The Encyclopedia of ADDICTIVE DRUGS

Introduction 9

those effects may occur in a later stage of pregnancy than types of harm in-
volving bones or other organs. In addition to matters affecting fetal devel-
opment, pregnancy can alter a drug’s effect on the woman, for example,
causing a dose to last longer than in a nonpregnant woman. That, in turn,
could cause a pregnant woman to receive a cumulative overdose if she uses
an amount suitable for a nonpregnant woman.

STATISTICS

Numbers are a common element in articles and speeches about drugs. Num-
bers can seem to provide precise information. Occasionally, however, the pre-
cision is illusory. For example, a study^6 of drug deaths in major U.S. cities
during the early 1970s found that 60% of deaths in New York involved meth-
adone, but it was involved in under 1% of deaths in Los Angeles and 0% in
Chicago. Depending on which city’s experience someone was inclined to cite,
methadone could be made to appear as a major or as an insignificant problem.
Statistics may lump substances together, perhaps saying that a particular per-
centage of persons who died had marijuana or cocaine in their blood. Those
are two very different drugs. What percentage was marijuana and what per-
centage was cocaine? What percentages were at a level of intoxication? Would
intoxication have had anything to do with the cause of death? If so, was the
death due to a poisonous effect of the drug, or was it due to a poor decision
while intoxicated? Many statistics offer no answers to such questions. Even
when statistics are both reliable and meaningful, often they are rapidly out-
dated.
For all those reasons,The Encyclopedia of Addictive Drugsoffers few statistics.
Numbers found in this book are solid and should still have meaning years
from now. The list of general sources at the end of this book includes Internet
Web sites that can provide the latest statistics. They may be accurate, but (as
indicated above) their meaning may be uncertain.

NOTES

1. For an overview see J. Orford, “Addiction as Excessive Appetite,”Addiction 96
   (2001): 15–31. For example, cocaine was long considered non-addictive because usage
   did not produce physical symptoms of addiction. In the 1980s this traditional under-
   standing was challenged by research reports such as F.H. Gawin and H.D. Kleber,
   “Abstinence Symptomatology and Psychiatric Diagnosis in Cocaine Abusers: Clinical
   Observations,”Archives of General Psychiatry43 (1986): 107–13; H.D. Kleber and F.H.
   Gawin, “In Reply,”Archives of General Psychiatry44 (1987): 298; H.D. Kleber, “Epidemic
   Cocaine Abuse: America’s Present, Britain’s Future?”British Journal of Addiction 83
   (1988): 1364. Those challenges met skepticism or even outright rejection from A.E.
   Skodol, “Diagnostic Issues in Cocaine Abuse,” in H.I. Spitz and J.S. Rosecan, eds.,
   Cocaine Abuse: New Directions in Treatment and Research(New York: Brunner/Mazel,
   1987), 120; D.W. Teller and P. Devenyi, “Bromocriptine in Cocaine Withdrawal—Does
   It Work?”International Journal of the Addictions23 (1988): 1197–1205; A.S.V. Burgen and
   J.F. Mitchell,Gaddum’s Pharmacology, 9th ed. (Oxford: Oxford University Press, 1985),
   76; J.E.F. Reynolds.Martindale: The Extra Pharmacopoeia, 28th ed. (London: The Phar-
   maceutical Press, 1982), 914; J.M. Arena, ed.,Poisoning: Toxicology, Symptoms, Treat-