Perspectives on Substance Use, Disorders, and Addiction

With Clinical Cases

"The human condition is one that destines us to alternate between states of contentment, discomfort, distress, and, worst of all, unbearable suffering.  Alcohol and other drugs (AODs) can enhance, alter, and relieve such feeling states. Margaret Fetting in this wonderfully nuanced and sophisticated book explores and explains how and why this is so dating back to ancient times up to the present. Professor Fetting richly explores the historical, cultural, social, and clinical contexts, and related theories, of intoxicant use in pursuing her special perspective. Throughout the book she provides compelling case vignettes that richly illustrate the various situations in which we use AODs adaptively and maladaptively. She is passionate about her subject matter; her writing style is evocative, and she builds a compelling narrative for why the desire for AODs is enjoyable for most, problematic for some, and devastating for a few. After pondering, studying, and treating these problems now approaching five decades I find her approach and perspective very refreshing because it takes me beyond my own models and paradigms for understanding, at the same time it provides me with a more flexible basis to better appreciate the wide range of use that AODs take in all its variant normal and pathological forms."

  "Margaret Fetting has produced an excellent and encompassing harm reduction perspective on drug use, abuse, and treatment for the globalized twenty-first century.”  

"Perspectives on Substance Use, Disorders, and Addiction, by Margaret Fetting is a special textbook for the beginning student and the experienced practitioner alike. It is intended as a thought-provoking overview of what is most cutting edge in thinking and clinical practice about substance use along the spectrum from non-problematic through addictive. This book is radical in acknowledging what we all know, that people have used substances for their positive effects from the beginning of time. It is ambitious in suggesting that we must consider many factors in any honest, disciplined attempt to understand how and why substance use becomes so devastating for individuals and society: globalization and other socio-cultural factors, individual cultural and family history, learning, personal meaning and self-medication of suffering.  Fetting introduces each of these areas clearly and succinctly. Her overarching philosophy for helping is harm reduction, an approach that is fully committed to seeing each individual who struggles with substance use issues as a unique human in unique circumstances who needs help that is collaboratively tailored to them. The ideas in this book are brought to life with powerful case vignettes and student contributions that bring the reader into real people’s lives. I have learned much that I am already using in my teaching and clinical work. I know you will too. Enjoy!"

"Dr. Margaret Fetting's book is essential reading for students, clinicians, and those who suffer from alcohol and substance use disorders. Fetting traces the ancient roots of the human wish to become intoxicated, and, without judgment, puts that desire into a modern context. For the past 80 years, the U.S. has relied on a one-size-fits-all treatment for a complex set of problems, and Fetting presents flexible and innovative approaches for addiction and substance-use disorders at a time when Americans are desperate for alternatives -- for themselves, their loved ones, and their clients. This highly readable, engaging book is essential for clinicians, faculty and students of addiction and also those who struggle with substance- and alcohol-use disorders themselves."