bluuebunny/crossref_metadata_2025 huggingface dataset:
Data collection in studies of life events and the harmful use of alcohol
Authors: GORMAN D. M.
Published: July 2006

Although stressful life events have been found to play a role in the development of a number of physical and psychiatric disorders, the research into their influence upon the harmful use of alcohol has been inconsistent. The published studies are reviewed in terms of the methods employed in data collection. It is concluded that a true test of the hypothesis that life events play an aetiological role in the development of the harmful use of alcohol has yet to be carried out, since valid and reliable techniques have not been used in assessing both life events and the onset of harmful use in any one study. Alternative procedures are suggested for use in future research.
Labelling alcoholic drinks: percentage proof, original gravity, percentage alcohol or standard drinks?
Authors: STOCKWELL TIM , HONIG FRANCES
Published: July 2006

Drivers who wish to stay ‘under the limit’, problem drinkers wishing to control their drinking and literally anyone who drinks alcohol and is concerned about their health are all increasingly exhorted to monitor their alcohol intake by counting ‘standard drinks’ (each containing 8–14 g, depending on the country in question). Unfortunately, the evidence presented in this paper suggests that this system permits many errors. In particular, it requires two assumptions to be met: (1) that drinks of the same beverage type (i.e. beer, wine, fortified wine or spirits) normally contain the same percentage of alcohol by volume; and (2) that people serve, or are served, alcoholic drinks in standard serves. It is shown that in practice the strength of drinks available for sale of a given beverage type varies widely and that ‘atypical’ strengths form a significant proportion of alcohol sales. Furthermore, whether drinking occurs in a private residence or on licensed premises, it is usual for quantities greater than the supposed Australian standard of 10 g to be served. In practice, most people are unaware of the strengths of different beverages or the rough equivalences between them. Even if they are taught the standard drink system, they cannot make allowances for ‘atypical’ variations in strength. It is suggested these problems could be readily overcome if all alcohol containers were labelled in terms of standard drinks. The benefits of such a labelling system are discussed with regard to health promotion, accident prevention and the accuracy of surveys of alcohol use.
The watering down of Australia's health policy on alcohol
Authors: HAWKS D. V.
Published: July 2006

The draft National Health Policy on alcohol in Australia, prepared by the Alcohol Sub‐Committee of the Ministerial Council on Drug Strategy and presented to that Council in November 1987, is compared to that approved by Ministers at their meeting in March 1989. Attention is directed to those policies and strategies which were substantially altered from the draft document and which, it is argued, represented the policy's most significant recommendations. The role of the alcohol industry in effecting these changes is speculated upon.
Alcohol and human performance
Authors: GLENCROSS DENIS J.
Published: July 2006

The present paper presents a comprehensive review of studies concerned with the effects of alcohol on human performance. It attempts to review the studies within the framework of the information processing model. The effects of alcohol on information processing and transmission rates, sensory and perceptual processes, motor‐control processes, attentional processes, and cognitive processes are described and discussed. It is proposed that such a processes analysis of human performance is a useful vehicle to describe the specific effects of alcohol. From the review it is concluded that much of the evidence from simple task description is equivocal. However, when information load is increased, when the stimulus‐response incompatibility increases, and when the number of competing information processes occur in ‘parallel’, then a strong, consistent and coherent pattern of performance deterioration is associated with alcohol consumption.
Drinking and cognitive impairment: current concepts and controversies
Authors: CLIFFORD CHRISTINE A.
Published: July 2006

The study of drinking and cognitive impairment has been very popular. Over the past 15 years much work has been conducted examining the specific characteristics of alcohol‐related impairment, concurrent morphological changes and the process itself. Numerous theories have been advanced and progress has been made in a number of areas. However, at the present time the area is undergoing a period of re‐evaluation. It is clear that if there is an association between alcohol consumption and cognitive impairment, there are a multitude of ‘other factors’ which need to be controlled for, before one can maintain that observed impairment is indeed a result of alcohol consumed.
Relapse prevention and management
Authors: ALLSOP STEVEN
Published: July 2006

The prevention and management of relapse has become a central theme in the research and literature of the addiction behaviours. The major focus of this work has been on identifying relapse precipitants and equipping clients with appropriate coping strategies. Such a focus either ignores or plays down the importance of the individual's decision‐making processes: both the quality of the initial decision to change and the role of decision‐making in any return to the behaviour are essential ingredients of an understanding of relapse. In reviewing the process of relapse within a context of ‘giving up addiction behaviour’, a model can be developed with clear clinical implications. This model emphasizes the role of decision‐making interacting with a client's resources and coping skills. The paper includes a summary examination of a clinical programme based on this model.
Cue exposure in the treatment of drug dependence: the potential of a new method for preventing relapse
Authors: HEATHER NICK , GREELEY JANET
Published: July 2006

