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Drug and Alcohol Review (September 2013), 32, 552555 DOI: 10.1111/dar.12010

Book Reviews

The Pharmacology of LSD: A Critical Review ANNELIE HINTZEN & TORSTEN PASSIE Oxford, UK: Oxford University Press, 2010 ISBN 13: 9780199589821, 150 pp. Paperback. Price: US$59.95 Lysergic acid diethylamide (LSD), more than any other psychedelic, retains an aura of controversy. Yet it once had a central role in psychopharmacology. Many of the rst generation of psychopharmacologists regarded LSD with personal and scientic fascination [1]. Their investigations kick-started a literature on LSD that now exceeds 4800 publications on pubmed.gov. There is a real need for review of this sprawling, often inaccessible literature. Annelie Hintzen and Torsten Passies welcome book, The Pharmacology of LSD: A Critical Reader provides an overview of human, animal and molecular experiments
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involving LSD. This is no small achievement. After an introduction, the main sections cover: pharmacological effects; interactions of LSD with endogenous and exogenous substances; psychological effects; neuropsychological effects; effects on psychiatric populations; and adverse effects. The result is a document that a regulatory agency might want before approving human studies with LSD. There are useful summaries of neuropsychological effects but also reassuringly soporic sections on the modest physiological effects. The overview of studies of potential drugdrug interactions is a particularly good resource. At its best, the book synthesises areas of investigation rather than summarising individual studies. Brief summaries of studies on gastrointestinal, endocrine and kidney functioning leave one wondering if and when this might be clinically relevant. In contrast, the section on adverse effects provides helpful syntheses of the state of knowledge. One wishes the authors went further and discussed contraindications for LSD administration and the state-of-the-art knowledge on preventing and treating adverse events. The relative lack of clinical focus is surprising. Both authors are physicians and Passie is a particularly good candidate to write about clinical knowledge of LSD. In the 1990s, he worked with Hanscarl Leuner, a prominent researcher on psychedelic psychotherapy. Passie has previously assembled a useful annotated bibliography of psychedelic psychotherapy and has conducted studies with related psychoactives such as ketamine. The authors use this expertise to provide an admirably even-handed assessment of LSD research. Perhaps the greatest challenge of this book is making sense of 50-year-old technical issues. I found myself wishing for contributions from a historian of science. Denied the opportunity to converge on truth through repeated studies, knowledge about LSD still reects fears and issues of the 1950s and 1960s. For example, excessive concerns about chromosome damage after LSD only make sense in the wake of the thalidomide scandal. Such context could help us to understand why a book that has eight pages on the psychological effects of LSD needs six pages to summarise largely irrelevant work on mutagenicity. More generally, modern readers may not realise the scientic milieu of LSD research. At the time, the new eld of psychopharmacology had begun to challenge psychoanalysis as a source of authority about mental illness. Clinical trials, standardised symptom questionnaires and blinded ratings were innovations that seemingly conicted with the way psychiatry understood the individual. LSD research shows divides between those who embraced and those who resisted the new approach [2].The authors do note some of these issues,

especially when discussing the unanswered question of whether schizophrenics have differential sensitivity to LSD. Still, greater systematic discussion of context might have been more effective. Other times, background could have simply deepened the readers enjoyment of how scientists grappled with the profound questions raised by LSD. Electrophysiological research can easily be presented as a dull series of neural activity in different brain regions. However, this same research is precisely where stillinuential theories of hallucinations (such as altered ltering of sensory information and release of stored representations in the cortex) were eshed out. It seems a missed opportunity to discuss LSD history without interweaving history of theories about hallucinations. Hintzen and Passie describe the basic ndings but seldom convey the intellectual adventures in all these studies. The translation of the book from original German is regrettably uneven. This produces a few inadvertent dubious claims (i.v. injection is pharmacologically the safest and best reproducible way to administer LSD) and many sentences that are awkward. As with any major undertaking, specialists may quibble with minor omissions. The authors cite the infamous LSD-related death of an elephant [3] but not subsequent nonfatal administrations [4]. Sidney Cohens [5] survey of LSD is best understood in light of the sort of methodological caveats and social context noted by Novak [6]. There is no mention of the very small study administering LSD to humans in the 1980s in the USA [7]. These points do not detract from the value of this book. It is should sit on the bookshelf of anyone interested in psychedelic pharmacology alongside such references as Grinspoon and Bakalars Psychedelic Drugs Reconsidered [8], Hollisters Chemical Psychosis [9], Otts Pharmacotheon [10] and Trouts Some Simple Tryptamines [11]. It may not be the denitive guide to LSD pharmacology, but it is a useful book with no current counterpart. Matthew J. Baggott Human Behavioral Pharmacology Laboratory University of Chicago Chicago, IL, USA References
[1] Healy D, ed. The psychopharmacologists, Vols 13, London: Arnold, 20002002. [2] Dyck E. Psychedelic psychiatry: LSD from clinic to campus. Baltimore, MD: Johns Hopkins University Press, 2008. [3] Jolyon West L, Pierce CM, Thomas WD. Lysergic acid diethylamide: its effects on a male Asiatic elephant. Science 1962;138:11003. [4] Siegel RK. LSD-induced effects in elephants: comparisons with musth behavior. Bull Psychon Soc 1984;22:536.
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Book Reviews

