Army Researchers Gave Soldiers Drugs, Book Says
Army researchers studying chemical weapons administered a variety of illicit drugs to volunteer soldiers over nearly a 20-year period, according to a new book.
Abstinence and moderate use goals in the treatment of marijuana dependence
Marijuana users approaching and abstinence-orientated treatment varied in the extent to which they were actively seeking abstinence as the outcome.
Journal of Personality Volume 75, Issue 3, Page 451-478, Jun 2007.
ABSTRACT The aim of the present study was to test potential models of smoking-related changes in mood and how these are moderated by personality (behavioral activation and inhibition systems). Three models yielding distinct predictions regarding mood cha...
When parents use drugs: key findings from qualitative research on parenting and children in Iran
Child & Family Social Work Volume 12, Issue 2, Page 113-122, May 2007.
ABSTRACT This paper reports on the finding of a grounded theory study on drug dependency and parenting in Iran. This study is qualitative in nature; data were obtained through semi-structured interviews. The grounded theory method was used to guide the an...
Introduction to Addictive Behaviours
Addiction Volume 102, Issue 5, Page 831-831, May 2007.
Background: Individual and sociocultural factors may pose significant barriers for drug abusers seeking treatment, particularly for African-American crack cocaine abusers. However, there is evidence that pretreatment interventions may reduce treatment initiation barriers. This study examined the effects of a pretreatment intervention designed to enhance treatment motivation, decrease crack use, and prepare crack abusers for treatment entry. Methods: Using street outreach, 443 African-American crack users were recruited in North Carolina and randomly assigned to either the pretreatment intervention or control group. Results: At 3-month follow-up, both groups significantly reduced their crack use but the intervention group participants were more likely to have initiated treatment. Conclusion: The intervention helped motivate change but structural barriers to treatment remained keeping actual admissions low. Policy makers may be interested in these pretreatment sites as an alternative to treatment for short term outcomes.
Drugs and Poverty – a literature review
Literature review compiled by the Scottish Drugs Forum on the relationship between drug use and poverty. Keywords: poverty, social class, deprivation, deprived communities.
Too frightened to care? Accounts by district nurses working with clients who misuse substances
Health & Social Care in the Community Volume 15, Issue 3, Page 238-245, May 2007.
Abstract Drug misusers have complex health and social care needs, and experience considerable difficulties in accessing the assessment, care and treatment that they require. Despite the development of specialist services in many parts of the UK, substance...
Impact of welfare cheque issue days on a service for those intoxicated in public
In British Columbia (BC), the Ministry of Human Resources issues welfare cheques to eligible recipients monthly on the last Wednesday of each month. Previous studies have indicated that there are significant increases in hospital admission, ED admission, 911 calls and deaths shortly after the distribution of the monthly welfare cheques. The objective of this analysis was to rigorously examine the impact of welfare cheque issue dates on admission to the Sobering Unit (SU), a service for the publicly intoxicated, in Vancouver, Canada. Data on 1234 consecutive admissions to the SU over a 7-month period were assessed, and the average number of daily admissions on each of the 7 days of the welfare cheque issue week and similar weekdays in other weeks were compared. A Wilcoxon rank-sum test was performed for the comparisons. Our results showed that there were significant increases in the number of admissions on the 3 days starting with Welfare Wednesday compared to the similar weekdays in other weeks (Welfare Wednesday vs. other Wednesdays: 8.7 vs. 5.1, p =0.02; Welfare Thursdays vs. other Thursdays: 9.6 vs. 5.3, p =0.02; Welfare Fridays vs. other Fridays: 8.6 vs. 5.7, p =0.04). The demonstrated impact of welfare cheque issue dates is an important consideration for the re-design, staffing and resource allocation of services for withdrawal management and potentially for other services offered to this population.
The relationship between alcohol misuse and the drinks industry sponsorship of sporting activities
Irish Gov't report on alcohol and sports sponsorship. Keywords: Ireland, Eire, alcohol, sport.
Achieving a high coverage – the challenge of controlling HIV spread in heroin users
In China, the national plan to open 1000 methadone clinics over a five-year period provides a unique opportunity to assess the impacts of harm reduction in a country with concentrated HIV epidemic amongst heroin users. To track the progress of this public health response, data were collected from the first methadone clinic in Liuzhou, Guangxi, a province with a high HIV prevalence. In the first 15 months of its operation, a cumulative total of 488 heroin users, 86% of which male, had joined the programme. The first dose of methadone was given efficiently at a median of 2 days after registration. Of the 240 heroin users attending the clinic in August 2006, 61% took methadone for four days or more each week. The number of active methadone users, however, leveled off at around 170 after the first two months, despite the availability of capacity to deliver more services. The reasons for this observation are: firstly, the provision of one single service that may not be convenient to all heroin users; and secondly, concerns of heroin users who may feel insecure to come forward. As broad coverage is essential in ultimately reducing HIV risk, a low threshold approach is crucial, which should be supported by the removal of social obstacles and a refinement of the administrative procedures.
