The Pathology of Drug Abuse, Second Edition

The Pathology of Drug Abuse, Second Edition is a comprehensive yet accessible guide to the pathology, toxicology, and pharmacology of commonly abused drugs. The book also offers detailed information on the origin, history, and production techniques used to make these drugs. As in the first edition, emphasis remains focused on the investigation of drug-related deaths and on practical approaches to the detection of drug abuse. The medical complications associated with each of the abused drugs are discussed in some detail as well. Individual chapters deal with cocaine, other naturally occurring stimulants, synthetic stimulants, hallucinogens, narcotics, anabolic steroids, and solvent abuse. Approximately 800 new references have been added since the publication of the first edition. Numerous new photomicrographs and drawings have been added, and many of the illustrations from the first edition have been redrawn to enhance clarity.

Table of Contents:
COCAINE History Prevalence of Cocaine-Related Morbidity Cultivation and Manufacture Cultivation and Crop Yields Cocaine Paste Production Drug Constants Routes of Administration Leaf Chewing Snorting Surgical Application Intravenous Use Genital Application Dermal Absorption Inhalation Gastrointestinal Absorption Maternal/Fetal Considerations Metabolism Cocaine Disposition Fetal Metabolism Interpreting Cocaine Blood Levels Cocaine Tissue Disposition Brain Heart Liver Kidneys Adrenals Hair Fat Biofluids Cocaine's Effects on Catecholamine Metabolism General Considerations Mechanisms of Catecholamine Toxicity Histopathology of Catecholamine Toxicity Contraction Band Necrosis and Sudden Death Epidemiologic Data External Markers of Cocaine Abuse Perforated Nasal Septum Cocaine "Tracks" "Crack Keratitis" Dental Erosions "Crack Thumb" "Crack Hands" Evidence of Terminal Seizures Toxicity by Organ System Intugement Cardiovascular System Pulmonary Disease Gastrointestinal Disorders Neurologic Disorders Renal Disease Hematologic Abnormalities Hormonal Alterations Immune System Abnormalities Pregnancy Interactions When is Cocaine the Cause of Death? OTHER NATURALLY OCCURRING STIMULANTS Absinthe History Clinical and Autopsy Studies Caffeine History Chemical Constants and Tissue Disposition Clinical Studies Blood Levels Autopsy Findings Khat History Chemistry and Clinical Studies Ephedrine History Chemistry and Metabolism Clinical Studies SYNTHETIC STIMULANTS Amphetamine and Methamphetamine History Illicit Manufacture Chemistry Routes of Administration Metabolism Tissue Disposition Interpreting Amphetamine Levels Toxicity by Organ System Phenylpropanolamine Historical Aspects Chemistry Metabolism Toxicity by Organ System Fenfluramine Historical Aspects Drug Constants Metabolism Blood and Tissue Levels Toxicity by Organ System HALLUCINOGENS Phenylethylamine Derivatives Mescaline Other 2-Carbon Phenethylamine Derivatives Substituted Amphetamines (Phenylisopropylamines) TMA (2,4,5-Trimethoxyamphetamine) DOM (Methyl-2,5-Dimethoxyamphetamine) PMA (Paramethoxyamphetamine) DOB (4-Bromo-2,5-Dimethoxyamphetamine, Also Called Bromo-DMA) Nexus (4-Bromo-2,5-Dimethoxyphenethylamine) MDA (3,4-Methylenedioxyamphetamine) "The Love Drug" MDMA (3,4-Methylenedioxymethamphetamine); Other Names Include XTC, Adam, MDM MDEA (3,4-Methylenedioxyethamphetamine) MAX (4-Methylaminorex) Other MDMA Homologs "KAT" Phenylalkylamines Simple Tryptamines Beta Carbolines Alpha-Methyltryptamines Ergolines Other Agents Phencyclidine Dextromethorphan NARCOTICS Introduction Prevalence of Opiate-Related Morbidity Classifications of Narcotic Agents History of Opiate Abuse Origins in Antiquity Introduction to Europe and Asia Invention of the Hypodermic Syringe Synthesis of Heroin The First Pathology Studies Cultivation and Manufacture Botanic Considerations Manufacture Sample Analysis Individual Narcotic Agents Morphine Heroin Codeine Methadone Propoxyphene Fentanyl and Other Synthetic Agents Other Opiates Interpreting Tissue and Blood Levels Introduction Testing Urine Testing Blood Interpreting Test Results Clinical Profile of Opiate Abusers Dermatologic Sequelae of Opiate Abuse Fresh Puncture Sites Atrophic Scarring Abscess and Ulcerations "Track" Marks Tattoos "Puffy" Hands Necrotizing Fascitis Histamine-Related Urticaria Fungal Lesions Miscellaneous Cutaneous Abnormalities Cardiovascular Disorders Introduction Pathology Associated with HIV Infection Endocarditis Other Myocardial Disorders Miscellaneous Disorders Pulmonary Disorders Noninfectious Complications Infectious Complications Gastrointestinal Disorders Introduction Bowel Disease Liver Disorders Renal Disorders Introduction Acute Renal Failure Due to Nontraumatic Rhabdomyolysis Secondary Amyloidosis Heroin Associated Nephropathy (HAN) and Other Glomerular Disorders Necrotizing Angiitis Neuropathology Introduction Hypoxic Encephalopathy Infectious Diseases Hormonal and Immune Alterations Bone and Soft Tissue Disorders Introduction Bone and Joint Infection Soft Tissue Infections Fibrous Myopathy of Pentazocine Abuse ANABOLIC STEROIDS Introduction Pharmacology Synthesis and Metabolism Black Market Steroids and Steroid Contaminants Legitimate Clinical Indications Steroid-Related Disorders Liver Disease Cardiovascular Disease Neurologic Disorders Musculoskeletal Disease Detecting Steroid Abuse ORGANIC SOLVENT AND AEROSOL ABUSE General Considerations Absorption and Tissue Disposition Clinical Syndromes Neurologic Disorders Renal Disease Gastrointestinal Disease Cardiovascular Disease Appendix Index