9
1355± 6215/99/010093± 09 $9.50 Society for the Study of Addiction to Alcohol and Other Drugs Carfax Publishing Limited Addiction Biology (1999) 4, 93± 101 Book and media reviews COMPILED BY CHRIS COOK Book reviews in this column will primarily be of titles focusing completely, or in part, on biological aspects of addiction. However, significant titles of general relevance to the addictions field will also be included, even if they are not ª biologicalº , as will titles of general methodological and clinical relevance, even if they are not on ª addictionsº . Similar considerations will apply to other media (software, audio tapes and CDs, videos, etc). However, specific ª addictionsº software applications seem to be relatively uncommon and, as these items are rarely reviewed elsewhere, we will endeavour to include reviews of some of the older programmes that are still useful, as well as new titles that appear. I would appreciate suggestions of any items suitable for reviews, but especially software and other media of specific relevance to the addictions. Please contact: Professor Chris Cook, Kent Institute of Medicine and Health Sciences, University of Kent at Canterbury, Kent CT2 7NR, UK. Email: [email protected] Ninth Special Report to the US Congress on Alcohol and Health from the Secretary of Health and Human Services, June 1997 NATIONAL INSTITUTE OF ALCOHOL ABUSE AND ALCOHOLISM US Department of Health and Human Services, Washington DC 420 pp., US$11.00 Every 4 years there is an air of excitement and anticipation in the alcohol research community. This atmosphere of anticipation has nothing to do with football or the World Cup, but rather the arrival of each successive Special Report to the US Congress on Alcohol and Health. That excited anticipation is fully justified as this series provides the most comprehensive and up-to-date review of the alcohol literature summarizing the state of the art of alcohol research. These reports are written in an accessible style and the target audience is the educated Congressman. Having said that, anyone involved in research in the alcohol field will find this an invaluable resource to update their knowledge in areas of research in which they are not directly involved. The First Special Report was published in 1971 shortly after the creation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and comprised only 118 pages summarizing knowl- edge at that time. Now, 25 years later, the Ninth Special Report provides evidence of how far the alcohol field has come, not least by virtue of the size of the latest report, at 420 pages. One can only speculate about the role that successive reports in this series have had on the development of the field itself. They provide a crucial opportunity both to keep alcohol firmly on the public health agenda in the US Congress, and to provide a showcase for the wide-ranging research portfolio supported by NIAAA. The considerable government invest- ment in the alcohol field in the United States has also encouraged many talented researchers to enter the field of alcohol research. As the Director of the National Institutes of Health, Harold Varmus notes in his preface ª the alcohol field now has access to the very best science as well as to the very best scientistsº. The territory covered by the report is extremely broad and the list of contributors is a veritable Who’s Who of the US alcohol field. The report contains a wealth of information on fields as diverse as epidemiology, genetics, pharmacology, behavioural science, health consequences, eco- nomics, prevention, treatment and health services research. As a reference source I find this series, and this report in particular, the most valuable and comprehensive text available. This is the ideal place to start, whether one is writing a review paper, preparing a lecture, writing a grant appli- cation, trying to gain familiarity with a new area

Book and media reviews

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Page 1: Book and media reviews

1355 ± 6215/99/010093 ± 09 $9.50 � Society for the Study of Addiction to Alcohol and Other DrugsCarfax Publishing Limited

Addiction B iology (1999) 4, 93 ± 101

Book and media reviews

COMPILED BY CHRIS COOK

B ook reviews in this colum n will primarily be of titles focusing completely, or in part, on biolog ical aspects of

addiction. However, significant titles of general relevance to the addictions field will also be included, even if they

are not ª biologicalº , as will titles of general methodological and clinica l relevance, even if they are not on

ª addictionsº . Similar considerations will apply to other media (software, audio tapes and CDs, videos, etc).

However, specific ª addictionsº software applications seem to be relatively uncom mon and, as these items are

rarely reviewed elsewhere, we will endeavour to include reviews of some of the older programmes that are still

useful, as well as new titles that appear. I would appreciate suggestions of any items suitable for reviews, but

especially software and other media of specific relevance to the addictions. Please conta ct: Professor Chris Cook,

Kent Institute of Medicine and Health Sciences, University of Kent at Canterbury, Kent CT2 7NR, UK.

