bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium Carbimide in Alcoholism Treatment. Part 2: medical findings of a short‐term, placebo‐controlled, double‐blind clinical trial
Authors: PEACHEY JOHN E. , ANNIS HELEN M. , BORNSTEIN EVELYN R. , MAGLANA SILVERIA M. , SYKORA KATHY
Published: January 2006

Drug‐induced toxicity in chronic alcoholics who participated in a 4‐month placebo (PI)—controlled clinical trial of the efficacy of calcium carbimide (CC) is reported. Daily monitoring of patients' compliance indicated that 85% of study medications were taken, and very little drinking took place during the study. Patients did not report more symptoms or experience more medical problems during CC administration than during placebo administration. There was no evidence of hepatotoxicity, or behavioural toxicity. Mean white blood cell count was slightly increased during CC treatment, and returned to baseline values when CC was stopped. Thyroid function was not affected by CC in patients with normal pretreatment function. However one patient with pretreatment reduced thyroid function became hypothyroid after CC administration, which indicates a need for systematic monitoring. We conclude that CC is safe for use in alcoholics with normal thyroid function, and may be the preferred alcohol‐sensitizing drug in some situations.
Calcium Carbimide in Alcoholism Treatment. Part 1: a placebo‐controlled, double‐blind clinical trial of short‐term efficacy⋆
Authors: PEACHEY JOHN E. , ANNIS HELEN M. , BORNSTEIN EVELYN R. , SYKORA KATHY , MAGLANA SILVERIA M. , SHAMAI SHMUEL
Published: January 2006

A randomized, double‐blind, placebo‐controlled single cross‐over study of the alcohol sensitizing drug, calcium carbimide (CC), was conducted in 128 patients with alcohol dependence. Seventy‐one (55%) completed the 4‐month study. Patients reported drinking and pill‐taking behaviour, and submitted urines (for analysis of alcohol and the tablet marker riboflavin) on 97%, and 91% of treatment days, respectively. All of the 69 analyzable computers were abstinent on at least 85% of days, and 58% (40) were alcohol‐free during the study. Medications were taken on at least 85% of days. Symptoms and adverse clinical findings were not increased in frequency during CC, compared to placebo. Seventy‐eight per cent of the patients believed they had received CC throughout the study, suggesting that CC exerts a strong psychological deterrent effect. Alcohol consumption was significantly reduced to the same extent with CC and placebo, compared to pre‐treatment levels.
Long‐term Outcomes of Drinking: a 20‐year longitudinal study of men
Authors: TEMPLE MARK T. , LEINO E. VICTOR
Published: January 2006

This paper examines long‐term changes in drinking, with regard to: (a) the degree to which overall patterns of drinking have shifted or remained across a 20‐year period; (b) whether these patterns vary on the basis of age; and (c) the degree to which distinct patterns of drinking may be differentially subject to mortality and/or nonresponse. Data for this investigation are from a 20‐year prospective follow‐up study of two general population surveys. The first of these was originally interviewed in 1964 and consists of interviews with 405 males aged 23 and older; the second, originally interviewed in 1967, consists of interviews with 786 males aged 21–59. The results indicate that while consumption was modestly associated with mortality from all causes, no significant relationship was observed between consumption and non‐response. The results also indicate that as respondents aged 20 years, mean levels of alcohol consumption remained stable. This was true despite the fact that when individual respondents did change their drinking, they were more likely to decrease their consumption than increase it. These results do not support conclusion drawn from cross‐sectional studies that aging modifies consumption patterns.
Consistency of Reported Levels of Alcohol‐related Problems in the Community
Authors: RITSON BRUCE , PECK DAVID
Published: January 2006

Regular drinkers identified in a general population survey of adults in the Lothian region were followed up 3 or 4 years later, with respect to alcohol‐related problems. Using a variety of analytic methods, a moderate degree of temporal consistency in problems was found, for total number of problems, and for individual problems, with feeling ashamed of having done something while drunk being the most consistent.
Help‐seeking Behaviour in Problem Drinkers: a review
Authors: JORDAN C. MAJELLA , OEI TIAN P. S.
Published: January 2006

Help‐seeking behaviour in problem drinkers is still poorly understood. This paper summarizes the research conducted so far into alcohol related help–seeking, and attempts to integrate existing models of illness behaviours to help‐seeking behaviour in problem drinkers. A conceptualization of alcohol related help‐seeking behaviour is presented and empirical findings are reviewed. It was concluded that much of the research so far is exploratory in nature and the findings are still not easily related. Help‐seeking behaviour in problem drinkers still awaits further exploration and advancement.
Regional Cerebral Blood Flow Changes Associated with Amyl Nitrite Inhalation
Authors: MATHEW ROY J. , WILSON WILLIAM H. , TANT STEPHEN R.
Published: January 2006