The results of this study support the efficacy of naltrexone in the relapse prevention of alcoholism amongst those with low levels of clinical depression and alcohol dependence severity. No effect of acamprosate was found.
Drug user involvement in treatment decisions
Joseph Rowntree Foundation report offering guidance on implementing inclusion initiatives in drug treatment. Keywords: inclusion, client involvement, service users.
Background: In this paper, we show how counselors and psychologists can use emails for online management of substance abusers, including the anatomy and content of emails that clinicians should send substance abusers. Some investigators have attempted to determine if providing mental health services online is an efficacious delivery of treatment. The question of efficacy is an empirical issue that cannot be settled unless we are explicitly clear about the content and nature of online treatment. We believe that it is not the communications via internet that matters, but the content of these communications. The purpose of this paper is to provide the content of our online counseling services so others can duplicate the work and investigate its efficacy. Results: We have managed nearly 300 clients online for recovery from substance abuse. Treatment included individual counseling (motivational interviewing, cognitive-behavior therapy, relapse prevention assignments), participation in an electronic support group and the development of a recovery team. Our findings of success with these interventions are reported elsewhere. Our experience has led to development of a protocol of care that is described more fully in this paper. This protocol is based on stages of change and relapse prevention theories and follows a Motivational Interviewing method of counseling. Conclusion: The use of electronic media in providing mental health treatment remains controversial due to concerns about confidentiality, security and legal considerations. More research is needed to validate and generalize the use of online treatment for mental health problems. If researchers have to build on each others work, it is paramount that we share our protocols of care, as we have done in this paper.
Treating posttraumatic stress in motor vehicle accident survivors
Eric Kuhn, PhD; Edward J. Hickling, PsyD
Drama-based education to motivate participation in substance abuse prevention
Background: The substance abuse prevention goal of the theatre production "TUNNELS" was to provide community education on substance abuse to an audience in Durham, NC and surrounding communities. The education effort intended to increase awareness and understanding of the risk and protective factors associated with alcohol and other drug use, and to promote pro-active behaviors in substance abuse prevention within the adult community. It was hypothesized that community-based education via drama would change attitudes toward alcohol and substance abuse, and increase participation in family and community activities aimed at substance abuse prevention. Methods: A focus group comprised of educators, substance abuse researchers and local substance abuse counselors developed "life stories" of users of alcohol and other drugs and a local playwright incorporated these and other experiences into a series of six vignettes. The production was publicized throughout the Durham area, and 700 adults attending the play signed a consent form and completed the pre-play survey. The participant pool was restricted to those adults who completed both the time-1 and time-2 surveys and resided within Durham and surrounding communities. Paired comparisons of mean responses were analyzed using a paired sample two-tailed t-test. A telephone survey three months after the play assessed attitudes toward substance abuse as a disease, and whether the respondents had increased their participation in prevention activities including discussions of the play with others. Results: Viewing the play increased the knowledge base of participants regarding substance abuse as a disease, even though the audience demonstrated an appreciation of risk and protective factors prior to attending the performance. In the pre-play survey, participants indicated a strong opinion that parental involvement in teen life was important, and therefore this was not increased as a result of viewing the play. It was found that the drama increased intent to participate in substance abuse prevention activities at home and in the community. Follow-up surveys performed three months after the performance indicated that participants had discussed the play with others and had increased their participation in substance abuse prevention activities, particularly regarding donations of money. Conclusion: Drama incorporates a component of emotional response to the informational content, and the combination of emotion and information works together to promote individual intentions to become more involved in family and community prevention activities. This study demonstrates the efficacy of drama as a mechanism to educate and motivate. Support for this mechanism is warranted at the level of state, local community, school district, and faith-based and community organizations.
Use of crystal methamphetamine among gay men in London
Among gay men in London surveyed in clinics, approximately one in ten reported using crystal methamphetamine in the preivous 12 months. Most men used it infrequently. There is no evidence of increasing use of crystal meth between 2003 and 2005.
These findings suggest that motivational interviewing may not work equally well for all types of psychotic disordered dually diagnosed patients.
