Drugs: A Very Short Introduction

Very Short Introductions #052

by Leslie L. Iversen

The twentieth century saw a remarkable upsurge of research on drugs, with major advances in the treatment of bacterial and viral infections, heart disease, stomach ulcers, cancer, and mental illnesses. These, along with the introduction of the oral contraceptive, have altered all of our lives.
There has also been an increase in the recreational use and abuse of drugs in the Western world. This Very Short Introduction gives a non-technical account of how drugs act on the body and how therapeutic drugs are developed and tested, then goes on to review both legal (prescription, alcohol,
nicotine, and caffeine) and illegal drugs, and discuss current ideas about why some drugs are addictive, and whether drug laws need reform.

Genres: Science, Nonfiction, Medicine, Drugs, Chemistry, Biology, Health

144 pages, Paperback

First published August 23, 2001

About the author

Leslie Lars Iversen FRS is a British pharmacologist, known for his work on the neurochemistry of synaptic transmitters

Iversen was Director of the MRC Neurochemical Pharmacology Unit, in Cambridge from 1971 to 1982, then Director of the Merck, Sharp & Dohme Neuroscience Research Centre from 1982 to 1995. He became Visiting Professor of Pharmacology, at the University of Oxford in 1995.

He was elected a Fellow of the Royal Society in 1980, and gave the Society's Ferrier Lecture in 1988.

Reviews

[Seth · Rating 2 out of 5]

I want to like this book. It contains a lot of information about drugs in several relevant fields of study - history, biochemistry, law, econonomics, etc. - much of which was new to me. Two issues are holding me back from giving it more than two stars.

The first is factual. In the section on how drugs work (one of the more interesting sections, IMO), Iversen includes some discussion on tolerance, defining the phenomenon like so: "If the same drug is taken repeatedly, it may lead to a large increase in the liver enzyme(s) involved in its metabolism... the drug will... become less and less effective over time". After reading what Iversen has to say on the subject, one could be forgiven for thinking that that's all that tolerance is. Actually, what Iversen simply calls 'tolerance' is properly distinguished as 'pharmacokinetic tolerance'. There's also pharmacodynamic tolerance, which is quite common, and is the result of desensitized and downregulated (or upregulated in some cases) target receptors. Iversen doesn't mention that at all. I admit I'm picking at one small detail here, but this seems like a really weird and misleading thing for an expert to do, and it makes me wonder what weird and misleading things escaped my notice.

The second is Iversen's treatment of the ethical/political issues surrounding drug development and use. He's not totally unwilling to acknowledge that such issues exist, and to his credit, endorses ending the war on drugs, but in the political climate of recent years, that seems like the most milquetoast thing he could possibly take a principled stance on. Other than that, he's largely an uncritical apologist for the FDA and similar agencies. His position seems to be that regulation might seem like it's doing some harm, but obviously, regulation is a necessary evil, and obviously, we have the best of all possible regulatory agencies. On the subject of animal testing, he only briefly mentions that there's some activism against it, and does so without actually acknowledging that there are real ethical issues involved. I get the impression that he sees such activism as nothing more than a hindrance to progress, not worth taking seriously. This all leaves a rather poor taste in my mouth.

[AB · Rating 5 out of 5]

Being a student pharmacist and all, I loved this book.
It was like a short revision after a whole year of a bunch of information.
It organizes everything in your brain especially if you know what he's talking about.
For those who have no idea about health or medications, you might find it a bit detailed concerning some drugs, since their mechanisms of actions are mentioned, which I didn't see was necessary if the audience the book was intended for was everybody.
I had hoped that he mentioned more about the companies.
All in all, very great, worth it.

[Daniel Wright · Rating 3 out of 5]

Chapter 1: History
Chapter 2: How drugs work
Chapter 3: Drugs as medicines
Chapter 4: Recreational drugs
Chapter 5: Making new medicines
Chapter 6: What can we expect from the future?

[Koen Duizings · Rating 3 out of 5]

This very short introduction tackles mainly medicinal drugs and explains how they work. I found the chapter on recreational drugs is slightly disappointing as it did not provide much new information. Also, the book tends to use specific terms that make it a tough read for people not so well schooled in the field of pharmacology. But like every 'A Very Short Introduction' there is plenty of useful information as well.

