bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor criterion validity of self‐reported hepatitis B infection and vaccination status among injecting drug users: A review
Authors: TOPP LIBBY , DAY CAROLYN , DORE GREGORY J. , MAHER LISA
Published: August 2010

Issues. Limited resources may dictate the use of self‐reported hepatitis B virus (HBV) status to determine the need for testing and/or vaccination in resource‐poor settings, as well as in research and surveillance. Approach. A synthesis of the literature on the criterion validity of self‐reported HBV infection and vaccination history among injecting drug users (IDU) in order to determine the utility or otherwise of self‐reports in this area. Key Findings. The degree of agreement between self‐reported and serological HBV status is consistently poor among IDU. In previous research, 46–95% of IDU with serological evidence of exposure to HBV did not report a history of infection, and serological evidence of vaccine‐conferred immunity was not detected among 50–73% of IDU who reported being vaccinated. Implications. A lack of awareness or misapprehension about their HBV status may lead some IDU to inadvertently engage in behaviours which place their injecting and sexual partners at risk, contributing to the continued potential for high incidence of HBV infection among this population. Conclusion. Self‐reported histories should not be used in lieu of serological testing when assessing infection history or immunisation status. Poor criterion validity also indicates that self‐reports of HBV infection status should not be used to estimate the prevalence and incidence of this infection. Due to their low sensitivity, self‐reports of HBV infection should at best be considered only as a lower bound prevalence estimate.[Topp L, Day C, Dore GJ, Maher L. Poor criterion validity of self‐reported hepatitis B infection and vaccination status among injecting drug users: A review. Drug Alcohol Rev 2009]
Antwerp Drugs and Alcohol Monitor: A Belgian local drug scene in the picture
Authors: TIEBERGHIEN JULIE , DECORTE TOM
Published: August 2010

Introduction and Aims. Qualitative data on local drug scenes in Belgium are scarce. As information on them remains limited to the official registration systems, the needs of a number of drug users are not taken into account. From a social scientific and policy point of view, there is a need for information on the experiences and the patterns of drug use. In this study, we have developed and tested a drugs and alcohol monitor for the city of Antwerp. Design and Methods. The Antwerp Drugs and Alcohol Monitor (ADAM) combines three qualitative methods: (i) in‐depth interviews with 39 key informants; (ii) ethnographic fieldwork by four community fieldworkers; and (iii) ethnographic fieldwork by the researcher. This methodology is based on an analysis of national and international literature on drug‐monitoring systems. Results. This paper presents an overview of the results of a pilot study in the city of Antwerp. The ADAM produces a detailed picture of the local drug issues (nature and extent of use, drug markets, quality of life, etc.) and thus offers the understanding that is required for a well‐founded local drug policy. Discussion and Conclusions. Provided that repeated measurements are made, a local drug monitor can inform policymakers, treatment experts, etc. on developments and phenomena concerning drug use. However, the ADAM is a qualitative drug‐monitoring system, and it must be emphasised that a combined monitor is more efficient. Indeed, a combination of qualitative and quantitative methods enhances the reliability of the results.[Tieberghien J, Decorte T. Antwerp Drugs and Alcohol Monitor: A Belgian local drug scene in the picture. Drug Alcohol Rev 2009]
Drugs and Psychosis Project: A multi‐centre European study on comorbidity
Authors: BALDACCHINO ALEX , BLAIR HANNAH , SCHERBAUM NORBERT , GROSSE‐VEHNE EVA , RIGLIETTA MARCO , TIDONE LAURA , CRIACO CATERINA , MARELLI MARIA C. , SOMMER BORGE , TAN LIZ , LITTLE HILARY , GHODSE HAMID
Published: August 2010

Introduction and Aims. This paper describes the sociodemographic characteristics of 196 psychotic patients admitted to acute psychiatric wards in the UK, Denmark, Germany and Italy, with the aim of comparing comorbid with non‐comorbid patients. Design and Methods. It is a prospective field study with repeated measures at 1, 6 and 12 months. Patients were recruited from acute psychiatric wards in four European centres. They were grouped as comorbid or not on the basis of urine analysis. The Schedules for Clinical Assessment in Neuropsychiatry was used to provide a psychiatric diagnosis, and the Positive and Negative Symptom Severity Scale for further information on specific symptoms with results from the Fragerstrom test for nicotine dependence also reported. Results. Comorbid patients were younger than those who were not but did not differ significantly in the other sociodemographic measures. Differences in sociodemographic characteristics of patients between centres were apparent. Comorbid patients had higher levels of positive and lower levels of negative symptoms than those who were non‐comorbid. Differences were found in the patterns of drug use between comorbid patients who were using cannabis compared with those who were not. Discussion and Conclusions. Cross‐cultural differences in the sociodemographic characteristics of the comorbid patient population give us a better insight into this heterogenous group.[Baldacchino A, Blair H, Scherbaum N, Grosse‐Vehne E, Riglietta M, Tidone L, Criaco C, Marelli MC, Sommer B, Tan L, Little H, Ghodse H. Drugs and Psychosis Project: A multi‐centre European study on comorbidity. Drug Alcohol Rev 2009;28:379–389]
The use of drug detection dogs in Sydney, Australia
Authors: DUNN MATTHEW , DEGENHARDT LOUISA
Published: August 2010