Cue exposure has been used successfully in the treatment of neurotic disorders. Its application to the treatment of drug dependence is founded on the premise that craving for drugs can become classically conditioned to internal and external drug‐related cues and that such conditioned craving responses play an important part in relapse to drug use. This article reviews the theoretical background for the use of cue exposure, research on cue reactivity in samples of drug‐dependent persons and the role of cue reactivity in relapse. What evidence exists on the clinical effectiveness of cue exposure is reviewed in some detail and a number of clinical issues relating to its practical application are discussed. It is concluded that controlled trials of the effectiveness of cue exposure treatment for drug dependence should be implemented without further delay.
Mass media and the prevention of drug problems: a psychological appraisal
Authors: O'CONNOR JOHN
Published: July 2006

It is often assumed that the mass media are capable of exerting great influence over large sections of their audience. In fact, to achieve anything like mass persuasion, certain conditions need to be met. The mass media can be a powerful influence if directed at emergent trends or attitudes, or in reinforcing behaviour that is being shaped by other forces. Messages to stop, curtail, or engage in new behaviours which run counter to prevailing norms will be ineffective without instruction and access to the means for change within an integrated system approach. It is crucial that the target population is segmented to receive tailored messages to which each group will be optimally receptive. The ‘stage of change’ a drug user is in is likely to be of particular importance.
Curious, bored and wanting to feel good: the drug use of detained young offenders
Authors: HOWARD JOHN , ZIBERT ERNIE
Published: July 2006

The drug use and related perceptions of 292 young offenders, 94% of those resident in the nine detention centres operated by the New South Wales (NSW) Department of Family and Community Services, were surveyed. The average age of the detainees was 16.3 years and 90.1% were male. Illicit drug use had commenced about 2 years after the use of non‐medicinal, but licit substances, and nearly 25% had used drugs from nine or more drug groupings. Alcohol (94.8%), analgesics (94.5%) and nicotine (92.4%) were the drugs most used, with 86.6% having used cannabis, 53.3% stimulants, 48.5% inhalants, 40.5% hallucinogens and 25.8% narcotics. The major reasons given for use were: wanting to feel good, curiosity and boredom. Familial drug use was common and heroin was perceived as the drug most dangerous to both body and mind. The results are discussed and suggestions made regarding appropriate services for adolescents, as most surveyed did not or would not use those which exist.
A study of an alcohol advertisement for low alcohol beer
Authors: McLAUGHLIN K. L. , SMITH D. I.
Published: July 2006

A study was undertaken to measure the blood alcohol levels (BALs) of five men and five women after they had consumed seven middies of Emu 2.2 (2.2% alcohol by volume) beer in 1 hour. This study was conducted in response to a newspaper advertisement which depicted a well‐known football player drinking seven middies of Emu 2.2 beer over 1 hour and registering a BAL of 0.012%. As predicted, the BALs of the ten adults varied considerably, but all greatly exceeded the very low result obtained by the football player. More importantly, from the point of view of road safety, all ten BALs exceeded the 0.02% probationary driver limit in Western Australia, and two of the BALs were above the 0.05% legal limit for driving in several other Australian states.
Compulsory treatment of alcoholism: the case against
Authors: MacAVOY MICHAEL G. , FLAHERTY BRUCE
Published: July 2006

The need for compulsory detention in the management of alcohol‐dependent persons is reviewed with a particular focus on legislation in New South Wales (NSW). It is argued that there is no justification for the severe loss of civil liberties in order to provide a general power of involuntary alcoholism treatment since such treatment is basically ineffective and in any case little treatment is actually given to those detained. The selective operation of the NSW Inebriates Act (in terms of class and race biases) is noted. The special circumstances of those who suffer severe alcohol‐related brain damage and those who are in acute life‐threatening circumstances are discussed. It is suggested that these cases are adequately covered by existing Mental Health and Guardianship legislation, obviating the need for special legislation such as an Inebriates Act.
The energy dependence syndrome
Authors: SPENCER JOHN
Published: July 2006

Two major global problems face mankind in the forthcoming decades. The rapidly increasing populations, especially in developing countries, are already causing social and economic strain in many areas, and the escalating demand for energy at both the individual and collective levels are matters requiring serious global attention. The product of increasing population and increasing energy demand compounds both problems. The origins of both population increase and escalating demand for energy originate behaviourally. That is to say that, theoretically, if the human behaviour underlying these problems could be modified, either voluntarily on an individual basis, or by educational, legislative or correctional means, then these worrying trends could be brought under control. This paper is concerned principally with the underlying behaviours and dynamics of energy usage by human beings as the present trend of ever‐increasing consumption which seems to be directionless and illogical is very similar to another group of existing behavioural disorder known as addiction behaviours or dependency. These behaviours have recently received much attention and research and some of the strategies for dealing with them may be of considerable use in modifying and controlling both the per caput and collective use of energy.
Benzodiazepine drugs in Australia: associated mortality and morbidity
Authors: LOCKWOOD A. , BERBATIS C. G.
Published: July 2006