Email: c.c .h.cook@ ukc.ac.uk

Ninth Special Report to the US Congress

on Alcohol and Health from the Secretary

of Health and Human Services, June 1997

NATIONAL INSTITUTE OF ALCOHOL

ABUSE AND ALCOHOLISM

US Department of Health and Human

Services, Washington DC

420 pp., US$11.00

Every 4 years there is an air of excitement and

anticipation in the alcohol research community.

This atmosphere of anticipation has nothing to

do with football or the World Cup, but rather the

arrival of each successive Special Report to the

US Congress on Alcohol and Health. That

excited anticipation is fully justified as this series

provides the most comprehensive and up-to-date

review of the alcohol literature summarizing the

state of the art of alcohol research. These reports

are written in an accessible style and the target

audience is the educated Congressman. Having

said that, anyone involved in research in the

alcohol field will find this an invaluable resource

to update their knowledge in areas of research in

which they are not directly involved.

The First Special Report was published in 1971

shortly after the creation of the National Institute

on Alcohol Abuse and Alcoholism (NIAAA) and

comprised only 118 pages summarizing knowl-

edge at that time. Now, 25 years later, the Ninth

Special Report provides evidence of how far the

alcohol field has come, not least by virtue of the

size of the latest report, at 420 pages. One can only

speculate about the role that successive reports in

this series have had on the development of the field

itself. They provide a crucial opportunity both to

keep alcohol firmly on the public health agenda in

the US Congress, and to provide a showcase for

the wide-ranging research portfolio supported by

NIAAA. The considerable government invest-

ment in the alcohol field in the United States has

also encouraged many talented researchers to

enter the field of alcohol research. As the Director

of the National Institutes of Health, Harold

Varmus notes in his preface ª the alcohol field now

has access to the very best science as well as to the

very best scientistsº .

The territory covered by the report is extremely

broad and the list of contributors is a veritable

W ho’s Who of the US alcohol field. The report

contains a wealth of information on fields as

diverse as epidemiology, genetics, pharmacology,

behavioural science, health consequences, eco-

nomics, prevention, treatment and health services

research. As a reference source I find this series,

and this report in particular, the most valuable

and comprehensive text available. This is the ideal

place to start, whether one is writing a review

paper, preparing a lecture, writing a grant appli-

cation, trying to gain familiarity with a new area

Page 2: Book and media reviews

94 B ook and media reviews

or simply trying to locate that elusive reference!

Quite simply, this is a triumphant achievement of

co-ordination and editorial skill; all the more

amazing that each successive Report so convinc-

ingly upstages its predecessor.

If I had to find a criticism it would be that the

report, and this one more so than preceding ones,

is overly US-centric. Only two of the 24 writers,

and only two of the 54 editors and referees, are

from outside the United States. All four of the

outsiders are based in Canada. The reference lists

exclude some important studies written by

authors outside the United States. Well, what

should one expect? Of course this is about the US

alcohol research community and NIAAA com-

municating important new developments, espe-

cially those that are Federally funded, to the US

Congress.

However, if this was the only book about

alcohol research one ever reads there would be a

danger that one might reach the conclusion that

there is little of importance in the field going on

outside the United States. Perhaps this is also an

indication of the need for non-US-based alcohol

researchers to work harder at making more of an

impact in the international arena. Nevertheless,

the report needs to carry a warning that this is not

quite the same as a systematic review of the field

in the same way that one would expect from an

academic journal. Future reports in this series

would do well to consider a wider international

contribution to the editorial board to improve the

balance.

One important study that was published too

late for inclusion in this report is Project

MATCH.1This study has had important implica-

tions for treatment research and will no doubt be

an important inclusion in the 10th Report in due

course.

If coverage in the report is an indication of the

relative importance of different areas within the

alcohol research field, one important observation

is the expansion of biological research compared

with the 8th Report. The development of the

basic science base in the alcohol field is obviously

to be welcomed. However, one would hope that

in future editions this continued biological expan-

sion is not at the expense of other important

areas, including psychosocial research.

