Matters of Substance, with enviable erudition, examines the many headed Hydra of mind acting drugs, both licit and illicit.  The esteemed author, Dr. Griffith Edwards, is emeritus professor of addiction behavior, at the Institute of Psychiatry, London.  As envisaged by Edwards, Earth is a drugged planet; indeed, everyone's a user.  The absorbing discourse of Edwards makes manifest that, over a lengthy timeframe, divergent populations have accumulated a vast reservoir of knowledge and experience regarding a multitude of drugs.  A cardinal aspiration of Edwards is to identify some of the contents of this expansive store of knowledge, importantly including identification of currents of social, cultural, and historic contexts coursing through the tempestuous waters of drugs.  There is further great effort, by Edwards, in quest of wise application of accumulated worldwide drug knowledge so as to achieve better informed responses to vexing, drug related concerns.

Notably, Edwards writes in a manner showing great respect for the multiplicity of hotly vented views regarding fretfully contentious, if not ineluctable, drug problems.  Stylistically, the text is molded in a manner which should well fit many lay readers as well as professionals.  Because many pieces are still missing, the highly complex puzzle of drugs is not presently fully solvable.  But plainly, Edwards' doughty plunge into the seemingly fathomless depths of drugs is an invaluable contribution to the drug literature, which may help galvanize further debate and better informed social action concerning a thicket of nettlesome issues entwined problematically with sundry licit and illicit, mind acting drugs.

The book's mainstay structural foundation is comprised of four "parts", ramifying into twenty chapters.  Licit drugs garner the centerstage attention of Part One.  Discerning discourse appertaining to licit drugs commences in Chapter One with instructive comment focusing on alcohol use.  As is true throughout the book, Edwards apprises the reader of his thoughtful views, albeit without making the reader feel bludgeoned by the force of his very powerful intellect.  In Chapter Two, for instance, Edwards in forthright manner opines that efforts to effectually control tobacco have failed.

The remainder of Part One proceeds in a characteristically informative and insightful fashion.  Benzodiazepines are expounded on expertly in Chapter Three.  This is followed, in Chapter Four, by perspicacious examination of volatile substance abuse, including an attempt to fathom its linkage with social deprivation.  The assembly of topics marshaled by Edwards in Chapter Five envelops caffeine, ether, and khat.  The edifying commentary of Edwards reaches typically to pithy comment concerning pharmacologic aspects of particular drugs.  Edwards ends Part One with the sobering conclusion, expressed in Chapter Six, that the havoc wreaked by alcohol and tobacco makes all illicit drugs look pallid in comparison.

The entirety of Part Two is devoted to highly adept dissection and study of a wide gamut of issues relating to opiates.  Consistent with the overall focus of the book, historic, social, and cultural factors tethered to opiates draw the keen attention of Edwards.  The tree of opium in China,  with its deep British and Indian roots, absorbs the attention of Chapter Eight.  In Chapter Nine, Edwards embarks on a two nation comparison regarding opiates.  The two nations are the US and the UK.  The respective American and British approaches over time to opiates are explicated engagingly by Edwards.  The knotty relationship enmeshing American soldiers, the Vietnam War, and heroin use is unraveled with assiduous care in Chapter Ten.  In Chapter Eleven, Edwards recounts interestingly the opiate experiences of some further countries.

Other drugs outside the law engrossingly attract the interest of Edwards in Part Three.  The substantive essence of Chapter Twelve, for example, is an intellectually penetrating gaze at cannabis, extending to relevant medical science, risks of harm, and historic roots.  Cocaine is the cynosure of riveting Chapter Thirteen, including comment on traditional cocaine use in South America and on the American and British experiences with cocaine.  In other chapters in this part, Edwards, in a brightly illumining way, shines a flashlight of intense scholarship at amphetamines (Chapter Fourteen); and at psychedelics, prominently including LSD (in Chapter Fifteen).  The historic bond binding dancing and drugs is studied in Chapter Sixteen.  The thematic message imparted by Chapter Seventeen is that drugs, licit and illicit, collectively raise a legion of immensely complex issues with seemingly endless ramifications.

Variant responses to multifarious concerns associated with mind acting drugs is the special focus of concluding Part Four.  As is the distinctive wont of Edwards, his musings in this realm are suffused with a spirit of due respect for widely disparate views.  In Chapter Eighteen, Edwards identifies an array of factors which make drugs "one Helluva problem".  A thematic emphasis of the chapter is that, once a drug is taken up by a particular society, its embeddedness will likely be quite difficult to overcome.  Some of the pros and cons of drug legalization (in contradistinction to drug criminalization) spark flames of intellectual fire in Chapter Nineteen.  Toiling in his usual workaday manner, Edwards cuts a wide swath through a mass of thorny issues sorely entangling the legalization of drugs debate, creating a trail in the direction of better informed debate regarding this hot button topic.  In final Chapter Twenty, Edwards proffers an abundance of parting ruminations concerning what should be done about drugs.

In intellectual consonance with the text, Edwards, in a succinct "postscript", opines candidly that the world's drug problems most likely will not soon be solved.

In a structural appendage of the book, titled "Sources and further reading", Edwards cites a goodly number of references which may effectively act as a conduit leading to further study of drugs.

The critical reader may caution that the musings of Edwards, even if not polemical, may nonetheless be quite distant from other expert views in the expansive field of drugs.  Perhaps a better balance of views may have been achieved if the book had been structured as a collection of contributed papers, culled from a bevy of experts.  There is also the not unimportant consideration that there are limits to current knowledge about mind acting drugs.

But Edwards shows gritty determination in exploring a drug landscape cratered historically with greatly challenging problems.  And perhaps the intellectual heavy lifting by Edwards, in a sturdily built textual edifice housing knowledge and opinion pertinent to mind acting drugs, will spur further investigative efforts as well as robust debate regarding this incompletely understood and vexing area.  The range of professionals who may be enlightened considerably by Edwards' scintillating book is wide, and encompasses:  psychologists, psychiatrists, pharmacologists, toxicologists, medical historians, medical sociologists, and addiction scientists.

© 2007 Leo Uzych

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.

Categories: General, Addiction