[Johan · Rating 2 out of 5]

Pretty good intro to drugs, both legal and illicit ones. Written by a person that is leaning quite towards drugs in the sense of medicine with quite a lot of descriptions about how the drugs act on the brain and the body in minute detail.

[Steve Mitchell · Rating 4 out of 5]

A great book that explains simply why cannabis should at the very least be decriminalised, why people that take cocaine and heroin need treatment rather than being sent to prison and how the big pharmaceutical companies are making profits off of people dying.

[Zac Dragan · Rating 3 out of 5]

Well I want some now

[Dmitry · Rating 3 out of 5]

(The English review is placed beneath Russian one)

Начал читать книгу с полной уверенностью, что страниц через 20-30 брошу, т.к. медицинская тема, за редким исключением, полностью не для меня, т.е. если это не популярная серия, направленная на широкий круг читателей. Что удивительно, но именно такой книгой оказалась и эта работа. Автор, по существу, создал расширенную версию Википедии на тему медицинских препаратов. Я бы не сказал, что это было увлекательное чтение, но и откровенно скучным его так же нельзя назвать. Плюс, небольшой объём фактически ликвидировал воду, пустословие.
Автор рассматривает всевозможные вопросы, связанные с темой лекарств. Начинает он с древних времен, когда самые первые таблетки, настойки, капли и пр. представлялись в единственной форме – трав. Автор коротко прошёлся по данной теме, упомянул некоторые моменты из истории древнего Рима и вроде Греции, а также некоторые их названии и от чего они помогали.
Далее автор разбивает книгу на две большие, и я бы сказал, основные темы: лечение и релаксация. Автор начинает, довольно коротко, рассматривать вопрос того, как появились первые современные лекарства. Т.е. как и когда цивилизация совершила тот главный и важный шаг от трав к нынешним, условно говоря, таблеткам. Кто их изобрёл первым, когда и при каких условиях. Основное время – 19-20 века, вплоть до наших дней.
Что касается второй темы, то автор рассмотрит вопросы того, как изначально использовались вещества, которые сегодня обозначаются как наркотики. Как и откуда они взялись и для чего в те времена использовались. По сути, все они к середине XX века были запрещены.
Следующий вопрос, это сами болезни, основные виды и пр. Тут я уже столкнулся с довольно сложным текстом, большую часть которого не понял. Сюда же (но более доступно): как работают медицинские препараты в нашем организме (при вдыхании, при глотании и так далее).
Где-то уже ближе к концу автор рассмотрит такие темы как вирусы и бактерии, включая вопросы борьбы с ними. Интересный момент, когда автор писал о том, что сложность борьбы с болезнями представляет та доза, которую нужно избрать. Это – первый момент. Второй момент, это проблема постоянной мутации вируса, когда он может, чуть ли не за один день, измениться, из-за чего принимаемое лекарство оказывается неспособно справится с болезнью.
Что касается наркотиков, то тут автор коротко рассмотрит основные их виды, их воздействие на человека, то влияние, которое они оказывают и как они использовались раньше в человеческой истории. Рассказ будет включать также 3 основных разрешённых наркотика: табак, алкоголь и кофеин. В принципе, ничего нового тут нет.
Заключительная часть посвящена тому, как появляются новые лекарства (от создания до выхода на массовый рынок), какие существуют в этом вопросе перспективы и роль права в данной отрасли. Автор приходит к заключению, что такой наркотик как марихуана и его опыт легализации, показывает, что это не приводит к увеличение количества потребителей и что в будущем государства придут именно к решению о его легализации.
В принципе, книгу можно прочить, чтобы иметь поверхностные знания по данной теме. Книга небольшая, читается легко и в дальнейшем может помочь при чтении более специальных текстов в книгах или журналах.

