Pharmacological Aspects of Drug Dependence : Toward an Integrated Neurobehavioral Approach

In spite of a "war on drugs" that spans years, and in spite of increases in law enforcement efforts and to a lesser extent treatment, substance abuse and dependence continue. While the number of people who experiment with drugs has decreased in recent years, those who use drugs repeatedly, per­ haps several times a week, a measure of "hard core" drug abusers, has not changed, and emergency room visits associated with substances abuse continues to rise. Considering both licit and illicit drug abuse, the number of drug abusers in, for example, the United States is very large and, accordingly, the cost to society is great. A recent Institute of Medicine study suggests that the overall cost is about $66 billion per year (1990 costs). Certainly when assessing the total cost of substance abuse, we must include of the costs of disease and behavioral disorders that are intimately associated with substance abuse. For example, sharing of needles among illicit drug abusers has been and is a critical vector in the spread of drug resistant TB, AIDS, and hepatitis. Further, the use of drugs and alcohol leads to unsafe sexual practices with the attendant risk of AIDS and other sexually transmitted diseases. Tragically, infants are born with drugs in their system and with infections and disease transmitted from the mothers who are drug abusers or their sex partners who are drug abusers. Front Matter....Pages I-XXV Front Matter....Pages 1-1 Genetic Vulnerability to Substance Abuse....Pages 3-52 Integrative Neurobehavioral Pharmacology: Focus on Cocaine....Pages 53-80 Front Matter....Pages 81-81 Marihuana....Pages 83-158 Cocaine....Pages 159-195 Opioid Analgesics....Pages 197-232 Phencyclidine: A Drug of Abuse and a Tool for Neuroscience Research....Pages 233-262 Benzodiazepine Discontinuation Syndromes: Clinical and Experimental Aspects....Pages 263-269 Nicotine....Pages 271-314 Caffeine Reinforcement, Discrimination, Tolerance and Physical Dependence in Laboratory Animals and Humans....Pages 315-341 Classical Hallucinogens....Pages 343-371 Alcohol....Pages 373-458 Front Matter....Pages 459-459 Pharmacotherapy of Addiction: Introduction and Principles....Pages 461-471 Development of Medications for Addictive Disorders....Pages 473-485 Long-Term Pharmacotherapy for Opiate (Primarily Heroin) Addiction: Opioid Agonists....Pages 487-562 Long-Term Pharmacotherapy for Opiate (Primarily Heroin) Addiction: Opioid Antagonists and Partial Agonists....Pages 563-598 Pharmacotherapy of Nicotine Dependence....Pages 599-626 Pharmacotherapies for Cocaine Dependence....Pages 627-644 Back Matter....Pages 645-658 This volume brings together in one place the latest research from the areas of molcular biology, neurochemistry and behavior analysis of drug abuse and dependence. Further, the authors have attempted to integrate, wherever possible, the data from these various levels of analysis. The research reported points to the complexity of the phenomenon of abuse and dependence and clearly demonstrates that it is determined by a variety of variables from molecular biology and genetics through behavioral history. The complexity is shown, however, to be amenable to rigorous scientific analysis and our success to date gives reason to hope that this distressing public health problem can ultimately be brought under control. Each of the chapters is written by a leading researcher in the field