Regional cerebral blood flow (CBF), mood states and somatic symptoms were measured before and after inhalation of amyl nitrite in 10 physically healthy volunteers with a prior history of using volatile nitrites for recreational purposes. CBF was measured with the same technique, under identical laboratory conditions, in an equal number of normal volunteers. During CBF measurements, blood pressure, pulse rate, respiratory rate and end‐tidal levels of carbon dioxide were monitored. The amyl nitrite group and the control group were compared on CBF, rating scale scores and physiological indices via analysis of variance. Amyl nitrite inhalation was associated with significant global increases in CBF, while the control group did not show any change. Pulse rate increase was the only physiological change associated with administration of the drug. Subjects who received the drug reported significant decrease in anger, fatigue and depression and increased palpitation, breathing difficulty, dizziness and headache. Changes in the rating scale scores, physiological indices, and somatic symptoms after amyl nitrite did not correlate with regional CBF change.
Parent, Peer and Personal Determinants of Adolescent Drinking
Authors: WILKS JEFFREY , CALLAN VICTOR J. , AUSTIN DEREK A.
Published: January 2006

This study examined direct and indirect influences of parents and peers on adolescent drinking. One hundred and six adolescents, their parents and a same‐sex best friend of the adolescent each completed measures that tapped actual and perceived drinking behaviour, and normative standards for alcohol use. Of methodological interest was that adolescents of both sexes provided accurate reports of their parents' and peer's drinking, as well as drinking norms. Path analyses revealed different effects for male and female adolescents. Strongest predictors of alcohol use for males were their perceptions of their father's and mother's drinking, and their father's actual drinking. Best friend's drinking was positively related to the adolescent males' perceptions of themselves as a drinker. The single predictor of their internalized norms was the perception adolescent males had of their friend's drinking. Significantly, the adolescent male's own norms predicted how much and what they drank. For adolescent females, how much they believed their best friend drank, and their friend's normative standards, were the strongest predictors of alcohol use. Father's drinking also influenced the drinking practices of daughters, but mothers had no impact on their daughters' alcohol use. In contrast to young males, females' personal preferences or liking of alcohol successfully predicted most of their drinking behaviour.
Use of Alcohol Among High School Students in Lesotho—a health promotion perspective
Authors: AMOS AMANDA
Published: January 2006

A recently published article on alcohol use among young people in Lesotho highlighted an important public health issue—the changing pattern of alcohol consumption in many Third World countries. In this commentary I wish to consider some of the factors which might be contributing to this growing problem and some of the steps that need to be taken to address this issue. In particular I will focus on the role of the alcohol industry and the tactics used to create and develop new markets.
Severity of Opiate Dependence in an Australian Sample: further validation of the SODQ
Authors: BURGESS PHILIP M. , STRIPP ANDREW M. , PEAD JOHN , HOLMAN C. PAUL
Published: January 2006

The Severity of Opiate Dependence Questionnaire (SODQ) was administered to 114 subjects attending an Australian drug dependency treatment canter. The psychometric properties of the SODQ were examined and compared with previous findings reported on American and British samples of opiate addicts. Severity of opiate dependence was assessed independently using a structured clinical interview based on DSM‐III‐R criteria (i.e. SCID‐R). Together those analyses suggested (i) measurement difficulties with some aspects of the opiate dependence syndrome and (ii) only a modest relationship between subjects' self‐report and clinicians’judgments of severity of opiate dependence.
The Diagnosis of Alcohol and Cannabis Dependence in Cocaine Dependents and Alcohol Dependence in their Families
Authors: MILLER NORMAN S. , GOLD MARK S. , BELKIN BETH M. , KLAHR ARYEH L.
Published: January 2006

Genetic research in alcoholism has made major advances in recent decades. Twin, adoption, high‐risk and familial studies have demonstrated an inheritance factor in alcoholism. Few studies have demonstrated a genetic predisposition to cocaine and cannabis dependence. Two hundred and sixty‐three inpatients were given a structured psychiatric interview retrospectively (180) and prospectively (113) to obtain DSM‐III‐R diagnosis of cocaine, alcohol and cannabis dependence disorders in the inpatients and of alcohol dependence in family members. Our study reveals a large number of cocaine dependents with a positive family history for alcohol dependence. Approximately 50% of cocaine addicts had at least a first or second degree relative with a diagnosis of alcohol dependence when studied by the family history and study methods. As many as 89% of cocaine dependents diagnosed by DSM‐III‐R criteria for cocaine dependence qualified for other alcohol and drug dependence diagnoses. Our study finds a high prevalence of alcohol (67% and 89%) and cannabis dependence (51% and 46%) in patients with cocaine dependence. Previous reports regarding alcohol and other drug dependence among cocaine dependents and their families are few and inconclusive. The diagnosis of other drug and alcohol dependence in cocaine dependence and in family members of cocaine dependents has important impact on etiology, prognosis and treatment.
The Edinburgh Alcohol Problems Clinic
Authors: RITSON BRUCE
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.
A systems approach to estimating the required capacity of alcohol treatment services
Authors: RUSH BRIAN
Published: January 2006