The use of benzodiazepine drugs in Australia results not only in widespread therapeutic benefits but also in harmful outcomes at both an individual and societal level. Accurate measurement of the level of harm has been precluded by a lack of robust data relating to the use of these drugs and to the resulting adverse consequences. This paper examines existing mortality and morbidity data, comments upon the available data sources and recommends areas where research is needed in order to clarify the relationship between the use of benzodiazepines and associated adverse effects.
Practical issues in the methadone management of pregnant heroin users
Authors: Batey Robert G. , Patterson Trudy , Sanders Frances
Published: July 2006

Methadone management of pregnant heroin‐using patients has become a standard approach to this particular population of patients. This paper discusses the establishment and running of an out‐patient stabilization programme and highlights areas of difficulty experienced in this exercise. Guidelines are suggested for those who wish to establish such a service in the future.
Perceptions of legal and illegal drugs: comparisons of parents, adolescents, and best friends
Authors: Wilks Jeffrey , Callan Victor J.
Published: July 2006

The topic of drugs is a sensitive issue and an area where considerable conflict and disagreement may exist between parents and children. In this study, 50 family groups (consisting of father‐mother‐adolescent‐adolescent's friend) responded to questions about a range of legal and illegal drugs used in Australia. A multidimensional scaling analysis revealed that parents, adolescents, and adolescents' best friends had similar perceptions about drugs, especially distinctions between legal and illegal substances, and drugs used more by younger people. LSD, cocaine and heroin were judged by all groups as causing personal and family problems, being strong and dangerous, not socially acceptable, bad for one's health and associated with crime. Marihuana, tobacco and alcohol were judged in opposite terms, as well as being perceived as popular, widespread and used by youth. Subjects' perceptions of drugs were very similar to representative state and national community samples, but were inaccurate when compared to official figures for drug prevalence and morbidity. In particular, respondents showed little appreciation of the problems associated with widely available legal drugs such as alcohol and tobacco.
Book Review
Authors: Batey R.
Published: July 2006

Book reviewed in this article:

Addiction: substance abuse and dependency NORMAN IMLAH
Do our guardians need guarding? An examination of the Australian system of self‐regulation of alcohol advertising
Authors: SAUNDERS BILL , YAP ELAINE
Published: July 2006

In this study the Australian system of self‐regulation of alcoholic beverage advertising was examined. Sixteen advertisements, eight print and eight television advertisements, were subjected to public scrutiny. Respondents rated advertisements using a self‐completion questionnaire based directly on the Australian Alcoholic Beverage Advertising Code. Responses were collated and where a majority of respondents had endorsed items that constituted a breach of the cose, a complaint, ostensibly from a member of the general public, was made to the Advertising Standards Council. All sixteen advertisements were regarded by the public as containing aspects which breached the code. However, the Advertising Standards Council rejected all but one of the sixteen complaints, often directly contradicting the opinions of our respondents. The social policy implications of these results are considered. It is contended that the system of self‐regulation of alcohol advertising does not serve the public interest. [Saunders B, Yap E. Do our guardians need guarding? An evaluation of the Australian system of self‐regulation of alcohol advertising. Drug Alcohol Rev 1991;10:15‐27.]
Drug policy reform in historical perspective: movements and mechanisms
Authors: ROOM ROBIN
Published: July 2006

The use of psychoactive drug's is regarded by many as a basic human drive, but it is one that induces a variety of societal responses to curb it. The present review examines two aspects of government policy on drugs: first, the influence of social movements on drug policy; and secondly, the choices for constraining drug use as an alternative to total prohibition. Addiction is essentially a repeated behaviour which is viewed as excessive or harmful. As such, it has many similarities with a wide range of human behaviours. With the concept of addiction becoming progressively banalized, there is the possibility of a more natural debate about decriminalization and legalization of drugs in terms of a balance between harm and benefits. The current public debate may create a climate for serious political consideration of the strategies. [Room R. Drug policy reform in historical perspective: movements and mechanisms. Drug Alcohol Rev 1991; 10: 37‐43]
Opioid drug accidental deaths in the Newcastle area of New South Wales, 1970‐1987
Authors: WALSH RAOUL A.
Published: July 2006

