Louis Lemberger and Alan Rubin PHYSIOLOGIC DISPOSITION OF DRUGS OF ABUSE New York: Spectrum Publications, 1976, 401 pp., $29.50.
This volume is of value primarily to the researcher, specifically the psychopharmacologist, and as a reference source. References are placed at the end of each chapter, with extensive literature review. There are 10 chapters. The first covers fundamental principles of drug distribution, and the last treats the subject of tolerance. The intervening eight chapters deal with the absorption, metabolism, interactions, and excretion of specific drugs: amphetamine; cannabinoids; the phenylalkylamines, specifically mescaline; the indolealkylamines, specifically LSD; morphine; barbiturates and methaqualone; cocaine; and caffeine, nicotine, and alcohol, the "recreational drugs of abuse."
The clinical psychiatrist will find the volume of limited value, not because of the in-depth analysis of the chemistry and physiology of each of the substances discussed but because he will find the mass of information hard to relate to his everyday work. There is some material of clinical use in each chapter - for example, the knowledge that an acidic urine facilitates the excretion of amphetamine, with a quicker resolution of psychiatric symptoms in an amphetamine psychosis. However, the main thrust of each chapter relates to the basic sciences of organic chemistry and physiology.
Little space is devoted to correlation with clinical findings. This is not surprising in that this volume is directed more to physiologic disposition of these drugs, emphasizing methods and routes of metabolism.
I found the first chapter to be of most interest, dealing specifically with principles of disposition. For physicians several years away from medical school, it provides an excellent review and brings them up to date on such matters as hepatic microsomal metabolism.
The chapters on specific drugs are not light reading. This is not a volume that one can assimilate easily or quickly, nor is it intended as such. It is an excellently researched and scholarly volume. I will use it as a reference source to try to explain to my patients or their families what happens when these drugs are abused.