This paper describes a model for estimating the required capacity of alcohol treatment systems at the local or regional level. Previous attempts at developing comprehensive forecasting models for addiction services are briefly described. The four steps followed in the development of the present model are then outlined. In many respects, the resulting model is specific to Ontario, Canada. However, the general approach, and many of the underlying concepts and assumptions, may have wider application in assessing the need for alcohol treatment services.
Home detoxification for problem drinkers: acceptability to clients, relatives, general practitioners and outcome after 60 days
Authors: STOCKWELL TIM , BOLT LIZ , MILNER INGRID , PUGH PETER , YOUNG IAN
Published: January 2006

The value of a new Home Detoxification service was assessed in a variety of ways employing data collected from 41 clients of the service, their family and GP's. By 60 days from the start of treatment, 11 clients were abstinent, two were controlling their drinking with relatively few problems, 13 had ‘improved’, 14 were not “improved’ and one had an unknown outcome. Subsequent involvement in treatment by both clients and then–partners was high in comparison with other studies. Significant predictors of ‘Good’ outcome included attendance for after–care by client and by spouse/partner and a low Alcohol Problems Inventory score. High levels of satisfaction were expressed with the HD service by clients, their carers and GP's. The great majority of clients gave “home’ as their preferred place of treatment and nearly half claimed they would have been unwilling to accept hospital care. There was evidence of significant, though modest, shifts in GP's management practices towards less use of hospitals and greater use of the patient's home after 15 months of the programme.
AIDS and HIV: the challenge for British drug services *
Authors: STIMSON GERRY V.
Published: January 2006

British drug policies are undergoing a major reassessment and reformulation in response to problems raised by HIV disease and AIDS. The years from 1986 to 1989 are one of the key periods of crisis and transformation in the history of the British response to drug problems, with the emergence in current debate of a new public health paradigm of drug use. Drug policies can be analysed by examining their assumptions about the nature of (a) the problem (b) the drug user and (c) the task facing policy makers and practitioners; and their assumption about (d) the appropriate people to deal with the problem and (e) their relationships with clients. The emergent public health paradigm assumes that (a) the main problem with drug use is the injection of drugs (b) drug injectors are concerned about their health (c) the task is to promote change in health and risk behaviours (d) people dealing with the problem must be broadly skilled ‘poly‐drug workers’ and (e) relationships with clients must be non‐judgemental and ‘user‐friendly’.
Reinforcing effects of cigarette advertising on under‐age smoking
Authors: AITKEN P. P. , EADIE D. R.
Published: January 2006

Interviews were conducted with 848 Glasgow children aged between 11 and 14 years. There were consistent differences between smokers and non‐smokers. Smokers tended to be more adept at recalling, recognizing and identifying cigarette advertisements. This suggests they tend to pay more attention to cigarette advertising. Smokers also tended to be generally more appreciative of cigarette advertising. Moreover, this greater awareness and appreciation of cigarette advertising was independent of other important predictors of under‐age smoking, such as smoking by peers, siblings and parents. These findings, taken in conjunction with previous research, indicate that cigarette advertising is reinforcing under‐age smoking. The smokers showed an enhanced or heightened preference for Kensitas Club, the brand favoured by adults. This is consistent with previous research indicating that promotional devices which help determine and reinforce adult cigarette brand preferences have an even greater effect on under‐age smokers.
Addiction: definition and implications
Authors: GOODMAN AVIEL
Published: January 2006

Integration of addiction into the theory and practice of psychiatry has been hampered by the lack of a definition of addiction which is scientifically useful. A definition is proposed, with diagnostic criteria specified in a format similar to that of DSM‐III‐R. Essentially, addiction designates a process whereby a behavior, that can function both to produce pleasure and to provide escape from internal discomfort, is employed in a pattern characterized by (1) recurrent failure to control the behaviour (powerlessness) and (2) continuation of the behaviour despite significant negative consequences (unmanageability). Some practical and theoretical implications of this definition are then explored.
Behavioural addictions: common features and treatment implications
Authors: BRADLEY BRENDAN P.
Published: January 2006

