bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative and positive expectancies in lone and group problem drinkers
Authors: JONES BARRY T. , McMAHON JOHN
Published: January 2006

In this experiment we show that measuring positive expectancy of alcohol use does not discriminate between lone and group problem drinkers whereas measuring negative expectancy does. Reliably, lower measures in group drinkers is consistent with; (i) our view that negative expectancy provides the motivation for problem drinkers to quit and that anything which inhibits the translation of negative experience into negative expectancy will correspondingly inhibit motivation; and with (ii) the observations of others that social (or group) support can, indeed, often inhibit recovery.
Ideology, history and changing models of liver cirrhosis epidemiology
Authors: HERD DEMISE
Published: January 2006

This analysis describes changes in assumptions about beverage alcohol use as a major cause of liver cirrhosis since the turn of the century. The findings reveal that social and political views shaped by the temperance movement, Repeal era and modern alcoholism movement have had a profound impact on medical and public health interpretations of the role of alcohol use in liver disease. Current clinical and epidemiological approaches that stress the importance of alcohol as a direct etiological agent for liver cirrhosis were popular during the 19th century in the wake of the temperance and prohibition movements, but were greatly modified to attribute a secondary role to alcohol use as a cause of cirrhosis during the Repeal and post‐World War II eras. The changes during the Repeal and post‐World War II eras coincided with the expansion of alcohol consumption and the liberalization of drinking norms in US society. As a result, the role of alcohol in causing cirrhosis among the general population was minimized and the disease was attributed to industrial toxins and air pollution. Contemporary research has affirmed the importance of beverage alcohol as a causal agent of liver cirrhosis using both clinical and epidemiological studies.
Managing service change in post HIV drugs services–a case study from Inner London
Authors: CRANFIELD S. , FEINMANN C. , FERLIE E. , WALTER C.
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.

The advent of HIV/AIDS has presented a major ideological challenge to established drug treatment agencies, where the incorporation of HIV‐prevention strategies has proved problematic. This case study analyses the response to the HIV/AIDS epidemic by the drug misuse services of one Inner London district health authority (Bloomsbury) during the period 1985–89. While innovation and enthusiasm were much in evidence, a number of special problems prevented an effective and coherent strategic response. Key factors in the management of change in drugs/HIV services are identified which may be of special importance to clinicians, managers and funders and a number of key organizational and managerial competencies are suggested.
Classical conditioning and cognitive determinants of subjective craving for opiates: an investigation of their relative contributions
Authors: POWELL JANE , BRADLEY BRENDAN , GRAY JEFFREY
Published: January 2006

Subjective craving for drugs is frequently reported by detoxified addicts. Explanatory models emphasizing classical conditioning (CC) and cognitive mechanisms have been proposed, and the mechanisms postulated by the two approaches are discussed here. There are three major variants of the CC model, arguing that craving is associated with conditioned changes which are respectively drug‐agonistic, opponent‐process, or withdrawal reactions. The cognitive model highlights the role of ‘outcome expectancies’ as determinants of both appetitive and avoidant motivations. The present investigation has identified correlates of craving predicted by the above models, and tested them empirically. Detoxified opiate addicts participated in a Craving Test requiring them to rate their craving, physical state, and emotions during exposure to both neutral and drug‐related material. Other measures, including personality and outcome expectancies for drug use, were also taken, and interrelationships among the variables were explored statistically. Whilst some of the predictions of the CC formulations were borne out, the cognitive model received more consistent support. The theoretical and treatment implications of these data are considered.
Smoking habits in relapsed subjects from a smoking cessation trial after one year
Authors: NØRREGAARD JESPER , TØNNESEN PHILIP , SIMONSEN KÅRE , PETERSEN LARS , SÄWE URBAIN
Published: January 2006

Reports of smoking cessation studies often claim that many relapsed subjects reduce their smoking. We investigated the smoking habits of relapsers 1 year after quitting in a smoking cessation trial using nicotine or placebo patches. All 289 participants in that study were summoned to a 1‐year follow‐up visit–148 (57%) of 259 relapsers attended, as did all 30 sustained abstainers. Fewer than 1% of the subjects had quit spontaneously after the primary relapse. Daily cigarette consumption, standard nicotine yield per cigarette, saliva cotinine concentration, expired carbon monoxide level and two nicotine dependency scales were assessed at entry and at the 1‐year follow‐up. In five of these six smoking‐related characteristics, there was a small but significant mean reduction of 7%‐27%. A significant weight gain of 0.5 ± 2.9 kg (mean ± SD) was recorded in the relapsers compared with 4.8 ± 4.2 kg for abstainers (p < 0.001). It is concluded that smoking habits in relapsers are relatively unchanged, and thus the most important outcome measure in smoking cessation trials is abstinent subjects.
HIV risk of transmission behaviour amongst HIV‐infected prisoners and its correlates
Authors: O'MAHONY PAUL , BARRY MYRA
Published: January 2006