Overall, this is an extremely well written,

accessible and valuable addition to any alcohol

researcher’s, or student’s, library whatever their

background discipline. It is unique to find such a

wide range of information in one place. Such a

book can only help to expand knowledge about,

and interest in, the alcohol field. However, it

should not be viewed as a substitute for academic

reviews in peer-reviewed journals or electronic

literature search methods for comprehensive

research inquiry. With that caveat, to quote Dr

Varmus, ª I commend the 9th Special Report to

the US Congress on Alcohol and Health to your

most serious attentionº .

D. COLIN DRUMMOND

Department of Psychiatry of Addictive B ehaviour,

St George’ s Hospita l M edical School,

University of London,

Cranmer Ter race,

London SW17 0RE, UK

Reference1. Project MATCH Research Group. Matching alco-

holism treatments to client heterogeneity: ProjectMATCH posttreatment drinking outcomes. J StudAlcohol 1997;58 :7 ± 29.

The Myth of Addiction

JOHN BOOTH DAVIES

UK, Harwood, 1997

197 pp., pbk, £13.00, ISBN 9057 022370

This book is the second edition of an already

well-known and established text. Although its

content and central message are fundamentally

the same as when first published, it is still an

important, thought-provoking and pertinent text

today. Through the use of social psychological

theory, some of the most central and established

concepts in the field of addiction are system-

atically called to account, although to say that

Booth Davies aims to explain addiction in terms

of social psychological processes does not reveal

or do justice to how challenging, absorbing and

infuriating these arguments are.

A plethora of colourful research illustrations is

utilized in an attempt to reduce the emphasis

placed on addiction as some mechanistic force

over which individuals have no control. With this

aim, a balance is sought through the incorporation

of individual motives and intentions into the

complex equation of addiction. It must be said

that a number of the lines of reasoning concerning

craving, withdrawal and so on are initially quite

seductive but, if taken to their logical conclusion,

Page 3: Book and media reviews

B ook and media reviews 95

would indicate that there is no such thing as

addiction. Few would be willing to take this

extreme position, and in recognition of this the

author’s fervour seems to be inconsistent to the

extent where he feels the need to remind the reader

that, ª It is not the message behind this book that

the illicit use of drugs never creates problems for

peopleº . Realistically, it is precisely this under-

lying message that is felt throughout the book that

makes it particularly challenging and gives the

reader something to get their teeth into.

The issue of the inclusion of behavioural

addictions is raised and debated in the context of

how the term `addiction’ often results in dubious

and socially functional explanations. This type of

argument is welcome as it may set the scene for a

thorough and systematic investigation into this

difficult area, which would inevitably include the

`normal’ use of any mood-altering substances and

behaviours. This, I imagine, will be a theoretically

illuminating and more balanced approach that

removes the focus from substances and helpless

victims and replaces the emphasis on explaining

different levels of involvement in a wide variety of

substances and behaviours which are available for

deliberate mood altering.

Although the book is controversial it is an easy

and lively read, and whatever your overall impres-

sions it is guaranteed that your assumptions

about addiction will be given a thorough airing,

which can only be a good thing.

SAM HAYLETT

Department of Psychology,

University of Kent at Canterbury, UK

Addictive Behaviour: M olecules to

M ankind ± Perspectives on the Nature of

Addiction

A. BONNER & J. WATERHOUSE (Eds)

Basingstoke, Macmillan Press, 1996

1312 pp., hbk, ISBN 0 33364 555 3

This book is a series of up-to-date easy-to-read

reviews written exclusively by UK authors, and

which despite its title is principally about the

psychopharmacology of alcohol with a distinct

bias in favour of serotonin. It arose out of and in

conjunction with a conference in 1993 held at the

Roehampton Institute in London, England, which

may explain a number of the book’s peculiarities,

and also why approximately half is authored by

workers at the Roehampton Institute. Psycho-

logical and social aspects of addiction are also

covered, which is generally written so as to be of

interest to those with a biological emphasis.

In terms of quality the reviews are good,

although not generally written by recognized

authorities. The book, however, lacks an overall

coherence, containing reviews which do not fit

well into the overall theme (such as a chapter on

the biological basis of bulimia nervosa, and an

excellent review on the cardiovascular effects of

drugs of abuse ± not just alcohol), and contains a

variety of styles including some with elements of

speculation and personal reminiscences. The

primary drawback of the book, however, is its

failure to do justice to drugs of abuse other than

alcohol ± many of which hardly receive a mention ±

and the lack of reference to non-drug-based types

of addictive behaviour (apart from the chapter

devoted to bulimia). There is also an irritatingly

large number of typing errors.