Marks’ editorial is welcome in that is suggests common treatment approaches for chemical and behavioural addictions, namely, exposure and relapse prevention. There are other common features of addictive substances or activities which may explain their addictive potential: they act as operant reinforcers and as Pavlovian unconditioned stimuli, tolerance develops, an initial positive mood is followed by dysphoria and addictions are stimulated by common states (arousal, stress, pain). Most of Marks' features are not unique to addictions but apply to primary drive states (normal eating, sleeping, elimination, sex) and many apply to normal goal‐orientated behaviour. Normal repetitive behaviour is more flexible than addictive behaviour, in allowing satisfactory substitution of alternatives. The restrictive range of activities which are satisfactory for the addict suggest that building up the behavioural repertoire may help in prevention and rehabilitation. Tics and Tourettes syndrome should not be regarded as addictions, since they involve simple, involuntary and non‐goal‐directed behavioural sequences. Considering addictions as goal‐directed is important: addicts are often ambivalent about whether they want to give up or continue. This often underlies dropout and relapse. Treatment must address this issue.
Trivializing dependence
Authors: JAFFE JEROME H.
Published: January 2006

There are a number of repetitive behaviors which have in common what appears to be a decrease in an individual's capacity to choose to discontinue them. The taxonomy we select to categorize these behaviors depends on our objectives. Broad definition which label as ‘addictions’ both repetitive use of drugs and repetitive behaviors not related to drug use call attention to the loss of flexibility that the behaviors have in common. However, such broad definitions may overemphasize the value of general behavioral approaches to change and obscure the fact that seemingly similar behaviors can be dramatically changed by very different specific interventions; (for example, nicotine gum for cigarette smoking, clomipramine for obsessive compulsive disorder.) It is also possible that calling both compulsive hair‐pulling and daily heroin use ‘addictive disorders’ may trivialize the concept of addiction and lead to an erosion of public support for research and intervention in the chemical addictions.
National survey of syringe exchange schemes in England
Authors: LART RACHEL , STIMSON GERRY V.
Published: January 2006

This report gives information from an England wide survey of syringe exchange carried out in early 1989. A postal questionnaire was sent to 74 agencies, responses received from 65 (88%), of which 55 were agencies operating syringe exchanges. The development of syringe exchanges has been marked by lack of central coordination, supervision and direction, allowing for local autonomy sensitivity to local conditions and a resulting diversity of practices. Four service models were identified: schemes run by drag agencies; phannacybased schemes; specialist stand‐alone schemes; and schemes based in non‐drug agencies. The average number of different clients per week was 21 and it is estimated that they distributed about one million syringes in the year 1988/89. Pharmacy based schemes presented fewer barriers in terms of access but offered limited services on site, while drug agency schemes presented more barriers in terms of access, but offered more services. The significance of these differences is related to the aims of syringe exchange. In a public health orientation, ease of access to sterile injecting equipment would be the priority and the question of individual help in other areas less important. From a drug problems orientation, the ability to offer clients more services to respond to their wider needs would be a priority. It is estimated that by the end of 1989 there were approximately 120 syringe exchange schemes in England.
Drug abuse and alcohol problems among cocaine abusers in an assessment/referral service
Authors: SMART REGINALD G. , OGBORNE ALAN C. , NEWTON‐TAYLOR BRENDA
Published: January 2006

This paper reports the social, demographic and drug abuse backgrounds of cocaine abusers seen at an alcohol and drug abuse assessment centre in Kitchener, Ontario. It compares cocaine abusers to cannabis users and alcoholics of the same age at the same centre. Cocaine and cannabis abusers are mainly young, single males while alcohol abusers are much older. The cocaine and cannabis abusers are both heavy drinkers but the cocaine group contained more high‐risk drinkers, more drug injectors and had a higher alcohol consumption. Cocaine abusers are young poly‐drug users for whom drinking is also a major problem. Treatment plans should take these problems into account.
Eating disorders in women who abuse alcohol
Authors: PEVELER ROBERT , FAIRBURN CHRISTOPHER
Published: January 2006

It has been suggested that various forms of addictive behaviour and substance abuse co‐exist more frequently than would be expected by chance. Such co‐morbidity may lessen the effectiveness of treatment, and may not be recognized by clinicians who specialize in one particular form of addiction. This study addresses one aspect of this issue: the co‐existence of eating disorders and alcohol abuse. Women attending an alcohol treatment unit completed a self‐report measure of the clinical features of eating disorders. Thirty‐six per cent of the sample reported the symptom of binge‐eating, 26% fulfilled diagnostic criteria for a probable current clinical eating disorder, and 19% had a history of probable anorexia nervosa. The findings suggest that the behaviour and attitudes characteristic of clinical eating disorders are over‐represented in women receiving treatment for an alcohol problem, and further study of such co‐morbidity is merited.
Solvent use and psychiatric comorbidity
Authors: DINWIDDIE STEPHEN H. , REICH THEODORE , CLONINGER C. ROBERT
Published: January 2006

