Drugs and Society

Drug abuse is fast becoming a major problem in South Asia. Newer and more potent drugs of abuse are becoming available, and the geographical proximity to the Golden Crescent and the Golden Triangle makes South Asia especially vulnerable. Drug abuse is closely linked to the rising prevalence of HIV and Hepatitis B.
This book aims to educate students of the health sciences on the impact of drug abuse on the lives of ordinary people, and is the result of a collaborative venture between pharmacologists and sociologists. Clinicians have also contributed. Each chapter includes a number of unique features including ‘Holding the line’, ‘Case in Point’, ‘Here and Now’, ‘Point/Counterpoint’ and ‘Learning Objectives’. ‘Holding the line’ details the efforts of the United States (US) Government to deal with drug abuse. ‘Case in point’ and ‘Here and Now’ illustrate the clinical, social and personal consequences of drug abuse. The learning objectives describe what the learner would be able to do on completing a particular chapter.

Chapter 1 serves as an introduction to the book. Various terms linked to drugs and drug abuse is defined. The table detailing the slang drug terms is very interesting. The extent of, and the implications of drug use in society has been comprehensively discussed. The classification of drug users into experimenters, compulsive users and floaters is interesting..

The second chapter tries to explain drug use and abuse. The major theoretical explanations of addiction have been covered from both biological and sociological perspectives. The discussion questions in this chapter, like in others, try to make the learner think about various points. The list of comprehensive references at the end of the chapter serves a guide to further reading for the interested student.

Drug use, regulation and the law is the focus of the third chapter. Governments all over the world have recognized the problem of drug use, and the Food and Drug Administration (FDA) of the United States (US) has tried to regulate drug use. The various US legislations which have tried to regulate drug use are mentioned. These may not however be of much interest for readers outside the US. The chapter ends with a section on pragmatic drug policies. Governments around the world have tried a coercive and an educative approach to curb drug use. The ideal may be a mixture of these two approaches, tailored to individual requirements.

‘Homeostatic Systems and Drugs’, is the area covered in the fourth chapter. The action of drugs of addiction on the neuron has been explained using simple line diagrams. I especially liked the simple explanations of the central nervous system (CNS) and the autonomic nervous system (ANS). The fifth chapter talks about ‘How and why drugs work’... Various aspects of clinical and basic pharmacology are covered. Dose-response relationship, margin of safety, drug antagonism and additive effects, are described. The inhalational and the intravenous route have the quickest onset of action. The adaptive processes which take place in the body on chronic use of drugs have been well described.

From the sixth chapter onwards, various types of drugs have been covered in detail. The description starts with the CNS depressants and the class of sedative-hypnotics. The benzodiazepines, the barbiturates and the non-benzodiazepines have been covered in some detail. The seventh chapter deals with a commonly abused drug all over the world, called alcohol. The description is detailed, but is again mainly from a US perspective. The next chapter continues to study alcohol mainly from a behavioural perspective. Cultural influences on alcohol use and the differences in the definition of alcoholics in various countries and cultures are interesting.
Narcotics or opioids starts with the description of the history of opium, which for centuries, was the most commonly abused narcotic. The stimulants form the focus of a separate chapter. Ampheta