The SAGE Handbook of Drug and Alcohol Studies: Biological Approaches

Kim Wolff (Editor), Jason M. White (Editor), Steven Karch (Editor)

Research output: Book/ReportBookpeer-review

Abstract

Introduction to Handbook of drug and alcohol studies, Volume II
Kim Wolff. Steven Karch and Jason White

The growing importance of drug and alcohol research
Our general aim in producing this two volume Handbook has been to map drug and alcohol research disciplines and to illustrate the contribution of different disciplines to the study of substance use. To our knowledge no such map currently exists. In the last two to three decades, the interest in drug and alcohol issues has increased markedly in many societies. This is due both to an increase in worldwide use of substances and an increased political focus on both illegal and legal drug use.

This societal interest is also reflected in academia, in social, biological and health policy developments at national and international levels, and in the growth and diversification of professional services with responsibility, in some way, for those using psychoactive substances. Research on the identification, detection, treatment and recreational consumption has been conducted from a range of different disciplinary perspectives, e.g. sociology, political science, history, biology, psychology, psychiatry, pharmacology, cultural studies, gender studies, geography, anthropology and economics. Consequently, the field by its very nature is inter-disciplinary and this characteristic is reflected in the Handbook. As a result, the Handbook is divided into two volumes reflecting both a social science (Volume 1) and a biological approach (Volume 2). While for many researchers, students and professionals both areas are important, the division into two sections allows a more meaningful way of compiling the contents in order to address the core interests of different groups of readers.

During the last 15 years or so, drug and alcohol studies have become a more established academic field of research involving researchers from different countries across the globe. Currently, drug and alcohol research centres and specialist units exist in a wide range of countries, either as departments in universities or as independent (public or private) research institutions. As a consequence, programmes and courses in drug and alcohol studies are offered at a number of academic levels, including foundation programmes, undergraduate and postgraduate degrees, as well as specific training for professionals in the field and also bespoke courses for students from a range of other academic disciplines.

The exponential growth in specialist alcohol and drug peer reviewed journals is a further testament to the growing importance of this area of research. In addition, drug and alcohol research is also being funded by both national and international funding agencies including for example, the Medical Research Council (MRC) and the Economic and Social research Council (ESRC) in the UK, National Institute on Drug Abuse (NIDA) and National Institute on Alcoholism and Alcohol Abuse (NIAAA) in the US, the National Health and Medical Research Council (NHMRC) and the Australian Research Council (ARC) in Australia, and the European Union. Consequently, the title 'Handbook of drug and alcohol studies' has been deliberately chosen as a way of reflecting this growing importance.

It has been our aim, that the Handbook reflects the state-of-the-art analytical and theoretical advances in the drug and alcohol research fields. However, many issues and key concepts are still contested, debated and discussed and therefore, the Handbook also covers what has been termed ‘controversies’. Whilst we have not aspired to settle discussions about controversial issues, we do hope that the Handbook will provide food-for-thought and encourage continued engagement, reflection and contemporary debate in all areas of drug and alcohol use and misuse.

It is our intention that this two volume Handbook can provide academics, postgraduate and undergraduate students, drug and alcohol professionals and, forensic and toxicological scientists with a high quality interdisciplinary reference book that covers contemporary key issues and some controversies in the drug and alcohol research fields. Currently, an increasing number of universities are offering programmes and courses in drug and alcohol studies, schools’ curricula cover alcohol and drug issues, and healthcare providers seek to equip those working in a variety of disciplines (such as, accident and emergency, mental health, social work/welfare, forensic services and the judiciary), with the skills to manage drug and alcohol use. Hopefully, the Handbook will be a resource for the growing academy and the drug and alcohol practitioners community, especially at a time when the issues are gaining prominence in both policy, practice and juristitial domains.

The Handbook contributors to volume 2 represent a wide range of expertise in the various disciplines in the biological sciences (see details at end). These authors have, we believe, been able to offer critical and up-to-date articles on contemporary issues and debates within drug and alcohol research. We have aimed at a geographically dispersed group of authors wherever possible. When reading the Handbook therefore, one should recognize and reflect on possible bias in the content and analyses in order to judge the potential global relevance of the different discussions in the chapters. We acknowledge that there may be biases and gaps in the Handbook coverage.
Outline of the Handbook
Volume II comprises 31 chapters, divided into four parts. Part I will begin to describe what is currently known about biological issues: the genetic factors causing interindividual and interethnic differences in drug and alcohol metabolism and hence drug response, whereas Part II revisits key aspects of the in the way in which a range of substances are handled by the body, covering progress in the research concerning the interactions between psychoactive substances and the major neurotransmitters, and their possible role as mediators of drug use and tolerance. Part III covers current, routine identification of alcohol and drugs, as well as, state-of-the-art developments in the detection of drugs and alcohol use, post-mortem analysis and population-level screening using waste water. Finally, Part IV covers controversies in drug and alcohol research. Some chapters deal with classic controversies, while others look towards emerging and future debates. Each section, is aptly pulled together by a ‘Future Directions’ chapter where the editors have provided a flavour of what might come next.

Part I
Addiction is a complex, chronic relapsing disorder that results from a persistence (continuation) of drug use that is modulated by genetic, developmental, experiential and environmental factors. Part I focuses on key questions of both research and clinical importance including to what extent the various substance use disorders and behavioural addictions have shared versus distinct genetic and epigenetic mechanisms. As well, the different methods used to research genetic influences on addictions according to the relevant literature will be described.

