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M M Stark, J P-James. 2nd ed, 2003, £12.50, pp 64. ISBN 1-84110-106-0
This is a very handy booklet, intended to provide concise and readily accessible facts about symptoms and signs of commonly used drugs. As mentioned in the introduction, its targeted audience is not the experienced A&E doctor or nurse, but healthcare professionals working in other environments, as well as public sector workers who often come into contact with persons under the influence of drugs. The booklet is also of particular use for partners, parents, or friends of people suspected of taking drugs.
The sections of the booklet are concise and helpful in establishing sequentially the various important aspects to consider in substance misuse. It starts with methods of administration and aspects of harm minimisation and risk reduction, and describes the various legal statutes and requirements. It gives an accurate table of the medical and health complications of substance misuse. One serious potential complication that can lead to death is not mentioned—that is, rhabdomyloysis, where an opiate user falls asleep after an overdose and remains unconscious in the same position, leading to muscle necrosis and potential death. The section on substance detection would be useful for enforcement agencies in monitoring drug profiles for potential prosecutions or healthcare professionals in monitoring detoxification programmes.
The booklet then goes on systematically to describe individual drug groups. The sections on management of some of the drugs are scant, but as mentioned above, this booklet is not targeted at medical doctors working daily in this field. The section on barbiturates does not cover the treatment of the acute intoxication.
The sections at the back of the booklet describing the Glasgow Coma Scale is helpful, but it would be more valuable if the authors had included the scores at which concern should be raised and the individual user is at risk.
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