Thirty‐eight from a total of 42 known HIV‐positive prisoners in the Irish prison system voluntarily cooperated in a survey of psychological attitudes, knowledge of risk behaviour, intentions with respect to future risk behaviour, and actual past risk behaviour Of this group, 65% reported that they had put others at risk of HIV, since they became aware of their own HIV + status. Only 16% stated that they would definitely not share their drug‐taking equipment in the future and 32% that they would always use a condom in sexual intercourse. In general, psychological and biographical variables were not strongly related to whether or not the respondents had put others at risk of HIV. Nor were there any significant differences in knowledge of at risk behaviour between those who had and those who had not put others at risk. However, there was some evidence for considerable independence between risk‐taking behaviour in the sexual and in the drug‐taking domains, in that risk‐taking in one area was not highly predictive of risk‐taking in the other.
Dying to be equal: women, alcohol, and cardiovascular disease
Authors: HANNA ELEANOR , DUFOUR MARY C. , ELLIOTT STEVEN , STINSON FREDERICK , HARFORD THOMAS C.
Published: January 2006

The Data Notes Series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism.

This data note explores the relationship of gender, alcohol consumption and premature death from cardiovascular disease (MCVD). Data on the 8164 deaths attributed to MCVD from the National Mortality Followback Study (NMFS) were analyzed controlling for gender and consumption. Women who are heavy drinkers die young at a rate equal to that of men who drink heavily. In light of this, we recommend that future research and preventive efforts in this area include females as subjects and alcohol as a major risk factor.
Drinking habits and detection of heavy drinking among middle‐aged women
Authors: SEPPÄ KAIJA , KOIVULA TIMO , SILLANAUKEE PEKKA
Published: January 2006

Little is known about alcohol consumption and the efficiency of alcohol questionnaires among women. In the present study 40‐year‐old (n= 90) and 45‐year‐old (n= 75) women participating in a health screening gave a self‐report about their alcohol consumption and filled out the Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) and the CAGE questionnaires. Teetotallers comprised 11% of the 40‐year‐old group and 8% of the 45‐year‐old women. CAGE, but not Mm‐MAST ‐worked with the traditional cut‐off point of two recommended for men. When the criterion for heavy drinking was a self‐reported consumption ≥140g of absolute alcohol per week or a positive (≥ 2) finding in the CAGE or ≥4 ‘yes’ answers in the Mm‐MAST, 20% of the 40‐year‐old and 17% of the 45‐year‐old group (together 19%) proved positive. Neither of the two questionnaires nor self‐report atone worked perfectly for identifying eke heavy drinker group (n = 3l) screened. Using the three above criteria; of the heavy drinkers 52% were detected by self‐report, 55% by CAGE, and 45% by Mm‐MAST. CAGE in combination with self‐report detected 90% and this combination, being short and simple, can be recommended for clinical practice.
The community drug team
Authors: STRANG JOHN , SMITH MIKE , SPURRELL SALLY
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.

The creation of a network of nearly 100 community drug teams (CDTs) across the UK stands as the most significant expansion to occur within drug services during the 1980s. Key characteristics include the narrowly defined geographical focus, the community emphasis, the multi‐disciplinary composition and the promotion of generic contribution through ‘consultancy’—as with Community Alcohol Teams. Subsequent adaptations have extended from the base of the CDT with outreach strategies and harm‐minimization techniques. However, the extent of collaboration from generic colleagues (especially general practitioners) has been initially poor and is only slowly improving. An unplanned abandonment of the original consultancy role for the CDT is widely evident, as CDT workers have become more actively involved in the delivery of care—either directly or on a ‘shared care’ basis. It is proposed that separate consideration should be given to short‐ and long‐term development strategies, including re‐examination of the target populations, staffing composition, and methods of work through consultancy and/or direct provision of care.
Effects of tobacco smoking on caloric intake
Authors: PERKINS KENNETH A.
Published: January 2006

Reduced body weight due to smoking may be an important factor inhibiting smoking cessation and promoting relapse after cessation in some smokers. It is popularly believed that smoking decreases body weight by suppressing appetite. However, cross‐sectional studies show that, despite their lower body weights, smokers do not eat less than non‐smokers or ex‐smokers and, in fact, tend to eat slightly more. Similarly, laboratory studies show no acute effects of smoking or nicotine intake via other means on caloric intake in smokers, although intake of non‐smokers may be reduced after nicotine. In contrast, longitudinal studies show that eating consistently increases in the first weeks after stopping smoking, but may recede to pre‐cessation levels with longer‐term abstinence, while resumption of smoking after cessation is accompanied by a reduction in eating. A similar pattern of results is seen for self‐reported hunger and some, but not all, constituents of diet. Thus, there appear to be no acute or chronic effects of smoking on eating in smokers maintaining regular smoking, but changes in eating are observed concomitant with changes in smoking status (i.e. cessation or relapse). Although tolerance to anorectic effects of nicotine is one potential explanation, these findings may be more parsimoniously explained by viewing changes in eating due to smoking as secondary to an alteration in the set point around which body weight is regulated. According to this notion, cessation is accompanied by increased eating only until a new, higher body weight set point is reached, while relapse (and perhaps initiation of smoking) decreases eating only until a lower set point is reached. Implications of these findings and a set point explanation for them are discussed.
Do cannabis drug abusers differ from intravenous drug abusers? The role of social and behavioural risk factors
Authors: STENBACKA MARLENE , ALLEBECK PETER , ROMELSJÖ ANDERS
Published: January 2006

