bluuebunny/crossref_metadata_2025 huggingface dataset:
Raves, drugs and experience: drug use by a sample of people who attend raves in Western Australia
Authors: LENTON SIMON , BOYS ANNABEL , NORCROSS KATH
Published: January 2006

Aims. To investigate the patterns of drug use among a sample of people in the rave scene in Perth, Western Australia and test the hypothesis that those who were less experienced in their drug use had less drug‐related knowledge. Design. Respondents were recruited through flyers in cafes, clothing and music stores and through snowballing. They were paid $20 for a 11/2 hour interview which comprised both qualitative and quantitative components. Setting. Respondents were interviewed in cafes or restaurants, private dwellings, agencies or other public spaces. Participants. Eighty‐three people who had been to a rave in the prior 6 months. Their mean age was 18.9years (range 13‐48) and 53% were male. Measurements. Brief history of drug use, HIV risk behaviour, knowledge of drug‐related harm and side effects experienced from drugs. Findings. The group was unremarkable apart from their drug use. Ninety per cent of respondents had ever used LSD, 76% had used ecstasy and 69% had used amphetamines. Before, during or after the last rave attended 52% used cannabis and 35% had used each of amphetamines and LSD. Those who were less experienced in their drug use had less knowledge about drugs. Many respondents began using ‘dance drugs’ while they were still at school. Conclusions. Those with less drug‐using experience may have less drug‐related knowledge and may be at greater risk of harm. Strategies should be implemented which involve people in the scene, promoters, health workers and the authorities to reduce drug‐related harm associated with raves and other dance events.
Injecting‐related harm and treatment‐seeking behaviour among injecting drug users
Authors: MORRISON ANITA , ELLIOTT LAWRENCE , GRUER LAURENCE
Published: January 2006

Aims. This study aims to identify the physical harm associated with injecting drug use and examine the treatment‐seeking behaviour of injecting drug users (IDUs). Specific attention is given to the factor associated with presentation and non‐presentation of injecting‐related problems. Design. Participants were interviewed by research staff using a semi‐structured questionnaire, then physically examined by a medical team. Setting. Needles exchanges in Glasgow. Participants. One hundred and twelve injecting drug users. Findings. Respondents' accounts of their current injecting‐related problems were found to be consistent with the clinician's findings, suggesting that IDUs are able to self‐diagnose injecting‐related harm. However, almost three‐quarters had not sought help for these problems. Qualitative data suggest the main reasons for non‐presentation, or delayed presentation, of injecting‐related problems are normalization of injecting‐related harm and a reluctance to attend available services. Almost half of those seeking treatment for injecting‐related/ problems did so during an emergency or crisis. Conclusions. Low threshold services, such as needle exchanges, may have to take a more proactive stance to encourage injectors to present with injecting‐related problems. This may help reduce injecting‐related harms, especially the resulting medical complications, which would in turn relieve the pressure on other services such as hospital Accident and Emergency Departments.
Leaving work to smoke
Authors: BORLAND RON , CAPPIELLO MARCO , OWEN NEVILLE
Published: January 2006

Work‐place smoking bans have not only reduced work‐day cigarette consumption but also been associated with going outside to smoke during working hours. We examined the extent of “exiled smoking”, estimated how much work‐day cigarette consumption can be attributed to it, and examined proximal predictors of both these two variables. Some 794 smokers from 42 medium‐sized work‐places were surveyed as the baseline for an intervention study. A self‐completed questionnaire assessed smoking behaviour on work and non‐working days, leaving work to smoke, and beliefs and opinions about smoking and smoking bans. Multiple regressions were used to examine predictors of leaving work to smoke, and of the amount smoked when doing so. Smokers reported consuming an average of 5.4 cigarettes during work breaks, 3.5 of which were associated with deliberately seeking opportunities to smoke; 39% reported leaving work to smoke one or more times per day during non‐break periods. Indices of addiction were significant predictors of both leaving work to smoke and of cigarette consumption while doing so. Leaving work to smoke is in part an activity of addicted smokers, presumably to maintain blood nicotine levels. There is the potential to further reduce rates of cigarette consumption associated with work‐place smoking bans if this “exiled smoking” can be reduced. This may be easier to achieve in light smokers.
Behavioural alcohol research: new directions or more of the same?
Authors: SHAKESHAFT ANTHONY P. , BOWMAN JENNY A. , SANSON‐FISHER ROB W.
Published: January 2006