Part I also introduces the reader to the relationship between administered drug doses, the observed blood (plasma or serum) or tissue concentrations and explores current thinking on what the body does to a drug and hence concerns itself with the the established parameters of drug absorption, distribution, metabolism, and excretion (ADME) and more recently liberation (LADME). An awareness of the pharmacokinetic principles of a drug will help the reader to understand the manner of its use and aids the clinician in a number of ways: in anticipating the optimal dosage regime, in predicting what may happen if the dosage regime is not followed, in responding to over dosing, and in monitoring the consequences of harmful or dependent use.

Part II
This section focuses on central topics in drug and alcohol research: pharmacokinetic and pharmacodynamic developments in established and newer compounds (chapters 4-16), detection (chapters 17-23) and treatment (chapter 19). In Part II we have deliberately included articles examining the neurobiological changes that accompany drug use (for instance, see chapter 7 cocaine). The different theoretical perspectives, which are presented in Part I are illustrated in various chapters in Part II. Receptor selectivity is considered with specific reference to opioid drugs (Chapter 6), whilst the endocannabinoid system and CB1R agonists, as well as THC (tetrahydrocannabinol) are discussed in detail in chapters 12 and 13. The relationship with dopamine and cocaine is explored in chapter 7 and other stimulants (chapters 8 and 9). The prevalence of ketamine now firmly established as a recreational drug has warranted a lengthy discussion covering both the mechanism of action of this complicated drug (particularly NMDA receptor antagonism), as well as clinical concerns around the growing evidence for ketamine-induced ulcerative cystitis in those who use high-doses regularly (Chapter 11).

The mechanism of action of drugs and alcohol in the body and their physiological effects are discussed in relation to different patterns of use from the occasional single dose experience to regular, dependent use and the impact of cessation of use. Newer synthetic substances and polydrug use are reflected in different chapters of this section. For example, benzodiazepines in much higher than recommended doses are not only used alone but also to potentiate the high from opiates and to lessen the withdrawal from stimulants (Chapter 12). In linking with the material in volume 1 that emphasizes the importance of examining the emergence and evolution of key concepts such as addiction, misuse, recreational use and of understanding the many factors and diverse stakeholder groups, volume 2 complements this information.

Part III
It has been our aim, in Part III to reflect on current as well as state-of-the-art developments in the detection of drugs and alcohol as well as consider the practical limitations for some biological matrices, and the mechanism of collection and supervision of samples. The most commonly used matrices for drug testing are urine, oral fluid (OF), blood and hair. These are discussed in detail alongside the identification of drugs of abuse in the aquatic environment (sewage treatment plant effluents) and their impact on the ecosystem. Treament is also covered in this section and for a wider perspective could be read in conjunction with the policy chapters in Volume 1 (’Drug Policy in Practice’, Chapter 11; ’The Treatment Response’, Ch 15 and; ’Matching patients to Treatments’, Ch 16). Evidence Forensic and postmortem toxicology are also explored well as the identification of alcohol in the workplace.

Part IV
The final section has a focus on debates and controversies that the editors felt would be of interest to the readership. Some have existed in the drug and alcohol research fields for some time and others belong in the contemporary period. The controversies included here are not intended to be comprehensive as the field is ever evolving particularly with novel substances or new ways of using old ones (the e-cigarette).

Some chapters present older controversies, for instance, on the issue of the treatment of benzodiazepine dependence and whether the approach should be ’Maintenance or abstinence’. Other chapters reflect controversies (Chapter 29) based on a wider classification of addiction the issue of ‘gambling and internet ‘addictions’ as covered in chapter 28 and ’non-addictive drug use in chapter 26. Drug Driving is covered here since there has been an international drive in this area to legislate against those driving under the influence of psychoactive substances with many implications for policy and practice. Approaches based on driver safety have been compared to the more criminological perspective (chapter 27).

Creating the Handbook
We started work on this handbook in 2011, submitting a proposal for the Handbook structure and chapter outline to Sage publishers. Based on the valuable comments received from a comprehensive review panel and from our editorial board members, we revised our outline; adding new chapters, modifying some and merging others. We then began the process of identifying potential authors and experts in order to represent the complexity and diversity of the field. We wanted to include authors from different parts of the globe, from different social science backgrounds, and at different stages of their careers. Completion of this task was lengthy and elaborate and we faced many challenges in recruiting the writers we wanted. We were fortunate in achieving most of the objectives we had set ourselves and in gaining collaboration from an excellent range of experts in the field. Having chosen the authors, we encouraged them to amend, augment or, indeed, change, our initial summary outline of the chapter that we wished them to write, and add their own interpretations, views and ideas about the topic. Consequently, each of the chapters can be seen as a highly individual and original expert contribution.

All chapter submissions were then anonymously reviewed by at least one external reviewer and by two people from the Editorial Board. Revised chapters were then re-reviewed and further revised until we considered them to be of a publishable standard. In sum, the handbook can be seen as a collaborative project characterised by lively debates and discussions between us as editors, the individual authors, the editorial board, reviewers, and the publisher. Hopefully readers of the Handbook will also add their own layer of interpretation to the perspectives, insights and conclusions offered in the chapters, ensuring that the drug and alcohol research fields will continue to be debated, developed and never completely finalised.
Original languageEnglish
Place of PublicationLondon
PublisherSage Publications
Number of pages541
ISBN (Print)978-1-14462-9867-1
Publication statusPublished - Jan 2017

Keywords

  • Addiction (consumption/abuse/dependence)
  • DRUG ABUSE
  • ALCOHOL-ABUSE
  • PHARMACOKINETICS
  • ILLICIT DRUG-USE

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