The aim of the study was to investigate the association between social and behavioural factors, and the use of different types of drugs in a cohort of 8168 Swedish men conscripted for military service in 1969–70. Data about social and behavioural characteristics, self‐reported use of alcohol and narcotics was obtained from a survey of all Swedish conscripts. Information on intravenous drug abuse up to 1970 was obtained from a survey of injecting males among persons brought to the central police arrest. A higher proportion of intravenous drug abusers than cannabis abusers came from social class III, had divorced parents, had been in contact with the police and juvenile authorities, and had low emotional control. Indicators of deviant behaviour, e.g. truancy, having run away from home, and contact with police or juvenile authorities, were associated with high odds ratios for intravenous drug abuse and for cannabis abuse. In multivariate analyses, these risk factors still carried significantly increased odds ratios. In general, the odds ratios associated with these background factors were higher for intravenous drug abuse than for cannabis abuse. The risk increased, however, with increasing level of cannabis abuse. In conclusion, poor social background and deviant behaviour was strongly associated with future intravenous drug addiction, whereas the association was much weaker in the case of future cannabis abuse.
Prevalence of the proposed DSM‐IV alcohol use disorders: United States, 1988
Authors: GRANT BRIDGET F.
Published: January 2006

Data from a 1988 survey on United States drinking practices and related problems teas used to derive the proposed DSM‐IV definitions of alcohol abuse and dependence. The prevalence of DSM‐IV alcohol abuse and dependence combined, incorporating the DSM‐III‐R duration criterion, was 6.00% in this general population sample. The majority of respondents were classified as alcohol dependent (5.93%), dependent without abuse (5.24%), and dependent with physiological dependence (5.06%). The rate for DSM‐IV alcohol abuse was negligible (0.06%) while elimination of the duration criterion had little impact on the prevalence of DSM‐IV alcohol use disorders. Reasons for the extremely low prevalence of DSM‐IV alcohol abuse and the slight increase in the prevalence of DSM‐IV alcohol use disorders as the result of eliminating the duration criterion are discussed in terms of the content of the abuse category and its relationship to the dependence definition.
Alcohol consumption among unemployed youths: results from a prospective study
Authors: JANLERT URBAN , HAMMARSTRÖM ANNE
Published: January 2006

A prospective study, including all 1083 pupils in the final year of compulsory schooling in a municipality in northern Sweden, was performed. Ninety‐seven point nine per cent of the pupils were followed up after five years. They completed a comprehensive self‐administered questionnaire including questions on alcohol consumption. Among men a positive correlation between long‐standing unemployment (> 20 weeks) and alcohol consumption at the beginning and at the end of the study, as well as the change in consumption during the follow‐up period was seen. This correlation was still present when earlier alcohol consumption and socio‐economic variables were controlled for. In women there was a positive correlation between unemployment and the level of alcohol consumption, but a negative correlation between unemployment and change in consumption. When controlling for motherhood and alcohol intake at the start of the study the correlation turned positive. Unemployment among women did not seem to affect recruitment to the high consumption group. Our remits support the suggestion that unemployment may be a risk indicator for increasing alcohol consumption among young people, particularly in young men.
Cigarette smoking and cognitive performance
Authors: SPILICH GEORGE J. , JUNE LORRAINE , RENNER JUDITH
Published: January 2006

While some investigations into the relationship between smoking and cognitive performance have reported that smoking facilitates performance, other research has come to the opposite conclusion. A review of the literature suggests that this variance in results may be due to differences among studies in design (comparing smokers only with deprived smokers rather than with non‐smokers) and also to differences in task demands. Therefore, performance of smokers having just smoked, matched smokers deprived for a brief period, and also non‐smokers was contrasted on a series of tasks which ranged from repetitive and perceptually‐bound tasks to complex, dynamic tasks dependent upon long‐term memory. It was found that while cigarette smoking had no negative effect upon performance for simple perceptual tasks, smoking was found to exert measurable negative effects upon performance for more complex information processing tasks.
The anatomy of a follow‐up
Authors: TWITCHELL GEOFFREY R. , HERTZOG CAROL A. , KLEIN JEFFERY L. , SCHUCKIT MARC A.
Published: January 2006

