Disorders of taste and smell are common occurrences that can lead to modifications of dietary habits that may in turn exacerbate disease states or nutritional deficiencies. In addition, they are often nagging problems that diminish the quality of life. Such disorders can result from a range of disease states, pharmacologic and surgical intervention, aging, radiation, and environmental exposure. A search for the pathogenetic mechanism should include the determination of possible (1) local injury from physical or chemical causes, (2) damage to neural projections, (3) disturbance of the cycle of regeneration of chemoreceptors resulting from general malnutrition, disease agents, metabolic disturbances, drugs, or radiation, and (4) alteration in the saliva or fluids bathing the olfactory mucosa by drugs or metabolic agents. Viral infections, normal aging, head injuries, and nasal obstructions are the most common causes of smell disorders. Drugs are common offenders in taste dysfunction. Chemosensory disorders frequently remit when concomitant medical conditions are treated or offending drugs removed, although full recovery may take several months. Considerable research is now under way in this area, and it is to be hoped that we will soon have a better understanding of how to diagnose and treat these common disorders.

The current widespread nontherapeutic use of psychoactive drugs began among a small group of college students in the early 1960s. It spread with explosive force into an epidemic of extraordinary scope involving all regions of the country, all socioeconomic classes, and all age groups. This article reviews the drugs currently used and identifies those who use them. It discusses the complex, rapidly changing patterns of use and the consequences of this epidemic for both the individual and the society. The inhalants, phencyclidine, cocaine, heroin, the psychotherapeutics (methaqualone and amphetamine), and marijuana are the most widely used drugs. Recent clinical and laboratory research indicates that these drugs pose serious hazards to physical and mental health. Marijuana is the most widely used illicit drug; one quarter of the entire U.S. population have used the drug, and 20 million people use it daily. The short-term and long-term adverse effects of marijuana have important social implications. Recent data suggest that drug users possess limited inner resources to cope with psychological stress and that they take drugs to fill a moral and spiritual void and to meet intense emotional needs. It is proposed that these character traits and emotional conflicts of drug users may reflect recent changes in child rearing and family stability.