Aims: To investigate the influence of product packaging of ready to drink (RTD), or pre-mixed drinks, and other alcoholic and non-alcoholic beverages on the palatability ratings of adolescents and adults. Respondents were interviewed at their own schools or a campus of the University of NSW. The experiment tested palatability ratings in blind and non-blind conditions with a selection of 12- to 30-year-old Australians (140 adolescents and 210 adults) from seven private schools across NSW and students from the University of NSW and Macquarie University. Methods: Beverage palatability was measured utilizing an interval ratio scale from 1 to 7 before and after packaging was presented. Views on whether the beverage packaging was designed to appeal to the participant were also analysed. Results: In general, the alcoholic beverage packaging was thought to be designed to appeal more to adults and palatability ratings significantly increased in the non-blind conditions. In contrast, the Bacardi Breezer packaging was especially palatable to younger participants. Conclusions: Although most alcoholic beverage packaging was not of particular appeal to adolescents, some RTD beverages may be appealing more to adolescents. Unlike other alcoholic products, the difference in palatability ratings for the Bacardi Breezer, from blind to non-blind conditions, was greater for younger participants.
Aim: This paper describes adolescents' exposure to alcohol advertising in stores and to alcohol-branded promotional items and their association with self-reported drinking. Methods: A cross-sectional survey was administered in non-tracked required courses to sixth, seventh, and eighth graders (n = 2125) in three California middle schools. Logistic regressions compared the odds of ever (vs. never) drinking and current (vs. ever) drinking after controlling for psychosocial and other risk factors for adolescent alcohol use. Results: Two-thirds of middle school students reported at least weekly visits to liquor, convenience, or small grocery stores where alcohol advertising is widespread. Such exposure was associated with higher odds of ever drinking, but was not associated with current drinking. One-fifth of students reported owning at least one alcohol promotional item. These students were three times more likely to have ever tried drinking and 1.5 times more likely to report current drinking than students without such items. Conclusions: This study provides clear evidence of an association of adolescent drinking with weekly exposure to alcohol advertising in stores and with ownership of alcohol promotional items. Given their potential influence on adolescent drinking behaviour, retail ads, and promotional items for alcohol deserve further study.
Warning About Abuse of Benzylpiperazine
Benzylpiperazine, a chemical cousin of ecstasy, could emerge as a new drug of abuse, according to a leading toxicologist.
Impact of parental history of substance use disorders on the clinical course of anxiety disorders
Background: Among the psychological difficulties seen in children of parents with substance use problems, the anxiety disorders are among the most chronic conditions. Although children of alcoholic parents often struggle with the effects of parental substance use problems long into adulthood, empirical investigations of the influence of parental substance use disorders on the course of anxiety disorders in adult offspring are rare. The purpose of this study was to examine prospectively the relationship between parental substance use disorders and the course of anxiety disorders in adulthood over the course of 12 years. Methods: Data on 618 subjects were derived from the Harvard/Brown Anxiety Research Project (HARP), a longitudinal naturalistic investigation of the clinical course of multiple anxiety disorders. Kaplan-Meier survival estimates were used to calculate probabilities of time to anxiety disorder remission and relapse. Proportional hazards regressions were conducted to determine whether the likelihood of remission and relapse for specific anxiety disorders was lower for those who had a history of parental substance use disorders than for individuals without this parental history. Results: Adults with a history of parental substance use disorders were significantly more likely to be divorced and to have a high school level of education. History of parental substance use disorder was a significant predictor of relapse of social phobia and panic disorders. Conclusions: These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients level of vulnerability to perceive scrutiny by others in social situations, and ability to maintain a long-term panic-free state.
Professional Perspectives On Addiction Medicine
Comprehensive handbook on methadone maintenance treatment for opioid addiction. Keywords: methadone, maintenance, substitute prescribing.
The psychological science of addiction
Addiction Volume 0, Issue 0, Page ???-???.
ABSTRACT Aim To discuss the contributions and future course of the psychological science of addiction. Background The psychology of addiction includes a tremendous range of scientific activity, from the basic experimental laboratory through increasingly...
Treatment For Homeless Youth Pays Off In Long Run, Study Finds
One of the few studies examining methods to help homeless youth found that a comprehensive intervention program can indeed dramatically improve their life situation.The six-month study of homeless youth in Albuquerque found that teens who completed the program significantly reduced their substance abuse and depression and increased their social stability, including the number of days living off the streets, compared to those who received standard treatment. [click link for full article]
Alcoholism: Clinical and Experimental Research Volume 0, Issue 0, Page ???-???.