Introduction and Aims.
At present there is little research into the use of drug detection dogs. The present study sought to explore the use of detection dogs in Sydney, Australia, utilising multiple data sources. Design and Methods. Data were taken from interviews with 100 regular ecstasy users and 20 key experts as part of the 2006 New South Wales arm of the Ecstasy and Related Drugs Reporting System, and secondary data sources. Results. The majority of regular ecstasy users reported taking some form of precaution if made aware that dogs would be at an event they were attending. A small proportion of the sample reported consuming their drugs when coming into contact with detection dogs. One group of key experts viewed the use of detection dogs as useful; one group disliked the use of detection dogs though cooperated with law enforcement when dogs were used; and one group considered that detection dogs contribute to greater harm. Secondary data sources further suggested that the use of detection dogs do not significantly assist police in identifying and apprehending drug suppliers. Discussion and Conclusions. The present study suggests that regular ecstasy users do not see detection dogs as an obstacle to their drug use. Future research is necessary to explore in greater depth the experiences that drug users have with detection dogs; the effect detection dogs may have on deterring drug consumption; whether encounters with detection dogs contribute to drug‐related harm; and the cost–benefit analysis of this law enforcement exercise. [Dunn M, Degenhardt L. The use of drug detection dogs in Sydney, Australia. Drug Alcohol Rev 2009]
An investigation into whether clients and/or their respective clinicians are aware of pending service exit in the first two months of treatment admission
Authors: PULFORD JUSTIN , ADAMS PETER , SHERIDAN JANIE
Published: August 2010

Introduction and Aims. When a client exits an alcohol and other drug (AOD) treatment service against clinical advice, they and their service may incur significant disadvantage. The extent of awareness by both clients and clinicians that treatment would not continue has not been examined. Accordingly, this paper presents findings from a study that sought to identify whether clients and/or their respective clinicians were aware of pending service exit that occurred within the first 2 months of treatment admission. Design and Methods. The study was set in an outpatient AOD treatment service located in Auckland, New Zealand. Data were obtained by structured questionnaire and were reported for a group of clients (n = 49), clinicians (n = 46) and matched client/clinician pairs (n = 36). Results. Overall, clients and clinicians were no more likely to accurately identify pending service exit at a rate greater than would be expected by chance alone. However, clinicians were significantly more likely to identify pending service exit as compared with their respective clients (47% vs. 25%), although a large proportion of both groups expected treatment to continue beyond what proved to be the final treatment appointment (44% and 52%, respectively). Discussion and Conclusions. These findings suggest that service exit that occurs within the first 2 months of treatment admission may be largely unpredictable and that, as a result of this unpredictability, the opportunities for a targeted response may be limited.[Pulford J, Adams P, Sheridan J. An investigation into whether clients and/or their respective clinicians are aware of pending service exit in the first two months of treatment admission. Drug Alcohol Rev 2009]
Five‐year longitudinal study of cannabis users in three remote Aboriginal communities in Arnhem Land, Northern Territory, Australia
Authors: LEE K. S. KYLIE , CONIGRAVE KATHERINE M. , CLOUGH ALAN R. , DOBBINS TIMOTHY A. , JARAGBA MURIEL J. , PATTON GEORGE C.
Published: August 2010

Introduction and Aims. To examine predictors of cannabis use at 5 year follow up in an Australian Aboriginal cohort. Design and Methods. A longitudinal study consisting of two waves of data collection 5 years apart was conducted. Of the 100 Aboriginal residents (aged 13–36 years) interviewed about cannabis use in 2001, 83 were re‐interviewed in 2005–2006 from three remote communities in Arnhem Land, Northern Territory, Australia. Self‐reported cannabis use was categorised at each time point (none; former use, quit≥3 months; lighter use, <6 cones, 2–3 times weekly; daily use,≥6 cones, daily) and summarised as any current use, heavy use, dependence or cessation. Other substance use, employment and involvement in school or training were also compiled. Results. Most respondents who reported cannabis use at baseline again reported use at follow up. A history of petrol sniffing predicted later heavy cannabis use (P < 0.05). Trends were evident for men to have persisting cannabis use, and for employment and/or engagement in school or training to be associated with cannabis cessation. Discussion and Conclusions. Ongoing heavy cannabis use is commonplace in this Aboriginal cohort and raises concerns for the physical, social and psychiatric burden on these already vulnerable communities. Prevention, treatment and intervention programs developed with communities are badly needed.[Lee KSK, Conigrave KM, Clough AR, Dobbins TA, Jaragba MJ, Patton GC. Five‐year longitudinal study of cannabis users in three remote Aboriginal communities in Arnhem Land, Northern Territory, Australia. Drug Alcohol Rev 2009]
Barriers to methamphetamine withdrawal treatment in Australia: Findings from a survey of AOD service providers
Authors: PENNAY AMY E. , LEE NICOLE K.
Published: August 2010

