Norman S. Miller

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.

This volume is intended for clinicians, researchers, residents, and students. The range is wide and the depth considerable for all the topics covered in the treatment of this timely and relevant subject. This book may serve equally well as a general introduction and a scholarly reference. Ultimately, it is designed to serve those patients suffering from abuse of and addiction to drugs and alcohol. The content and organization of the book flow from general concepts of abuse and addiction to specific details of the pharmacology of alcohol and drugs. Special chapters on topics not found in most other books, such as pharmacology of drug-drug interactions, abstinence, and prevention, are included. This book is written especially for the clinician interested in the pharma­ cology of alcohol and drugs of abuse and addiction. The pharmacology is integrated into a conceptual approach to diagnosis and treatment of alcohol and drug abuse and addiction. The form and style are didactic, critical as well as straightforward in presentation. Literature references from recent clinical research and basic research provide the foundation for the chapters throughout the book. Be­ cause the book is written by a clinician-researcher, the information is readily adaptable to clinical problems and research ideas. I would like to express my deep appreciation to Susan Newsom and Darlene Tucci for their invaluable technical assistance. Norman S. Miller vii Contents Preface ....................................................... vii CHAPTER 1 Introduction to the Pharmacological Effects of Alcohol and Drugs and Addiction on the Brain and Behavior .... . . . . . . . . . . . . . . . . . .. . . 1 . . . . . .

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.