[5] Cohen S. Lysergic acid diethylamide: side effects and complications. J Nerv Ment Dis 1960;130:3040. [6] Novak SJ. LSD before Leary: Sidney Cohens critique of 1950s psychedelic drug research. Isis 1997;88:87110. [7] Francom P, Andrenyak D, Lim HK, Bridges RR, Foltz RL, Jones RT. Determination of LSD in urine by capillary column gas chromatography and electron impact mass spectrometry. J Anal Toxicol 1988;12:18. [8] Grinspoon L, Bakalar JB. Psychedelic drugs reconsidered, 3rd edn. New York: The Lindesmith Center, 1997. [9] Hollister LE. Chemical psychoses: LSD and related drugs (No. 691). Springeld: Thomas, 1968. [10] Ott J. Pharmacotheon: entheogenic drugs, their plant sources and history. Kennewick: Natural Products Company, 1993. [11] Trout K. Some simple tryptamines. Austin: Mydriatic productions, 2002.

Recover to Live: Kick any Habit, Manage any Addiction CHRISTOPHER KENNEDY LAWFORD Dallas, Texas, USA: BenBella Books Inc., 2012 ISBN: 978 1 93666196 1, 352 pp. Hardback. Price: A$16.70 The book is intended to be read by individuals who have a habit or an addiction or have loved ones who do, and offers hope that change is possible and that recovery is possible. It is based on the personal experiences of the author and interviews with 100 addictions experts from around the world. Lawford does an excellent job of translation, laced with personal insights derived from his own life and recovery journey, providing statistical evidence and expert opinion that means the book also constitutes an accessible primer for students and professionals new to the eld. The rst section, Is your unhealthy habit really dependence?, is divided into seven chapters addressing alcohol, drugs, eating disorders, gambling, hoarding, sex and pornography, and smoking. Part two offers a smorgasbord of help seeking options, overviewing intervention methods as diverse as cognitive behaviour therapy, 12-step programs, mindfulness, meditation, nutrition and exercise, body work and journaling (classed as self-care tools with proven benets) and Lawford attempts, with the assistance of his experts, to synthesise the evidence in each domain.This is both the strength and the weakness of the bookthe author has access to many of the most signicant thinkers in addiction research and treatmentbut they present an evidence base that is perhaps too optimistic and, on occasion, self-promoting. One expert contributor lists professional guidance as one of the seven imperatives of recoverythis is the problem of asking experts, their expertise is seen as an essential part of the process. The book concludes with a nal chapter that is a call to armsHaving a life worth livingthe art of recoverywhich, while it may offend some sensitised
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palettes with its optimistic language of recovery and transcendence, offers hope and guidance to readers. Recovery is described variously as another word for freedom, as seeing new meaning in life and as a spiritual quest. Lawford does not get mired in debates about abstinence nor about user rights, but proposes a paradigm shift based on a new recovery movement where social, community-based processes enable recovery journeys and the power of social identication sustains lasting recovery. Robert DuPont is quoted as claiming the core problem of addiction is not getting clean and sober, it is staying clean and sober (Lawford, pp. 301302), and what the author offers the reader is a call to advocacy and collective action. This proposed Global Recovery Initiative has the potential to offer a meaningful bridge from formal treatment for those who need it to the peer and para-professional world of visible and supportive recovery communities. It is not the case that such communities do not already exist, in formal and informal contexts across the globe, it is that they have not had coherent leadership or coordination to both challenge the professionalised views of the workforce and to directly access those who need friendship, guidance, pride, hope and belonging from peers to sustain meaningful and valuable lives in recovery; however, it is dened. David Best Turning Point Drug and Alcohol Centre and Monash University Melbourne, VIC, Australia Harm Reduction in Substance Use and High-Risk Behaviour: International Policy and Practice RICHARD PATES and DIANE RILEY (Eds) West Sussex, UK: Wiley-Blackwell, 2012 ISBN 978-1-4051-8297-3, 472 pp. PBK. Price: $77.95 Harm Reduction in Substance Use and High-Risk Behaviour: International Policy and Practice is a textbook that aims to serve as a resource for students, researchers and policy-makers interested in understanding the history, evolution and current state of harm reduction practices internationally. As readers of this Journal will know, harm reduction strategies are interventions that aim to reduce the negative consequences of substance use and other harmful behaviours. Historically, evidence of harm reduction practices has been traced to the 18th century in London, where legislation and taxation were used to minimise the harms associated with drinking gin. More recently, harm reduction strategies have been widely adopted since the 1980s, with needle and syringe exchange programmes having been found to be particularly useful in preventing the sharing of used syringes.