Introduction and Aims. Despite the high prevalence of methamphetamine use and dependence in Australia, withdrawal treatment access for methamphetamine accounts for only 9.3% of total withdrawal treatment presentations. Furthermore, treatment completion for methamphetamine users is one of the lowest of all drugs. There is not a clear understanding for the reasons why methamphetamine withdrawal treatment presentations and efficacy is so low. This study examined the current practices and barriers to methamphetamine withdrawal treatment in Australia. Design and Methods. Twenty‐four interviews were conducted with employees from alcohol and other drug services from around Australia. These services were questioned about a range of issues relating to methamphetamine withdrawal treatment including current treatment practices, perception of the effectiveness of current treatment and barriers to treatment. Results. The study found that current practices in the treatment of methamphetamine withdrawal are diverse and uncertain. Service providers identified a great number of barriers to the treatment of methamphetamine withdrawal that encompass personal, social, cultural and organisational barriers. Discussion and Conclusions. The results of this study suggest that alcohol and other drug service providers are not clear about the best way to respond to clients seeking methamphetamine withdrawal treatment. Furthermore, the study showed a general pessimism about withdrawal treatment for this group. Treatment services should consider improving withdrawal protocols, educating clinicians and reconsidering entry criteria to better respond to methamphetamine users who have made the important first step into withdrawal treatment.[Pennay AE, Lee NK. Barriers to methamphetamine withdrawal treatment in Australia: Findings from a survey of AOD service providers. Drug Alcohol Rev 2009]
Youth retention: Factors associated with treatment drop‐out from youth alcohol and other drug treatment
Authors: SCHRODER RIA , SELLMAN DOUG , FRAMPTON CHRIS , DEERING DARYLE
Published: August 2010

Introduction and Aims. This study examined factors associated with treatment drop‐out among young people aged 13–19 years attending alcohol and other drug (AOD) treatment. Design and Methods. Data were gathered from structured interviews (n = 79) and a clinical file search of 184 randomly selected young people who had attended youth specific AOD treatment services in Aotearoa, New Zealand during 2003 or 2004. Results. The median length of stay was 2.7 months for those attending day/residential services (n = 42) and 4.0 sessions for those attending outpatient services (n = 37) 16.7% of participants from day/residential services dropped out of treatment early (within the first month) and 32.4% of participants from outpatient treatment services dropped out of treatment early (before the third session). Fixed client characteristics, such as age, sex, ethnicity, substance use and mental health diagnoses were not found to be associated with treatment retention. Dynamic client characteristics, such as motivation to attend treatment and expectations about treatment outcomes and program characteristics, such as positive experiences with treatment staff and feeling involved in the treatment process were found to be associated with treatment retention. Discussion and Conclusions. The findings of this study support previous research indicating that fixed client characteristics are not sufficient to explain youth retention in AOD treatment. Of more use are dynamic client characteristics and program variables. These findings stress the potential for improving treatment retention by creating more youth appropriate services.[Schroder R, Sellman D, Frampton C, Deering D. Youth retention: Factors associated with treatment drop‐out from youth alcohol and other drug treatment. Drug Alcohol Rev 2009]
Alcohol use and the Traveller community in the west of Ireland
Authors: VAN HOUT MARIE CLAIRE
Published: August 2010

Introduction and Aims.
The Traveller community as ethnic minority is vulnerable to problematic alcohol use, because of social exclusion, discrimination, lack of awareness and difficulties in engaging with addiction treatment protocols. Design and Methods. This research yielded an exploratory account of Travellers and alcohol use according to the perspectives of the Travellers and key service providers in the west of Ireland, within the context of a large‐scale study on Travellers and substance use. The research consisted of 12 peer‐accompanied focus groups of Traveller men and women (n = 57) and 45 semistructured interviews with a self‐selecting sample of key service agencies. The research themes related to Traveller culture and alcohol use, sex differences, reasons for consuming alcohol, attitude to alcohol use, problematic alcohol use, levels of alcohol harm‐related knowledge, perceptions of alcohol‐related risk and experiences of addiction services. A thematic analysis of the information garnered guided this comparative analysis. Results. The Traveller community, and in particular Traveller men, are presenting with increasingly problematic alcohol use, because of dissipation of their culture and their experiences of marginalisation, discrimination, depression, illiteracy and poverty. Difficulties engaging with law enforcement, community health and addiction services compromise their efforts to deal with this problem and home detoxification attempts are common. Discussion and Conclusions. Services must aim to take into consideration the cultural needs of Travellers and provide appropriate educational materials, peer education programs and flexible treatment approaches for those Travellers experiencing problematic alcohol use. [Van Hout MC. Alcohol use and the Traveller community in the west of Ireland. Drug Alcohol Rev 2009]
The characteristics of acute non‐fatal medication‐related events attended by ambulance services in the Melbourne Metropolitan Area 1998–2002
Authors: HUTTON JENNIE , DENT ANDREW , BUYKX PENNY , BURGESS STEPHEN , FLANDER LOUISA , DIETZE PAUL
Published: August 2010

