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Book Forum: Substance Abuse   |    
A Handbook on Drug and Alcohol Abuse: The Biomedical Aspects, 4th ed.
Am J Psychiatry 2005;162:1556-a-1557. doi:10.1176/appi.ajp.162.8.1556-a
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Los Angeles, Calif.

By Gail Winger, Ph.D., James H. Woods, Ph.D., and Frederick G. Hofmann, Ph.D. New York, Oxford University Press, 2004, 181 pp., $60.00; $31.95 (paper).

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Knowledge about drugs of abuse, from pharmacology to trends in use, is constantly changing and can come from many different sources, including books, journals, the Internet, and the popular media. Too often, however, much of that information is biased, scientifically flawed, or peppered with a political agenda. Drs. Winger, Woods, and Hofmann, instead, have produced a scientific, concise, and comprehensive primer on virtually all drugs of abuse. As with previous editions (the last edition was 10 years ago), the authors have crafted this book for a wide target audience—from undergraduate pharmacology students to medical students, to substance abuse specialists, and to laypeople with a curiosity about drugs of abuse.

The book opens with a short description of how to define drug abuse and then turns to recent trends of drug use in the United States, providing a general description of the neurological aspects of drug use. The heart of the book is divided into specific chapters that discuss all of the major drugs of abuse: tobacco/nicotine, opioids, CNS depressants (alcohol, barbiturates, benzodiazepines, solvents, inhalants), marijuana, and CNS stimulants (cocaine, amphetamines). Of interest, there is an entire chapter dedicated to "club drugs," namely, gamma hydroxybutyrate, 3,4-methylenedioxymethamphetamine (Ecstasy), and ketamine.

Each chapter concisely and concretely describes the epidemiology, trends of use, and pharmacology of the drug of abuse. Special emphasis is placed on the toxic effects of drugs of abuse, including acute intoxication effects as well as long-term medical consequences.

Two new features of this edition are a chapter devoted entirely to the medical issues associated with drug abuse and an expansion of the chapter on drug abuse and the law. Particular emphasis is placed on infections obtained from intravenous drug use and the pulmonary effects of smoking drugs. The chapter examining drug abuse and the law succinctly summarizes the history of drug regulation in the United States and adds much-needed information about international drug laws.

Overall, this handbook is clearly written and presents the information in a well-organized and scientific fashion. Its brevity is appropriate, especially for the reader who is not a specialist in addictions. However, this is not the book to seek out for treatment; very little space is given over to how to treat substance-dependent individuals (this is not the book’s purpose). Every significant drug of abuse is well covered and enough details are provided to familiarize or update the reader with accurate information. The only important drugs of abuse that are not described are anabolic steroids; a review of these would be particularly relevant given the recent attention placed on them by the media and popular culture. Finally, the book could use a concluding chapter and perhaps the addition of more illustrations, especially a visual depiction of the drug of abuse, to aid the reader. Nevertheless, the authors have done well to produce a work that is understandable to a wide audience and that is not weighed down in confusing research terminology.




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