bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of death and hospitalization from assault occurring in and around licensed premises: a comparative analysis
Authors: LANGLEY JOHN , CHALMERS DAVID , FANSLOW JANET
Published: March 2003

The aim of the research was to: determine the incidence of serious assault in and around licensed premises in New Zealand, and to compare the circumstances of assault with those that occurred in other locations. For the period 1978–87, inclusive, 49 assault fatalities occurred in or around licensed premises representing 9.4% of all homicides and 12.9% where a place was specified. The comparable figures for assaults resulting in hospitalization in 1988 were: 251, 10.2% and 18.4%, respectively. Further analyses suggests that our estimate of the incidence rate is likely to be an underestimate due to changes over time in the large number of assault cases which have no specific place of occurrence identified. In comparison with homes homicides in licensed premises were more likely to involve: males; Maori, unarmed fights and brawls; unknown assailants; alcohol; occur during the evening and toward the end of the week; and result in head injury. For non‐fatal events similar differences were found. In comparison with homes non‐fatal assaults were more likely to involve: males; young adults, Maori, the unemployed, unanned fights and brawls, and head injury. There have been a number of significant policy changes in New Zealand since 1988 which may have resulted in a change to the situation reponed here.
Evaluation of a cognitive‐behavioural intervention for pregnant injecting drug users at risk of HIV infection
Authors: O'Neill Katy , Baker Amanda , Cooke Margaret , Collins Edith , Heather Nick , Wodak1 Alex
Published: March 2003

Pregnant injecting drug users were randomly assigned to: (i) individually receive a six‐session cognitivebehavioural intervention in addition to their usual methadone maintenance treatment (intervention condition (I) ( n = 40)); or (ii) their usual methadone maintenance treatment only (control condition (C) ( n = 40)). There was no change in drug use per se in either group after the intervention. However, at 9‐month follow‐up the I group had significantly reduced some HIV risk‐taking behaviours (in particular injecting risk behaviours). The I group reduced the needle risk associated both with "typical" use (drug use in the month before interview) and "binge" use (drug use in the month nominated as the heaviest month of drug use in the previous 6 months). The intervention had no effect on sexual risk behaviours. The finding of reduced injecting risk behaviour following the six‐session intervention suggests that such an intervention may be of benefit for individuals persisting with injecting risk behaviours despite methadone maintenance treatment and the availability of sterile injection equipment.
Personal and familial characteristics of resilient sons of male alcoholics
Authors: Vitaro Frank , Dobkin Patricia L. , Carbonneau Rene , Tremblay Richard E.
Published: March 2003

This study compared sons of male alcoholics (SOMAs) who had no problems with those who were abusing substances, those who had school problems, those who were delinquent and those who were multiproblem. Corresponding groups of non‐SOMAs were also included. Groups were compared at ages 6, 10, 12 and 14 years on teacher‐ and peer‐rated aggressiveness, hyperactivity, inattention, anxiety and prosociality; parent‐rated temperament; parents' disciplinary practices; school performance; family socio‐economic status; self‐reported substance (ab)use and delinquency; and school performance (from school records). Differences between SOMAs and non‐SOMAs were small. According to teachers and peers, no problem SOMAs and nonSOMAs were less aggressive‐oppositional, inattentive and hyperactive than problem SOMAs and nonSOMAs. These effects differed as a function of age, however. Also, no problem SOMAs and non‐SOMAs performed better in school than boys in the problem groups. We discuss the relevance of these findings for identifying factors that render children resilient and for early screening to select truly at risk SOMAs for prevention programs.
Alcohol‐related harm and alcohol consumption in Moscow before, during and after a major anti‐alcohol campaign
Authors: Nemtsov A. V.
Published: March 2003

Aims. To examine the rates of alcohol‐related harm in relation to levels of alcohol consumption before, during and after a major anti‐alcohol campaign in Moscow. Design. Changes in State alcohol sale and alcohol consumption and certain forms of alcohol‐related harm were observed as a function of time. Findings. Following the 1985 anti‐alcohol campaign, State alcohol sales decreased by 38.0% in 1.5 years in Moscow, and total consumption decreased by 28.6%. At the same time, admissions for alcohol‐related mental and behavioural disorders, deaths from liver cirrhosis, alcohol poisoning and other blood alcohol positive violent deaths decreased by 63.3%, 33.0%, 50.8% and 50.9%, respectively. There was a linear correlation between medical variables and alcohol consumption during its decrease in 1985‐86. An increase in blood alcohol positive violent deaths began in 1987, before the increases in other variables. Growth of total alcohol consumption began in 1987, and continued during all subsequent years, although it was especially high in 1992‐93 at the time of the introduction of market reforms in Russia. Alcohol‐related mental and behavioural disorders and liver cirrhosis mortality increased after a time‐lag following the rise in alcohol consumption. Conclusions. The findings provide stark evidence of the potential impact of policy measures applied to general alcohol consumption on alcohol‐related harm.
Alcohol‐related words are distracting to both alcohol abusers and non‐abusers in the Stroop colour‐naming task
Authors: Bauer Daliah , Cox W. Miles
Published: March 2003