Opioid drug accidental deaths were reviewed in coronial post‐mortem files of the Newcastle City Morgue, New South Wales, between 1970 and 1987. There were 23 accidental deaths directly caused by opioids, with 19 deaths (83%) involving the use of heroin/morphine. Deaths on weekends/public holidays were over‐represented compared with weekdays. In 14 cases (61%), the police notes suggested that help‐seeking had been inappropriately delayed by people in the presence of the subject. In almost half the cases where blood alcohol analyses were performed, the results were positive with a mean of 0.14 g alcohol per 100 ml. For a shorter time period 1985‐1987, opioid‐related suicides were also examined. Data on the five subjects involved in the suicides suggested they were a different target group for prevention. Opioids appear to be a very much smaller cause of death than alcohol and tobacco in the Newcastle Area. [Walsh RA. Opioid drug accidental deaths in the Newcastle area of New South Wales, 1970‐1987. Drug Alcohol Rev 1991; 10: 79‐83]
The measurement of harmful outcomes following drinking on licensed premises
Authors: STOCKWELL TIM , SOMERFORD PETER , LANG ERNIE
Published: July 2006

The relationships between five potential indicators of alcohol‐related harm following drinking on licensed premises in Perth were explored. These were annual purchases made by individual licensees of ‘high’ (>=3.8%) and ‘low’ (<3.8%) alcohol content drinks, the number of times a particular licensed establishment is cited by drivers as the last place of drinking prior to failing a roadside breath‐test (including after accidents) and the annual number of assaults occurring either on or in the vicinity of particular licensed premises. The study area selected was a central part of the Perth metropolitan area with 367 licensed premises serving a residential population of 400 000. Highly significant correlations were found between each of the five variables. The correlations involving purchases of low alcohol drinks, however, were small. When purchases of alcohol were controlled, significant, though lower, correlations, were still evident between the other three variables. This suggests that there are risk factors other than extent of alcohol sales which further research will need to identify, and that these indicators of harm can be of value in monitoring the impact of future intervention strategies. [Stockwell T, Somerford P, Lang E. The measurement of harmful outcomes following drinking on licensed premises. Drug Alcohol Rev 1991; 10: 99‐106]
Evaluation of a strategy for changing group stereotypes of the heroin user
Authors: WILKS JEFFREY , AUSTIN DEREK A.
Published: July 2006

This study examined characteristics attributed to a person using an illegal narcotic drug (heroin) and sought to change established stereotypes by participation in a group education experience. Prior to the main study, 100 Advanced Psychology students generated lists of adjectives they would use to describe a heroin user. The most frequently mentioned characteristics were placed in structured lists as pre‐ and post‐test measures. Both semantic differential and open‐choice formats were used. The Prevention Role Play, a recently developed strategy in drug education, was used to challenge the group's stereotypes. Significant shifts in attributions were revealed between the pre‐ and post‐test measures. After the Role Play students reduced their negative stereotype on a number of dimensions though they still described the heroin user as confused, insecure, troubled and lonely. The discussion considers possible strategies for facilitating positive attitude change. [Wilks J, Austin DA. Evaluation of a strategy for changing group stereotypes of the heroin user. Drug Alcohol Rev 1991; 10: 107‐113]
Drug withdrawal: a selective review
Authors: FOY AIDAN
Published: July 2006

This review will concentrate on the contributions medical science, in particular pharmacology and electrophysiology, have made to the understanding of withdrawal states and so will look mostly at the first element in withdrawal. Behavioural and emotional issues will be dealt with in the section on management.
Pharmacotherapy of alcohol and drug problems
Authors: SELLERS EDWARD M. , ROMACH MYROSLAVA K.
Published: July 2006

Substantial progress has been made in the pharmacotherapy of withdrawal syndromes and organic complications of alcohol and drug abuse. Diazepam loading (alcohol withdrawal), phenobarbital loading (barbituate withdrawal) and diazepam tapering (benzodiazepine discontinuation) have considerably simplified treatment of withdrawal syndromes and have enhanced efficacy. Propylthiouracil shows considerable promise in the out‐patient treatment of alcoholic liver disease. New medications, particularly those modifying serotonergic function, have efficacy in decreasing alcohol consumption and show considerable therapeutic potential. Human pharmacology and pharmacotherapy should be a central part of training programmes in the field in order that further advances can be made.
What's so special about methadone maintenance?
Authors: NEWMAN ROBERT G.
Published: July 2006

Despite the proven effectiveness of methadone maintenance treatment in the management of opiate dependence, methadone maintenance programmes have met with almost universal opposition and controversy in countries all over the world. The unique aspects of methadone treatment are examined, including the stringent restrictions imposed on methadone programmes and the convention of sub‐optimal dosing adhered to in many programmes. Finally, some reasons for the under‐utilization of this treatment mode are proposed, and the implications of current attitudes towards methadone maintenance programmes are examined.
Neurological complications of alcohol usage
Authors: PRICE JOHN
Published: July 2006

The relationships between alcohol usage and a number of neurological syndromes are reviewed. These are often complex and incompletely understood. Multiple rather than single factors are the rule rather than the exception. The correct diagnosis may be missed particularly where the aetiological role of alcohol is overlooked. Multiple diagnoses are not uncommon. Issues of differential diagnosis and diagnostic procedures are discussed. Management, including a number of its pitfalls, is outlined.
Medical education in substance use disorders
Authors: SAUNDERS JOHN B. , ROCHE ANN M.
Published: July 2006