Introduction and Aims.
To describe the characteristics of non‐fatal medication‐related ambulance attendances in Melbourne. Design and Methods. A retrospective analysis of 16 705 patient care records completed by ambulance paramedics in Melbourne where medications had a causal role in the attendance. Results. A single medication only was implicated in 11 765 cases (70% of the total). Of these, 85% involved one of six types of medication: benzodiazepines (52%), paracetamol (15%), selective serotonin re‐uptake inhibitors (6.5%), combination paracetamol and opioids (4%), phenothiazines (3.4%) and tricyclic antidepressants (TCA) (3.7%). Cases involving benzodiazepines were significantly (P < 0.001) older (Average = 37 years) than those involving paracetamol (Average = 30 years). Thirty‐four per cent of cases involved concurrent alcohol use, and this varied according to drug type (paracetamol 26%, benzodiazepines 40%, selective serotonin re‐uptake inhibitors 35%, paracetamol and opioids 35%). An abnormal Glasgow Coma Scale score was found in 19% of cases, again varying according to drug type (paracetamol 10%, TCA 39%, benzodiazepines 21%, paracetamol and opioids 17%, phenothiazines 15%). Ten per cent of cases were not transported to hospital ranging from 3% for TCA to 13% for benzodiazepines. Discussion and Conclusions. The majority of non‐fatal medication events attended by ambulance paramedics involve one of six substances. Benzodiazepines were most commonly implicated and, as management may require only simple supportive treatment, significant numbers are not transported to hospital. The unique clinical population is identified in this study and the ongoing medical and psychiatric treatment of these patients not transported to hospital in the study period needs to be considered. [Hutton J, Dent A, Buykx P, Burgess S, Flander L, Dietze P. The characteristics of acute non‐fatal medication‐related events attended by ambulance services in the Melbourne Metropolitan Area 1998–2002. Drug Alcohol Rev 2009]
Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA study
Authors: YALDIZLI ÖZGÜR , KUHL HANS CHRISTIAN , GRAF MARC , WIESBECK GERHARD A. , WURST FRIEDRICH M.
Published: August 2010

Introduction and Aims.
Alcoholism, depression and suicide attempts (SA) are strongly interrelated. The aims were to determine risk factors and develop a prognostic predictor model for SA in a subgroup of patients with a history of alcohol dependence or abuse and depressive symptoms. Design and Methods. A subgroup analysis from the data of the World Health Organisation (WHO)/the International Society for Biomedical Research on Alcoholism (ISBRA)‐collaborative study on biological state and trait marker of alcohol use and dependence, an international multi‐centre study with a cross‐sectional design, based on a standardised questionnaire. We analysed from 1314 variables 43 factors—including demographic characteristics, dependence variables, comorbid disorders, personality trait markers and family history—that were supposed to be most predictive for SA according to the literature. Correlation analyses by the χ2‐test and Mann–Whitney U‐test were performed to obtain statistical meaningful parameters for logistic regression analysis. Results. Of the 1863 persons included in the WHO/ISBRA study, 292 had both a history of depressive symptoms and alcohol dependence or abuse and were included in the subgroup analysis. In the logistic regression analysis, drinking status, depressive symptoms, adverse drinking experiences during alcohol consumption, bad experiences from drug abuse and antidepressant therapy were found to be independent risk factors for SA. Positive family history of alcoholism was a model‐improving co‐factor. This predictive model explains approximately 60% of the variance (Nagelkerkes' square). Discussion and Conclusions. This prognostic model derived from data of the WHO/ISBRA collaborative study shows important risk factors for SA in patients with history of alcohol abuse or dependence and depressive symptoms. [ Yaldizli Ö, Kuhl HC, Graf M, Wiesbeck GA, Wurst FM. Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA study. Drug Alcohol Rev 2009]
Postgraduate education for doctors in smoking cessation
Authors: ZWAR NICHOLAS A. , RICHMOND ROBYN L. , DAVIDSON DAVID , HASAN IQBAL
Published: August 2010

Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466–473]
Postgraduate medical education on tobacco and smoking cessation in Europe
Authors: KRALIKOVA EVA , BONEVSKI BILLIE , STEPANKOVA LENKA , POHLOVA LUDMILA , MLADKOVA NIKOL
Published: August 2010

