Abstract
Let's not beat about the bush; this is a terrific book. While there are several large texts on the general topic of addiction, this book addresses only alcohol related problems and in doing so is able to go into a depth of coverage seldom achieved in such texts. The 42 chapters divided into six parts, each by leaders in their particular field on almost all of the important topics related to problematic alcohol use, establish it as the authoritative reference on the topic. It has the clarity to encourage nonspecialists in the alcohol and drug field to delve into it, and the depth to teach the most knowledgeable of specialists something new. Ultimately during the review period I went back to this book frequently, not to check out various sections for review but rather to enjoy browsing and learning something new. It's that rare kind of book of textbook; not just an excellent reference but also a good read.
Its broad sweep covers topics such as the history and classification of alcohol problems (Part I; Alcohol and People), the medical complications of alcohol use (Part II; Clinical Pathology), the aetiological processes involved in the development of alcohol problems (Part III; Antecedents of Drinking, Alcohol Problems and Dependence and Part IV; Drinking Patterns and Types of Alcohol Problem), treatments, their effectiveness and the process of natural recovery (Part V; Treatment and Recovery) and public health and prevention issues (Part VI; Prevention of Alcohol Problems).
Each part starts with an editor's introduction. Each chapter begins with a synopsis of about a page in length; an excellent device for orientating the reader and providing a context within which to place the information that follows. The synopses are invariably concise and, in themselves, could produce a short and useful entry level text. Within each chapter, a wealth of information is supported not just by references to key research findings but by descriptions of the key findings and their implications. This layout means that while the content has sufficient depth for alcohol and drug specialists to learn something new each time they dip into the book, it is not so esoteric that nonspecialists can't also benefit from it.
What parts of the book did I value the most? Given the relative evenness in the contributions it is difficult to highlight any one area over another. Following my own particular area of interest therefore, the chapter ‘Treating comorbidity of alcohol problems and psychiatric disorder’ by Kim Mueser and David Kavanagh reviewed the area of coexisting substance use and mental health disorders succinctly. But perhaps the sections I enjoyed the most were those I knew the least about; those dealing with public health issues and a more social perspective on alcohol use.
However, despite the authors’ claims that all the topics of clinical importance are adequately covered, there are some deficiencies. As useful as the chapter on coexisting substance use and mental health disorders is, giving only 42 pages to the topic is woeful. I admit my biases in this area. I acknowledge that few other generalist addiction textbooks deal with the topic as well as this one. But I remain unable to see how the significant interactions between alcohol and some of the most common and disabling disorders known warrants less space than a discussion on the effects of alcohol on, for example, muscle, skin and bone. There is little attention given to the problem of polysubstance use and the difficulties of helping people who use other drugs in addition to alcohol. While alcohol use by adolescents crops up in discussion in a number of places there is no section dedicated to the nature and treatment of alcohol and drug problems in young people and as such, no coherent discussion of this area. Related to this latter point, I could find little on the role of family interventions in alcohol and drug treatment.
In the end, the main benefactors of any textbook need to be our patients. This book will help encourage clinicians to learn and to provide them with easy access to high quality and relevant information. As such the book is a great success. But it also maintains the separation of alcohol disorders from drug use problems, and more importantly of alcohol and drug disorders from other mental health disorders. Perhaps the mark of the book is that I had hoped it wouldn't do this – and that is an unreasonable expectation; certainly not one I would place on many other textbooks in the alcohol and drug area.