This article describes the methods that were used to maximize subject retention in an 8–12 year follow‐up study of 454 men. Guidelines and suggestions are given regarding follow‐up structure, strategies to relocate lost subjects, and efforts to maintain contact and ensure subject cooperation. Through these methods all 454 subjects have been located, and at the present time an estimated 98% or greater will be completely evaluated at follow‐up. Hopefully these suggestions will be helpful to researchers and clinicians interested in longitudinal studies.
The Fifth Thomas James Okey Memorial Lecture: Research and practice: the necessary symbiosis
Authors: STRANG JOHN
Published: January 2006

What relationship should exist between research and practice in the field of addictive behaviour? Are the perspectives essentially independent, or is there a necessary interaction? The extent of productive interaction is considered in three examples; (i) detoxification, (ii) stable abstinence, and (iii) goals other than abstinence. Changes are occurring in the drugs being used, the extents and types of associated co‐morbidity, the levels of public and professional concern, and the explanatory paradigms which are dominant; and so it will be increasingly important for both practitioners and researchers to be sensitive and reactive to these changing circumstances. The most productive state for both research and practice will exist when they both feed off, and feed into each other–when there is indeed a necessary symbiosis.
Providing drug injectors with easier access to sterile injecting equipment: a description of a pharmacy based scheme
Authors: MCKEGANEY NEIL , BARNARD MARINA
Published: January 2006

In this short paper we describe the operation of a pharmacy‐based scheme operating in Glasgow to provide injecting drug users with sterile injecting equipment. The operation of the scheme is described under a number of headings: its physical location, the policy of selling injecting equipment, the return of previously used equipment, counseling and referral, and, the style of working of pharmacy staff. It is shown that while retail pharmacies may be an important point of contact with injecting drug users it should not be assumed that pharmacy staff already possess the requisite skills for working in this area. There is a need for pharmacists’and their staff to be able to draw upon the experience of colleagues working in this area in order to benefit from a pool of common experience. In addition there is a need to provide staff with access to appropriate back‐up and support services.
Self‐reports by alcohol and drug abuse inpatients: factors affecting reliability and validity
Authors: BROWN JOSEPH , KRANZLER HENRY R. , BOCA FRANCES K. DEL
Published: January 2006

The reliability and validity of self‐report data regarding substance abuse has often been questioned. To determine how best to enhance the veracity of self‐report, three factors which might affect self‐report veracity were examined: alcohol status at time of interview; level of cognitive functioning; and method of self‐report data collection. Subjects were 234 admissions to an inpatient substance abuse treatment unit. Self‐report data were collected via both personal interview on the day of admission and questionnaire within the first week of stay. Self‐reports concerned use of alcohol, cocaine, and marijuana in the days preceding admission. Test–retest reliability for the questionnaire data produced reliability coefficients of 0.88, 0.91, and 0.88, for alcohol, cocaine, and marijuana, respectively. Variation in inter‐test interval had virtually no effect upon reliability coefficients. Interview data were compared to toxicologic analyses of blood and urine samples collected on admission. Overall, this comparison showed self‐reports to be valid, with a 97% agreement between verbal report and laboratory data for alcohol, 93% for cocaine, and 84% for marijuana. The comparison of interview data with questionnaire responses also showed self‐reports to be valid: 90% agreement for alcohol, 93% for cocaine, and 81% for marijuana. Level of cognitive function did not influence the validity of self‐reports for any of the three substances. Recent consumption of alcohol also had no statistically significant effect on the validity of self‐reported marijuana use, regardless of the operational form of validity tested. However, BAC‐negative subjects produced a significantly greater validity coefficient for self‐reported cocaine use (kappa = 0.87) than did BAC‐positive patients (kappa = 0.43), when interview data were compared with toxicologic measures. A similar finding was not uncovered when interview and questionnaire data were compared. An interaction between admission alcohol status and cognitive function was uncovered for cocaine self‐reports when interview data was compared with toxicologic measures. The rate of agreement for alcohol‐negative subjects is quite high for both cognitively impaired and unimpaired subjects (M = 93% and M = 94%, respectively) as well as for alcohol‐positive, cognitively unimpaired subjects (M = 94%), but not for alcohol–positive, cognitively impaired subjects (M = 67%). Results are discussed in terms of threats to the validity of self‐report and strategies for the optimization of response accuracy.
Treatment dependence: preliminary description of yet another syndrome
Authors: BELL JAMES
Published: January 2006

The last decade has witnessed an expansion of treatment services and research into alcoholism and addiction. As so often happens when attempting to find solutions to pressing individual and social problems, the solutions have come to acquire an importance of their own, obscuring the problems they were intended to solve. Many programmes are characterized by stereotyped approaches to treatment, which seem more in line with the needs of the staff than with the problems of the clients. The hopes that treatment for addictions will solve some of the problems of contemporary society have given treatment a salience which cannot be justified in terms of results. Frustrated at the results of treatment, clinic staff intensify their efforts and attribute the shortcomings of treatment to a lack of client motivation. There are disconcerting parallels between these behaviours in clinicians and the behavioural changes of the Alcohol Dependence Syndrome. The label‘Treatment dependence syndrome’is proposed to characterize a pattern of individual and institutional behaviour which is both self‐perpetuating and self‐defeating.
Letters to the Editor
Authors: Cohen Peter
Published: January 2006