Issues.
Smoking prevalence in European countries is high. Adequately trained physicians can play a key role in reducing smoking rates in Europe. This paper provides an overview of postgraduate smoking cessation training for physicians in Europe. Approach. Two methods were used: (i) a review of the Europe‐based published and grey literature between 1999 and 2009 on postgraduate education programs for physicians in smoking cessation; and (ii) a survey of key informants identified through two European tobacco control list serves. Key Findings. A total of nine relevant articles were identified through the literature search which showed over 170 postgraduate training programs offered in Europe in smoking cessation. The survey resulted in a 100% response rate from 38 key informants from 28 European countries. Respondents from all countries except Latvia reported knowledge of the existence of smoking cessation training programs. Course content included brief intervention training (93%), pharmacotherapy (96%), motivational interviewing skills (85%) and training in the stages of change (89%). Participation by physicians in these courses was reported to be low (ranging in total participation estimates from 15 to 1100 per country). Implications. The study showed numerous training opportunities for physicians in Europe. However, postgraduate training in smoking cessation might not be reaching physicians and might not be rigorously evaluated. Conclusions. It is imperative that the effectiveness of the programs in changing provider practices and patient smoking outcomes is adequately evaluated. Further research is also indicated for methods of disseminating effective educational activities throughout Europe with the intention of increasing participation. [Kralikova E, Bonevski B, Stepankova L, Pohlova L, Mladkova N. Postgraduate medical education on tobacco and smoking cessation in Europe. Drug Alcohol Rev 2009;28:474–483]
Faculty development in tobacco cessation: Training health professionals and promoting tobacco control in developing countries
Authors: MURAMOTO MYRA L. , LANDO HARRY
Published: August 2010

Issues.
Cessation programs are essential components of comprehensive tobacco control. Health‐care providers, especially physicians, have major responsibility for role modeling and promoting cessation. For successful, sustainable cessation training programs, countries need health‐care professionals with knowledge and skills to deliver and teach tobacco cessation. Approach. Review literature relevant to faculty development in tobacco cessation and discuss its strategic potential in tobacco control. Key Findings. Faculty development is essential for sustainable tobacco cessation training programs, and a potentially powerful strategy to shift professional and societal norms towards cessation and support of comprehensive tobacco control in countries with normative tobacco use and underdeveloped tobacco control programs. Implications. Medical faculty are in a key position to influence tobacco cessation and control programs because of their roles as educators and researchers, receptivity to innovation and, influence on competencies and standards for medical education and practice. Faculty development programs must consider the number and type of faculty, and tobacco cessation curricula needed. Faculty development fosters the ability to institutionalise cessation education for students and community practitioners. Academic faculty are often leaders in their professional disciplines, influential in establishing clinical practice standards, and technical experts for government and other key health organisations. Conclusion. Training health‐care professional faculty to become knowledgeable and committed to tobacco cessation opens opportunities to promote cessation and shift professional and societal norms away from tobacco use. [Muramoto ML, Lando H. Faculty development in tobacco cessation: Training health professionals and promoting tobacco control in developing countries. Drug Alcohol Rev 2009;28:498–506]
Preparing pharmacy students and pharmacists to provide tobacco cessation counselling
Authors: WILLIAMS DENNIS M.
Published: August 2010

Issues.
Tobacco use and abuse is a major health risk for people across the world and is responsible for nearly 500 000 deaths in the USA annually. Currently, the accepted role of pharmacists is the provision of pharmaceutical care, which includes health promotion and prevention of disease. Pharmacists should work collaboratively with other health‐care professionals to provide tobacco‐cessation counselling to smokers. Approach. Recently, in the USA, a curriculum has been developed by faculty at a school of pharmacy and distributed to pharmacy schools across the nation in a train‐the‐trainer format. This curriculum has been implemented in varying degrees in schools across the USA. In addition, there are national efforts to increase the involvement of practising pharmacists in promoting tobacco cessation by offering comprehensive programs or by increasing awareness and referrals. Key Findings. The acceptance of the Rx for Change programs by schools of pharmacy has been high and the education and skills are being taught to most current pharmacy graduates. There is an increased emphasis on the role of pharmacists to assist in meeting national health goals including reducing tobacco‐related risks. Implications. Numerous opportunities exist for pharmacists to provide tobacco cessation counselling. Barriers to implementation of programs include lack of confidence by pharmacists and a perceived lack of demand by patients. Conclusion. The consequences of tobacco use are well known. Pharmacists should enhance their involvement in health promotion and disease prevention and actively develop tobacco cessation counselling programs using available resources for the benefit of their patients. [Williams DM. Preparing pharmacy students and pharmacists to provide tobacco cessation counselling. Drug Alcohol Rev 2009;28:533–540]
Address the gaps in tobacco cessation training and services: Developing professional organisational alliances to create social movements
Authors: BOTELHO RICK , WASSUM KEN , BENZIAN HABIB , SELBY PETER , CHAN SOPHIA
Published: August 2010