Aim. To compare alcohol abusers' and non‐abusers' distraction for alcohol‐related and emotional words, controlling for emotional valence of those words. Design and method. The experiment compared 20 alcohol abusers and 20 non‐abusers in terms of performance on a computerized Stroop colour‐naming test using alcohol‐related and non‐alcohol‐related words. Findings. Abusers rated the alcohol stimuli greater in emotional valence than the emotional stimuli. Therefore, differences in emotional‐valence ratings between the two groups were statistically controlled. Against expectation, both alcohol abusers and non‐abusers were more distracted by alcohol stimuli than by positive or negative emotional stimuli. Conclusions. The results indicate that alcohol words are distracting for drinkers in general, and this may indicate a high level of salience for these kinds of stimuli.
Assessing the relationship between maternal opiate use and antepartum haemorrhage
Authors: Hulse G. K. , Milne E. , English D. R. , Holman C. D. J.
Published: March 2003

Aims/Design. Assessment of the association between the regular use of opiates by women during pregnancy and antepartum haemorrhage has been made difficult by the low prevalence of these conditions observed in clinical settings. As a consequence, most published studies lack statistical power due to the small number of cases. We combined all suitable published data in a meta‐analysis to assess the association more accurately. Findings. Meta‐analysis produced a pooled estimate of the crude odds ratio for antepartum haemorrhage in relation to maternal opiate use of 2.33 (95%CI 1.32‐4.30). Conclusions. This odds ratio estimate is consistent with a moderately strong association. Studies included did not adjust for possible confounders (e.g. prenatal care, cocaine or tobacco), so confounding is likely to account for at least some of the observed effect. The relative consistency of results from studies included in the meta‐analysis that were conducted in different countries and at different times adds to the strength of the evidence for an association between opiate use and antepartum haemorrhage. Well designed studies are urgently required to assess the independent effects of different types and patterns of maternal opiate use and confounders such as cigarette smoking, illicit cocaine use and antenatal care on antepartum haemorrhage.
RESEARCH REPORT Male drinking and violence‐related injury in the emergency room
Authors: Borges Guilherme , Cherpitel Cheryl J. , Rosovsky Haydee
Published: March 2003

Abstract Aims. To present epidemiological measures of associations between violence‐related injuries (assaults and fights), alcohol consumption prior to the event, and drinking patterns among males attending hospital emergency rooms (ERs) in Mexico City. Design. All patients were interviewed and breath tested for alcohol consumption. The data were analyzed using a case‐control design. Setting. Eight ERs in Mexico City that were representative of the types of emergency care systems available in that city (from public, private and social security systems hospitals). Participants. Cases were males patients ( n= 445) admitted to the ER because of a fight or an assault. The control group was comprised of patients ( n= 320) admitted to the ER because of accidents that are less frequently reported as alcohol‐related (i.e. work‐place accidents, animal bites or recreational accidents excluding near drowning). Measurements. A breath sample to estimate BAC, as well as an interviewer‐administered questionnaire were used. Findings. Alcohol consumption prior to injury was found to be a more important risk factor than usual drinking for injuries resulting from violence, while quantity of usual alcohol consumption was more predictive of violence‐related injuries than frequency of drinking. Conclusions. These data suggest the importance of using more appropriate control groups when estimating associations of alcohol and violence‐related injuries so that associations will not be underestimated. More research is needed to establish unbiased estimates of alcohol‐related violence.
RESEARCH REPORT Sample selection bias in the emergency room: an examination of the role of alcohol in injury
Authors: Treno Andrew J. , Gruenewald Paul J. , Johnson Fred W.
Published: March 2003

Abstract Aims. Injury location, injury cause and patient drinking patterns were used to predict blood alcohol content (BAC) and self‐reported drinking before injury using emergency room (ER) data. Design. Models estimating both BAC and self‐reported drinking among emergency room injury patients were used; the ER sample was also compared to an injured sample from the general population. Setting. Data were from three of six communities participating in the project "Preventing Alcohol Trauma: a community trial". Participants. ER data were collected from nine hospitals on Friday and Saturday nights between 6 p.m. and 2 a.m. on alternate weekends from June 1992 to December 1995. Telephone survey data were collected between April 1992 and March 1996. Measurements. Drinking measures included drinking frequency, drinks per occasion, and variance. Other measures involved injury time, location, and type; drinking before and after injury; and age, race, gender, education, marital status and household income. Model estimation corrected both for selection bias and censoring of the dependent measure. Findings. The results indicate: (1) ER populations tended to be female, less well educated, non‐white, poor and younger; (2) there were significant selection bias effects in the ER sample; (3) assaults were more likely to involve drinking than other injury types; (4) drinking patterns were significant non‐linear predictors of alcohol involvement; and (5) selfreported drinking before injury was both a sensitive and specific indicator of measured BAC. Conclusions. Assaults uniquely involve the use of alcohol and selection bias may threaten ER study validity.
Patterns of sexual and injecting risk behaviours in French intravenous drug users not reporting HIV and hepatitis C virus seropositivities
Authors: Vidal‐Trecan Gwenaelle , Coste Joel , Varescon‐Pousson Isabelle , Reboul‐Marty Jeanne , Christoforov Boyan , Boissonnas Alain
Published: March 2003