Despite its peculiarities, this is a valuable book

which fills a vacant niche, by bringing together

together a wide range of up-to-date information in

easily assessable form, and is most suitable for

those interested in the biological basis of addic-

tion, and especially for those interested in alcohol.

FERGUS LAW

Lecturer in Psychopharmacology of Addiction,

University of B ristol, UK

Addiction Intervention

R. K. WRIGHT & D. G. WRIGHT

Binghampton, NY, Haworth Press, USA, 1998

154 pp., pbk, $24.00, ISBN 0 78900 434 8

This is a wonderful book for anyone interested in

following a 12-Step intervention. The chapters

are concise and clearly laid out. There are plenty

of examples of what to do. I think anyone could

pull enough information from the book to pro-

ceed with an intervention and see it through to

conclusion. However, if the Disease Model of

addiction is not your mantra, the book loses some

of its appeal.

The content that causes most concern is that of

the outcome of each intervention. While I appre-

ciate that when trying to teach people you should

be encouraging, I doubt that reading about only

successful interventions really helps. There are

suggestions that people will not accept help ± all

Page 4: Book and media reviews

96 B ook and media reviews

put down to denial± but little in the way of the

reality of relapse. This is surprising, bearing in

mind the stress placed by this book on the nature

of addiction as a chronic relapsing fatal illness,

and leaves a subtext that engaging in this type of

intervention is universally successful promoting

abstinence.

My other worry concerns the amount of time

and effort invested in one patient/client, who is

denying his/her problem, when there are so many

others out there who admit to having problems

with substances and are seeking help. Further to

this, if some one is denying there is a problem,

will they necessarily be in need of inpatient care/

detoxification, which is the primary aim of

intervention according to the book? My experi-

ence suggests that if there is a clinical need for

non-community-based treatment, the substance

user has ceased denying there is a problem, even

if he/she might continue to try to minimize it.

Notwithstanding, I think Addiction Inter vention

makes a useful addition to any practitioner’s

understanding of motivation and the precursors

of change. It also reminds one that addiction is a

problem that is usually bigger than the individual

who presents (or does not) and can be under-

stood fully only in the context of home, work and

social environments.

GREG HALSE

Addiction Problems Clinic,

Chatham, Kent, UK

Nicotine, Caffe ine and Social Drinking:

behaviour and brain function

J. SNEL & M. M. LORIST (Eds)

Harwood Academic Publishers, Amsterdam,

1998

473 pp., hbk, £47.00, ISBN 90 5702 218 4

This multi-authored volume is divided into three

sections, dealing with nicotine, caffeine and

alcohol, respectively. Each section begins with a

chapter on pharmacokinetics which is followed by

a number of contributions reviewing effects on

human performance and cognition. The standard

of contributions overall is reasonably competent.

I was particularly impressed by the chapter by

Nichols & Martin from the University of Tasma-

nia, looking at the vexed question of possible

toxic effects of social drinking of alcohol on brain

function, manifesting itself in impairment of

memory and information-processing abilities.

They provide a scholarly and appropriately cau-

tious review of a methodologically and con-

ceptually difficult area. The chapter by Streufert

& Pogash from Pennsylvania State University on

similar issues was another useful dissection of

complex research findings.

The section on nicotine was disappointing. A

competent outline of nicotine pharmacokinetics

by LeHouezec, subject matter which has been

covered thoroughly by other authors recently, is

followed by a lengthy review by Pritchard &

Robinson (from R.J. Reynolds Tobacco Com-

pany) on nicotine’s effects on performance. It is

perhaps no surprise that they tend to the view that

nicotine’s effects consist largely of absolute facili-

tation rather than relief of withdrawal-induced

deficits, although they do not rule out the

possibility of some interaction between these

factors. These authors show a relentless propensity

to look for positive nicotine effects, for example

dismissing poorer academic performance in smok-

ing students as attributable to pre-existing factors

such as socio-economic group and lower IQ,

whilst citing with approval a study reporting better

examination results in undergraduate smokers

than non-smokers. In such a contentious and

important area of public health disinterested

commentators are hard to come by.