Issues.
To contribute towards reversing the tobacco pandemic, professional organisational alliances must reduce the wide international variability in the smoking rates among health‐care professionals and students, and also address the gaps in tobacco cessation training and services. Approach. Ongoing international surveys for monitoring smoking rates could provide the impetus for these alliances to develop programs that reduce smoking rates among professional and lay populations. Key Findings. Health professional organisations must advocate for systematically implementing comprehensive tobacco cessation training programs. Implications. These programs can include both evidence‐based interventions and experience‐based learning innovations. These innovations can help individuals address the limitations of evidence‐based guidelines. This shift from teaching individuals about changing‐specific risk behaviours to engaging individuals to learn how to change any risk behaviour expands the reach and impact of behaviour change programs. Conclusions. Practitioners and staff need first‐hand experience of these learning innovations before guiding patients through the same process. Using both evidence‐based guidelines and experience‐based learning methods, organisational leaders can develop professional alliances to create social movements that promote healthy habits in general. For example, they can develop voluntary learning programs in primary care and community settings that are led by patients and that are for patients. Such bottom‐up approaches have greater potential yield in addressing gaps in health promotion and disease prevention, and particularly for tobacco cessation services. This strategy is a more feasible option for resource‐limited, developing countries that cannot afford costly tobacco cessation programs. [Botelho R, Wassum K, Benzian H, Selby P, Chan S. Address the gaps in tobacco cessation training and services: Developing professional organisational alliances to create social movements. Drug Alcohol Rev 2009;28:558–566]
Overview of interventions to enhance primary‐care provider management of patients with substance‐use disorders
Authors: ANDERSON PETER
Published: August 2010

Issues. Despite the evidence for the effectiveness and cost‐effectiveness of interventions to manage substance use disorders, which are common presenting complaints in primary care, primary‐care providers find managing substance use disorders a difficult business. This paper provides an overview of the evidence for interventions, including training and education programmes, in enhancing the management of alcohol‐ and tobacco‐use disorders by health‐care providers. Approach. The Cochrane Library and the database of the Cochrane Effective Practice and Organisation of Care Group were searched for answers to five questions: (i) Can education and training increase the involvement of primary care providers? (ii) Can education and training cause harm? (iii) Can education and training be enhanced with support and other organisational factors? (iv) Can finance systems change provider behaviour? and (v) Is political support needed? Key Findings. Education and training can increase the involvement of primary‐care providers in managing alcohol‐ and tobacco‐use disorders, with the impact enhanced by additional support and other organisational factors. There is some evidence that if education and training does not take account of providers' attitudes, then harm can be caused. There is limited evidence that finance systems can change provider behaviour, and that comprehensive policy, in which a health sector response is a part, can increase the potential of primary‐care management of alcohol‐ and tobacco‐use disorders. Conclusions. Tailored education and training programmes for the management of alcohol‐ and tobacco‐use disorders need to be broadly implemented and embedded in overall comprehensive policies that provide the necessary organisational and financial incentives for enhancing provider behaviour. There is an urgent need to extend the evidence base on the impact of education and training and other strategies to increase the involvement of providers in managing substance‐use disorders.[Anderson P. Overview of interventions to enhance primary‐care provider management of patients with substance‐use disorders. Drug Alcohol Rev 2009;28:567–574]
Differences in self and independent ratings on an organisational dual diagnosis capacity measure
Authors: LEE NICOLE , CAMERON JACQUI
Published: August 2010

Introduction and Aims. There are a number of tools to assist services to measure their capacity to respond to co‐occurring substance use and mental health disorders. This study aimed to examine whether services could accurately self‐rate their dual diagnosis capacity. Design and Methods. Data were collected from 13 alcohol and drug services across Australia that participated in a comorbidity capacity building initiative. The organisations provided a range of services, including pharmacotherapy and counselling services, residential and outpatient services, youth and adult services and withdrawal. There was a mix of government and non‐government services. Results. Services rated themselves substantially higher than the independent raters at both baseline and follow up. Discussion and Conclusions. The results suggest that services may not accurately assess their own capacity. For organisations trying to make improvements in their services, independent assessment may be more helpful than self‐assessment in accurately determining service gaps. Overestimation of capacity may lead to failure to address important service needs.[Lee N, Cameron J. Differences in self and independent ratings on an organisational dual diagnosis capacity measure. Drug Alcohol Rev 2009]
The impact of drinking pattern on alcohol‐related violence among adolescents: An international comparative analysis
Authors: BYE ELIN K. , ROSSOW INGEBORG
Published: August 2010