From a family study of 286 alcoholics, 157 felons, 60 control subjects, and 1640 of their relatives, 130 solvent users were retrospectively identified. Risk for diagnosis of antisocial personality disorder was significantly elevated for all solvent users. Relatives, though not probands, were more likely to receive diagnoses of alcoholism and secondary depression, but this relationship appeared to be mediated by the presence of antisocial personality disorder. Solvent users were not at increased risk for primary depression or other psychiatric illnesses. Subjects reporting any solvent use also had significantly increased risk of suicidal ideation and suicide attempt compared to non‐users, with half of the solvent users reporting suicidal ideation and 30% reporting a history of suicide attempt. However, risk for suicidal ideation and suicide attempt among solvent users appeared to covary with presence of antisocial personality disorder, alcoholism, and secondary depression rather than being specifically associated with solvent use.
Changes in suicide rates after reductions in alcohol consumption and problems in Ontario, 1975–1983
Authors: SMART REGINALD G. , MANN ROBERT E.
Published: January 2006

In this paper the relationships among suicide rates in Ontario for males, females and the total population, alcohol consumption, and other alcohol‐related problems are examined for the period 1963–1983. Suicide rates, like other alcohol‐related problems, were strongly correlated with per capita consumption over the total period. However, during the recent period of stabilization in consumption (1975–83), the correlations were markedly reduced and substantial differences in trends for males and females were observed. The contribution to these diverging trends of such factors as increased treatment of alcohol abuse, rising unemployment, and reduced use of tranquillizing drugs is discussed.
Drinking habits of elderly Chinese
Authors: HEOK KUA EE
Published: January 2006

A random sample of 612 elderly Chinese was interviewed on their drinking habits. About 36.5% never drank, 50.3% drank less than once a month, 10% between one and three times a month, and 3.2% four or more times a week. Only two subjects had symptoms of mild alcohol dependence with SADQ scores of 10 and 12, and another two had alcohol‐related gastritis.
Conditioned learning in alcohol dependence: implications for cue exposure treatment
Authors: DRUMMOND D. COLIN , COOPER TROY , GLAUTIER STEVEN P.
Published: January 2006

A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol‐related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.
The drinking habits of Sikh, Hindu, Muslim and white men in the West Midlands: a community survey
Authors: COCHRANE RAYMOND , BAL SUKHWANT
Published: January 2006

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol‐related disorders. A community survey of random samples of 200 each of Sikh, Muslim and Hindu men and 200 white English‐born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/Temple attenders drank regularly.
Involvement of tobacco in alcoholism and illicit drug use
Authors: HENNINGFIELD JACK E. , CLAYTON RICHARD , POLLIN WILLIAM
Published: January 2006

Survey data from the United States indicate that tobacco use is associated with the initiation of use of other addicting substances, and that increasing levels of tobacco use are associated with increasing levels of use of other psychoactive substances. Furthermore, factors affecting initiation, abstinence, and relapse to the use of tobacco, alcohol, and opioids are similar in nature. In addition, there are similarities in the addictive processes underlying the use of these substances. Taken together, these data suggest that tobacco use is involved, possibly more than by simple association, in the use of other substances containing psychoactive chemicals. In the present paper we discuss the involvement of tobacco in the use of alcohol, opioids, cocaine, and other substances, as well as some of the implications of these observations for researchers and clinicians. One such implication is that it may be possible to use tobacco and nicotine as models for phenomena of interest to other substance use researchers. For example, drug abuse treatment and prevention strategies could be explored using tobacco use as a target behavior, and biological phenomena such as the development of tolerance and physical dependence may be more readily studied with nicotine than with many other drugs. Certain pharmacologic differences across substances are also discussed in tight of their implications for development of treatment and drug control policies.
The nicotine addiction trap: a 40‐year sentence for four cigarettes
Authors: RUSSELL M. A. H.
Published: January 2006

It is generally recognised that smoking causes more preventable illness than any other form of drug addiction. Despite this, and unlike the case with other addictions, few services are provided to help people to give it up. Yet nicotine is highly addictive. Its role in the recruitment process, the development of dependence and as a block to smoking cessation are discussed within the context of the typical smoking career. Over 90% of teenagers who smoke 3–4 cigarettes are trapped into a career of regular smoking which typically lasts for some 30–40 years. Only 35% of regular smokers succeed in stopping permanently before the age of 60, although the large majority want to stop and fry to stop. The pharmacological effects of nicotine and other factors that determine dependence on smoking, together with the attitudinal and cognitive factors that determine motivation to stop smoking, are considered within the framework of a decision‐making model which reflects the cycles of change in smoking status at different stages of the smoking career. It is argued that, in future intervention strategies, the newly developed treatment approaches should be included to complement traditional motivational approaches based on educational and restrictive measures.
Back to the future with oral snuff
Authors: Connolly Gregory N.
Published: January 2006