This paper outlines recent developments in drug and alcohol medical education, and highlights improved prospects for prevention and appropriate management of substance use disorders. The paper also presents a model of effective drug and alcohol medical education designed to induce both clinical competence and effective practice behaviour. Of particular note is the trend towards greater emphasis on skills development, especially clinical interaction skills. This emphasis is underpinned by an increasingly behavioural orientation, whereby concern is focused on fostering clinical competence in specific skills, e.g. identification, history taking and interventions. Practical examples of the application of such approaches are noted. In addition, relevance of concepts, such as self‐efficacy and role legitimacy, to the area of drug and alcohol medical education is highlighted. Together with recent data on early intervention, and the widespread recognition and support for medical practitioners' involvement in drug and alcohol problems, future prospects are viewed as very encouraging.
Lying down with the lion: co‐operating with the alcohol industry? The 1991 Leonard Ball Oration
Authors: Hawks David
Published: July 2006

The author examines the extent to which the alcohol industry, while purporting to be a responsible industry sensitive to the potential harm associated with alcohol, has attempted to subvert the efforts of those seeking to reduce that harm. Reference is made to recent attempts to circumvent the advertising code, exaggerate the beneficial health effects of alcohol, co‐opt the NH & MRC guidelines regarding responsible drinking and minimize community support for control measures. Notwithstanding these manifestations of the industry's duplicity, it will be argued that the lion and the sheep will need at some stage to lie down together if the alcohol industry is not to suffer the same fate as the tobacco industry. It will be suggested that among the issues on which both sides might co‐operate are the advertising and promotion of alcohol, the responsible serving of alcohol and the design of the licensed drinking environment. It will, moreover, be argued that such co‐operation is in the long‐term interest of the alcohol industry, which like any other must be responsive to community concerns.
An Australian survey of the procedures used for the treatment of opiate users
Authors: BAILLIE ANDREW J. , WEBSTER PAM , MATTICK RICHARD P.
Published: July 2006

Drug and alcohol agencies across Australia were asked to describe the services they offer to opiate users. Of the 284 agencies identified as providing treatment, 229 (81%) responded. A standard assessment procedure was used in 72% of agencies. Eighty (35%) agencies offered detoxification and had assisted 7883 clients with detoxification in the 12 months prior to March 1990. Methadone maintenance was offered in 20% of agencies with 5234 clients currently receiving this treatment. Daily doses of methadone in the range of 40–80 mg were described for most (51%) clients receiving methadone and concurrent counselling was provided in 45% of cases. Standard psychosocial interventions were provided by 60% of agencies. Out‐patient or non‐residential settings were most common (36%), with residential therapeutic communities being the setting for 21% of programmes. Supportive counselling was the most commonly used individual approach, and cognitive‐behavioural or 12‐step approaches were the most commonly used group approaches. Brief support or referral to Nar‐Anon were the most popular family interventions. Procedures aimed at reducing the risk of HIV were in place at 85% of agencies. These findings are discussed in light of research evidence. Briefly, there is a diversity of treatment options available from different treatment agencies which is not reflected within the agencies, little aftercare is offered despite high rates of relapse, and doses of methadone are lower than has been found to be optimal.
The standard drink and alcohol consumption
Authors: CARRUTHERS SUSAN J. , BINNS COLIN W.
Published: July 2006

The term ‘standard drink’ is commonly used when researchers collect alcohol consumption data and when educators create campaigns to encourage people to drink responsibly. However, little is known about community knowledge of the term ‘standard drink’ or what it represents in terms of what people are drinking in their own homes or on unlicensed premises. This study measured the amounts of a variety of alcoholic beverages that a sample of Perth metropolitan people use when drinking on unlicensed premises. The level of knowledge of the alcohol content of a variety of beverages and the knowledge of the term standard drink and what it represents in terms of commonly consumed beverages was also measured. The results showed that knowledge of the alcohol content of beverages was very poor. Knowledge of the term standard drink and what it represents in terms of absolute alcohol was also poor. Regarding the amounts of beverages poured, red and white wine, champagne and spirits are likely to be poured in amounts well in excess of a standard drink when people are drinking in their own homes. The results of this study have implications for the efficacy of educational campaigns designed to encourage safe and responsible drinking practices through the monitoring of personal intake. Before these can be effective, the terminology used must be familiar and well understood by the community towards which they are aimed. The results also discussed with respect to the design and administration of alcohol consumption questionnaires.
Drug abuse economics: cost estimates and policy implications
Authors: COLLINS D. J. , LAPSLEY H. M.
Published: July 2006