Background: An exaggerated heart rate (HR) increase following alcohol intoxication has been suggested to reflect sensitivity to alcohol-induced reward. The goal of this study is to verify whether pairing alcohol ingestion with conditioned reward and nonr...
Women And Recovery From Alcoholism
PhD candidate Ms Janice Withnall, from the UWS School of Education, is carrying out the project in a bid to better understand the experiences of women who have successfully stopped drinking.National statistics show that alcohol-related illness hospitalises 95,000 Australians a year. Of that group, 7 per cent are women who are alcohol dependent. [click link for full article]
Aberlour Trust report examining the situation of chilkdren in families where there is alcohol or drugs misuse. Keywords: drug-using parents, children, young people, family.
The Howard Journal of Criminal Justice Volume 46, Issue 1, Page 1-15, Feb 2007.
Abstract: The release to the community of a sexual offender is frequently accompanied by intense coverage in the news media. Too often, the type of coverage these releases receive serves only to force many offenders into hiding or out of one community an...
EARLY DRINKING AND THE DEVELOPMENT OF ALCOHOLISM: A COMMENTARY ON SARTOR ET AL. (2007)
Addiction Volume 102, Issue 2, Page 188-189, Feb 2007.
Stress-Induced and Alcohol Cue-Induced Craving in Recently Abstinent Alcohol-Dependent Individuals
Alcoholism: Clinical and Experimental Research Volume 0, Issue 0, Page ???-???.
Background: Research has shown that exposure to stress/negative affect and to alcohol cues can each increase alcohol craving and relapse susceptibility in alcohol-dependent individuals. However, whether the emotional and physiological states associated w...
Social Gradients In Binge Drinking And Abstaining In British Women
British women's binge drinking is clearly defined by their age and education, suggests a large, long term study in the Journal of Epidemiology and Community Health.Educated women binge drink in their 20s, but curb their habits by their 40s. But the reverse is true of women with little education, whose binge drinking is more likely to take off in their 40s, shows the research. [click link for full article]
Gambling Treatment MUST Be Available On The NHS, Say Doctors
In its hard-hitting report, Gambling addiction and its treatment within the NHS, released recently, the BMA is calling for gambling to be a recognised addiction that requires treatment on the NHS.This recommendation is part of a tough set of proposals aimed at helping healthcare professionals deal effectively with the growing problem of gambling addiction in the UK. The report is timely given the 2005 Gambling Act is due to come into force this September. [click link for full article]
Liver transplant and hepatitis C in methadone maintenance therapy: a case report
Methadone maintenance therapy for the treatment of opioid dependence continues to carry a social stigma. Until recently, patients on methadone were not considered for liver transplantation. We describe the first case of a patient on methadone who received a liver transplant for end stage liver disease and was successfully treated for recurrent hepatitis C. More than five years post transplant and three years post viral clearance, the patient continues to do well and is stable on low-dose methadone. This case emphasizes the need to reconsider the non-evidence based policy adopted by transplant centers that require methadone maintenance therapy patients to stop methadone prior to consideration for transplant evaluation.
An Introduction to Family Therapy: Systemic Theory and Practice by Rudi Dallos and Ros Draper
Journal of Family Therapy Volume 29, Issue 1, Page 91-92, Feb 2007.
Risk-taking and the adolescent brain: who is at risk?
Developmental Science Volume 10, Issue 2, Page F8-F14, Mar 2007.
Abstract Relative to other ages, adolescence is described as a period of increased impulsive and risk-taking behavior that can lead to fatal outcomes (suicide, substance abuse, HIV, accidents, etc.). This study was designed to examine neural correlates of...
Methadone-exposed newborn infants: outcome after alterations to a service for mothers and infants
Child: Care, Health and Development Volume 33, Issue 2, Page 206-212, Mar 2007.
Abstract Objective To evaluate the impact of a shared care approach in clinical management with a drug liaison midwife (DLM) service for mothers and infants established in 1995–1996 in an inner city area and to address the problem of congenital abnormali...
Detoxification study which compared the short-time efficacy of a standardised regimen comprising 6 days Buprenorphine and 10 days Valproate to a control group who took a 10-day traditional Clonidine/Carbamazepine regimen.
