Book Review

Addictive Behaviour: Molecules to mankind; perspectives on the nature of addiction

N Engl J Med 1997; 336:299January 23, 1997

Article

Addictive Behaviour: Molecules to mankind; perspectives on the nature of addiction
Edited by Adrian Bonner and James Waterhouse. 312 pp. New York, St. Martin's Press, 1996. $59.95. ISBN: 0-333-64555-3

This book contains a wealth of information on addiction. The topics range from psychoanalytic theory and public health policy to biochemistry. Substance dependence is broadly defined, and separate sections deal with stimulants, smoking, and alcohol and eating disorders. The primary emphasis is on alcohol research. For the most part, the book appropriately avoids discussion of other drugs, such as hallucinogens, that may be abused but that have less potential to be addictive. Separate chapters review the relation between crime and addiction, the effects of drugs on the brain and heart, the effects of alcohol on memory, and the nature of craving.

The great strength of this book is the enormous scope of the material it summarizes. Despite the breadth of this endeavor, the reviews are comprehensive and up to date. Particularly noteworthy are the chapter on the relation between personality and addictive behavior, and the chapter on biochemical substrates. Also included are a wealth of demographic statistics, although these pertain largely to the United Kingdom.

One problem is that the book does not effectively target any particular group of readers. The broad scope of the material covered would serve as an ideal general introduction to the field, but the presentations are largely descriptive rather than instructive. Major theories such as the dopaminergic reward model and the Kalant model of tolerance are mentioned, but without diagrams and with little discussion of the interactions between the elements of the models. In this way the book provides an effective road map, but the reader must still look up the original papers in order to understand what is being discussed.

Readers who are knowledgeable about the field of addiction will find this book valuable, but they may be frustrated by the way in which the material is organized. For example, the neurobiology of addiction is nicely dealt with in chapters 4 and 13, although these chapters do not appear in the same section. Similarly, readers who are interested in the role of tryptophan in addiction will need to scan eight chapters to obtain this information. Biologic markers of alcohol consumption are compared in three chapters, although a search of neither the chapter titles nor the index would be helpful in finding these sections. Persistent readers will be rewarded by discussions by various investigators with different points of view that are often complementary but also somewhat redundant.

This book takes diverse approaches to the many faces of the problems of addiction. The editors and authors have done a good job in collecting information on the topic, although readers may need to work a bit in order to extract it. Although the work falls somewhat short of being an instructive textbook, it contains material that is otherwise difficult to find and can serve as a guide for motivated readers to explore unfamiliar areas.

Edward M. DeMet, Ph.D.
Veterans Affairs Medical Center, Long Beach, CA 90822