Karl Battig, another author with a long history

of close links to the tobacco industry, provides a

contrarian view of smoking motivation, down-

playing the role of nicotine titration and empha-

sizing sensory factors and anticipatory behav-

ioural responses. Here again is an account which

is certainly not inimical to the perceived interests

of the industry, and which many might challenge.

Most surprising is Warburton’s chapter on the

effects of moderate amounts of caffeine and

nicotine on attentional performance. What is

moderate, you may ask? In the case of nicotine,

we are told, it is a dose which produces no more

than 50 m g/ml [sic] of nicotine in plasma. This of

course would be an acutely lethal dose. Even on

the charitable assumption that micrograms were a

misprint for nanograms, 50 ng/ml hardly repre-

sents a moderate nicotine dose. Smokers take an

average increment of 10 ± 15 ng/ml from a ciga-

rette, and the immediate post-cigarette peak

concentration in dependent smokers averages

about 35 ng/ml.

With a book like this you are left with many

unanswered questions. What is its aim? Is it to

Page 5: Book and media reviews

B ook and media reviews 97

normalize cigarette smoking, by discussing nic-

otine in the same context as caffeine and social

drinking? What is the intended audience? How

were authors selected? The Preface, which con-

sists of just one page, leaves these issues largely

untouched. There appears to be an almost

complete lack of any editorial function. Even

the fact that one of the contributors died before

his chapter appeared is given no explicit men-

tion. I suspect that few will read this book, and

that its impact on the field will be hardly

detectable.

MARTIN J. JARVIS

ICRF Health B ehaviour Unit,

Department of Epidemiology and Public Health,

University College London, UK

New Treatm ents for Opiate Dependence

SUSAN M. STINE & T. R. KOSTEN (Eds)

Basingstoke, Taylor & Francis, UK, 1997

286 pp, hbk, £25.00, ISBN 157230 190 2

This authoritative account of the treatment of

opiate dependence reflects the achievements of

the distinguished team of researchers and clini-

cians working in the Department of Psychiatry at

Yale, who have contributed immensely to this

field over the last 30 years. The focus of the book

is not so much on novel treatments as on

delivering a comprehensive account of the evolu-

tion and refinement of methadone maintenance

and detoxification treatment, particularly with

reference to recent developments in treatment-

matching. The book highlights the importance of

the integration of physical and psychosocial

treatments for optimizing success, and also

devotes attention to the treatment of medical

complications, particularly the problems of the

HIV-positive opiate-dependent patient.

The British reader will detect the American

slant and might feel a little short-changed by the

coverage of some clinical issues that are taxing

UK clinicians at present: for example, only a

single paragraph on hepatitis C compared with

extensive coverage of HIV and AIDS; the discus-

sion of co-morbid substance abuse is confined to

cocaine and alcohol ± no mention of benzodiaze-

pine co-dependence; a whole section on harm

minimization services without mention of needle

exchanges; no mention of lofexidine, the cloni-

dine analogue that is becoming increasingly

popular for the treatment of opiate withdrawal in

the United Kingdom.

I learnt a great deal from reading this book. My

only criticism is that it lacks criticism, and there

are no leaps of imagination in the discussion of

future treatment directions. The major disadvan-

tages of treatment with opiate medication are

barely alluded to. The account of naltrexone as a

pharmacological treatment for relapse prevention

is comprehensive but conventional, describing its

limited applications. However, all the papers

cited were published 15 years ago, a time when

attitudes to treatment were very different. Over

the last few years our understanding of the role of

dopaminergic pathways in dependence has

advanced significantly. However, there is no

speculation on the implications this might have

for the development of genuinely novel treat-

ments, for example, drugs selective for dopamine

receptor subtypes. Despite these quibbles, this

book is an excellent account of current clinical

perspectives on the treatment of people who are

opiate-dependent.

JENNY BEARN

B eth lem Royal Hospita l,

London, UK

Alcohol Use and Abuse among Latinos.

Issues and exam ples of culturally

competent services

MELVIN DELGADO

Binghampton, NY, Haworth Press, USA, 1998

208 pp., pbk, $30.00, ISBN 0 7890 0500 X

Melvin Delgado has produced a multi-authored

text in paperback that studies the difficulties that

the Latin community in the United States have in

accessing treatment for addictions.