Introduction and Aims.Drinking pattern seems to be an important mediator of the alcohol–violence association. Aggregate level studies have demonstrated that the alcohol–violence association is stronger in countries where intoxication occurs relatively more frequent to the overall drinking. However, this has not been tested against empirical data at the individual level or with respect to violence among young people. Thus, the aim of the present study was to test whether the association between alcohol consumption and prevalence of alcohol‐related aggression in young people would be stronger in countries where intoxication is relatively more prevalent.Design and Methods.The data comprised school surveys (pupils at age 16) from 13 countries in the European School Survey Project on Alcohol and Other Drugs 2003. The countries were divided into high, medium and low levels of intoxication rate.Results.The prevalence of alcohol‐related aggression varied considerably across countries, and was significantly higher in drinking cultures where intoxication is relatively more prevalent.Discussion and Conclusions.The findings of this study suggest that challenges for prevention of acute alcohol‐related harms in young people may be larger in countries where adolescents to a larger extent drink to intoxication. From a prevention point of view it also seems warranted to direct more future studies into the area of potential for preventing intoxication and drunkenness, not in the least among young people.[Bye EK, Rossow I. The impact of drinking pattern on alcohol‐related violence among adolescents: An international comparative analysis.Drug Alcohol Rev2009]
Itraconazole‐induced Torsade de Pointes in a patient receiving methadone substitution therapy
Authors: NOORZURANI MD HARIS ROBSON , VICKNASINGAM BALASINGAM , NARAYANAN SURESH
Published: August 2010

Issues. Methadone, a pharmacological agent used to treat heroin dependence is relatively safe, but may cause cardiac arrhythmias in the concurrent presence of other risk factors. Approach and Key Findings. This case report highlights the risk of Torsade de Pointes, a life‐threatening cardiac arrhythmia, in a heroin‐dependent patient receiving methadone substitution therapy who was prescribed itraconazole for vaginal thrush. The patient presented to the accident and emergency department for chest discomfort and an episode of syncope following two doses of itraconazole (200 mg). Electrocardiogram monitoring at the accident and emergency department showed prolonged rate‐corrected QT interval leading to Torsade de Pointes. The patient was admitted for cardiac monitoring, and electrocardiogram returned to normal upon discontinuation of methadone. Implication. This cardiac arrhythmia was most likely as a result of a drug interaction between methadone and itraconazole because the patient presented with no other risk factors. Conclusion. Given the benefits of methadone as a substitution treatment for heroin‐dependent individuals, the association between methadone and cardiac arrhythmias is of great concern. Physicians treating heroin‐dependent patients on methadone substitution therapy should therefore be cautious of the potential risk of drug interactions that may lead to fatal cardiac arrhythmias.[NoorZurani MHR, Vicknasingam B, Narayanan S. Itraconazole‐induced Torsade de Pointes in a patient receiving methadone substitution therapy. Drug Alcohol Rev 2009;28:688–690]
An overview of systematic reviews on cannabis and psychosis: Discussing apparently conflicting results
Authors: MINOZZI SILVIA , DAVOLI MARINA , BARGAGLI ANNA M. , AMATO LAURA , VECCHI SIMONA , PERUCCI CARLO A.
Published: August 2010

Issues. Cross‐sectional surveys have revealed that cannabis is the most widely used illicit substance in Western countries. Cannabis intoxication can lead to acute, transient psychotic symptoms and the short‐term exacerbation of pre‐existing psychotic symptoms. However, controversy exists about whether cannabis can actually cause long‐term psychosis. Approach. We summarised the findings of systematic reviews on the association between cannabis use and psychosis, searching MEDLINE, EMBASE and CINAHL up to August 2007. We assessed the methodological quality, selected the better quality reviews and analysed reasons for discordant results. Key Findings. We included five systematic reviews. Four of the reviews performed a meta‐analysis and showed a consistent association between cannabis use and psychosis; the fifth review considered psychological problems more broadly, did not perform a meta‐analysis and reported an inconsistent association. The reasons for discordance were: different outcomes (psychosis vs. psychological problems), different inclusion criteria for primary studies and different methods for summarising the results. Implications. This overview shows a consistent association between cannabis use and psychotic symptoms, though it is not possible to draw firm conclusions about a causal relationship. Reverse causality and residual confounding cannot be excluded. An interaction with other environmental and genetic factors is difficult to ascertain. Conclusion. We conclude that there is insufficient knowledge to determine the level of risk associated with cannabis use in relation to psychotic symptoms and that more information is needed on both the risks of cannabis use and the benefits of preventive interventions to support evidence‐based approaches in this area.[Minozzi S, Davoli M, Bargagli AM, Amato L, Vecchi S, Perucci CA. An overview of systematic reviews on cannabis and psychosis: Discussing apparently conflicting results. Drug Alcohol Rev 2009]
Predictors and consequences of incarceration among a sample of young Thai methamphetamine users
Authors: SHERMAN SUSAN G. , SUTCLIFFE CATHERINE G. , SRIROJN BANGORN , GERMAN DANIELLE , THOMSON NICK , ARAMRATTANA APINUN , CELENTANO DAVID D.
Published: August 2010