This paper presents a brief summary of the results of a study estimating the economic costs of drug abuse in Australia and commentary on these results. It proceeds to draw some conclusions about the extent of the potential benefits of drug harm minimization programmes and of the types of programmes which might yield high rates of return. It applies some standard analyses normally used in the areas of industry and taxation economics to draw conclusions in regard to tobacco advertising, competition between federal and state governments in drug policies and the hypothecation (earmarking) of taxes to drug programmes.
Application of pharmacological principles to benzodiazepine therapy
Authors: EVANS LARRY
Published: July 2006

The benzodiazepines are a group of drugs which have recently received considerable adverse publicity from within the media, much of which is undeserved. It is not unusual for drugs to produce these strong reactions from within both the professional and the general community. This paper examines the validity of the benzodiazepines in clinical practice and suggests rational guidelines for their continued use based on the clinical pharmacology of the compounds concerned.
Characteristics of clients receiving treatment in Australian drug and alcohol agencies: a national census
Authors: WEBSTER PAM , MATTICK RICHARD P. , BAILLIE ANDREW J.
Published: July 2006

The first Australian national census of clients of drug and alcohol treatment agencies was undertaken to document the characteristics of clients attending these facilities. Of the agencies surveyed nationwide, 431 (85.2%) completed and returned census forms describing demographic and drug use details of their clients. A total of 6175 clients were reported to have received services (beyond methadone maintenance alone) in the responding agencies on the census day. Ninety percent of the clients seen were substance users, and 10% of clients were relatives or friends of a substance user. The mean age of the clients was 34 years and two‐thirds were male. The majority were Australian born, with 10% described as Aborigines or Torres Strait Islanders. The majority of the clients were not in paid employment. Fifty‐five percent of all clients received treatments services on a non‐residential basis. The most frequent presenting drug problem reported was alcohol, followed by opiates and tobacco. Thirty‐three percent of the substance users were reported to have injected illicit drugs in the past 12 months.
Adolescent views on risky and illegal alcohol use
Authors: WILKS JEFFREY
Published: July 2006

A sample of 1154 adolescents from central Queensland indicated their agreement or disagreement with 28 reasons why young people drink alcohol in ways that are risky or illegal. As predicted, agreement varied across the three age groups sampled, with younger respondents being most likely to agree with drinking reasons. In contrast, very few sex differences emerged in the study. This suggests that young males and females share some common views about situations related to problematic alcohol consumption, and that age differences may be the more important factor in the development of alcohol education messages.
Relationship between the number and type of alcohol outlets and mortality due to liver cirrhosis and traffic accidents
Authors: SMITH D. IAN
Published: July 2006

The aim of the study was to determine the effect on liver cirrhosis and driver and motorcyclist mortality of changing the alcohol outlet rates in New South Wales relative to the adjacent control State of Victoria. A longitudinal study design with a six year before period (1968–1973) and a nine year after period (1974–1982) was used. A 10.5% relative increase in the total outlet rate for New South Wales during the after period was associated with significant increases in liver cirrhosis mortality (males + 22.1%, females + 17.7%) and driver and motorcyclist mortality (males + 19.8%, females + 18.9%) in comparison to the control state. The analyses also indicated that the increases in the dependent variables were apparently due to the higher outlet rates for restaurants and stores rather than for hotels and taverns. Attention is drawn to a number of limitations of the study design.
Men's issues: gender role conflict and substance abuse
Authors: RITTER ALISON J. , COLE MICHAEL J.
Published: July 2006

The present paper aims to explore issues related to men within the context of seeking help for substance abuse. The male gender role is in conflict with help‐seeking behaviour and with the fundamental principles of therapy, i.e. introspection, emotional expressivity and acknowledgement of difficulties. This creates a paradox for the male seeking psychological treatment and, it will be argued, particularly for the male substance abuser. It is argued that interventions which address the gender role and challenge men's perceptions of themselves are critical variables in the outcome of therapy, i.e. enabling them to make the necessary changes in order to promote psychological well‐being. An examination of the male gender role in relation to intrapsychic issues and family systems will be followed by a brief discussion of therapeutic interventions. Some of the difficulties and issues confronted by workers who work with male substance abusers will be explored.
The measurement of outcome in opiate treatment evaluation studies
Authors: DARKE SHANE
Published: July 2006

One of the major contributors to the fragmentation of the opiate treatment outcome literature has been the plethora of measurement techniques employed by researchers. This has led to a situation where direct comparability between studies is often extremely difficult, if not impossible. In this article the measurement methodologies employed in the major treatment outcome studies are reviewed, and the implications for future research discussed.
Australian reports into drug use and the possibility of heroin maintenance
Authors: HARTLAND N. , McDONALD D. , DANCE P. , BAMMER G.
Published: July 2006