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.
Recent liver cirrhosis declines: estimates of the impact of alcohol abuse treatment and alcoholics anonymous
Authors: SMART REGINALD G. , MANN ROBERT E.
Published: January 2006

This paper examines the proposition that increased treatment for alcohol abuse and Alcoholics Anonymous (AA) membership can account for a large pan of the recent declines in cirrhosis mortality and morbidity. Data on treatment and AA membership in the USA between 1979 and 1987 and in Ontario between 1975 and 1986 are used, together with estimates of cirrhosis risk and the likely impact of treatment and AA membership. The results show that increased treatment levels and AA membership could account for all of the reductions in cirrhosis deaths and hospital admissions in Ontario. In the USA all of the deaths and about 40% of the admissions could be accounted for by these factors.
Structural changes in the hippocampal formation after long‐term alcohol consumption and withdrawal in the rat
Authors: PAULA‐BARBOSA M. M. , BRANDÃO F. , MADEIRA M. D. , CADETE‐LEITE A.
Published: January 2006

The effects of long‐term alcohol consumption and withdrawal upon the structure of the rat hippocampal formation were studied by applying morphometric methods to material processed for light and electron microscopy. The somatostatinergic neurons of the hilus zvere aha studied. Groups of 6 rats were treated as follows: (a) given alcohol for 6, 12 and 18 months; (b) paired controls; and (c) rats switched to a normal diet in the 6 months after 6 and 12 month!, of alcohol intake. A progressive loss of hippocampal neurons after chronic alcohol consumption was found. The loss was aggravated during withdrawal from alcohol, with the exception of the hilar cells. The dendrites of granule cells front the alcohol‐treated rats displayed signs of regrowing, but they did not do so in rats withdrawn from alcohol. The synapses between mossy fibre terminals and CA3 dendrites appear to be rather resistant to alcohol insult, and evidence of morphological plasticity mas found in withdrawn rats. If an homology can be established between humans and rodents then the changes observed in alcohol‐fed rats can be regarded as underpinning some of the functional and behavioural alterations depicted under these circumstances, The peculiar changes found in some nerve cell populations after withdrawal of alcohol could be related to the deficient or incomplete functional recovery often seen after abstinence from alcohol.
The Alcohol Use Disorders Identification Test (AUDIT) in a routine health examination of long‐term unemployed
Authors: CLAUSSEN BJØRGULF , AASLAND OLAF GJERLØW
Published: January 2006

A representative sample of 310 long‐term unemployed in Norway was followed for 2 years with clinical examinations and the AUDIT questionnaire. 30% of the men and 8% of the women scored over the cut‐off point for an alcohol use disorder. This gives a probable prevalence of 16%. The test predicted return to employment in this sample. The AUDIT answers were also used as a basis for dividing into three groups:‘normal',‘hazardous’ and‘harmful'. At 2 year follow‐up, 27% had changed group, 32 respondents to the worse and 24 to the better. This‘unstable’ group was characterized by weaker social network and more frequent drinking. The AUDIT was judged as a useful instrument both in a routine health examination and as an epidemiological tool.
ICD‐10 harmful use of alcohol and the alcohol dependence syndrome: prevalence and implications
Authors: GRANT BRIDGET F.
Published: January 2006

Data from a 1988 survey on United States drinking practices and related problems was used to derive the prevalence and population estimates of harmful use of alcohol and the alcohol dependence syndrome as defined in the ICD‐10 Clinical Descriptions and Diagnostic Guidelines Version (ICD‐10‐CDDG). Corresponding estimates were also presented for ICD‐10‐CDDG diagnoses that incorporated the duration criterion of the ICD‐10‐Diagnostic Criteria for Research Version (ICD‐10‐DCR). The prevalence of ICD‐10 harmful use and dependence combined, with and without the duration criterion, were 5.2% and 7.1%, respectively. Corresponding harmful use rates were negligible (0.27%). Implications of the extremely low prevalence of harmful use in the US population and the impact of the duration criterion on the rates are discussed in terms of the fundamental nature of alcohol use disorders as syndromes and the viability of the harmful use of alcohol category as originally conceptualized.
Attachment among adult children of alcoholics
Authors: EL‐GUEBALY NADY , WEST MALCOLM , MATICKA‐TYNDALE ELEANOR , POOL MARY
Published: January 2006

Disturbed or impoverished relationships have been identified as a predominant feature of adult children of alcoholics (ACOAs). Recently, the concept of co‐dependency has been advanced to depict the interpersonal difficulties of these individuals, but lacks definitional rigor. The notion that childhood experiences with parents are ‘carried forward’ to affect attitudes and behaviors relevant to later intimate relationships is also consistent with attachment theory. This study examined the patterns of attachment of ACOAs as compared to adult children of non alcoholics (ACONAs). A cross‐sectional sample of 203 individuals attending either a short term hospital based outpatient psychiatric program or a community based alcoholism treatment program was included in this study. Results supported the hypothesis that female ACOAs had a distinctive dysfunctional attachment profile. There were no significant differences in the attachment styles of male ACOAs as compared to ACONAs, or male substance abusers as compared to non‐abusers.
Book Reviews
Authors: GOSSOP MICHAEL
Published: January 2006