Heavy Drinking Takes Excessive Toll On Women With Hepatitis C
Women tend to survive longer than men if infected with the liver-destroying hepatitis C virus (HCV) -- but if they drink heavily, that survival advantage completely disappears, according to a new study."Previous studies indicated that alcohol use is a risk factor for HCV disease progression, but they seldom examined the effect on women and men separately," said lead author Chiung Chen. "Even fewer studies were able to examine the effect of alcohol on HCV mortality. [click link for full article]
Toward a New Recovery Movement
William White's history of addiction treatment. Keywords: history, alcoholism, treatment, theory.
Patient Level Opioid Risk Management
Technical guide to the use of opioids in the management of pain. Keywords: opioids, pain, clinical management.
Safer Management of Controlled Drugs
Department of Health (UK) advice on control and security for controlled drugs. Keywords: pharmacists, chemists, storage, management, controlled drugs.
Drinking: adults’ behaviour and knowledge in 2006
A report on research using the ONS Omnibus Survey produced by the Office for National Statistics on behalf of the Information Centre for Health and Social Care. Keywords: drinking patterns, consumption, alcohol misuse, prevention, education.
Naltrexone Implants Don't Eliminate Overdose Risk
Implants that deliver time-released doses of the anti-addiction medication naltrexone have been touted for preventing drug overdoses, but Australian researchers have found at least five fatal overdoses among implant patients.
Methadone in pregnancy: treatment retention and neonatal outcomes
Addiction Volume 102, Issue 2, Page 264-270, Feb 2007.
ABSTRACT Aim To examine the association between retention in methadone treatment during pregnancy and key neonatal outcomes. Design Client data from the New South Wales Pharmaceutical Drugs of Addiction System was linked to birth information from the NS...
Background: Individuals with substance use disorders (SUDs) are at increased risk for hepatitis C viral infection (HCV), and few studies have explored their treatment responses empirically. The objective of this study was to assess interferon alpha therapy (IFN) completion and response rates among patients with HCV who had a history of comorbid SUDs. More data is needed to inform treatment strategies and guidelines for these patients. Using a medical record database, information was retrospectively collected on 307,437 veterans seen in the Veterans Integrated Service Network 20 (VISN 20) of the Veterans Healthcare Administration (VHA) between 1998 and 2003. For patients treated with any type of IFN (including regular or pegylated IFN) or combination therapy (IFN and ribavirin) who had a known HCV genotype, IFN completion and response rates were compared among patients with a history of SUD (SUD+ Group) and patients without a history of SUD (SUD- Group). Results: Odds ratio analyses revealed that compared with the SUD- Group, the SUD+ Group was equally likely to complete IFN therapy if they had genotypes 2 and 3 (73.1% vs. 68.0%), and if they had genotypes 1 and 4 (39.5% vs. 39.9%). Within the sample of all patients who began IFN therapy, the SUD- and SUD+ groups were similarly likely to achieve an end of treatment response (genotypes 2 and 3, 52.8% vs. 54.3%; genotypes 1 and 4, 24.5% vs. 24.8%) and a sustained viral response (genotypes 2 and 3, 42.6% vs. 41.1%; genotypes 1 and 4: 16.0% vs. 22.3%). Conclusions: Individuals with and without a history of SUD responded to antiviral therapy for HCV at similar rates. Collectively, these findings suggest that patients who have co-morbid SUD and HCV diagnoses can successfully complete a course of antiviral therapy.
Playing SOCA with drug policy?
Background: Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. Methods: During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention) and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP) in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. Results: There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a) political climate surrounding naloxone distribution; b) extant prescription drug laws; c) initial low levels of recruitment into the program; d) development of participant appropriate training methodology; e) challenges in the design of a suitable formal evaluation; and f) evolution of program response to naloxone. Conclusions: Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in program planning and implementation, developing evaluation instruments for feasibility and simplicity, and responding to and incorporating feedback from participants.
Excessive Drinking, Not Alcoholism, May Lead To Most Alcohol-Related Problems
* Many people assume that most people who drink to excess are probably alcoholics. * A recent survey of 4,761 New Mexico adults found that while 16.5 percent drank alcohol in excess of national guidelines, only 1.8 percent met criteria for alcohol dependence. * This suggests that a majority of persons at risk for alcohol-related problems are not alcohol dependent. [click link for full article]
'Moral panic' threat to children of drug addicts
HUNDREDS of children whose parents are drug addicts face the risk of being taken into care because of a "moral panic" over the issue, Scotland's drug and alcohol tsar has warned.
What five cigarettes a day does to your arteries
A new scan at the University College London is showing the damage that a five-a-day cigarette habit can do to an otherwise healthy person's arteries. Here KATHRYN KNIGHT tries it out