Aims. To characterize and identify determinants of risk behaviour patterns of intravenous drug users (IDUs) independently of changes due to knowledge of HIV or hepatitis C Virus (HCV) seropositivity. Design. A cross‐sectional survey using a structured questionnaire concerning sexual, injecting and HIV and HCV antibody testing practices. Setting. IDUs were interviewed in the Paris region at 10 treatment or psychosocial centres. Participants. Six hundred and twelve consecutive sexually active IDUs over 18 years able to answer the questionnaire. Measurements. Five hundred and ninety‐five IDUs completed the questionnaire. The risk‐behaviour patterns of the 328 IDUs not reporting HIV or HCV seropositivity were analysed by phi correlation. Risk factors for each risk behaviour were determined by regression logistic models yielding odds ratios (OR) and their 95% confidence intervals (95%CI). Findings. Several risk behaviour patterns were suggested: (1) lending, borrowing; (2) not or inconsistently testing HIV and HCV serology and not or inconsistently using condoms; (3) having multiple partners and prostitution; and (4) not using clean equipment. Alcohol abuse was independently and specifically associated with lending (OR = 3.8; 95% CI: 2.1‐7.0) and borrowing (OR = 3.3; 95% CI: 1.8‐6.1); homelessness with injecting risk behaviours and with prostitution (OR = 2.7; 95% CI: 1.2‐6.1); low educational level and having children with not or inconsistently using condom and serology testing; and cocaine use with not or inconsistently using condoms (OR = 0.4; 95% CI: 0.3‐0.7) and serology testing and not using clean equipment (OR = 0.4; 95% CI: 0.2‐0.8). Having multiple partners and prostitution had no common risk factors. Conclusions. Identifying specific risk factors could help to target drug harm reduction programmes for each risk behaviour pattern among IDUs not reporting HIV and HCV seropositivity.
How healthy are the police? A survey of life‐style factors
Authors: Richmond Robyn L. , Wodak Alex , Kehoe Linda , Heather Nick
Published: March 2003

Aims. To examine the prevalence of five life‐style behaviours among New South Wales police. Design. A cross‐sectional survey using a self‐administered questionnaire. Setting and participants. A total of 852 police were recruited from metropolitan Sydney. Measurements. Prevalence related to age and sex of self‐reported alcohol consumption, cigarette smoking, inadequate exercise, perception of overweight and stress symptoms. Results. A high level (89%) of participation was achieved in the survey. Almost half (48%) of males and more than two‐fifths (40%) of females consumed alcohol excessively including continuous hazardous or harmful consumption and binge drinking. Excessive drinking was more prevalent among younger police. There were 8% of male and 15% of female police who reported that they did not drink alcohol. Over one‐quarter (27%) of male and one‐third (32%) of female respondents reported smoking. Almost half (46%) of men and women (47%) believed that they were overweight. More than one‐fifth (21%) of men and less than one‐quarter (24%) of women reported that they did not exercise. Finally, 12% of men and 15% of women reported feeling moderate to severe symptoms of stress. Conclusions. The police work‐force offers an opportunity to screen for a large number of healthy, young and high risk individuals (particularly men) who are hard to reach in other settings and who rarely visit their general practitioner. A sizeable majority (83%) of NSW police had at least one unhealthy life‐style behaviour with 19% reporting 3‐5 unhealthy factors. The high prevalence of excessive alcohol consumption among police is of particular concern. More active health promotion and provision of brief interventions among police may reduce morbidity and mortality associated with unhealthy life‐styles.
Differences between hospital patients with alcohol problems referred for counselling by physicians' routine clinical practice versus screening questionnaires
Authors: Hapke U. , Rumpf H.‐J. , John U.
Published: March 2003

Aims. To test the hypothesis that screening for alcohol‐related disorders in a general hospital with questionnaires generates a target group of patients for alcohol counselling which differs from patients referred by physicians' routine clinical practice. Design. A prospective study with follow‐up after 12 months. Setting. Medical and surgical wards of a general hospital. Participants. A sample of 298 patients detected by screening questionnaires (CAGE, MAST) was compared with a sample of 87 patients referred by physicians. Measurements. The main measurements were a diagnostic interview (SCAN), two questionnaires to estimate the severity of dependence and the motivation to change drinking behaviour (RCQ, LAS), and socio‐demographic variables. Outcome criteria were utilization of remedial programmes, decreases in hazardous and excessive drinking and abstinence rates. Findings and conclusions. Patients referred by physicians were more often separated and unemployed, were more likely to be alcohol‐dependent and to be more severely dependent, had a higher rate of alcohol‐related diseases as reasons for admission, were more often motivated to change drinking behaviour, had a higher participation rate in remedial programmes and more often exhibited improvements in drinking behaviour compared with the sample identified by screening questionnaires. However, there was evidence of improvements in drinking in both samples. Data show that while screening reaches a less problematic sample with lower motivation to change, it is a worthwhile activity which extends the spectrum of patients eligible for brief interventions.
The relationship between childhood sexual abuse and alcohol abuse in women ‐ a case‐control study
Authors: Fleming Jillian , Mullen Paul E. , Sibthorpe Beverly , Attewell Robyn , Bammer Gabriele
Published: March 2003

