Recent Developments in Alcoholism: Combined Alcohol and Drug Abuse Typologies of Alcoholics The Withdrawal Syndrome Renal and Electrolyte Consequences

461 Pages·1986·13.59 MB·English

by  Richard R. Clayton (auth.)

RECENT DEVELOPMENTS IN
ALCOHOLISM
VOLUME 4
RECENT
DEVELOPMENTS IN
Edited by
MARC GALANTER
Alberl Einslein College of Medicine
Bronx, New York
Associate Editors
HENRI BEG LEITER, RICHARD DEITRICH,
DONALD GOODWIN, EDWARD GOTTHEIL,
ALFONSO PAREDES, MARCUS ROTHSCHILD,
and DAVID VAN THIEL
Editorial Assistant
VIRGINIA PRIVIT AR
An Official Publication of the American Medical Society on Alcoholism
and Other Drug Dependencies and the Research Society on Alcoholism.
This series was founded by the National Council on Alcoholism.
ALCOHOLISM
VOLUME 4
Combined Alcohol and Drug Abuse
Typologies of Alcoholics
The Withdrawal Syndrome
Renal and Electrolyte Consequences
Springer Science+ Business Media, LLC
The Library of Congress has cataloged this work as follows:
Recent developments in alcoholism: an official publication of the American Medical Soci
ety on Alcoholism, and the Research Society on Alcoholism, and the National Council on
Alcoholism—Vol. 1 New York: Plenum Press, cl983-
v.: ill.; 25 cm.
Cataloging in publication.
Editor: Marc Galanter.
ISSN 0738-422X = Recent developments in alcoholism.
1. Alcoholism—Periodicals. I. Galanter, Marc. II. American Medical Society on
Alcoholism. III. Research Society on Alcohol (U.S.) IV. National Council on Alcoholism.
[DNLM: 1. Alcoholism—periodicals. Wl REl06AH(P)]
HV5001.R4 ôlô.S&VOS—dcl9 83-643791
Library of Congress [8311] AACR 2 MARC-S
ISBN 978-1-4899-1697-6 ISBN 978-1-4899-1695-2 (eBook)
DOI 10.1007/978-1-4899-1695-2
© Springer Science+Business Media New York 1986
Originally published by Plenum Press, New York in 1986
Softcover reprint of the hardcover 1st edition 1986
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Editorial Board American Medical Society on
Alcoholism and Other Drug
Dependencies
Cililirnlllll:
Charles S. Lieber, MD.
Burton M. Altura, PhD. Presidwl:
Herbert Barry III, PhD. Max A. Schneider, MD.
Henri Begleiter, MD., Ph.D. Presidenl-Elecl:
Floyd E. Bloom, MD. Margaret Bean-Bayog, M.D.
Irvin L. Blose, MD. Secrelary:
Bernice E. Coleman, M.D. Jess W. Bromley, MD.
Paul Cushman, MD. Treasurer:
Richard A. Deitrich, Ph.D. Jasper G. Chen See, MD.
Richard L. Douglass, M.P.H., PhD. Immediale Pasl Presidenl:
Carlton K. Erickson, PhD. Irvin L. Blose, MD.
Louis Faillace, MD. Board of Directors:
Vernelle Fox, MD. Sheila B. Blume, M.D.
Richard Fuller, M.D. Sandra Jo Counts, MD.
Donald M. Gallant, M.D. Jean L. Forest, MD.
Donald W. Goodman, MD. Marc Galanter, MD.
R. Adron Harris, PhD. Donald M. Gallant, MD.
Paula L. Hoffman, PhD. Ann Geller, MD.
George Jacobson, PhD. Stanley E. GitIow, MD.
Charles Kaelber, MD. William B. Hawthorne, MD.
Robert Landeen, MD. Roland E. Herrington, MD.
Ting·Kai Li, MD. Charles S. Lieber, MD.
Peter E. Nathan, Ph.D. Joseph c. MacMillan, M.D.
Larissa A. Pohorecky, MD. Al J. Mooney III, MD.
Alex D. Pokorny, MD. Anthony Radcliffe, MD.
Percy E. Ryberg, MD. Daniel E. Smith, MD.
Barry Stimmel, MD. G. Douglas Talbott, MD.
Patricia B. Sutker, PhD. Maxwell N. Weisman, MD.
George Vaillant, MD.
David Van Thiel, M.D. Research Society on Alcoholism
Joseph Westermeyer, M.D.
Sheldon Zimberg, M.D.
President:
Boris Tabakoff, PhD.
Vice-Presidenl:
Ting-Kai Li, M.D.
Secrelary:
Marc Galanter, MD.
Treasurer:
Henri Begleiter, MD., Ph.D.
Board of Directors:
Herbert Barry III, PhD.
Floyd E. Bloom, MD.
Theodore J. Cicero, PhD.
Richard A. Deitrich, PhD.
John A. Ewing, MD.
Dora B. Goldstein, MD.
Charles S. Lieber, MD.
Peter E. Nathan, PhD.
Carrie L. Randall, PhD.
Marc A. Schuckit, MD.
Contributors
Arthur I. Alterman, Veterans Administration Medical Center, Philadelphia,
Pennsylvania 19104; and University of Pennsylvania School of Medicine,
Philadelphia, Pennsylvania 19104
Thomas F. Babor, Alcohol Research Center, Department of Psychiatry, Uni
versity. of Connecticut Health Center, Farmington, Connecticut 06032
Jerome F.X. Carroll, Continuum Program, Eagleville Hospital, Eagleville,
Pennsylvania 19408
Richard R. Clayton, Department of Sociology, University of Kentucky, Lex
ington, Kentucky 40506
Paul Cushman, Jr., Drug Dependency Treatment Program, McGuire Veterans
Hospital, Richmond, Virginia 23249; and Departments of Medicine, Psy
chiatry, Pharmacology and Toxicology, Medical College of Virginia, Rich
mond, Virginia 23298
Dennis M. Donovan, Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, Washington 98195; and Alcohol De
pendence Treatment Program, Veterans Administration Medical Center,
Seattle, Washington 98108
Dora B. Goldstein, Department of Pharmacology, Stanford University School
of Medicine, Stanford, California 94305
David A. Gorelick, Alcohol and Drug Treatment Program, Behavioral Phar
macology Laboratory, Brentwood Division, West Los Angeles Veterans
Administration Medical Center, Los Angeles, California 90073; and De
partment of Psychiatry, School of Medicine, University of California, Los
