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© 1983 Medical Council on Alcohol

research-article

ALCOHOL AND DRUG DEPENDENCE: AREAS OF CHANGE OR UNCERTAINTY

J. S. MADDEN

Alcohol and Drug Dependence Unit, West Cheshire Hospital Chester CH2 1BQ, U.K.

Received 15 April 1983; Developing areas are reviewed whose resolution will promote understanding of basic issues or the solution of controversies. Points that are discussed include the neuronal actions of dependence producing substances (especially on neural membranes, GABA and calmodulin), and contrary claims for acetaldehyde as a cause or a protection against alcohol misuse. Therapeutic implications are proposed for the high frequency of cerebral impairment among problem drinkers; the routine provision of drugs to cover alcohol withdrawal is questioned; growing attacks on methadone maintenance as a suitable treatment of opioid dependence are discussed. Suggestions for safe drinking levels are outlined, with particular regard to hypertension, cirrhosis, pancreatitis and foetal alcohol effects.


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