Aim.Despite a large body of literature, a substantial burden of illness related to the abuse of alcohol, as well as significant economic and social costs, persist. As such, a critical examination of the type of research being published in relation to alcohol misuse seems appropriate, particularly since some experts in the field have expressed the view that the current distribution of research types may not be optimal.Findings.The types of research conducted in two separate years, 1983 and 1993, were examined critically. Generally, the types of research conducted in both years was found to be similar: the majority of published alcohol research is behavioural, the majority of published behavioural alcohol research is descriptive and the majority of published behavioural intervention alcohol research represents tertiary prevention studies. Although the reasons for this distribution of research types are undoubtedly numerous and complex, some possible explanations are discussed.Conclusions.Overall, it is concluded that the current approach to alcohol research may have engendered a distribution of research types which is somewhat less than ideal and that, as such, a new approach may be indicated. Some strategies that may assist in redressing the perceived imbalance are considered.
Tobacco health warnings and smoking‐related cognitions and behaviours
Authors: BORLAND RON
Published: January 2006

Aims. To explore whether the introduction onto cigarette packs of new larger, more prominent health warnings in black on white would lead to an increase in: noticing warnings, thoughts about the effects of smoking, and consequent behaviours of not smoking a planned cigarette and/or prematurely stubbing out one already lit. In addition evidence was sought linking these effect to smoking cessation. Design. Two national cross‐sectional surveys of broadly representative samples of smokers: one about 2 weeks before the mandated introduction date of the warnings, and a follow‐up 6 months later, pan‐way through implementation. A longitudinal subsample of smokers from the initial baseline survey was resurveyed at follow‐up. Setting. In Australia, new health warnings and strengthened contents labelling of cigarette packets were mandated for cigarettes manufactured from 1 January 1995. Participants. Broadly representative samples of Australian smokers: 510 at baseline, and 512 at follow‐up. Two hundred and forty‐three of the baseline sample were also resurveyed. Measurements. Self‐report on effects of warnings and smoking cessation activity. Findings. In the cross‐sectional sample at follow‐Up, 66% of smokers reported at least sometimes noticing the health warnings when taking out a cigarette (compared with 37% at baseline), and 14% reported they had refrained from smoking on at least one occasion as a result (compared with 7% at baseline). Not smoking as a result of noticing the (old) warnings at baseline was predictive of quitting at follow‐up. Frequency of stubbing out cigarettes before they were finished as a result of thinking about smoking‐related harm was not affected by the new warnings, but was predictive of making quit attempts. Conclusions. The new health warnings were more potent at stimulating both thoughts about negative effects of smoking and the appropriate consequent action of not smoking the planned cigarette. This is important as spontaneous rejection of cigarettes predicted subsequent cessation.
Patterns of symptom complaints in methadone maintenance patients
Authors: DYER KYLE R. , WHITE JASON M.
Published: January 2006