I started to read the book with full confidence that in 20-30 pages I will quit reading, because the medical topic, with rare exceptions, is not completely for me, i.e. if it is not a popular series aimed at a wide range of readers. Surprisingly, this work turned out to be such a book. The author essentially created an extended version of Wikipedia on the topic of medicines. I wouldn't say it was a fascinating reading, but it wasn't boring either. Plus, the small volume actually eliminated the verbiage.
The author considers all sorts of questions related to the topic of drugs. He begins with ancient times, when the very first tablets, infusions, drops, etc. were presented in a single form - the form of herbs. The author briefly described the topic, then mentioned some points from the history of ancient Rome and Greece, as well as some of their (drugs) names and from what sickness they helped.
Then the author breaks the book down into two big, and I would say, main topics: treatment and recreation. The author begins, quite briefly, to consider the question of how the first modern medicines appeared. That is, how and when civilization has made that main and important step from herbs to the present, conditionally speaking, pills. Who invented the first modern drugs, when and under what conditions. The main time is the 19th-20th centuries, up to now.
As for the second topic, the author will consider how substances that are today designated as dangerous drugs were originally used. How and where they came from and what they were used for in those days. In fact, they were all banned by the middle of the 20th century.
The next question is the diseases themselves, the main species, etc. Here I have already encountered a rather complicated text, most of which I did not understand. Here as well (but more accessible): how do medicines work in our bodies (by inhalation, swallowing, etc.).
Somewhere towards the end, the author will look at topics such as viruses and bacteria, including how to control them. An interesting point is when the author wrote that the complexity of disease control represents the dose to be chosen. This is the first point. The second point is the problem of the virus's constant mutation, when it can change in almost one day, making the medicine unable to cope with the disease.
As far as drugs are concerned, the author briefly discusses their main types, their impact on the human being, the impact they have and how they have been used in human history. The story will also include 3 main legal drugs: tobacco, alcohol, and caffeine. Basically, there is nothing new here.
The final part is devoted to how new medicines appear (from creation to mass market), what are the prospects and the role of law in the industry. The author concludes that a drug such as marijuana and its experience of legalization shows that this does not lead to an increase in the number of consumers and that in the future, states will decide on its legalization.
In principle, the book can be read to have basic knowledge of the subject. The book is small, easy to read and can further help when reading more special texts in books or magazines.

[Aleksandar · Rating 5 out of 5]

I never would have thought that so much information can be compressed within a very short introduction. I got the audiobook version, and it is instantly worth listening to again. The only negative is that the book feels a little fragmented, as it jumps forward and backwards in tracking the historic development of different cures. As an interesting side effect, this book also chronicles the development of medicine itself, covering the basics of modern medical standards. Surprisingly, it doesn't shy away from discussing the biochemistry of various "gold standard" drugs, and enough is explained in the first chapters that you can understand what the author wants to convey. The look behind the scenes of the pharmaceutical industry is fascinating, the astonishing fact that a single chemist can go thorough tens of thousands of compounds with "robot chemistry" is hard to imagine. The social dynamics of poverty and evaluate to modern medical discoveries is also discussed, albeit briefly. Interesting facts abound; such as all drugs being molecules made of less than 100 atoms!. In brief, this is a highly recommender read.

[Shhhhh Ahhhhh · Rating 5 out of 5]

Fantastic book. It revealed the extent of my own ignorance on the subject. It covered everything you might imagine could be called a drug, legal, illegal, prescription, otc, etc. It talked about the ways that drugs can work, methods for delivery and why those work the way they do, dose-response relationships, and, very broadly, abuse, dependance, and tolerance. Brief discussion on analogues. There was also a fascinating section on the ongoing war between our development of antibiotics and bacteria/viruses developing antibiotic resistance. Very good book.

[Bronte Page · Rating 5 out of 5]

Drugs: A Very Short Introduction is yet another entry into Oxford Univerity Press' Very Short introduction. This time covering man made drugs both pharmaceutical and recreations. Drugs: A VSI take you through a history of drugs, how they work, what advancements have been made over the years and where they are heading.

This was my favourite book of the series thus far. The perfect blend of interesting and accessible, covering lots of different areas in the topic and covering both where the field has been and where it is going. Everything a Very Short Introduction should be.

[Julia Bilderback · Rating 3 out of 5]

Sort of random, but this is the first book that I have come across that acknowledges that MS can be painful. It talks shortly about it in the pain meds section. Even books fully on MS a lot of times either don't talk about pain at all or actually say that MS isn't painful. Nice to see this finally being talked about. This book was misnamed since it focuses more on pharmacology then "drugs." It also goes into how many of the big drug companies take advantage of people with high prices. Many people suffer for years waiting for drugs to become generic/cheaper. It actually makes me wonder how many people died/die of AIDS all because of the price of drugs that can help them.

[Andre William · Rating 4 out of 5]

The book is quite useful and interesting. For people in the medical field it will be useful to read and take a different look at this field. The book covers a wide range of topics, including the origins of drug use, the effects of drugs on the brain and body, the role of drugs in medicine and society, and drug policy and regulatory issues. The purpose of the book is to provide readers with a balanced and informative view of the complex issues surrounding drugs and drug use. What surprised me the most was the effects of drugs such as Diazepam, Pregabalin, Codeine. They have different effects in a variety of cases.

