Drugs of Abuse: A Comprehensive Series for Clinicians – serie

Marijuana is the most widely used illicit drug in Amer­ ica. Some 40% of the adult population has tried mari­ juana at least once. It is the third largest agricultural commodity in the nation and a $10 billion industry. In many areas of the country, marijuana production or sale is the largest moneymaker by far. In Florida, for ex­ ample, it ranks ahead of every business except tourism. It is also a widely misunderstood substance. An en­ tire generation of Americans grew up believing that marijuana was virtually risk-free. This belief persists, despite growing evidence of physical, psychological, and social harm that is caused by the drug. The worst victims of this misinformation are young people. They, of all groups, are the least equipped to uncover and objectively evaluate the evidence regarding marijuana. At the same time, they are the most at risk for long-term problems resulting from marijuana use. v PREFACE vi As physicians we must make every effort to guide young people away from this drug. There are very significant dangers in young people experimenting with marijuana. The drug detoxification center at our hospital-and centers throughout the country-are packed with middle-class young people who started out smoking pot. None of them intended to become addicted, but the fact is that young people are more vulnerable to the influence of the drugs and become dependent easily. They may escalate usage, and progress to use of other drugs.

This book is written for a truly general medical audience. Clinicians, researchers, residents, and students will find Al­ cohol a direct treatment of the major drug problem in Amer­ ica. Along with the first volume in this series on marijuana, Alcohol is timely and relevant. The subject is presented with clarity in an effort to provide professionals and interested readers with a basic background in the field of alcohol studies. The emphasis is on what is known and can be coun­ ted on as fundamental knowledge on the various aspects of history, epidemiology, diagnosis, treatment, and prevention of alcoholism. Because drugs other than alcohol are such an important feature of the contemporary alcoholic, they are covered as a part of the natural history of alcoholism. Change and progress are essential to knowledge; past and current research in the alcohol field, as well as detailed discussions of what further needs to be investigated, are in­ cluded in the volume. The student as well as the practitioner vii viii PREFACE will find the contents useful for didactic purposes as well as a clinical reference. We believe that the researcher will also profit from the comprehensive coverage of the subject. The chapters are organized in sections to highlight important topics and are arranged in a sequence to ensure a logical de­ velopment of the subject, alcohol. Throughout the book we combine our clinical and research experiences to provide a synthesis that we hope will have widespread clinical usefulness. N.S.M.

Author Mark S. Gold presents the latest medical information on nicotine and tobacco's neurobiological, physiological, and psychological effects. This timely monograph also discusses the latest diagnostic and treatment programs as well as model programs for use by practitioners which were developed by the National Cancer Institute and other eminent organizations. The author also includes a comprehensive history of tobacco use.

For every news story in the popular press detailing the horrors and the violence associated with cocaine, there have been corresponding studies in the medical litera­ ture shedding new light on our understanding of this most troublesome drug. Our knowledge of addiction, and specifically cocaine addiction, has increased dra­ matically within the last few years. We stand on the threshold of an exciting new era in addictionology that promises better treatments, improved diagnostic proce­ dures, and more effective preventative strategies. We must prepare today for the avalanche of exciting dis­ coveries that will arrive in the coming years. Along with the first two volumes in this series, Marijuana and Alcohol, this book strives to help the general medical community to stay abreast of the latest medical information on addiction, while presenting a fundamental resource on the neurobiology, physiology, epidemiology, history, diagnosis, treatment, and p- v vi PREFACE vention of cocaine abuse. In addition, the comorbidity of cocaine abuse and eating disorders, depression, anx­ iety, hypertension, and various other disorders is dis­ cussed in detail. Finally, the last chapter presents new strategies tailored to specific patient groups and aimed at confronting the ever-changing face of drug abuse.

Marijuana is the most widely used illicit drug in Amer­ ica. Some 40% of the adult population has tried mari­ juana at least once. It is the third largest agricultural commodity in the nation and a $10 billion industry. In many areas of the country, marijuana production or sale is the largest moneymaker by far. In Florida, for ex­ ample, it ranks ahead of every business except tourism. It is also a widely misunderstood substance. An en­ tire generation of Americans grew up believing that marijuana was virtually risk-free. This belief persists, despite growing evidence of physical, psychological, and social harm that is caused by the drug. The worst victims of this misinformation are young people. They, of all groups, are the least equipped to uncover and objectively evaluate the evidence regarding marijuana. At the same time, they are the most at risk for long-term problems resulting from marijuana use. v PREFACE vi As physicians we must make every effort to guide young people away from this drug. There are very significant dangers in young people experimenting with marijuana. The drug detoxification center at our hospital-and centers throughout the country-are packed with middle-class young people who started out smoking pot. None of them intended to become addicted, but the fact is that young people are more vulnerable to the influence of the drugs and become dependent easily. They may escalate usage, and progress to use of other drugs.