The introduction gives an operationalized defi-

nition of what the concept ª cultural competenceº

means and distills the literature into five princi-

ples. First, the workers in the field should be

matched in terms of language background and

awareness of the community’s culture Secondly,

there should be an emphasis on identifying the

assets of a community. Thirdly, staff should be

appropriately trained. Fourthly, the community

assets should be used and finally, the community

should be active participants in service delivery.

The following two chapters describe the epide-

miology of substance use among Hispanics,

Page 6: Book and media reviews

98 B ook and media reviews

begging the question of whether Latinos are

synonymous with Hispanics. The book needs a

glossary. The 12 tables included in these chapters

allow one to get close to the original data. For

instance, 61.5% of Hispanic youth who had used

cocaine in the previous 30 days carried a con-

cealed weapon compared to 13.5% of Hispanic

youth who did not use cocaine in the last 30 days.

In Britain a weapon is often assumed to be a knife

but in this context they meant guns.

The middle section of the book encourages

service providers to reach the target population of

Latinas (female Hispanics) by siting services in

beauty parlours. The method of evaluation of the

service is impressive.

The last section of the book concerns the

specific group of Hispanics close to the Mexican

border and the factors that make Latinos and

Latinas more vulnerable to use of alcohol. Finally,

there is a chapter on the alcohol problems of the

lesbian Latinas and their conflict with the strong

family and Catholic values of the Latino culture.

As a study of how to investigate vulnerable

groups in a population the book is well organized

and extensively referenced, including e-mail

addresses. The idea of putting services into areas

visited routinely by the target population is well

taken. Could addiction services in Britain ever

find themselves located in hairdressers and bet-

ting shops? The language used is daunting for

someone not acquainted with the literature. This

book will be of interest to those involved in

service planning, those with an interest in trans-

cultural psychiatry and research workers in the

epidemiology of substance misuse.

NICK DUNN

M ount Zeehan Unit,

St Martin’s Hospita l,

Canterbur y, UK

Cancer & Clinical Biochemistry

PETER PANNALL & DUSAN KOTASEK

ACB, UK, 1997

£21.00, ISBN 0 90242 909 4

It is fascinating to see in one book the myriad of

biochemical abnormalities that can occur in

patients with cancer. One is easily made aware of

many of these abnormalities skimming through

this book by just looking at the attractively laid-

out case histories. They are accompanied by

tables and or graphs that illustrate clearly how, for

example, electrolytes, enzymes or tumour mark-

ers can vary during the course of a patient’s

illness. However, the best chapter in my view is

the first, on the nature of cancer. It clearly

explains about cell growth and how this is

controlled by growth factors, signalling proteins

and transcription inhibitors which are influenced

by genes. This complicated process is made

understandable by listing many of the known

oncogenes according to how their protein prod-

ucts function. It then becomes easier to under-

stand how abnormalities or loss of these functions

allow cancer to develop and progress.

The next chapter, on biochemical effects of

tumour growth, is comprehensive and easy to

read. It explains how factors such as obstruction,

destruction or involvement by tumour affect

various organs and the resulting biochemical

abnormalities. The next two chapters on tumour

markers I found disappointing for their failure to

clearly indicate the situations where the marker is

essential for patient management. It is important

in this cost-conscious age that the clinical bio-

chemist, for whom this book was primarily

written, knows when to challenge the clinician

who asks for a barrage of markers or serial

markers. A section describes cancers of unknown

primary site but fails to indicate that the impor-

tance of the serum markers is to indicate whether

the patient has a treatable cancer, as may be

indicated by an elevated HCG or AFP. The section

on lung cancer fails to point out that in most cases

a chest X-ray is better than a tumour marker. They

also omit to point out that the potential value of

AFP screening in those at high risk of developing

hepatocellular carcinoma is to detect tumours that

are solitary and can be resected with curable

intent. Despite these criticisms the book does give

a comprehensive account of a wide variety of

cancers and the compounds that can be elevated

and possibly used as tumour markers. For those

working in the field of addiction, this book gives a

good overview of the biochemical abnormalities

associated with cancer but does not specifically

address the relationship between tobacco or

alcohol and cancer.

