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Appendix C
Pages 161-168

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From page 161...
... This peculiar distinction resulted in the establishment of two separate institutes, the National Institute on Drug Abuse and the National Institute on Alcoholism and Alcohol Abuse, the latter with its own constituency of alcoholics and recovered alcoholics not, perish the thought, alcohol addicts and ax-addicts. Rather than call drug abuse what it is, some well-meaning lexicographer thought to cover the whole field with a new term, "substance abuse," which 161
From page 162...
... The field of drug abuse-substance abuse, whatever you call it must seem a bewildering morass to the newcomer, especially to the young scientist trained in the cutting-edge techniques of molecular biology. Raising the profile of drug abuse research among scientists means identifying those critical questions that can be attacked by the most up-to-date techniques of molecular genetics and neurobiology as well as by carefully designed, controlled experiments on animal and human behavior.
From page 163...
... Subtractive cloning suggests an approach that is too little exploited the search for differential neurochemical changes that occur only with self-administration but not with passive exposure to the same drug. Research on the addictive process itself is a conceptual challenge.
From page 164...
... A fascinating recent epidemiologic study by Denise Kandel suggests, remarkably, that intrauterine exposure to nicotine during a woman's pregnancy predisposes her daughters to the use of tobacco in adolescence and thereafter. This result points to the need for more extensive animal research, in which prospective controlled experiments can be done (impossible on ethical grounds in humans)
From page 165...
... Animal models date back to the pioneering work of Wikler, who first showed that conditioned cues play a key role. Current experiments by O'Brien's group demonstrate that drug-related stimuli can evoke craving and associated physiologic changes in abstinent heroin or cocaine addicts.
From page 166...
... These provocative and potentially useful findings have thus far been ignored; clearly, these data need to be replicated and if confirmed, followed up vigorously. Questions are raised by the surprising recent finding that naltrexone, a specific antagonist at mu opioid receptors, is beneficial in preventing relapse to alcohol addiction.
From page 167...
... Finally, the field of drug abuse is especially ripe for interdisciplinary research, for the establishment of more centers of excellence in which molecular geneticists, neurobiologists, animal behavior experts, clinicians, and social scientists will collaborate closely (and close collaboration is the key to keeping a conscious focus on drug abuse) to increase our understanding of the peculiar compulsive and self-destructive behavior of the drug addict.


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