Books Reviewed in this Article:

Kava: The Pacific Drug VINCENT LEBOT, MARK MERLIN & LAMONT LINDSTROM

Alcohol Addiction and Self‐Regulation: A Controlled Trial of a Relapse Prevention Program for Finnish Inpatient Alcoholics ANJA KOSKI‐JÄNNES

Cure, Care or Control–Alcoholism Treatment in Sixteen Countries HARALD KLINGEMANN, JUKKA‐PEKKA TAKALA & JEFFREY HUNT (Eds)

Social Problems around the Baltic Sea JUSSI SIMPURA & CHRISTOFFER TIGERSTEDT (Eds)

Self‐Control and the Addictive Behaviours NICK HEATHER, WILLIAM R. MILLER & JANET GREELEY (Eds)

Alcohol and Illness—The Epidemiological Viewpoint JOHN C. DUFFY (Ed.)
Suicide, alcohol, and divorce; aspects of gender and family integration
Authors: ROSSOW INGEBORG
Published: January 2006

Both over time and between countries within our cultural domain there seems to be a persistent male predominance in the suicide rate. Based on Durkheim's theory of social integration as a key issue in egoistic suicide, the present study aimed at analyzing two empirically operational aspects of social disintegrative factors on the male and female suicide rates in Norway; namely alcohol consumption and divorce. Times series analyses on differenced data from 1911 to 1990 showed that both alcohol consumption and divorce were independently and statistically significantly associated with the male suicide rate, but not with the female suicide rate. The results are discussed on basis of gender roles and social integration.
Predictors of successful smoking cessation following advice from nurses in general practice
Authors: SANDERS DIANA , PEVELER ROBERT , MANT DAVID , FOWLER GODFREY
Published: January 2006

At follow‐up of 751 subjects receiving a brief nurse‐administered anti‐smoking intervention in general practice, 135 subjects (18%) reported stopping smoking, of whom 44 (6%) reported sustained cessation for one year. The demographic, social and attitudinal characteristics of these subjects were compared with 616 subjects who continued to smoke. The most important predictors of cessation were intention to stop (OR 5.1, 95% CI 2.1–12.0), personal rating of likelihood of cessation (OR 4.9, 95% CI 2.8–8.5), nurse rating of likelihood of cessation (OR 4.0, 95% CI 2.2–7.4), and smoking habit of partner (1.9, 95% CI 1.3–2.9). As practice nurses are able to distinguish likely quitters from those who are not motivated and less likely to succeed, it is important to decide whether it is more cost effective to target support at the motivated or to spend more time encouraging less motivated. The most challenging, but possibly the most rewarding, task is to try to reduce the high proportion of new ex‐smokers who relapse. Although 41.1% (95% CI 28.1, 58.0) of those expressing a definite intention to stop smoking gave up, only 17.9% (95% CI 8.9, 30.4) achieved sustained cessation. However, as sustained cessation is strongly predicted by social variables, suck as marital status and time spent in the company of smokers, preventing relapse may not be easy to achieve through medical intervention alone.
Recycling with nicotine patches in smoking cessation
Authors: TØNNESEN PHILIP , NØRREGAARD JESPER , SÄWE URBAIN , SIMONSEN KÅRE
Published: January 2006

The aim was to evaluate if recycling of failures from a smoking cessation study may be of value. The study comprised 126 smokers (50%) of 252 failures, from a double‐blind smoking cessation trial with nicotine patch, who accepted recycling after 1 year. Subjects were allocated nicotine patches delivering 15, 20 or 25 mg of nicotine (over 16 hours) according to their base‐line saliva cotinine concentrations in an open trial. The treatment period was 12 weeks followed by tapering over 6 weeks. The percentage of quitters after 3, 12, 26, and 52 weeks was 44, 20, 7 and 6%, respectively. After 26 weeks, all subjects had relapsed in the group previously treated with active nicotine patch compared with 12% abstainers in the previous placebo subjects. The sustained abstinence rate without slips after one year was 2%. Recycling does not seem to be of long‐term clinical relevance in our set‐up for subjects initially treated with nicotine, but of some value in subjects quitting without nicotine therapy initially.
The association between severity of DSM‐III‐R alcohol dependence and medical and social consequences
Authors: CAETANO RAUL
Published: January 2006