Aims. The aim of this paper was to examine the association between reporting childhood sexual abuse (CSA) and alcohol abuse in a community sample of women using multivariate analysis which took into account a range of potential confounding variables (such as a family history of alcoholism) and effect modifiers (such as having an alcoholic partner). Design. A two‐stage retrospective case‐control study was used to investigate the relationship between reporting CSA and alcohol abuse in women. Participants. Seven hundred and ten women randomly selected from the Australian federal electoral rolls. Measurements. The Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol abuse. A series of questions based on those developed by Wyatt (1985) were used to ascertain the prevalence of CSA. Findings. The final model showed that the relationship between a history of CSA and alcohol abuse reflected a complex interaction between CSA and a range of other factors in a woman's background. CSA was not by itself a significant predictor of alcohol abuse (OR = 0.61; 95% CI = 0.31‐1.20). However, a history of CSA became significant in combination with co‐factors which included: having a mother who was perceived as cold and uncaring; having an alcoholic partner; and believing that alcohol is a sexual disinhibitor. Conclusion. This study indicates that CSA alone is not a causative factor in the development of alcohol abuse among women and highlights the importance of examining the family background of women with alcohol problems.
Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in South West England and Mexico City
Authors: Orford Jim , Natera Guillermina , Davies Jill , Nava Adriana , Mora Jazmin , Rigby Kate , Bradbury Colin , Bowie Nadia , Copello Alex , Velleman5 Richard
Published: March 2003

Aims. To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. Design. Cross‐sectional interview and questionnaire study of a series of family members in two contrasting socio‐cultural groups. Setting. Mexico City and South West England. Participants. Two hundred and seven family members from separate families, three‐quarters women, one‐quarter men, mostly partners or parents. Data. Long semi‐structured interviews; the Coping Questionnaire (CQ). Findings. Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. Conclusions. It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.
Illicit drug use among Mexicans and Mexican Americans in California: the effects of gender and acculturation
Authors: Vega William Armando , Alderete Ethel , Kolody Bohdan , Aguilar‐Gaxiola Sergio
Published: March 2003

Aims. To examine the effects of gender and acculturation on illicit drug use among the Mexican‐origin population in California. Design. The 3012 subjects between 18 and 59 years of age were selected under a stratified, multi‐stage cluster sampling method. Setting. Fresno County in California is primarily agricultural, with only one metropolitan area. Over 30% of the total population of 764 800, are Hispanics, of Mexican origin. Measurements. A modified version of the World Health Organization's Composite International Diagnostic Instrument (WHO‐CIDI) was used to ascertain drug use. Respondents were considered drug users if they had ever used marijuana, cocaine, hallucinogens, heroin or inhalants. Acculturation was measured with a Likert scale, assessing English vs. Spanish language preference. Other covariates of interest were nativity and place of residence. Findings. Men had higher rates of use than women for every drug (men = 46.3%, women = 23.2%). Urban rates were higher than rural rates, for both women (urban = 32.8% vs. rural = 16.6%) and men (urban = 57.0% vs. rural = 36.8%). In logistic regression models, men were more likely than women to have ever used illicit drugs or inhalants (adjusted OR = 4.8), cocaine (adjusted OR = 5.3) or marijuana (OR = 4.3). However, the combined effect of United States nativity and acculturation, on drug use, was greater among women (adjusted OR = 29.3) than among men (adjusted OR = 7.4). The effect of acculturation was stronger among urban, than among town or rural residents. Conclusions. Acculturation and United States nativity are risk factors for illicit drug use among Mexican origin men and women. However, women have increased vulnerability compared with men. Findings reinforce the need for culturally based public health interventions.
RESEARCH REPORT The early course of change in methadone maintenance
Authors: Cacciola John S. , Alterman Arthur I. , Rutherford Megan J. , Mckay James R. , Mclellan A. Thomas
Published: March 2003

