This publication by Springer provides readers with a valuable textbook concerning the clinical management of the addicted patient in the perioperative period. The focus of the information presented is on the physiological and pharmacological challenges of these patients and how these difficulties are best managed. The text is centred predominantly on acute perioperative care and does not explore other management issues commonly encountered in addiction medicine, such as cognitive behavioural or psychiatric therapies. The contributing authors are predominantly physicians practicing anesthesiology.

The book is divided into three parts. Part I provides readers with a general background on the disease of addiction. The text ranges from historical accounts of the introduction of drugs to ancient civilizations to descriptions of contemporary functional magnetic resonance imaging and genetic studies of the addicted brain. The final chapter in Part 1 is on pharmacological approaches to the treatment of addiction with a focus on the use of methadone and buprenorphine. This chapter presents a clear and understandable discussion for those not accustomed to the use of these drugs. Issues surrounding the perioperative administration of these drugs are also addressed and suitably explored for perioperative care providers.

Part II of the book offers readers an overview of specific drug classes of abuse, including chapters on opioids, club drugs, cocaine, and alcohol. The text is well written with a focus on the pertinent pharmacological and physiological issues of each drug in the perioperative environment. The discussions, which are divided into the preoperative, intraoperative, and postoperative phases of surgery, are written in a clear, concise, and comprehensive manner. The chapter on propofol addiction is especially significant and likely the most comprehensive summary of the subject matter to date.

Although Part II is well written, it falls somewhat short in that some drug classes are conspicuously absent or the detail may be less comprehensive than desired. For example, no mention is made of the barbiturates or anabolic steroids. Both categories of drugs can produce profound pharmacological and physiological challenges in perioperative care that would have been valuable to discuss.

The focus of Part III, the final section of the book, is on discussions of specific populations in the context of addiction. Some of these chapters include drug-seeking healthcare professionals, pregnant women, adolescent populations, or individuals recovering from substance abuse. Fundamental principles on managing these populations are summarized in this section, and it makes a suitable resource for the perioperative clinician. The chapters are varied in their content in terms of the amount and type of clinical information provided. For example, the chapter on the drug-seeking healthcare professional discusses many social issues (legal, financial, family, and intervention), while the chapter on the patient recovering from substance abuse has a more pharmacological focus with discussions regarding adjunctive anesthetic agents and drug-drug interactions.

Overall, this is a praiseworthy textbook that provides a thorough overview of perioperative addiction. The diverse information provided can serve as an authoritative reference on this subject. In addition, the organization of information into preoperative, intraoperative, and postoperative phases can function as a valuable bedside guide on how best to care for this challenging patient population.