This paper describes the relationship between severity of dependence and medical and social consequences in a clinical sample. Respondents constitute a sample of 219 men and 162 women interviewed in nine alcohol programs in a Northern California county. Results suggest that the number of dependence indicators reported by respondents is a valid indicator of severity of alcohol dependence, and that there is a positive relationship between the number of indicators and the number of medical and social consequences reported by respondents. When specific medical and social consequences are examined, an analysis restricted to men only, the number of dependence indicators is associated with stomach, heart and liver problems, DTs, hallucinations, public drunkenness, family arguments and serious accidents, but it is not associated with drunk driving arrests and job problems.
Discriminating needle exchange attenders from non‐attenders
Authors: FRISCHER MARTIN , ELLIOTT LAWRENCE
Published: January 2006

In 1990, approximately 1500 of Glasgow's estimated 9400 injecting drug users attended the city's four needle and syringe exchanges. In the same year, a multisite and citywide strategy was used to interview an estimated 5% sample of the city's injectors using an internationally agreed WHO structured schedule. Of the 503 injectors who participated in the study 54% (n = 272) had made use of exchanges in the last 6 months (including 165 injectors recruited from exchanges), while the remaining 46% (n = 231) had not. Twenty‐seven variables were entered into a stepwise discriminant analysis to predict group membership (attenders vs. non‐attenders). Fourteen variables emerged in the final discriminant function, which explained 17.3% of the variance between the two groups. Comparison of the model to random classification of cases resulted in a third fewer cases being wrongly assigned. Needle exchange attenders report injecting fewer drugs, less injecting with and passing on of used equipment and greater use of condoms with casual partners, compared to non‐attenders. They also had greater knowledge of AIDS and had made and maintained more harm reduction changes, although they were less likely to have received treatment than non‐attenders. The finding that attenders were less likely to inject with or pass on used needles and syringes is discussed in the context of availability of clean equipment and perception of risk. Variables reflecting lifestyle such as housing, employment and prison experience were not found to have any discriminatory power.
Comparing DSM‐III‐R and ICD‐10 substance use disorders
Authors: COTTLER LINDA B.
Published: January 2006

At the present, the DSM‐III‐R is nearing the final stages of metamorphosis to DSM‐IV. A series of field trials has been completed which has focused the attention on coverage of the different systems, the impact of social and legal problems on crossing the diagnostic threshold, the importance of subtyping by tolerance and withdrawal, the exclusionary diagnosis of abuse, the duration criterion, and other nosological comparisons. The focus of Ms Data Note is the comparison of rates between DSM‐III, III‐R, and both the old and new ICD‐10 diagnostic systems, using data from the DSM‐IV Substance Use Disorders Field Trials. Especially noteworthy is the inclusion of African Americans, females, and a population with a range of diagnoses and use patterns. Comparisons of DSM‐III, III‐R and ICD‐10 substance use diagnoses among alcohol, nicotine, cannabis, cocaine substance users indicate considerable agreement for dependence but less similarities between systems for abuse and harmful use. These findings suggest that the dependence criteria may be more stable than those chosen to represent abuse and harmful use. Mare work needs to be done to evaluate the differences and similarities of the diagnostic systems.
Book Reviews
Authors: GOSSOP MICHAEL
Published: January 2006

Books Reviewed in this Article:

AIDS, Drugs and Sexual Risk: Lives in the Balance NEIL MCKEGANY & MARINA BARNARD

Cocaine: Scientific and Social Dimensions

Treatment of Cocaine Abuse: An Annotated Bibliography JOHN J. MILETICH

Alcohol and Drugs, The Scottish Experience M. PLANT, E. B. RITSON & R. ROBERTSON (Eds)

Alcohol in Human Violence KAI PERNANEN

Natural Experiments with Decreased Availability of Alcoholic Beverages: Finnish Alcohol Strikes in 1972 and 1985—Vol. 10 ESA ÖSTERBERG & SIRKKA‐LIISA SÄILÄ (Eds)

A Rum State. Alcohol and State Policy in Australia 1788–1988 MILTON LEWIS (Ed.)
The post‐repeal eclipse in knowledge about the harmful effects of alcohol
Authors: KATCHER BRIAN S.
Published: January 2006

National Prohibition in the USA (1919‐1933) was followed by an era in which medical scientists played an important role in minimizing the harmful effects of alcohol. Cirrhosis, cardiomyapathy, adverse fetal effects, and esophageal cancer are examples of alcohol‐related health problems that were well known at the beginning of the 20th century but were dismissed during the late 1930's and early 1940's, only to be rediscovered during the 1960's and afterwards. This eclipse in knowledge occurred because of skepticism about earlier claims that had been made in the name of scientific temperance and, most importantly, because of changing standards for medical evidence. The paradigm for disease causation that gave birth to modem medicine was based on microbiology and reinforced by hormone and nutrition discoveries. Most alcohol‐related health problems are poorly explained by this paradigm. The more recent epidemiologic paradigm for noninfectious disease is more applicable to the health risks associated with heavy drinking. A transformation of knowledge about alcohol's relationship to disease has occurred.
Liver cirrhosis deaths within occupations and industries in the California occupational mortality study
Authors: LEIGH J. PAUL , JIANG WILLIAM Y.
Published: January 2006