Abstract. The modern cigarette was introduced at the turn of the century and, in the absence of scientific evidence showing it to be harmful, it was exempt from virtually all health and safety laws that have been passed since that time. Laws and voluntary codes have been adopted in the United Kingdom (UK) and the United States (US) that restrict the advertising of tobacco products. Tobacco manufacturers have used the regulatory exemptions to introduce new or modified tobacco products when consumers became concerned about the safety of existing ones. This strategy has allowed manufacturers to maintain existing demand for tobacco products and create new demand among young people. The UK decision to ban oral snuff is a historic step and will deny tobacco companies the ability to create new demand for a harmful substance among children.
AIDS‐related risk behaviour, polydrug use and temazepam
Authors: KLEE HILARY , FAUGIER JEAN , HAYES CATH , BOULTON TOM , MORRIS JULIE
Published: January 2006

In a study of AIDS‐related risk behaviour among injecting drug users in the north west of England it was found that 90% were polydrug users, and 28% were using temazepam. A third of all polydrug users had regularly used more than three drugs in addition to their preferred drug in the previous year. Statistical analysis revealed that the use of temazepam and extensive polydrug use were associated with sharing injecting equipment. Significant associations were also found with indices of sexual risk behaviour. It was concluded that multiple drug use and the use of temazepam were associated with behaviour that could increase exposure to HIV infection.
The effect of impulsivity and empathy on abstinence of poly‐substance abusers: a prospective study
Authors: McCOWN WILLIAM
Published: January 2006

The relation between impulsivity, empathy, and abstinence of poly‐substance abusers in self‐help groups is investigated prospectively. Utilizing S. B. G Eysenck et al. ’Impulsivity Questionnaire (17), new self‐help’ club' members were assessed for traits of empathy and impulsivity. Abstinence was assessed one year later. Impulsivity correlated negatively with abstinence and positively with numbers of ‘slips’. Contrary to previous research, empathy failed to correlate with either variable. Possible interpretations and future research directions are discussed.
The structure of problem behaviours among Irish adolescents
Authors: GRUBE JOEL W. , MORGAN MARK
Published: January 2006

Problem behaviour theory proposes that adolescent substance use and other problem behaviours comprise a single dimension reflecting a general underlying tendency towards deviance. This general deviance hypothesis was tested ‐with survey data obtained from 2731 adolescents from Dublin, Ireland. A series of hierarchical maximum likelihood factor analyses indicated that three specific factors were necessary to account for the covariation among problem behaviour measures. These factors corresponded to substance use (drinking, smoking, marijuana use, and other drug use), relatively minor problem behaviours (swearing, lying), and relatively serious problem behaviours (stealing, vandalism). Contrary to the general deviance hypothesis, a second order factor representing general deviance accounted for only 14% of the variance in substance use, on the average, as opposed to 74% of the variance in minor and serious problem behaviours. These findings thus indicate that substance use among these Irish adolescents is relatively independent of a general tendency toward deviance. They also suggest that the general deviance hypothesis, as it usually is applied, may be culturally specific and relevant only for adolescents from the United States and similar cultural contexts.
Discrimination on the grounds of diagnosis
Authors: FARRELL MICHAEL , LEWIS GLYN
Published: January 2006

The study used the methodology of randomly allocating case vignettes to a sample of British consultant psychiatrists to assess the influence of a past diagnosis of alcohol dependence on present treatment attitudes. The case vignettes either did or did not include the previous diagnosis of alcohol dependence and the sex of the ‘case’ was also randomized. Psychiatrists receiving the vignette with the diagnosis of alcohol dependence were more likely to rate the patient as difficult, annoying, less in need of admission, uncomplaint, having a poor prognosis and more likely to be discharged from follow‐up. There was minimal sex difference. Psychiatrist with a special interest in addictions regarded people with a past diagnosis of alcohol dependence as less difficult to manage than their non‐specialist colleagues. The implications for education and treatment are discussed.
The drug market position of cocaine among young adults in Sydney
Authors: HOMEL PETER , FLAHERTY BRUCE , REILLY CATHERINE , HALL WAYNE , CARLESS JACQUELINE
Published: January 2006

A study was undertaken to explore the ‘market position’ of cocaine among young adults in Sydney, Australia. The intention was to estimate how likely Australia is to experience an epidemic of cocaine use if the availability of the drug was to increase. A sample of 499 young adults in which illicit drug users were overrepresented were surveyed. The results suggested that there was not a large untapped market for cocaine. In terms of risk and attraction, cocaine was perceived to be more like the traditional ‘hard drugs’ of heroin, stimulants and hallucinogens than the traditional ‘soft drugs’ of alcohol and marijuana. Only 5% of the sample were prepared to try cocaine if offered it by a close friend.
The development and initial validation of a questionnaire on smoking urges
Authors: TIFFANY STEPHEN T. , DROBES DAVID J.
Published: January 2006