Introduction and Aims. Our study examined the incidence of arrest and incarceration, investigated predictors of incarceration and explored the persistence of depression, alcohol use and drug use after incarceration among young methamphetamine users from Thailand. Design and Methods. Participants were aged 18–25 years old and were a part of a 12 month randomised social network trial that aimed to reduce sexual risk and methamphetamine use. Estimates of the incidence of arrest and incarceration over 12 months were calculated. A matched case–control study (n = 73 cases; n = 223 controls) was performed to examine incarceration risk factors using conditional logistic regression. Persistence of drug‐risk behaviours were explored after incarceration. Results. Study participants (n = 950) were 72% male, with a median age of 19 years and a median of 9 years of schooling. Frequent drug and alcohol use were reported at baseline. In total, 35% of the sample reported ever having been arrested and 22% reported ever having been incarcerated at baseline. During the 12 month follow up, 16% of the sample was arrested. In univariate analyses, risk factors for incarceration included frequent drug and alcohol use, being less educated, and a history of arrest and incarceration. A high prevalence of drug and alcohol use and involvement in the drug economy persisted after arrest. Discussion and Conclusions. The study indicates a high prevalence of recidivism among this young sample, with continued involvement in drug‐risk behaviours after incarceration. Appropriate interventions are needed to address root causes of arrest, largely related to substance use.[Sherman SG, Sutcliffe CG, Srirojn B, German D, Thomson N, Aramrattana A, Celentano DD. Predictors and consequences of incarceration among a sample of young Thai methamphetamine users. Drug Alcohol Rev 2010]
Predictors of early dropout in methadone maintenance treatment program in Yunnan province, China
Authors: CHE YANHUA , ASSANANGKORNCHAI SAWITRI , MCNEIL EDWARD , CHONGSUVIVATWONG VIRASAKDI , LI JIANHUA , GEATER ALAN , YOU JING
Published: August 2010

Introduction and Aim. The aim of this study is to identify the predictors of early dropout of patients in methadone maintenance treatment (MMT) clinics in Yunnan province, China. Methods. A cohort study was conducted on 218 patients starting treatment in five MMT clinics between 1 March 2008 and 31 August, with follow up to 28 February 2009. Patients were interviewed using a semistructured questionnaire covering socio‐demographic characteristics and drug abuse history. Attendance at clinic and daily dose were abstracted from the clinic records. The mean average daily dose per patient in each period was compared across three periods, 0–1, >1–3 and >3–6 months, using analysis of variance and random‐intercept mixed linear regression modelling. Cox regression model with time‐varying average daily dose within each period was performed to identify factors predicting dropout in the MMT program. Results. Cumulative probability of retention at 1, 3 and 6 months was 94%, 75% and 57%, respectively. There was no relationship between dose and probability of dropout in periods 1 and 2. However, after 3 months higher average daily dose (>60 mg) was associated with lower probability of dropout. Dropout was more likely among the Han ethnic group [hazard ratio (HR) = 1.86, 95% confidence interval (CI): 1.65–3.26], in those who had to spend over 30 min to visit the clinic (HR = 1.63, 95% CI: 1.07–2.49) and in those living with other drug users (HR = 2.71, 95% CI: 1.55–4.74). Discussion and Conclusion. Patients' early dropout was related to ethnicity, clinic accessibility, living with drug users and methadone dose. A higher methadone dose as appropriate for maintenance treatment is recommended.[Che Y, Assanangkornchai S, Mcneil E, Chongsuvivatwong V, Li J, Geater A, You J. Predictors of early dropout in methadone maintenance treatment program in Yunnan province, China. Drug Alcohol Rev 2010]
Do young people attending addiction services differ from those attending youth mental health services?
Authors: CHRISTIE GRANT , MERRY SALLY , ROBINSON ELIZABETH
Published: August 2010

Introduction and Aims. We aimed to describe and compare the self‐reported substance use, psychopathology and psychosocial morbidity in adolescents attending two adolescent outpatient services, a triage‐based mental health service and an engagement‐focused addiction service in Auckland, New Zealand. Design and Methods. A naturalistic cross‐section of 131 (addiction service = 67, mental health service = 64) 14–18‐year‐old boys and girls attending each service completed a standardised screening and assessment instrument, the Drug Use Screening Inventory—Revised. The Drug Use Screening Inventory—Revised measures self‐reported problems across 10 domains of functioning, including substance use, behaviour, psychiatric symptoms and school and family functioning. Descriptive statistics were used to provide an overview of the self‐reported morbidity in each group and t‐tests were used to determine differences between the two groups. Results. Adolescents attending the addiction service reported significantly more problems with substance use, school performance and peer relationships than those attending the mental health service. There was no significant difference in reported psychiatric symptoms, behavioural problems, social competency, health problems, family problems, difficulties in work functioning or leisure time between the two groups. Discussion and Conclusions. Young people presenting to engagement‐focused substance use services report similar difficulties to those at mental health services across most areas of psychosocial functioning. Addiction services may require equivalent staffing expertise and workforce development to that in mental health to effectively meet young people's needs. [Christie G, Merry S, Robinson E. Do young people attending addiction services differ from those attending youth mental health services? Drug Alcohol Rev 2010]