Angeles, California 90024
Edward Gottheil, Department of Psychiatry and Human Behavior, Jefferson
Medical College, Thomas Jefferson University, Philadelphia, Pennsyl
vania 19107
Michie N. Hesselbrock, Department of Psychiatry, University of Connecticut
Health Center, Farmington, Connecticut 06032
vii
viii Contributors
Daniel R. Kivlahan, Department of Psychiatry and Behavioral Sciences, Uni
versity of Washington, Seattle, Washington 98195; and Alcohol Depen
dence Treatment Program, Veterans Administration Medical Center, Se
attle, Washington 98108
Richard J. Lauerman, Alcohol Research Center, Department of Psychiatry,
University of Connecticut Health Center, Farmington, Connecticut 06032
Roger E. Meyer, Alcohol Research Center, Department of Psychiatry, Uni
versity of Connecticut Health Center, Farmington, Connecticut 06032
Leslie C. Morey, Department of Psychology, Vanderbilt University, Nash
ville, Tennessee 37240
Claudio A. Naranjo, Clinical Pharmacology Program, Addiction Research
Foundation Clinical Institute, and Departments of Pharmacology and
Medicine, University of Toronto, Ontario M5S 2S1, Canada
Alfonso Paredes, Department of Psychiatry, The Neuropsychiatric Institute,
Alcohol Research Center, University of California, Los Angeles, Califor
nia 90024
Thomas O. Pitts, Renal-Electrolyte Division, Department of Medicine, Pitts
burgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsyl
vania 15261
Eugene P. Schoener, Department of Pharmacology, Wayne State University
School of Medicine, Detroit, Michigan 48201
Edward M. Sellers, Clinical Institute, Addiction Research Foundation, and
Departments of Pharmacology and Medicine, University of Toronto, On
tario M5S 2S1, Canada
Harvey A. Skinner, Addiction Research Foundation, Toronto, Ontario M5S
2S1, Canada
Ralph E. Tarter, Department of Psychology, University of Pittsburgh School
of Medicine, Pittsburgh, Pennsylvania 15213
David H. Van Thiel, Division of Gastroenterology, Department of Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
15261
Contributors ix
R. Dale Walker, Department of Psychiatry and Behavioral Sciences, Univer
sity of Washington, Seattle, Washington 98195; and Alcohol Dependence
Treatment Program, Veterans Administration Medical Center, Seattle,
Washington 98108
Jeffery N. Wilkins, Crisis Oriented Psychiatric Evaluation Service, Clinical
Psychopharmacology Unit, Brentwood Division, West Los Angeles Vet
erans Administration Medical Center, Los Angeles, California 90073; and
Department of Psychiatry, School of Medicine, University of California,
Los Angeles, California 90024
Preface
From the President of the Research Society on Alcoholism
In recent years the alcohol research field has matured and is attracting a
substantial number of eager and technically sophisticated researchers. There
is a feeling of excitement and premonitions of breakthroughs as more and
more of alcohol's actions are being detailed. I, however, have at times been
sobered by the perception that the lure of parsimonious explanations and the
appeal of studying easily demonstrable effects obscure the critical issues re
garding alcohol abuse and alcoholism. Central questions regarding (1) the
reinforcing properties of ethanol and other factors responsible for inappro
priate consumption of alcohol, (2) the heterogenous characteristics (both bi
ologic and sociologic) of the alcoholic population, and (3) the differential
predisposition of individuals to alcohol-induced medical problems needed to
be vigorously pursued. Researchers who used animals as models for the
human condition needed to become more intimately aware of the variety of
factors that are of importance in the development of alcoholism in an indi
vidual. On the other hand, researchers studying humans needed to attempt
to more clearly define and categorize diagnostic criteria and characteristics of
various alcoholic populations. Such categorization and continued character
ization of alcoholism allows not only for a framework of concepts within
which proper animal models for studies of biologic mechanisms can be de
veloped but also allows for consideration of the most apt treatment
approaches.
I have been most heartened during the last two years by the increased
attention being paid to the development of appropriate concepts for studies
of alcoholism. This increase in attention to concepts has certainly been evi
denced in the presentations at the annual meeting of the Research Society on
Alcoholism (RSA) and in the published material appearing in the AMSAODDI
RSA journal and in this book series. I would hope that continued insight will
be displayed by the experienced researchers in the alcoholism field and that
this insight will be used to guide those newly entering alcohol research.
Science is the testing of hypothesis, but hypothesis should be firmly grounded.
Progress toward the solution of the major problems in the alcoholism field
will be swift with adherence to proper concepts and good scientific methods.
Boris Tabakoff, Ph.D.
xi