Aim. Not all maintenance patients respond to methadone in the same manner, and many complain of withdrawal symptoms during the 24‐hour inter‐dosing interval (i.e. the dose does not ‘hold’). The persistence of these complaints are a source of concern as they may signal unsanctioned drug use and poor treatment outcome. This study examined the prevalence and profile of symptom complaints in methadone maintenance patients who report that their methadone dose does not ‘hold’. Design. In the first phase, a cross‐sectional survey of 114 methadone patients examined a range of symptoms including direct opioid effects, and withdrawal. Phase 2 involved a comparison of the temporal pattern of symptom complaints between patients who reported the oral dose not ‘holding’ and those who did not. Setting. Participants in this study were enrolled in the South Australian Public Methadone Maintenance Program. Measurements. In Phase I, a checklist of 21 commonly reported symptom complaints associated with methadone maintenance treatment was administered. In Phase 2, this checklist was modified to include only those symptoms that changed in the 24‐hour inter‐dosing interval. The checklist was administered eight times over this period. Further data were collected using the Morphine Benzedrine Group Scale of the Addiction Research Centre Inventory, a measure of positive opioid effect. Findings. In Phase 1, it was found that approximately one‐third of the sample reported that the methadone dose was consistently inadequate in preventing withdrawal symptoms for the entire inter‐dosing interval. They could not be differentiated by demographic, health, other drug use or treatment characteristics. In Phase 2, despite having a higher oral methadone dose, patients reporting that their daily dose did not ‘hold’ experienced a smaller degree of opioid effect, and a greater intensity of opioid withdrawal, during the 24‐hour period. Conclusion. These data demonstrate that there is a change in pharmacodynamic response over the 24‐hour period for all methadone patients, but the degree of change is greater in a subgroup of patients. Charting symptom presentation throughout the inter‐dosing interval can aid in identifying those patients who are experiencing difficulties with their treatment regime.
Maternal cocaine use and low birth weight newborns: a meta‐analysis
Authors: HULSE G. K. , ENGLISH D. R. , MILNE E. , HOLMAN C. D. J. , BOWER C. I.
Published: January 2006

Aim/design. Many epidemiological studies published on the association between maternal cocaine/crack use and birth weight have either lacked precision or failed to control for major confounding, predominantly by tobacco smoking. Meta‐analysis enables a single summary measure of effect to be calculated by combining data from any number of individual studies, thus enhancing statistical power. We undertook a number of meta‐analyses using only studies that had adjusted for tobacco smoking to estimate more precisely the effect of maternal cocaine use on birth weight. Findings. A meta‐analysis of five studies presenting data for ‘any’ prenatal cocaine exposure, adjusted far tobacco smoking but unadjusted for gestational age, produced a pooled relative risk estimate from a fixed effects analysis of 2.15 (95% CI 1.75‐2.64). However, there was substantial heterogeneity among studies (p < 0.001), and the relative risk from a random effects analysis was smaller (1.65) with a confidence interval that included unity (95% CI 0.94‐2.83). Addition of a further study adjusted for gestational age had minimal effect on the pooled estimate: the fixed effects relative risk was 2.14 (1.77‐2.60) and the random effects estimate 1.77 (1.15‐2.71). When data on more intense prenatal exposure were analysed, the fixed and random effects analysis produced the lame pooled estimate of the relative risk of 4.42 (2.24‐8.71), suggesting that more frequent cocaine exposure was associated with a higher relative risk for low birth weight. Data from studies on mean reduction in birth weight produced a pooled estimate of 112 g (95% CI 62‐161 g). Conclusions. The current study suggests that maternal cocaine use causes low birth weight, and that the effect is greater with heavier use. However, despite the adjustment for tobacco and the adjustment by some studies for other confounders such as race, maternal age, gravidity and socio‐economic status, it could be argued that other life‐style factors not controlled for may account for the observed effects. While this argument is not supported by some other types of study, the issue of residual confounding can only be finally addressed by analytical studies which adequately control for important variables.
Outcome studies of brief alcohol intervention in general practice: the problem of lost subjects
Authors: EDWARDS ADRIAN G. K. , ROLLNICK STEPHEN
Published: January 2006

