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Book Forum: Addictive Disorders   |    
Pagliaros' Comprehensive Guide to Drugs and Substances of Abuse
Am J Psychiatry 2004;161:2148-a-2149. doi:10.1176/appi.ajp.161.11.2148-a
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Sayville, N.Y.

By Louis A. Pagliaro, C.Psych., M.S., Pharm.D., Ph.D., and Ann Marie Pagliaro, R.N., B.S.N., M.S.N. Washington, D.C., American Pharmacists Association, 2004, 462 pp., $89.00.

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Have you ever been told by a patient that her boyfriend had offered her some "nugget"? or by concerned parents that their son talked about using "blue lips" at a rave? Have you been asked to evaluate a habitual user of propoxyphene? or a recent immigrant who chews khat? If you have had such an experience, it would have been comforting to find a copy of this book on your shelf to provide a quick and authoritative reference for these and many other "drugs and substances." As an experiment, I searched for each of the above substances on the World Wide Web with the help of a common search engine, using combinations of words, but, except for propoxyphene (Darvon), I had difficulty finding any useful information. Many of the web sites located promoted the acquisition and taking of drugs, their information hardly trustworthy. The web site of the National Institute on Drug Abuse was not easy to use when only the street name or chemical name of a drug was available. Pagliaros" Comprehensive Guide to Drugs and Substances of Abuse, however, offers an extensive index of street, chemical, and brand names and a concise 3–5-page monograph about each of more than 100 drugs abused in the United States and Canada.

These monographs, which take up about two-thirds of the book, list the different names of each drug and its classification, pharmacology, mechanisms of action, medical uses, common patterns of abuse, toxicity, effects in pregnancy and lactation, withdrawal syndromes, overdosage, and other important facts. The volume also contains an introduction to drugs and substances of abuse that describes a useful and practical framework for thinking about drug problems in the individual and society. Unfortunately, the authors never quite explain the difference between a "drug" and a "substance." They apply both terms to alcohol and seldom use the terms separately.

In addition to the introduction and monographs, the book contains three chapters on groupings of drugs: psychodepressants (including opiates, alcohol, and sedatives), psychostimulants (including cocaine, amphetamines, caffeine, and nicotine), and psychedelics (including cannabinoids, indoles like LSD, and phenethlyamines). The book confines itself to drugs taken to alter the user’s psychic state and does not cover amyl nitrate or other vasodilators used to enhance sexual pleasure or anabolic steroids used to enhance performance and body image.

The Pagliaros are a husband-and-wife team from the University of Alberta in Canada who have written a great many books and papers on substance abuse. Louis is a professor of pharmacopsychology (formerly professor of pharmacy and pharmaceutical sciences), and Ann Marie is a professor of nursing and director of a substance abuse and clinical pharmacology research group at the university. Together they have prepared a very practical, clearly written reference book that can be of great assistance to the clinician. It is not a textbook of addiction, however, because the principles and practical aspects of treatment are only touched on. Neuroanatomy, neurophysiology, and brain imaging in addiction are not discussed, and many other aspects important to treatment are absent. On the other hand, addiction texts do not contain the kind of drug-specific information provided by the Pagliaros’ guide. Therefore, this well-organized and helpful handbook on drugs of abuse is recommended as an important addition to the reference libraries of individual and group practices, hospitals, clinics, and training programs for health and mental health professionals.




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