Abstract Aims. This study examined the functional and substance use status of methadone maintenance (MM) patients at treatment entry and 2 and 7 months later. Design. Two groups of subjects were identified for longitudinal follow‐up, those in continuous MM treatment and those who left treatment. Setting. The study was conducted at the Philadelphia Veterans Affairs Medical Center MM Program. Participants. Subjects were 157 men admitted to treatment. Measurements. Change was evaluated using the Addiction Severity Index and urinalysis results. Findings. Both groups of subjects reported significant reductions in drug use and increases in psychosocial functioning from admission to month 2, but demonstrated no significant changes from months 2 to 7. Subjects who left treatment, however, had more heroin use and criminal activity at all evaluation points than subjects who remained in treatment. Urinalysis data also suggested that subjects who left treatment were using drugs more frequently while in treatment than were those subjects who remained continuously enrolled in MM. Finally, subjects who left treatment spent more time in restricted environments (e.g. inpatient treatment, jail) at follow‐up. Conclusions. Services may need to be enhanced to foster continuing progress in patients who remain in MM treatment and to retain those patients with more severe problems who leave treatment early.
RESEARCH REPORT Differentiation in the Amsterdam dispensing circuit: determinants of methadone dosage and site of methadone prescription methadone
Authors: Langendam Miranda W. , Haastrecht Harry J. A. Van , Brussel Giel H. A. Van , Anneke Hans Reurs , Hoek A. R. Van Den , Coutinho Roel A. , Ameijden Erik J.C. Van
Published: March 2003

Abstract Aims. To evaluate the Methadone Dispensing Circuit in Amsterdam by identifying determinants of methadone dosage and client characteristics in the different types of methadone programmes. Design and participants. Four hundred and forty‐four participants of a cohort study of drug users in Amsterdam who had consented to link data of the Central Methadone Register to the cohort data. Findings. From 1985 to 1994, methadone dosage increased from 41 to 59 mg/day. The mean methadone dosage was higher for ethnic West Europeans, Germans, older drug users, HIV‐positive drug users, those with a longer duration of prostitution, current injectors, those with a longer duration of injecting, longer duration of methadone use, higher frequency of being dispensed methadone and clients of the prostitutes' and foreigners' outpatient clinic. For clients of the general practitioner, at the police station and in prison the methadone dosage was lower. We found different sets of client characteristics in those receiving methadone at the methadone outpost, the methadone bus, the prostitutes' and foreigners' outpatient clinic, the general practitioner and the outdoor addiction clinic. Conclusions. These results indicate that the Amsterdam system is highly differentiated in a way that is largely concordant with the intended general policy on methadone treatment.
The "improved" public house, 1870‐1950: the key to civilized drinking or the primrose path to drunkenness?
Authors: Greenaway John R.
Published: March 2003

The Victorian temperance movement aimed to eliminate, not reform, public houses, but from 1870 interest began to be taken in promoting an "improved" public house which could promote counter‐attractions to drink. Disinterested management, based upon public ownership or a trust company, was advocated as the best means of achieving this. There was, however, an ambiguity about the nature of the "improved" public house. Was the goal an austere establishment where the drinking could be controlled in the public interest, or was it a comfortable leisure centre which would promote civilized drinking? This ambiguity lay unresolved during the period of the Carlisle experiment in state control in the period after 1915. Increasingly during the inter‐war years the policies of the state‐run Carlisle scheme and the more go‐ahead brewers converged. The issue was originally conceptualized as a moral one, then as one of national efficiency and finally as a commercial one.
Alcohol consumption and mortality. II. Studies of male populations
Authors: Leino E. Victor , Romelsjo Anders , Shoemaker Carlisle , Ager Catherine R. , Allebeck Peter , Ferrer Heidi P. , Fillmore Kaye Middleton , Golding Jacqueline M. , Graves Karen L. , Kniep Steven
Published: March 2003

Aims. This is the second of a set of three papers evaluating drinking status and mortality risk. Analysis of eight general population surveys of men evaluated all‐cause mortality rates by drinking pattern. Design and participants. Raw data from three studies of youth and five studies of adults were evaluated. Logistic regression models controlled for confounding characteristics. Meta‐analysis combined study results. Measurements. Drinking pattern was alternatively defined by quantity, frequency and volume of drinking. Final models included drinking pattern (as well as abstinence in the youth models and long‐term abstainers and former drinkers in adult models), age and other confounding variables. Models also evaluated interactions of age and, respectively, long‐term abstinence and former drinking. Findings. No evidence was found for the hypothesis that abstinence is associated with greater mortality risk than light drinking. In the youth samples, abstainers had a lower risk of dying than those drinking less than 15 times per month. One study of the adult samples showed a significant age by former drinker interaction; this did not alter the lack of association of former drinking with mortality risk or the homogeneity of results across studies for this finding. The most consistent finding was the association of heavy drinking with mortality among youth. Among adults, drinking 43 or more drinks per month and drinking 21 or more times per month were associated with increased mortality risk. Quantity per occasion was not significantly associated with mortality risk among adults. Conclusions. That frequent drinking was related to mortality risk, whereas heavier quantity was unrelated, is inconsistent with the belief that daily consumption of a few glasses of wine has salutary effects. Empirically, however, this pattern tends to be unusual. Findings were homogeneous across studies lending generalizability to results.
Polydrug abuse in heroin addicts: a behavioral economic analysis
Authors: Petry Nancy M. , Bickel Warren K
Published: March 2003