Official Australian reports into drug use reveal a high level of agreement over the nature of drug use and the problems associated with drug use. We examine the lines of argument which make up the shared approach of past reports into drugs, and assess to what degree the connections between these lines of argument are changing. This assessment reflects on the possibility of arguing that heroin should be made available for the treatment (including maintenance) of heroin‐dependent users. This paper is derived from a report prepared for a feasibility study which examined whether or not heroin should be made available in the Australian Capital Territory in a controlled manner. After a close reading of a number of official reports, we conclude that it is possible to argue that heroin should become available.
Comments on ‘the great legalization debate’
Authors: SANTAMARIA JOSEPH N.
Published: July 2006

The debate over the legalization of drugs should be encouraged so that an appropriate and acceptable strategy can be formulated. Any policy should be based on the available data which should not be used selectively to establish an ideological position. Ultimately, the policy should be determined by what outcomes are considered to be the most desirable, taking into account both short term and long term objectives.
Drinking habits of central Queensland adolescents: local research for local needs
Authors: WILKS JEFFREY
Published: July 2006

This study examined the utility of monitoring adolescent drinking habits in order to assist the development of local drug education programmes. Drinking patterns are reported for a quota‐sample of 1154 adolescents aged from 13 to 18 years in central Queensland. Results showed that the prevalence of drinking increased according to age, with 47% of 13‐year‐olds reporting that they have used alcohol (not just sips or tastes), through to 93% among the 18‐year‐old group. Older teenagers were more likely to report drinking in the past month and the past week, though their consumption patterns are very similar to young people in other studies. Locations for drinking varied with age, younger groups drinking more often in home settings while older groups enjoyed a greater range of public and private venues. Beverage preferences again showed some age and sex differences, but overall males expressed a preference for regular beer and spirits, while females reported a preference for spirits and wine coolers. The importance of conducting local research to address local needs is discussed.
Prodigious alcohol consumption by Australian rugby league footballers
Authors: LAWSON JAMES S. , EVANS ALICE R.
Published: July 2006

As an incidental finding in a general ‘life‐style’ survey, amateur rugby footballers were found to drink prodigious (12–24 schooners per session) quantities of beer. Such drinking was regarded by the players as part of the traditions of mateship associated with the game. The need for intervention is discussed.
Structure and measurement of dimensions of risk for HIV transmission in injecting drug users
Authors: ROSS MICHAEL W. , BUZOLIC ADRIAN , WODAK ALEX , STOWE AARON , GOLD JULIAN , MILLER M. E.
Published: July 2006

Dimensions of HIV infection risks were investigated in 1,245 injecting drug users (IDUs) in Sydney, Australia. Factor analysis of the degree of risk of the 33 items of risk behaviours revealed ten dimensions, which covered the domains of oral sex, withdrawal before ejaculation, protected intercourse, unprotected vaginal intercourse, saliva, blood products, manual sex, needles and syringes, unprotected anal sex, and social transmission. The perceived riskiness of particular activities closely approximated the objectively assessed risk of particular practices. Women assessed the risks of classes of activities (with the exception of oral sex) as being higher than did men. IDUs appear to have readily interpretable and consistent perceptions of HIV transmission risks, and these dimensions have utility for measuring perception and knowledge of HIV transmission risks.
Detection of problem‐drinkers in an emergency department using a breathalyser and questionnaire
Authors: ROBINSON GEOFFREY M. , LESLIE HAMISH , ROBINSON BRIAN J.
Published: July 2006

Over a 2‐week period in January 1990 consecutive adult emergency attenders were breathalysed and screened for problem drinking using the WHO screening instrument. Results were compared with a similar study conducted 8 years previously. Of the patients tested, 12.5% had a positive alcohol in 1990 compared with 16% in 1982. Of those with positive alcohol results, the mean blood alcohol equivalent (BAE) concentration was significantly (p = 0.0006) lower in 1990 (73.6 ± 65.1; mg/100 ml; mean ± SD) when compared to those levels found in 1982 (136.9 ± 102.4 mg/100 ml). There was also significant reductions in 1990 of positive breath alcohol attenders both from road traffic accidents (p < 0.03), and from head injuries (p < 0.005) compared to 1982. In 1990 the questionnaire was positive in 23% of attendees. These studies suggest a trend towards less alcohol misuse in emergency department patients, but nevertheless indicate high rates of problem drinking. It is suggested that alcohol breathalysers be available in emergency departments to assist the detection of alcohol misusers and predict alcohol‐associated medical problems.
A computerized information system for monitoring and evaluating substance misuse services
Authors: OLEARNIK HENRYK , POWER ROBERT
Published: July 2006

A computerized, comprehensive information system for the managerial monitoring and evaluation of local substance misuse service delivery is presented. It is based on a model which comprises basic elements of service provision such as, client caseload, time management and workload, work and client satisfaction, in both quantitative and qualitative terms. Findings from its initial implementation in a community drug team and drug dependency units in one of the London District Health Authorities are discussed. The possibility of using this evaluation package by drug and alcohol agencies themselves for the purpose of self‐evaluation and monitoring as well as quality assurance is also discussed.
Alcohol, cardiovascular diseases and all causes of death: a review of the epidemiological evidence
Authors: BEAGLEHOLE ROBERT , JACKSON RODNEY
Published: July 2006

