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Drugs of Abuse, 1stEdition, (Reprint 1999) by Simon Wills. Softcover, 6" x 9".
Pharmaceutical Press, 1, Lambeth High Street, London, SE1 7JN, UK, Tel +44 (0) 1491 829 272, Fax +44 (0) 1491 829 292: xiv + 262 pages, ISBN 0-85369-352-8. Price £18.95 (including delivery to any UK address); £19.95 (including delivery to any non-UK address)
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It has been correctly said that the drugs are the double-edged swords, fatal in overdoses or unintended use. Drug abuse is wide spread and a number criminal organization is indulged in the minting of money by manufacturing and supplying these grave substances to the innocent people incapacitating them of their daily activities .The lenient law has permitted its use without restraint. It is important that public should understand the hazards prone to drug abuse.
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This book deals with these particular aspects of the drugs that carry abuse potential. This book also imparts information that is of utmost utility to the health professionals, people involved in deaddiction centers, Self-help groups or agencies dealing with curbing of drug abuse or for the medical students. The book is simplified to make it easily understandable. The knowledge depicted in this book is concise, relevant, useful and handy. The book contains twenty vital chapters on the drug abuse.
The first chapter introduces the reviewer about abuse & dependence and their legal implications. One may wonder that these are synonymous terms but on the contrary they are different. The author has used simple markers to differentiate these two terminologies. Certain other misleading and adjuvant terms i.e. Drug misuse (tends to imply that a drug has proper indication for use but is being employed for an incorrect purpose), Designer drugs which are analogues of the street drugs, drug seeking behavior, intoxication, reinforcement and tolerance are clarified in an easy manner by author. This chapters also emphasis the necessity for legislation over use of these illicit substances.
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The second chapter deals with the Adverse Consequences of Drug Injection. Intravenous injection form one of the preferred route for injecting drugs i.e. cocaine, amphetamines and heroin that carry abuse potential. These injections are sterilized in an unhygienic fashion and most of drug abusers continue to use the same needle couple of times before discarding it. Such activities make them more prone to infection and these injections serve as source of contamination. There is also a common activity of needle exchange among abusers to derive the thrill. These specific chapter talks about the methods used for sterilization of the injections by the drug users and their health implications. The author further elaborates that the street drugs are adulterated with cheap inert substances that can be more dangerous. He states the detection of thrombocytopenia in heroin users, this developed due to immune reaction to an adulterant mixed with heroin.
The next series of chapters throws light on the particular psychoactive agents which are the common drugs of abuse.
Chapter three deals with opioids. Man has used Opium over centuries as a medicine and intoxicant. It is cultivated in many areas all over the world. Interestingly, use of opium led to an outbreak of war between China and Britain & creation of large no of addicts in its use as analgesic in US Civil war. In earlier days, it was one of the common drugs freely prescribed and sold without hesitation. In the recent times its intoxication and health problems are realized and abated to legislation. But yet, even today most abuse is centered on an opium derivative heroin. The infusion of opium causes a euphoria, Detachable feeling and pleasant sleep without impairing movement or intelligence, this soothing effect makes it a popular drug of abuse. This chapter also reviews pharmacology, adverse effects, dependence and its treatment in a nutshell.
Chapter fours cover the Cannabis. This term reefers to the preparation derived from Indian hemp Cannabis Sativa , a bushy plant native to India. Though, this plant was popular in the four ancient civilization dated as early as 1600 BC but it was used for different purposes. The consumption of cannabis began in early 19th century and has flared thereafter. There are around 60 psychoactive ingredients of the resin of cannabis but tetra hydro cannabinol is the most important among these. It produces elation and merriment followed by relaxation. Many users prefer to use inhalation or oral form. This chapters deals with pharmacology, adverse effects and the long-term use of cannabis.
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Chapter five includes cocaine. Cocaine, derived from the coca plant originated from South America. This was considered as a divine gift and reserved for the high societies. Chewing of coca leaves produced a stimulus to manual labors. Though, cocaine is perceived as a expensive drug but still carries a major proportion of abusers world wide. When cocaine is injected or smoked there is euphoria, excitement, alertness and rapid inflow of thoughts. It allays fatigue and infuses energy subjectively and increases strength and mental supremacy. This chapter also includes pharmacology, adverse effects, and health implications on the long term use and treatment.
The next chapters encompasses information on amphetamines and Ecstasy (Methyl amphetamines) related drugs, which gained importance in 1930 when it was learnt that it dispensed feeling of guilt, hatred and promoted emotional harmony. The detailed data on its pharmacology are available.
The next three chapters' deals with LSD, phencyclidine and volatile substances abuse. LSD commonly called "trips", it causes psychedelic effects. Phencyclidine or "angel dust" was first investigated intravenous anaesthetic in 1950 but was withdrawn as it produced hallucinations, agitation and delirium. This is now smoked and often mixed with tobacco and cannabis, as it is cheap. Drug abusers develop euphoria followed by hallucinations on its consumption. Volatile substance abuse is a deliberate inhalation of a volatile substance to achieve change in mental status. A rapid high or feeling of exhilaration is produced with in few minutes similar to drunkenness. The pharmacology, treatment of their abuse and steps to reduce this abuse are discussed.
Chapter ten focuses on the performance enchancing drugs, which forms the burning issue in international sports. Anabolic steroids use is increasingly prevalent in the West but the laws imposing restriction on its use is debatable in many countries. These drugs increase physical strength and muscle mass. They also increase stamina and decrease fatigue. The author also cites various other drugs like diuretic, tamoxifen, HCG ,Growth hormone which supplement the action of anabolic steroids. Clenbuterol (antiasthmatic drug),Gamma hydroxybutyrate and other nutritional supplements are also enclosed in this text. This erudition briefs the viewer about the potential risks induced by these drugs and supplements that are sold freely in the market.
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Chapter eleven covers the prescription drugs which includes anaesthetic ,antidepressants, sedatives and certain other commonly prescribed drugs causing psychotropic effects, intoxication or dependence. It also stresses on the identification of a particular toxicity of these substances using characteristic physical signs. This learning is very vital for the prescribers for the safe use of these drugs to the patients.
Chapter 12 integument the over the counter drugs which are sold without prescription. This chapter includes the list of such agents and problem imposed by it.
The Chapters 13,14 & 15 confronts with caffeine, tobacco and alcoholism & their dependence. While surveying the information on tobacco & alcohol, one can understand the dangerous chances of developing serious health problems i.e. cancer. In the world today a major proportion of accidents occur as people mix drinking and driving.
Chapter 16 deals with indigenous plants possessing psychotropic effects. Hallucinogenic mushrooms, nutmeg, khat, morning glory, caffeine containing plants ,potato family which contains antimuscarinic agents, cactus and ginseng , ephedra are included. With this lore one may understand the intoxication and medicolegal aspects attributed to their consumption.
Chapter 17 deals with nitrites which is an antianginal drug, but this "Poppers" also became a street drug as it removed inhibitions
The last three chapters deal with Street drugs, drugs of abuse and concurrent illness and drug abuse and its implication in pregnancy and nursing mothers. Appendices include guidelines on needle exchange schemes and the list of the street drugs.
Thus, this book covers the complete information on different drugs inducing dependence, their effects in specific conditions like pregnancy, breast-feeding and concurrent illness. This book can be used as a reference or for personal education or for the forensic or pharmacology experts.
-Dr Anshu Sethi & Dr BK Bajaj
New Delhi, India
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