A bstract A im . To assess how price and income affect hypothetical drug‐purchasing decisions of polydrug abusers undergoing treatment for heroin addiction . Participants, design and setting. Forty subjects participated in experiments in which they hypothetically "purchased" drugs as price or income varied . Intervention. Experiment 1 examined effects of heroin price on purchases of heroin, valium, cocaine, marijuana and alcohol. Experiment 2 examined the effects of both heroin and valium prices on purchases of these drugs. In both these experiments, income remained constant. Experiment 3 examined the effects of increasing income on drug choices, with drug prices constant . Findings. As price of heroin rose in Experiment 1, heroin purchases decreased. Reductions in heroin purchases were proportionally less than price increases, demonstrating inelastic demand for heroin. Valium and cocaine purchases increased as heroin price rose, and cross‐price elasticity coefficients indicated that these drugs substituted for heroin. In Experiment 2, demand for both heroin and valium was inelastic. Valium substituted for heroin, but heroin purchases were independent of valium prices, suggesting an asymmetrical substitution effect. Marijuana and alcohol purchases were independent of valium price, but both these drugs substituted for heroin. In Experiment 3 demand for heroin and cocaine was income elastic, with purchases rising in greater proportion than income. Marijuana, alcohol and valium purchases did not vary with income, demonstrating that demand for these drugs was income inelastic. Hypothetical choices were reliable both between and within subjects. Moreover, drug choices in this hypothetical situation were correlated with urinalysis results, demonstrating initial validity of this methodology . C onclusions. This methodology may be useful for understanding the phenomenon of polydrug abuse .
Responses to televised alcohol associated with drinking 10‐17‐year‐olds advertisem ents behaviour of
Authors: Wyllie Allan , Zhang Jia Fang , Casswell Sally
Published: March 2003

A im s. To examine the nature of the relationships between 10‐17‐year‐old New Zealanders' responses to alcohol advertisements and their drinking behaviour and future drinking expectations, with consideration also being given to the role of positive and negative beliefs about drinking . D esign. Survey involving 500 face‐to‐face interviews, with selection based on random cluster sampling . Setting. In respondents' homes in New Zealand's three largest urban areas . Participants. Ten‐17‐year‐old New Zealanders . M easurem ents. Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response) . Findings. An exploratory structural equation model provided tentative support for the theory‐based hypothesis that positive responses to beer advertisements increased the frequency of current drinking and expected future drinking, among this age group. There was no evidence for the hypothesized reciprocal effects; the frequency of drinking (including non‐drinking) did not significantly affect the respondent's liking of beer advertisements. There was also no support for a hypothesis that linking of the beer advertisements was a product of a general liking for alcohol. Many of the young people themselves felt that alcohol advertising encouraged teenagers to drink. This was especially the case among 10‐13‐year‐old males, who were the most likely to accept the portrayals in alcohol advertising as realistic . C onclusions. Although there are limitations on the confidence with which conclusions can be drawn, the findings are consistent with qualitative and quantitative research and different theoretical perspectives on advertising processes which suggest alcohol advertising is likely to have some influence on young people .
G ender differences in alcohol‐related problem s: controlling for drinking behaviour
Authors: Bongers I. M . B. , Van L . A. M. , Sendegoor H . F. L . Garret , Oers J. A. M. Van
Published: March 2003

A bstract A im s. Two hypotheses were tested to explain a high prevalence of alcohol‐related problems among women relative to their low prevalence of excessive drinking: (1) At a given level of drinking, women may report more problems of any type than do men. (2) At a given level of drinking, the number of problems or the severity of the reported problems may be lower among women than among men. D esign. General population survey. Setting. Rotterdam, The Netherlands. Participants. 3537 Dutch respondents within the age range 16‐69 years . M easurem ents. Alcohol‐related problems were measured in five problem areas: psychological dependence, symptomatic drinking, social problems, health problems/accidents and frequent drunkenness/ hangovers. A problem index was formed by adding up the scores in the five separate problem areas. Alcohol use was measured by the Quantity‐Frequency‐Variability index. Findings. For the same level of drinking, women were as likely as men to report alcohol‐related problems except that women light drinkers were actually less likely to report problems than men. Men tended to have a greater accumulation of different types of problems within drinking categories than women. Overall problem severity, however, did not differ between men and women. The apparent excess prevalence of alcohol problems in women relative to drinking level appears to be due to presence of problems even among light drinkers and a greater preponderance of light drinkers in women than men. C onclusions. The first hypothesis was rejected; drinking levels being the same, the level of alcohol problems is the same or even lower for women than for men. As hypothesized, men tend to have a greater accumulation of different kinds of problems than women. However, the severity of the reported problems does not differ between men and women.
T he relationship between and cigarette sm oking in depressive sym ptom s U S adolescents
Authors: Escobedo Luis G. , Reddy Murii , Giovino Gary A.
Published: March 2003

A bstract A im s. Data from the Teenage Attitudes and Practices Survey were analyzed to assess the relationship between depressive symptoms and cigarette smoking. D esigns, Setting, Participants. Nationally representative sample of adolescents interviewed in 1989 and again in 1993. M easurem ents. Prevalence rate and adjusted odds ratio for smoking at follow‐up by depressive symptoms status at baseline. Findings. Adolescents with depressive symptoms were more likely than other adolescents to start smoking. C onclusions. The associations between depressive symptoms and regular smoking appears to be established by adolescence.
Psychiatric symptoms in male cannabis users not using other illicit drugs
Authors: Troisi Alfonso , Pasini Augusto , Saracco Michele , Spalletta Gianfranco
Published: March 2003