GORDON J. S. RUSTIN

Director of M edical Oncolog y,

M ount Vernon Hospita l,

Northwood,

M iddlesex, UK

Page 7: Book and media reviews

B ook and media reviews 99

Software

Drug Data 2: a multimedia encyclopaedia

on drugs and drug use

Healthwise, CD-ROM 1997

Drug data 2 (Liverpool: HealthWise, Resources

Team) is an interesting and engaging CD-ROM

encyclopñ dia covering a wide range of topics

concerning drugs and drug use. The package has

been developed for adults who are interested in or

concerned about the topic and is not designed for

unsupervised use by young children. The authors

therefore suggest that adults should view the

program before using it with young people. A

ª parental lockº facility enables access to certain

images in the encyclopñ dia to be blocked by a

password if deemed unsuitable for a young

audience, while allowing access to the rest of the

database.

Minimum recommended PC hardware

requirements are a 486SX processor, with 8 Mb

of RAM, Windows, a 2-speed CD-ROM, sound

card and 20 Mb of free hard disk space. Installa-

tion of the program was painless and the system

requires that the disk is inserted in CD-ROM

drive during operation. A small yellow window in

the bottom left of the screen provides brief

reminders of what each button does. There is also

a ª helpº facility and a troubleshooting text file

which can be read using any word processor.

On accessing the program, the user is greeted

with a Homepage which comprises six main

sections: where drugs come from; how drugs

work; drugs and the law; drug services: a drugs

knowledge quiz; and a library of images and

videos. A detailed dictionary of drug-related

terms is also provided with approximately 500

entries. Many of the dictionary entries are drug

names or slang/street names, the most common

of which reveal detailed information under 15

separate headings when doubled-clicked with

the mouse. Other entries consist merely of one

line explaining what the term refers to (e.g.

Fluoxetine [Prozac]). The inclusion of slang

names in this list, although potentially very

useful, may also be hazardous, as such terms

can date rapidly and often vary across different

regions. This could result in unhelpful confu-

sion. One example of this that I found was that

the entry explaining the slang term ª gearº

neglects to mention its association with drugs

other than heroin. I was also surprised to find

that the dictionary entry under alcohol did not

include a description of the standard unit system

for measuring ethanol consumption. One rather

nice touch, particularly for someone unfamiliar

with the subject, is that by clicking on a small

musical note prompt found next to most of

the medical or chemical terms, one can hear

the correct pronunciation of the word. Diction-

ary screens also include the hypertext feature,

allowing the user to cross-reference to other

entries, images or video clips to help clarify

descriptions.

In addition to information on the action of

drugs on the brain, drugs in pregnancy and drug

testing, the section on ª How drugs workº also

includes useful material about routes of admin-

istration. The differences between taking drugs by

ingestion, smoking, sniffing, snorting or injection

are illustrated with some cleverly animated dia-

grams of the path followed by a drug through the

body to the brain. Elsewhere, still pictures and

video clips of drugs and related paraphernalia

are on show. Some of the video clips are very

detailed and involving, while others reveal little

more than a camera zoorning in and out of a still

photograph.

In the ª true or falseº quiz section a range of

topics is covered, many designed to challenge

common assumptions which people might hold.

Each answer appears as soon as the choice of

response has been made and a useful, brief

explanation, together with cross-references to

more detailed information is given. However, I

found certain answers to be ambiguous or even

misleading. For example, one answer about

cannabis declares that the effects of cannabis are

the same as for LSD, albeit milder and shorter-

acting. Young people who have experienced these

drugs might find this puzzling.

Overall, and with these minor criticisms aside,

I found that this CD-ROM offers a very useful

and engaging way to encourage thought around

important topics relating to drug and alcohol use.

I would definitely recommend it to anyone with a

general interest in the subject, particularly teach-

ers wishing to lead classroom discussions and

parents wanting to become more informed about

drug use.

ANNABEL BOYS

Research Psycholog ist,

National Addiction Centre,

London, UK

Page 8: Book and media reviews

100 B ook and media reviews

Drug Discovery and Evaluation

Pharm acological Assays

H. G. VOGEL & W. H. VOGEL (Eds)

Springer-Verlag, Berlin, Heidelberg, New York,

1997

xxxi + 757 pp., hbk (with CD-ROM), £92.00,

ISBN 3 540 6029 1

There is no doubt that a great deal of effor t has

been invested in collating this compendium of

techniques used in drug discovery and develop-

ment. Each chapter deals with a major physio-

logical system and the material is subdivided into

specific indications for drug use. Every technique

is introduced by its `purpose’ and `rationale’ and

is followed by an appraisal, together with an

outline of salient modifications. There is even a

CD-ROM, but its installation is not straightfor-

ward: all those I challenged had difficulties using

it and several gave up completely.

