British Journal of Addiction (1992) 87, 937-942
Letters to the Editor
The editor welcomes all letters whether they are short case reports, preliminary reports of research, discussion or comments on papers published in the journal. Authors should follow the same guidelines given for the preparation and submission of articles on the inside back cover of each issue.
Abuse of neuroleptic drugs? SIR—A recent letter in the BJA^ suggests that neuroleptic drugs have abuse potential. It appears that the term abuse is being used very loosely here' and does not conform to the definition of drug abuse as given in the DSM-III-R,^ or by the World Health Organization.' The WHO' definition of abuse indicates that inappropriate use of drugs as described in this letter,' i.e. overuse, should be regarded more correctly as misuse rather than abuse. Furthermore, the DSM-III-R gives a new specific category into which the side effects described here' would be better placed, viz. substance-induced organic mental disorder.^ Unfortunately, this distinction is not just an academic exercise since this loose usage of the term abuse could become accepted in both professional and public circles leading to the false belief that major tranquillizers are addictive, with resultant decrease in compliance and useage of these valuable agents. MARK A. GILLMAN & FREDERICK J. LICHTIGFELD
South African Brain Research Institute, 6 Campbell Street, Waverley 2090, Johannesburg, South Africa.
References 1.
BUCKLEY, P., CANNON, M . & LARKIN, C . (1991)
Abuse of neuroleptic drugs, British Journal of Addiction, 86, pp. 789-790.
2.
AMERICAN PSYCHIATRY ASSOCIATION (1987) Diag-
3.
nostic and Statistical Manual of Mental Disorders, 3rd edn, revised (DSM-III-R) (Washington, DC, American Psychiatry Association). MARKS, J. (1988) Psychoactive drugs: the present
4.
tive Drugs: improving prescribing practices, pp. 8-21 (Geneva, World Health Organization). PERRY, S. (1987) Substance-induced organic mental
situation, in: GHODSE, H . & KHAN, I. (Eds) Psychoac-
disorders, in: HALES, R. E . & YUDOFSKY, S. C . (Eds),
pp. 157-176 (Washington, American Psychiatric Press).
Is alcohol a carcinogenic risk? SIR—I read with interest the commentary by Turner & Anderson' in the BJA on the above subject. Because, for centuries, alcohol has been a sociallyaccepted beverage, our society has tended to ignore or minimize the body of evidence that indicates its deleterious effects. Often, the virtues of low and moderate level of drinking have been extolled. It is important that these issues are clarified and Turner and Anderson have adequately commented on the epidemiological aspects of alcohol-related carcinogenesis and exposed the fallacy of arguments in Drinking to Your Health.^ Alcohol use may be associated with decreased incidence of prostate cancer just as tobacco use is associated with lowered incidence of endometrial cancer (for example, see Ref. 3) but, as Turner and Anderson rightly point out, no sensible person would advocate drinking to protect against prostate cancer or smoking to prevent endometrial cancer. Such issues have to be looked into more carefully than a superficial observation of a certain control population that, for
937
Letters to the Editor
The editor welcomes all letters whether they are short case reports, preliminary reports of research, discussion or comments on papers published in the journal. Authors should follow the same guidelines given for the preparation and submission of articles on the inside back cover of each issue.
Abuse of neuroleptic drugs? SIR—A recent letter in the BJA^ suggests that neuroleptic drugs have abuse potential. It appears that the term abuse is being used very loosely here' and does not conform to the definition of drug abuse as given in the DSM-III-R,^ or by the World Health Organization.' The WHO' definition of abuse indicates that inappropriate use of drugs as described in this letter,' i.e. overuse, should be regarded more correctly as misuse rather than abuse. Furthermore, the DSM-III-R gives a new specific category into which the side effects described here' would be better placed, viz. substance-induced organic mental disorder.^ Unfortunately, this distinction is not just an academic exercise since this loose usage of the term abuse could become accepted in both professional and public circles leading to the false belief that major tranquillizers are addictive, with resultant decrease in compliance and useage of these valuable agents. MARK A. GILLMAN & FREDERICK J. LICHTIGFELD
South African Brain Research Institute, 6 Campbell Street, Waverley 2090, Johannesburg, South Africa.
References 1.
BUCKLEY, P., CANNON, M . & LARKIN, C . (1991)
Abuse of neuroleptic drugs, British Journal of Addiction, 86, pp. 789-790.
2.
AMERICAN PSYCHIATRY ASSOCIATION (1987) Diag-
3.
nostic and Statistical Manual of Mental Disorders, 3rd edn, revised (DSM-III-R) (Washington, DC, American Psychiatry Association). MARKS, J. (1988) Psychoactive drugs: the present
4.
tive Drugs: improving prescribing practices, pp. 8-21 (Geneva, World Health Organization). PERRY, S. (1987) Substance-induced organic mental
situation, in: GHODSE, H . & KHAN, I. (Eds) Psychoac-
disorders, in: HALES, R. E . & YUDOFSKY, S. C . (Eds),
pp. 157-176 (Washington, American Psychiatric Press).
Is alcohol a carcinogenic risk? SIR—I read with interest the commentary by Turner & Anderson' in the BJA on the above subject. Because, for centuries, alcohol has been a sociallyaccepted beverage, our society has tended to ignore or minimize the body of evidence that indicates its deleterious effects. Often, the virtues of low and moderate level of drinking have been extolled. It is important that these issues are clarified and Turner and Anderson have adequately commented on the epidemiological aspects of alcohol-related carcinogenesis and exposed the fallacy of arguments in Drinking to Your Health.^ Alcohol use may be associated with decreased incidence of prostate cancer just as tobacco use is associated with lowered incidence of endometrial cancer (for example, see Ref. 3) but, as Turner and Anderson rightly point out, no sensible person would advocate drinking to protect against prostate cancer or smoking to prevent endometrial cancer. Such issues have to be looked into more carefully than a superficial observation of a certain control population that, for
937