Aim. To assess the prevalence of DSM‐III‐R axes I and II disorders and the severity of psychiatric symptoms in cannabis users who did not use other illicit drugs . Design. Cross‐sectional psychiatric examination of subjects with different patterns of cannabis use: cannabis dependence, abuse and occasional use . Participants. One hundred and thirty‐three cannabis users identified through random urine testing of draftees to the Italian army and interviewed after 2‐5 days of abstinence from drug use . Measurements. The subjects completed the Beck Depression Inventory, the Spielberger State‐Trait Anxiety Index and the 20‐item revised Toronto Alexithymia Scale and were then interviewed with the Structured Clinical Interview for DSM‐III‐R . Findings. The prevalence of co‐morbid psychiatric disorders varied with the pattern of cannabis use: 83% of subjects with DSM‐III‐R cannabis dependence, 46% of those with DSM‐III‐R cannabis abuse and 29% of occasional users received at least one DSM‐III‐R psychiatric diagnosis. The severity of depressive, anxious and alexithymic symptoms increased progressively with the degree of involvement with cannabis . Conclusions. In this sample of young men, the risk of associated psychiatric disabilities varied with the pattern of cannabis use. Chronic use of cannabis was associated with a high prevalence of co‐morbid psychiatric disorders.
The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: a meta‐analysis
Authors: Marsch Lisa A.
Published: March 2003

Aims. To provide empirically based evaluation data regarding the efficacy of psychopharmacological interventions in opiate substance abuse, the present study employed meta‐analytic statistical procedures to determine the effectiveness of methadone hydrochloride as a pharmacotherapeutic agent . Design. Empirical research findings from 11 studies investigating the effect of methadone maintenance treatment (MMT) on illicit opiate use, and eight and 24 studies investigating the effect of MMT on HIV risk behaviors and criminal activities, respectively, by individuals in such treatment were addressed . Findings. Results demonstrate a consistent, statistically significant relationship between MMT and the reduction of illicit opiate use, HIV risk behaviors and drug and property‐related criminal behaviors. The effectiveness of MMT is most apparent in its ability to reduce drug‐related criminal behaviors. MMT had a moderate effect in reducing illicit opiate use and drug and property‐related criminal behaviors, and a small to moderate effect in reducing HIV risk behaviors . Conclusions. Results clarify discrepancies in the literature and are useful in predicting the outcomes of individuals in treatment. The treatment's effectiveness is evident among opiate‐dependent individuals across a variety of contexts, cultural and ethnic groups, and study designs.
Treating alcohol problems: a study of programme effectiveness and cost effectiveness according to length and delivery of treatment
Authors: Long Clive G. , Williams Martin , Hollin Clive R.
Published: March 2003

Aims. To compare effectiveness and cost‐effectiveness of a 5‐week inpatient and a two week in‐ and day‐patient regime . Design. Pre‐post assessment of consecutive treatment referrals with follow‐up at 6 and 12 months. In a sequential study design, 112 patients underwent a 5‐week residential programme while a subsequent 100 patients underwent a 2‐week in‐ and day‐patient programme. To investigate the effect of changing programme delivery, patient groups from before and after the programme changes were compared . Setting. Addiction treatment unit in an independent hospital . Participants. One hundred and thirty‐six males and 76 female patients with an ICD‐10 diagnosis of Alcohol Dependence Syndrome . Measurements. Self‐report (Comprehensive Drinkers Profile: Follow‐Up Drinkers Profile: SADQ), collateral report (Collateral Interview Form) and blood test (MCV & GGT) data were used to categorize patients into abstinent, non‐problem drinker, drinking but improved and unimproved groups. Percentage of days abstinent, intensity of drinking, length of time in treatment, treatment cost and use of aftercare were also measured . Findings. Abstinence or non‐problem drinking was achieved by 55.6% of all patients at 1 year. Change in programme delivery did not affect outcome but treatment costs and mean length of stay for the revised programme were significantly reduced . Conclusions. A two week in‐ and day‐patient treatment was more cost effective than a 5‐week inpatient treatment. Design limitations make these conclusions tentative pending a randomized controlled trial.
An outcome evaluation of a hospital‐based early intervention program
Authors: Welte John W. , Perry Patricia , Longabaugh Richard , Clifford Patrick R.
Published: March 2003