Mortality rates were drawn from the California Occupational Mortality Study (COMS) to analyze liver cirrhosis deaths within occupations and industries from 1979 to 1981. Age‐adjusted Standardized Mortality Rates (SMRs) were made available by the State of California for separate analyses of women, men, blacks and whites. Rankings of occupations with narrow confidence intervals were strikingly similar for blacks and whites. Within occupations, the highest female SMRs were for waitresses, telephone operators, cosmetologists, dress makers, hospital orderlies, textile workers, and laborers. The lowest female SMRs were for skilled crafts workers and teachers. High male occupations included water transportation workers, bartenders, loggers, laborers, roofers, construction workers, farm workers, iron workers, and painters. Low male occupations included teachers, physicians and dentists, managers, factory supervisors, business sales workers, heavy equipment operators, and other professionals. High female industries included eating and drinking places, laundry/dry cleaning, nursing and personal care facilities, aerospace, beauty shops, and entertainment. Low female industries included wholesale trades and education. High male industries included water transportation, military, guard services, eating and drinking places, iron and steel mitts, and railroads. Low male industries included research/engineering labs, education, and computer manufacturing. This study was descriptive. It remains unknown whether certain jobs cause excessive drinking and cirrhosis, or whether people who are prone to develop cirrhosis select certain jobs.
Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption‐II
Authors: SAUNDERS JOHN B , AASLAND OLAF G. , BABOR THOMAS F. , DE LA FUENTE JUAN R. , GRANT MARCUS
Published: January 2006

The Alcohol Use Disorders Identification Test (A UDIT) has been developed from a six‐country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10‐item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol‐related problems. Questions were selected from a 150‐item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non‐hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross‐national study.
Persons with substance use disorders in mental health organizations in the United States in 1988
Authors: WITKIN MICHAEL J. , ATAY JOANNE E. , MANDERSCHEID RONALD W.
Published: January 2006

The Data Note Series Is edited by Dr Bridget Grant, Chief of Biometry at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), USA.

Data from a 1988 enumeration of Mental health organisations Mid separate psychiatric services of non‐Federal general hospitals in the United States were used to derive estimates of the number of person with alcohol and/or drug abuse (substance use) disorders in these organisations. For all organizations combined, the percent of persons with substance use disorders were 8% each in inpatient, residential treatment, and outpatient care and only 3% in partial cars program elements. However, within type of program element, there was variation according to type of organisation. It should be noted that the percent of persons with substance use in menial health organisations would be even greater than reported if: (1) the universe of mental health organizations surveyed was expanded; (2) the reporting period included persons receiving services throughout the year rather than on a single day; and (3) provision was made for including persons with a secondary diagnosis of substance abuse.
Societal norms and risk‐taking behaviour: inter‐cultural comparisons of casualties and alcohol consumption
Authors: GIESBRECHT NORMAN , DICK ROB
Published: January 2006

Inter‐cultural comparisons point to associations among aggregate rates of consumption and certain alcohol‐related complications, particularly chronic effects, such as liver cirrhosis mortality. Accidental, poisoning and violent incidents are not considered to have as strong an association with societal drinking patterns, since situational, environmental and interactional features contributing to the incident are likely to play a strong role relative to the volume of alcohol consumed. This paper compares annual alcohol consumption rates and male and female mortality rates for liver cirrhosis and 12 main accidental/violent causes of death for Canada, Finland, France, the Netherlands, Switzerland, and the US between 1965 and 1987, Using filtering techniques to account for autocorrelation, conservative measures of association were developed. The results indicate that while statistically significant correlations were evident with regard to liver cirrhosis and suicide in some jurisdictions, in most instances the comparisons were not significant. Further work is suggested with regard to the following: utilizing more refined approaches to examine the covariations of casualties and alcohol consumption, and studies combining aggregate level investigations with those focusing at the group or interactional level‐in particular those specifying and examining societal norms and risk‐taking at the group and sub‐population levels.
Alcohol and civil aviation
Authors: HOLDENER FRIDOLIN
Published: January 2006

In aviation medicine until the early 1960s the idea that pilots would fly while under the influence of alcohol was taboo. In the United States of America, the taboo was broken when it became known that 30% of fatally injured pilots in general aviation had been under the influence of alcohol Since then the rate has declined to 10%. No fatal accidents involving alcohol have been recorded in airline passenger transport. The prevalence of pilots flying under the influence of alcohol is unknown. The lowest studied blood alcohol concentration (BAG) with impaired flying skill today is 0.025%, effectively suggesting that the permitted level should be zero, but many aviation authorities have not yet translated such findings into rules and regulations. In the early 1970s the US Federal Air Surgeon began to re‐issue licences for rehabilitated alcoholic pilots. Previously alcoholism had been a reason for mandatory permanent grounding. The possibility of returning to the cockpit first opened the way to early recognition of alcoholic pilots on a larger scale. Today many airlines have their own alcohol programmes. This paper gives a brief account of the Swissair programme with its four phases: observation, intervention, treatment and follow‐up.