Handbook of the Medical Consequences of Alcohol and Drug Abuse.

Handbook of the Medical Consequences of Alcohol and Drug Abuse Brick J, ed. Binghamton, NY 13904-1580, The Haworth Press, 2004, paperback, 347 pp, ISBN: 0-7890-1864-0, $49.95.

This peer-reviewed text contains 10 chapters that summarize the most recent basic research and clinical findings of 19 authors who are established experts and new scientists in the field of alcohol and drug abuse. This book is intended to improve the basic science knowledge of a wide range of health care practitioners, including physical therapists, on alcohol and substance use and abuse. The book also is all excellent source of current scientific literature for the promotion of public awareness of the problems associated with alcohol and drug abuse. This book addresses the effects of alcohol and drug abuse on various organ systems, from the prenatal period to adult life. Drugs discussed include marijuana, opioids, cocaine, LSD, phencyclidine, amphetamines, and several inhalants. Virtually all references cited throughout the book come from credible research published between the 1990s and the present, making the information applicable for many years to come.

The first 5 chapters cover basic science and clinical issues in alcohol abuse. Chapter 1 provides the definitions related to the use and abuse of alcohol as well as alcohol dependence. It addresses the measurement of alcohol concentrations in the body fluids, and briefly defines "what constitutes a drink." The chapter also defines the terms used both in the book and in the current literature.

Chapter 2 discusses the relationship between alcohol and traumatic injuries; its adverse effects on the musculoskeletal system, liver, pancreas, and heart; and the risk for certain cancers. In addition, it briefly discusses both the detrimental and beneficial effects of alcohol. Chapter 3 covers the effects of alcohol and abused drugs from the neuropsychological perspective. It examines the relationship between brain and behavior under the influence of drugs, suggesting that they induce pervasive effects that may be immediate and acute or long-term. This chapter also discusses the role of alcohol and multiple drug abuse in abnormal neurotransmitter functions, which may subsequently lead to brain damage.

Chapter 4 discusses the adverse effect of alcohol on neuronal action potential, neurotransmitters, cognition, and the recovery from alcohol dependence. The latter information provides a promising direction for the future management of people who are alcoholic. This chapter is especially useful to both new scientists and experienced practitioners in alcoholism treatment. Chapter 5 presents studies (including information from autopsy and brain scans) on the effects of alcohol on the fetus. In addition, it discusses the postnatal, neurobehavioral deficits in intelligence, language, learning, memory, attention span, decision-making processes, judgment, and other psychosocial aspects resulting from prenatal exposure to alcohol.

The last 5 chapters cover the current knowledge on drug abuse. Chapter 6 covers the available information on marijuana and discusses the quality of research on the effects of this drug on the respiratory system, immune system, cardiovascular system, hormones, and fertility as well as its prenatal effects. In addition, the chapter also presents information on the psychological and psychiatric effects of marijuana on attention, memory, academic performance, motivation and dependence, and the medical use of this drug.

Chapter 7 presents issues related to opioid drugs and methadone, the latter being an effective drug used in the treatment of people who are addicted to heroin. The chapter covers topics ranging from subtle and indirect effects of heroin (eg, infection) to the ultimate health risk--death. This chapter also compares and contrasts the effects of methadone and heroin on the function and dysfunction of various organ systems.

Chapter 8 covers the history of cocaine followed by the adverse effects of this drug, methamphetamine, and phenylpropanolamine. This chapter describes both the psychological and physiological effects of cocaine on the cardio-pulmonary, vascular, and central nervous systems. The clinical effects of cocaine on genitourinary, gastrointestinal, hepatic, pancreatic, and ocular systems are briefly discussed.

Chapter 9 is devoted to the prenatal effects of nicotine, cocaine, marijuana, and opioid drugs. The chapter discusses behavioral teratology and presents epidemiological data on effects of these drugs on physical growth, cognition, behavior; language, auditory processing, attention, and other psychomotor and motor parameters.

Finally, chapter 10 provides an up-to-date discussion of the history, epidemiology, routes of administration, adverse effects, and treatment of inhalant agents. These substances constitute a broad class of toxic and abused drugs, ranging from nitrous oxide to gasoline.

I recommend this book as a valuable addition to the library of health care practitioners, including physical therapists, who specialize in neuroscience or whose practice involve the management of people with alcoholism or substance abuse disorders.

Kamran Tavakol, PT, PhD Howard University Washington, DC

Dr Tavakol is Associate Professor in the Department of Physical Therapy where he teaches foundational science courses in pathology, pharmacology, and cardiopulmonary management. His current research interests include changes in blood lipids in response to aerobic exercise and the pharmacodynamics of cardiovascular and musculoskeletal medications.