It is unfortunate that the book gets off to a bad

start on page 1 where we are told that drug-

binding affinity indicates its potency (it does not).

However, a major problem is that some of the

methods are reproduced, almost verbatim, from

landmark papers. This means that they are

hopelessly out of date and important points are

masked by details such as the names of suppliers

and even the trade-name of the cages used! In

contrast, in vivo microdialysis and voltammetry

are covered only briefly and I defy anyone to set

up these techniques, or even to appreciate the

difficulties, from the descriptions provided. Con-

fidence is further shaken by reading that binding

studies of b -adrenoceptors use displacement by

propranolol of [3H]DHA, a combination of

ligands which has been deprecated for years. We

are also told that radioenzymic assays are used to

measure plasma catecholamines (no mention of

HPLC here).

There is a short section on tests for drug

dependence: two pages under ̀ central analgesics’ .

Substitution tests, primary and precipitated with-

drawal from opiates are described but self-

administration studies are dismissed. The light ±

dark shuttle-box appears twice (under different

headings) in section 2.4, which deals with anx-

iolytics. However, there is no discussion of the

applications or modifications of such tests in

studies of drug withdrawal; yet the effects of

anxiolytics on seizure threshold appear here

rather than under anti-epileptics. Obviously, it is

right that some obscure methods are excluded,

but I would not count conditioned place-prefer-

ence among these. I also expected, but failed, to

find important techniques such as northern

blotting and in situ hybridization.

Finally, except when a reasonable library is

totally inaccessible, I am not convinced of the

need for a book of this type at all (with or without

a CD-ROM). However, I am convinced that

there is no substitute for reading contemporary

primary sources and consulting those with hands-

on experience.

S.C. STANFORD

Department of Pharmacology,

University College London,

Gower Street,

London, UK

The Cell ª Unit of Lifeº ± A Visual Primer

ALEXANDER N. GLAZER

Oxford University Press & Cogito Learning

Medica Inc, 1998

CD-ROM, £9.95, ISBN 1 888 90218 3

The unitary component of life, the cell, is the

subject of this CD-ROM. This multimedia learn-

ing aid comprises six main sections, each further

divided into two or three subsections. The basic

components of the cell are described in the first

section, ª Vital Unitsº , and the fundamental divi-

sion between eukaryotic and prokaryotic cell as

well as their evolutionary origins are discussed in

the second part. The presentation continues by

demonstrating the assembly of prokaryotic and

eukaryotic cells, the process of energy production

in a cell and finally a brief look at ª Life’s

B luepr intsº , namely genes and genomes.

Each of the six sections can be accessed by

clicking on a dot in the main menu. Figurative

representations of each subsections are then

revealed and by double-clicking on the image,

information about the topic is displayed in the

form of a short piece of text as well as animated or

photographic illustrations. There is imaginative

use of graphics, particularly in the section on the

components of eukaryotic cells. Graphics show

the layers peeling off onion-fashion to reveal

organelles. In some instances, different parts of the

cell can be magnified using a virtual magnifying

glass to show cellular structure at the tissue level.

The marketing blurb on Unit of Life promotes it

as a ª fascinatingº and ª entertainingº interactive

Page 9: Book and media reviews

B ook and media reviews 101

exploration of the cell and its workings. Admirable

3-D animation has been combined with video clips

of cell sections, organelles, the process of cell

division, etc. However, despite the creative visual

imagery the material lacks depth and is, in fact,

quite simplistic in its scientific content. Overall,

the subject content of Unit of Life is too elementary

to be of any benefit to readers of this journal. The

ideal target audience for this particular CD-ROM

would be junior schoolchildren or adults with no

scientific training whatsoever. For such an audi-

ence, it represents a well-produced, well-pre-

sented piece of educational material with superb

illustrations and graphics. As a working scientist, I

found the Unit of Life tedious to watch.

GURSHARAN KALSI

M olecular Psychiatry Laboratory,

UCL Medical School,

London, UK

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