[M. Ashraf · Rating 3 out of 5]

It is an O.K book not what I was expecting though, more one the illegal drugs than drugs in general.
Aspirin, Drug registration, company wars were informative.
The case for Cannabis though it is from 2001 we are seeing a turn now for legalization.
Good VSI.

[Anali · Rating 3 out of 5]

A truly concise introduction to the history, development and the future of Drugs. This book reminds me of why I never ventured into the field of biomedicine or pharmacology in the first place. The Chapter - "Drugs as Medicine" left me googling a lot of terms before I gave it up halfway.

[Rex Libris · Rating 5 out of 5]

This book lives up to its name: It is an introduction to drugs. The authors discusses the different types of drugs, how they were developed, how they are used (and abused), and to what effect. If you have a passing interest in pharmacology, this book is well worth a read.

[FrancescoInari · Rating 4 out of 5]

Remarkable, short but very exhaustive book on pharmacology from the theoretical aspect of research (and usage/effect of different drugs) to the economical incentives of the pharmaceutical industry, everything described in a pretty objective and nuanced way.

[Marcella · Rating 3 out of 5]

The book is too short for the number of subtopics it wanted to deal with. They should have avoided the legal drugs and focus on the illegal one or use a more comprehensive approach.

[Sara · Rating 3 out of 5]

It was interesting and informative, especially the chapter in which the process of drug registration was explained.

[tisasday · Rating 4 out of 5]

Written in a way that is easy to understand and with information that is very important to understand. The highly portable size is a underrated bonus.

[Bryndís · Rating 4 out of 5]

This is how every Very Short Introduction should be. It was interesting, relevant, logical, to-the-point, with useful examples.
Learned a little something.

[Shamma El-shafi · Rating 5 out of 5]

Surprisingly, it answered a lot of questions.

[Audrey Kalman]

interesting how quickly mindsets on various drugs have changed since this was published

[Laurian R · Rating 3 out of 5]

Pretty basic. Nothing I didn't know already. These are hit or miss. Could have sonmething useful in it, though.

[gala · Rating 3 out of 5]

limited breadth even for a very short introduction

[Barry · Rating 4 out of 5]

I found the book a bit dated but quite good in the history parts.

[David · Rating 5 out of 5]

Found it to be a good introduction to a very massive subject matter. Author did a good job. Good readability for a diverse and complex topic.

[Teo · Rating 4 out of 5]

2018.03.26–2018.03.27

A good intro as far as VSIs go (taking also some harm reduction perspective), though I wonder if the second edition from 2016 would have felt less dated with regard to some of the aspects discussed (e.g., the medicinal/therapeutic potential of many drugs historically famous mostly for their recreational use).

Contents

Iversen LL (2001) (04:41) Drugs, The - A Very Short Introduction

List of illustrations
• 01. Imhotep, Egyptian god of medicine
• 02. Title page of Nicholas Culpepper’s Pharmacopoeia 1653 edn.
• 03. Dr Paul Ehrlich
• 04. Lucky Strike ad
• 05. Mariani wine
• 06. An armoury of powerful medicines
• 07. Nicotine diagram
• 08. Diagram dose-response curve
• 09. How drugs affect biological processes
• 10. Aspirin cartoon
• 11. Chemical structures of drug molecules
• 12. Chemical transmission in the nervous system
• 13. Peripheral nervous system
• 14. Bacterium Staphylococcus aureus
• 15. Tobacco being harvested
• 16. Lung cancer from smoking cigarettes
• 17. Caffeine cartoon
• 18. Coffee advert 1660
• 19. Seizures of illegal drugs in the United Kingdom 1988–1998
• 20. Robot chemistry
• 21. The making of a new medicine
• 22. Spending on prescription drugs in the USA
• 23. Tuberculosis mortality rates dropped dramatically during the twentieth century

1. History
2. How drugs work
3. Drugs as medicines
4. Recreational drugs
5. Making new medicines
6. The twentieth century and beyond

References
Further reading
Index

[Kathleen O'Neal · Rating 5 out of 5]

An exemplary VSI on a very important topic that impacts all of our lives. Its non-sensationalistic treatment of its topic is definitely worth anyone's time.