Perspectives on Substance Use, Disorders and Addiction, Second Edition, is a philosophical and clinical text that suggests new ways to think about the relationships, enjoyment, and troubles with substances of pleasure. The book is designed for students and clinicians who come in contact with and treat individuals and families struggling with the causes and consequences of substance use disorders and addiction. The second edition of Perspectives presents a refreshing blend of ancient and contemporary ideas on the natural pleasures and potential powers of alcohol and drugs in our everyday individual and collective lives.

Severe Substance Use Disorder

Severe Substance Use Disorder


This chapter includes three case studies of individuals with severe substance use disorders. We struggled as a therapeutic team, and each individual was satisfied with his progress.

Clinical Cases

Jon: Shadow Use to Termination of Therapy

This is a case study about a long-term marijuana user who started using at age 13. When he was 36 we terminated our 4-year therapy relationship, recognizing that Jon did not want to stop his shadow using habit at this time in his life.

A former student of mine called with a feverish tone in her voice and asked if I was accepting referrals. She conveyed a sense of immediacy as she told me about her friend who was being “bullied, pressured, and cornered” by ...

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