This paper reviews the epidemiological evidence on the association of alcohol consumption with the major cardiovascular diseases (hypertension, stroke and coronary heart disease), and all causes of death. The focus is on light and moderate consumption and several important methodological issues are apparent with the epidemiological evidence on alcohol and mortality. The epidemiological data justify the following recommendations on alcohol consumption. The evidence does not support the unqualified claim that light and moderate drinking confers overall health benefits. However, in persons over 35 years of age, there is no consistent evidence that daily consumption of up to 2–3 drinks in men or up to 1–2 drinks in women increases the risk of dying. Non‐drinkers should not be encouraged to change their drinking status. The consumption of more than 2–3 drinks per day in men and more than 1–2 drinks per day in women should be actively discouraged. Further research on the effects of light and moderate alcohol consumption on cardiovascular disease and all causes of death are required, particularly in young people, women and the elderly.
Public support for the prevention of alcohol‐related problems
Authors: HAWKS DAVID , LANG ERNIE , STOCKWELL TIM , RYDON PHIL , LOCKWOOD ANNE
Published: July 2006

Support for a number of strategies and policies for the prevention of alcohol related harm was ascertained as part of a larger survey of public attitudes and behaviours in a representative sample of the Perth metropolitan area. Support for these policies varied, but was generally positive, with young male drinkers the least supportive. The greatest degree of support was found for a variety of training strategies for licensees and barstaff, while a number of restrictive practices, such as reduced trading hours and the banning of the sale of beer in jugs, were less popular. Those who had recently worked in the alcohol trade were less likely than the general population to be supportive of these policies. This effect could not be completely explained by their generally being younger and drinkers. It is concluded that governments generally have a mandate to introduce certain policies and practices into the licensed drinking environment, but that the resistance of the alcohol trade to such measures may need to be overcome if they are to be successfully introduced.
A comparison of residential heroin detoxification patients and methadone maintenance patients
Authors: CAPLEHORN JOHN R. M. , SAUNDERS JOHN B.
Published: July 2006

Interviews were conducted with 101 heroin dependent persons entering a residential drug‐free detoxification unit in 1989. These self‐report data were compared with those previously collected in 1985‐6 from 457 methadone maintenance patients. The detoxification patients injected less frequently, used less heroin, had been physically dependent for a shorter period and were more likely to be single, unemployed and to have been charged with a criminal offence in the last 12 months. It is suggested that these findings may indicate that addicts who use more heroin are less likely to seek drug‐free detoxification. The wider implication of the finding is that future surveys of injecting drug users should assume that there are significant differences between heroin users entering different modalities of treatment.
A 40 month follow‐up of pregnant drug using women treated at Westmead Hospital
Authors: BATEY ROBERT G. , WEISSEL KATHY
Published: July 2006

A 40 month follow‐up of 84 women admitted to a study of the outpatient management of pregnant heroin users is reported. Fifty‐eight of the patients were on methadone at the time of their delivery while a further 26 remained on heroin at delivery. The whereabouts of 61 patients were identified at the time of follow‐up but only 46 consented to interview. Twenty‐three could not be traced even utilising the services of the Departments of Corrective Services and Community Services. The general health of mothers and babies was reported as good to excellent and only one child was in the care of the State. Many patients on methadone at delivery had exited the programme whereas those on heroin at delivery were likely to be on methadone programmes at follow‐up. A majority of all patients had had no new legal charges laid in the 12 months preceding the interview and if any charges had been laid they were likely to be traffic offences. Drug use, on the other hand, continued to be a problem even in those on methadone programmes. Up to 75% of patients in one group reported intermittent use of heroin and other drugs and these self reports were confirmed by urine testing. The data suggest that methadone does lead to a reduction in criminal activity and in daily drug usage but it does not completely abolish drug seeking behaviour. Overall, the results suggest that the use of methadone is safe for mother and baby and it has positive benefit in the management of pregnant drug users.
Correlates of student substance use
Authors: CRUNDALL IAN A.
Published: July 2006

Fifteen socio‐demographic variables were examined as potential correlates of alcohol, tobacco, inhalant, marijuana and other illicit drug use among students in Years 7 to 11. The variables which most consistently discriminated users and non‐users related to truancy, adult supervision of leisure, self‐esteem, income and the quality of the mother‐child relationship. Age was also a discriminator for all but the illicit group of drugs and revealed an inverse association with inhalant use. Drinking and smoking by various family members or others distinguished the users of alcohol and tobacco too. While further identification of correlates is encouraged, those highlighted should help to target interventions and validate self‐report measures of substance use.