Michael A. Nader - Substance Use Disorders: From Etiology to Treatment

The TheHandbook of Experimental Pharmacologyis one of the most authoritative and influential book series in pharmacology. It provides critical and comprehensive discussions of the most significant areas of pharmacological research, written by leading international authorities. Each volume in the series represents the most informative and contemporary account of its subject available, making it an unrivalled reference source. is one of the most authoritative and influential book series in pharmacology. It provides critical and comprehensive discussions of the most significant areas of pharmacological research, written by leading international authorities. Each volume in the series represents the most informative and contemporary account of its subject available, making it an unrivalled reference source.

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Drug abuse continues to be a major public health problem worldwide contributing to extensive morbidity and mortality that have tremendous economic and human costs. Many Western countries have seen a dramatic increase in the use of opioid drugs where, for example, in the USA the use of both prescription and illicit opioids have contributed to the death of over 300,000 people in the past decade (Center for Disease Control 2018). Many communities are now experiencing a new wave of cocaine and other stimulant use as well as the emergence of synthetic drugs. While much attention is given to illegal drugs, the two prominent legal substances, tobacco and alcohol, continue to exert the biggest threat to human health worldwide with an estimated 143.7 deaths per 100,000 people per year (Peacock et al. 2018). Another drug that now straddles the legal and illegal markets is cannabis where dramatic sociopolitical changes in many countries have led to the legalization of medicinal and recreational cannabis. The societal and health consequences of these policy changes are still unknown, but what is clear is that similar to other drugs, cannabis can lead to a pathological use disorder for which there are limited treatment options. Disturbingly, there are today still few available treatments for substance use disorders (SUDs). The growing use of drugs combined with the low-risk perception of the harm of these substances in society has raised significant alarm and brought renewed awareness of the critical need for advanced knowledge about the effects of these psychoactive drugs on the brain that can guide the development of much needed new treatment strategies to save lives.

The primary problem facing clinicians treating individuals with SUD is relapse (OBrien and Anthony 2005). In fact, relapse rates have remained unchanged over the last 40 years (Dong et al. 2017). It has been noted (Humphreys and Bickel 2018) that there are common neuroadaptations across SUDs, but there are still significant gaps of knowledge about how these common neural pathways and circuits contribute to relapse vulnerability, as well as whether and how they recover during long-term abstinence. There is also a wide range of individual differences in behavioral and neurobiological responses to chronic drug abuse; these differences manifest themselves during recovery attempts, with some people having a greater ability to maintain abstinence than others. Clearly, more research is needed to understand these individual differences in attempts to develop a personalized treatment strategy for SUDs.

The goal of this volume is to describe innovative basic science and clinical research focused on various drugs of abuse given their critical impact in many communities today. The first three chapters provide overviews of research techniques: population-based research, molecular techniques, and small-molecule chemistry. The remaining chapters focus on (1) molecular mechanisms, (2) preclinical behavioral pharmacology, and (3) clinical pharmacology for opioids (mu and kappa receptor), stimulants (cocaine and amphetamines), marijuana, nicotine, alcohol, and newly emerging substances of abuse. Together, these chapters bridge preclinical and clinical behavioral pharmacology in expanding knowledge about the current state of the field.