A 32‐item questionnaire on smoking urges was administered to 230 daily cigarette smokers assigned to one of three levels of cigarette deprivation (0, 1 or 6 hours). Factor analyses showed that a two‐factor solution best described the item structure for each of the three deprivation levels and for the entire sample. Factor scales of 15 and 11 items derived from rotation to simple structure were highly reliable, 0.95 and 0.93, respectively, and moderately correlated (r=0.71). Average scores on both scales increased significantly with level of deprivation, and the Factor 1 scale was significantly higher than the Factor 2 scale at all levels. Factor 1 scale items reflected primarily intention and desire to smoke, and anticipation of pleasure from smoking. Factor 2 scale items were comprised primarily of anticipation of relief from negative affect and nicotine withdrawal, and urgent and overwhelming desire to smoke.
Drug self‐administration methods in abuse liability evaluation
Authors: HENNINGFIELD JACK E. , COHEN CAROLINE , HEISHMAN STEPHEN J.
Published: January 2006

The human drug self‐administration paradigm is an extension of the animal model developed in the 1960s. The paradigm can be used to investigate the determinants and correlates of drug‐seeking and drug‐taking behavior and has proven useful in the development of medications for treating drug dependence. This paper describes the basic components of the human self‐administration model and discusses studies that illustrate some of its applications, including assessment of the reinforcing effects of drugs, analysis of behavioral and pharmacological mechanisms of drug self‐administration and measurement of the abuse liability, behavioral toxicity, and aversive effects of drugs. Some of the strengths and limitations of using the paradigm with human research subjects are also presented. It is concluded that the drug self‐administration model should not replace other measures of abuse liability testing in humans, but should be incorporated into comprehensive programs of drug abuse assessment wherever possible.
Drug discrimination methods in human drug abuse liability evaluation
Authors: PRESTON KENZIE L.
Published: January 2006

The drug discrimination paradigm, which is sometimes considered to provide an animal model of human subjective effects, has been adapted for use with human subjects. This procedure provides a direct measure of stimulus similarity between the test drug and a known standard drug, information that may be of value in predicting abuse liability of novel compounds. The present paper reviews the general methods used in human drug discrimination studies, some of the drugs that have been tested, factors to consider in designing drug discrimination studies in humans, and evidence concerning the utility of the procedure in abuse liability assessment. Further research is needed to validate this procedure and to determine the conditions under which it has the greatest value in abuse liability assessment.
Pharmacokinetic considerations in abuse liability evaluation
Authors: FARRÉ MAGI , CAMÍ JORDI
Published: January 2006

The behavioral effects of a drug are related to three factors: its intrinsic pharmacological activity, its physicochemical properties, and its pharmacokinetic parameters. In many cases differences in absorption, distribution, metabolism, and elimination may explain the different abuse liability profiles of drugs from within the same pharmacological class. Rapid absorption rate and high lipid solubility are the most important factors contributing to early drug concentrations in the brain. Differences in drug metabolism may be related to dose‐dependent kinetics, first‐pass metabolism, and variations in genetic traits (e.g. poor or extensive metabolizers). Metabolic pathways may produce active metabolites with similar or greater pharmacological activity than the parent substance. Drugs with a rapid elimination rate have been associated with greater self‐administration and with early emergence of withdrawal symptoms. More pharmacokinetic studies are needed in human drug abuse liability evaluations. Knowledge of the plasma concentrations of drugs and their pharmacokinetic parameters can be essential to interpret differences among similar drugs in human abuse liability assessments.
Abuse liability assessment of anxiolytics/ hypnotics: rationale and laboratory lore
Authors: EVANS SUZETTE M. , CRITCHFIELD THOMAS S. , GRIFFITHS ROLAND R.
Published: January 2006

This paper describes the rationale, practical details, and laboratory lore relevant to conducting an acute dose‐effect crossover evaluation for abuse liability of a novel anxiolytic/hypnotic compound relative to a standard compound. Basic principles underlying meaningful abuse liability assessments are presented and illustrated with examples from a comparative evaluation of the hypnotics zolpidem and triazolam. These principles include using a double‐blind placebo‐controlled design, selecting an appropriate comparison compound, evaluating a wide range of doses including supratherapeutic doses, using subjects with histories of sedative drug abuse, and using a range of dependent measures. The dose‐effect crossover evaluation is proposed as a crucial first step in any rigorous drug abuse liability evaluation of a novel anxiolytic or hypnotic drug. Such a study can be expected to generate a broad data base which not only provides a prediction about the likelihood of abuse of the novel compound, but provides an assessment of some of the adverse consequences of recreational abuse. The crossover study also establishes parameters for subsequent studies such as direct assessment of reinforcing effects with drug self‐administration testing.
Contextual factors related to the drinking behaviors of American business and professional women
Authors: SHORE ELSIE R. , BATT STEVE
Published: January 2006

American women in business and professional occupations (n=453) completed a survey that included questions on alcohol use, drinking context, and work and other activities. Spouses' and best friends' consumption and subjects' frequency in drinking settings correlated with their consumption and negative consequences of alcohol use. Multiple regression analyses indicated that predictor variables for consumption were frequency in drinking settings, a measure of three personal motives for drinking, age, and number of organization memberships. Predictor variables for negative consequences were subject's consumption, spouse's drinking, frequency in drinking settings, and age.

