From the mid-1980s there has been a progressive movement in the management of drug misuse from specialist treatment alone towards therapy in the community by a variety of care-givers. The latter centres on the general medical practitioner, albeit often in conjunction with the specialist. The transfer stemmed from two disparate factors: HIV infection and financial constraints. The present volume meets a need to update primary care practitioners about techniques within their reach that develop their comprehension, accessibility, assessment and treatment of drug misusers.

The text also contains information to broaden the perspective of psychiatrists. The chapters on psychiatric and other medical disorders as well as the descriptions of the social difficulties that underlie, accentuate or result from drug misuse are especially to be commended.

Bad luck attended the timing of the publication. Guidelines for the management of drug misuse have since been provided by the Department of Health, together with proposals for tighter restrictions in the UK on the prescribing of substitute methadone by general practitioners. The book would benefit from pruning of frequent repetitions between the authors of separate chapters and by abridgement of outdated and unrealistic attacks on drug laws.

Despite some shortcomings the editor and his international contributors provide a balanced narrative for those working in general psychiatry as well as for the main readership in primary care. There are useful accounts of interactive services between general practitioners and specialists, but the text repeatedly warns that some treatments (for example, relapse prevention and injectable drugs) are beyond its scope. The volume offers a convenient introduction for the novice trainee in substance misuse. Further information is required to gain sufficient knowledge for unsupervised practice in the speciality. This is a book for the general psychiatric library, rather than more specialised bookcases.