Aim. To determine the effectiveness of the Health Care Intervention Service (HIS), an early intervention program for general hospital patients with alcohol dependence or at risk for alcohol dependence . Design, setting and participants. HIS consists of screening, assessment and assignment to either full or risk‐reduction intervention. Full intervention includes a referral to treatment. Outcomes were compared across three groups: those who received a full intervention, those who received a risk‐reduction intervention, and a comparison group of similar patients from hospitals with no HIS program. Patients were screened for alcohol involvement and interviewed during their hospitalization (prior to the intervention in HIS hospitals) and again 6 months following the intervention . Findings. Full intervention was effective in increasing the probability of abstinence, reducing the number of heavy drinking days, and encouraging patients to accept the referral to treatment. Risk‐reduction intervention was effective in reducing alcohol consumption and consequences, but only for those patients who had some signs of dependence at the first interview . Conclusions. HIS has demonstrated its effectiveness in a "real world" bureaucratic and clinical environment.
Early experiences with tobacco among women smokers, ex‐smokers, and never‐smokers
Authors: Pomerleau Ovide F. , Pomerleau Cynthia S. , Namenek Rebecca J.
Published: March 2003

Aims. Recent research suggests that people who become smokers may be more sensitive to the positive effects of nicotine than those who do not take up smoking . Design and setting. The present study was designed to investigate this hypothesis by querying initial experiences with cigarette smoking in smokers, ex‐smokers and never‐smokers recruited from the local community . Participants. Subjects were 80 women (23 highly dependent smokers (Fagerstrom Tolerance Questionnaire score 7), 30 less‐dependent smokers (FTQ6), 12 ex‐smokers and 15 never‐smokers) . Measurements. Subjects were asked to rate pleasurable sensations and displeasurable sensations on a scale of 1=none to 4=intense, and to indicate the presence or absence of pleasurable rush or buzz, relaxation, dizziness, nausea and cough; social context was also queried. Pleasurable rush or buzz, relaxation, dizziness, nausea and cough were related to ratings of pleasurable and unpleasant sensations to establish their affective valence . Findings. Pleasurable sensations, pleasurable rush or buzz and relaxation (pleasant effects) were significantly more likely to occur in the smoker categories than in never‐smokers. The ratio of pleasurable to unpleasant sensations, computed as an index of overall hedonic impact of initial exposure, also significantly favored the smoker categories. By contrast, unpleasant sensations, nausea and cough (unpleasant effects) did not differ significantly among groups. Dizziness, which did not definitely emerge as either pleasurable or unpleasant, was significantly more likely to be reported among the smoker groups than among never‐smokers . Conclusions. People who become highly dependent cigarette smokers appear to have more pleasurable sensations at their initial exposure to tobacco; unpleasant reactions to the first cigarette do not seem to protect against subsequent smoking.
Current directions in research on understanding and preventing intoxicated aggression
Authors: Graham Kathryn , Leonard Kenneth E. , Room Robin , Wild T. Cameron , Pihl Robert O. , Bois Christine , Single Eric
Published: March 2003

The present paper describes promising research directions that emerged from a recent international conference on intoxication and aggression and from the scientific literature generally. In this overview, intoxicated aggression is seen as arising from an interactional process involving multiple contributing factors or causes. This model helps to define research directions that can further understanding and prevention. First, the societal/cultural framing of intoxication and aggression exerts a powerful influence on drinking behaviour and needs to be better understood. Another important area for research is the moderating role on alcoholrelated aggression of personal factors such as predisposition to aggression and individual differences in expectations about alcohol and aggression. Research on the role of basic pharmacological effects of alcohol in increasing the likelihood of aggressive behaviour is also a critical aspect of understanding intoxicated aggression. Drinking contexts and environments play a considerable role in the relationship between intoxication and aggressive behaviour and need to be better understood. Another critical direction for future research is the study of intoxicated aggression as a process involving the interaction of the person, the situation and the effects of alcohol in natural and experimental settings. Finally, the paper highlights promising directions for research on interventions to prevent intoxicated aggression and violence.
Effects on criminal violence of different beverage types and private and public drinking
Authors: Norstrom Thor
Published: March 2003

Aim. The purpose of the study is to analyse the relationship between homicide and assault rates on one hand, and various indicators of alcohol consumption on the other. The latter include private and public drinking with a further disaggregation into beverage‐specific drinking. Measurements. The data comprise aggregate time series for Sweden during the period 1956‐94. The assault rate is measured as the number of police reported assaults (at all degrees of aggravation) per 100 000 inhabitants (15 + ). The homicide rate is measured as the number of homicides (where the victim was at least one year old) per 100 000 inhabitants (15 + ). Private consumption is gauged as retail sales of alcohol, and public consumption as on‐premise sales (litres 100% per inhabitant, 15 + ). These two measures are disaggregated further into beverage specific sales (beer, spirits and wine). Findings. According to the findings, there is a statistically significant relationship between the assault rate and a combined measure of on‐premise sales of beer and spirits. The estimated relationship corresponds to an attributable fraction of about 40%. The homicide rate is significantly associated with retail sales of spirits; the attributable fraction is estimated at about 50%. Wine sales are not related to any of the two violence indicators. Conclusions. The findings suggest that the assault rate is related to consumption of beer and spirits in bars and restaurants, while the homicide rate is linked to consumption of spirits in private contexts. The findings, notably specific to Sweden during a certain time period, can be interpreted as the outcome of the interplay of a number of factors, including opportunity structure, social control and context of drinking, drinking patterns associated with the different beverage types and characteristics of the drinkers.