The results suggest that social context may be important in understanding women's drinking. Variables directly related to drinking, such as time spent in drinking situations, are correlated with increased drinking, while other contextual variables, such as membership in organizations, may play a preventive role.
A longitudinal study of New Zealand children's experience with alcohol
Authors: CASSWELL SALLY , STEWART JOANNA , CONNOLLY GARY , SILVA PHIL
Published: January 2006

A longitudinal study assessed the use of alcohol and related measures among New Zealand children aged 9, 11, 13 and 15 years. The proportion of children who were abstainers was at a similar level to the adult population by age 15 years. Those remaining abstainers were more likely to have infrequently drinking parents and to have been warned of the bad effects of alcohol by their parents. In terms of amount consumed and frequency of drinking, there was an increase with age and a marked increase between the ages of 13 and 15 years. Frequency of drinking was positively associated with the frequency of drinking by the mother and father. Girls drank less than boys until the age of 15 years, when they drank slightly more and a difference in terms of socio‐economic status (SES) emerged at age 15 years with tower SES groups drinking more.
Homicides committed by abusers of alcohol and illicit drugs
Authors: LINDQVIST PER
Published: January 2006

This paper concerns 52 abusers of alcohol and 19 abusers of illicit drugs who had committed a homicide in northern Sweden between 1970 and 1981 or in Stockholm between 1971 and 1980. Twenty‐three individuals were found guilty of murder, 21 of manslaughter and 27 of assault and causing another's death. The study group was characterized by a high prevalence of personality disorders, alcohol‐induced brain damages and social derangement. Alcohol intoxication during the acts was seen in all cases of alcohol abusing offenders. Most of the victims were abusers themselves, were (ex‐)partners or acquaintances of the offenders and had been drinking together with their killer. Homicides where the victim seemed to have been the prime aggressor constituted almost half of all instances. The homicides committed by abusers of illicit drugs were characterized by less intimacy and the offenders were often considerably younger than their victims.
Implications of using the composite and short versions of the Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ)
Authors: GORMAN D. M. , CARTWRIGHT A. K. J.
Published: January 2006

The Alcohol and Alcohol Problems Perception Questionnaire (AAPPQ) has often been used in studies seeking to understand or change the attitudes of workers towards alcohol abusers. Data are normally presented in terms of either individual subscales or as a composite scale, and recently a short version of the composite scale has been proposed. Using data from a quasi‐experimental community intervention the information provided by the summary scales is compared with that from the individual subscales. The analysis suggests that there are two systems within the data—a role security/basic role requirements system and a therapeutic commitment system. Both summary scales are misleading in that they reflect the role security/basic role requirements system scales and not those measuring therapeutic commitment. It is concluded that the summary scales should only be used when the underlying data structure is understood.
The relevance of receptor binding studies to tobacco research
Authors: WONNACOTT SUSAN
Published: January 2006

The initial event in the process by which nicotine acts on the nervous system is its interaction with specific receptor molecules in the neuronal membrane. This interaction can be characterised in radioligand binding assays, using [3H]nicotine. While this approach has generated a detailed description of recognition sites for nicotine in the brain, caution is necessary in correlating these binding proteins with physiologically relevant sites of action of nicotine. Of particular interest is the disparity between effective nicotine concentrations in binding and functional assays, which may reflect receptor desensitization and could be pertinent to the development of dependence. Receptor heterogeneity, reflecting subtypes of nicotine receptor having different radioligand binding specificities and differing properties, introduces a new dimension in the consideration of nicotine's actions. Thus, receptor binding assays have an important role to play, in conjunction with other approaches, in unravelling the complex mechanisms that can lead to nicotine dependence.
Is nicotine more addictive than cocaine?
Authors: HENNINGFIELD JACK E. , COHEN CAROLINE , SLADE JOHN D.
Published: January 2006

Is nicotine more addictive than cocaine? That claim is increasingly in vogue, often supported by data showing the high likelihood of progression to daily tobacco use following experimentation and the high percentage of cigarette smokers, compared with cocaine users who appear addicted. In the context of criteria for addiction or dependence presented by the World Health Organization, the American Psychiatric Association, and the US Surgeon General, we consider several lines of evidence, including patterns of use, mortality, physical dependence potential, and pharmacologic addiction liability measures. Within each line of evidence, we compare nicotine with cocaine. We conclude that on the current evidence nicotine cannot be considered more addicting than cocaine. Both are highly addicting drugs for which patterns of use and the development of dependence are strongly influenced by factors such as availability, price, social pressures, and regulations, as well as certain pharmacologic characteristics.