principles of Addiction Medicine, 7e

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Preface

Terminology

A Note on Terminology

appropriate public policy or legislation, including funding for research, treatment, or graduate medical education. This most current edition of the textbook maintains the importance of ter minology and continues with a dedicated terminology chapter (Chapter 2) and encourages all clinicians to lead by example with the use of medically clear, accurate, and nonstigmatizing terminology. For the seventh edition of the textbook, we expanded the fron tiers of nonstigmatizing terminology by encouraging our authors and editors to consider how the topics of race, diversity, equity, inclusion, and justice relate to their chapter contents, especially in chapters dealing with the topics of genetics, epidemiology, assessment, and treatment. This has provided attention to these topics throughout the textbook. More specifically, we have also added three new chapters to bring deeper understanding and meaning within addiction medicine: Race, Ethnicity, Gender, and Social Determinants of Health, Disparities, and Access to Care; Treatment Considerations for LGBTQ Patients; and Reducing Inequities of Care Through Changes in Practice. Addiction medicine is shaped by constantly evolving science and practical clinical experience. It is our sincere hope that this textbook will embody the best of what both of these can offer to clinicians as we work to serve our patients and society.

The editors of The ASAM Principles of Addiction Medicine recognize that addiction is a medical condition with its own ter minology used by not only clinicians and researchers but also patients, policy makers, the press, families, and other stakehold ers. There are certain terms that can have several meanings and often unintended effects. Most importantly, such terms can fur ther the stigma about people and patients with addiction-related conditions. The terms “alcoholic” and “addict” are examples of such terms—they can be used by health care workers in a pejo rative manner to label a problem medical patient, by family to label a member’s violent and irresponsible behavior, by persons with a substance use disorder attending 12-step meetings as a positive label defining themselves as actively participating in recovery, by the general public to define anybody “who drinks too much” or “is a drug user,” and by addiction professionals to indicate a patient’s substance use disorder. Pejorative terms can erode the motivation of people affected by these conditions to accept help from family, friends, or professionals. Medically inaccurate terms can cause confusion and lead to unclear research results, difficulty translating such results into practice, and inappropriate clinical care. Furthermore, inappropriate and imprecise terms can dehumanize patients as well as undermine and erode efforts toward scientifically informed and ethically

Acknowledgments

The editors wish to thank the American Society of Addiction Medicine (ASAM) for the opportunity to work on this text book. Our section editors and authors generously lent their time and expertise, and we celebrate new authors and editors who have joined the team of experts in updating the seventh edition. All authors and editors have made a significant contri bution to the field of addiction medicine. Our publishing partners at Wolters Kluwer—Chris Teja, Ariel S. Winter, Sean Hanrahan, and Bridgett Dougherty— worked with authors and editors and behind the scenes to help lead this project to fruition. Anne Luzier, Sr. Manager, Scientific Publications, nurtured most every aspect of this textbook from beginning to end, under the sage stewardship and advocacy of ASAM Director of Quality Improvement, Leigh Hause-Alvarado, MEd, MBA.

Finally, with enduring respect and recognition, we wish to acknowledge the contributions and leadership of the edi tors of previous editions of The ASAM Principles of Addiction Medicine : Norman S. Miller, MD, Martin C. Doot, MD, Bonnie B. Wilford, MS, Allan W. Graham, MD, Terry K. Schultz, MD, Michael F. Mayo-Smith, MD, David A. Fiellin, MD, Richard K. Ries, MD, and Richard Saitz, MD. Shannon C. Miller, MD, DFASAM, DLFAPA Richard N. Rosenthal, MD, MA, DLFAPA, DFAAAP, FASAM Sharon Levy, MD, MPH, FASAM, FAAP Andrew J. Saxon, MD, FASAM Jeanette M. Tetrault, MD, FACP, FASAM Sarah E. Wakeman, MD, FASAM

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