Aims. To identify the attrition rate of eligible subjects from the general practice brief intervention studies, reasons for attrition, and the potential bias arising from lost subjects. Design. Review of all published trials of brief intervention for excessive drinkers in primary care settings. Findings. The attrition rate of eligible subjects from the general practice brief intervention studies ranges from 44.3 to 83.2% (mean 70.6%). The potential bias introduced by the characteristics of subjects available and not available for research is not adequately addressed. Where there is evidence, subjects unavailable for study or those lost to follow‐up usually show different characteristics (e.g. younger, heavier drinkers, less educated) from those completing the study. Conclusions. Study populations in general practice‐based brief alcohol interventions may have been those most susceptible to intervention. This suggests caution is appropriate in generalizing from brief intervention study results to routine primary care.
Transitions between routes of benzodiazepine administration among heroin users in Sydney
Authors: ROSS JOANNE , DARKE SHANE , HALL WAYNE
Published: January 2006

A sample of 312 heroin users were interviewed regarding their benzodiazepine use. The majority (94%) had used bensodiazepines, 72% in the 6 months prior to interview. Benzodiazepine injecting was common, with 28% of the sample having injected these drugs, 13% in the 6 months preceding interview. Current benzodiazepine injectors showed greater polydrug use, injection‐related HIV risk‐taking behaviour, criminal involvement, psychological distress and injection‐related health problems, as well as poorer general health, and an increased risk of having overdosed, than other users of benzodiazepines. Of those subjects mho had injected benzodiasepines, 55% were no longer current benzodiazepine injectors. Concern for general health emerged as the most common reason for having made a transition away from injecting, and for being likely to make such a transition.
Drinking, the majority fallacy, cognitive dissonance and social pressure
Authors: MÄKELÄ KLAUS
Published: January 2006

In drinking and drug surveys, peers are perceived as drinking more and using more drugs than the respondent. Particularly in youth studies, this majority fallacy is often interpreted as an indication of peer pressure toward drinking and drug use. However, exaggerating the alcohol and drug behaviours of significant others may be a way of reducing cognitive dissonance. The behaviour of most people deviates from their ideal norms. The ensuing dissonance can be alleviated by introducing the behaviour of others as a third element in the cognitive field. Data from three Scandinavian surveys support the following two predictions based on the theory of cognitive dissonance: (1) The tendency to report that other people drink more than oneself is more marked in restrictive than in permissive communities. (2) On each level of alcohol intake, the tendency to report that other people drink more than oneself is stronger among respondents having negative alcohol attitudes than among respondents with positive attitudes to alcohol. The need to alleviate the cognitive dissonance caused by a discrepancy between actual behaviour and normative standards is thus one of the mechanisms generating the majority fallacy: “I may not be perfect, but other people are still worse”. Feeling better than others does not necessarily amount to a pressure to turn bad.
Long‐acting injectable bromocriptine does not reduce relapse in alcoholics
Authors: NARANJO C. A. , DONGIER M. , BREMNER K. E.
Published: January 2006

Dopamine is one of several neurotransmitters that may mediate alcohol intake and dependence. A randomized, double‐blind, placebo‐controlled international, multicentre study was conducted la assess the effects of a long‐acting injectable preparation of bromocriptine, a dopamine agonist, (Pariodel‐LAR) in reducing relapse in 366 moderately/severely dependent alcoholics (DSM‐III‐R), drinking approximately 200 g alcohol (14.5 standard drinks) per day. After detoxification they were randomized to receive six monthly injections of bromocriptine 25 mg (n = 120), bromocriptine 50 mg (n = 124), or placebo (n = 122). Brief psychosocial treatment was allowed. At 6 months there were no significant differences between treatment groups in rates of relapse to any drinking or to drinking 5 days per month and 3 drinks per day. Pre‐treatment alcohol intake did not determine response. Efficacy ratings by subjects and investigators and adverse events, reported by 51% of subjects, did not differ between treatments. The results of this large study, in which compliance was enhanced by Partodel‐LAR®, do not indicate that bromocriptine is efficacious in the maintenance of abstinence or reduced drinking. Possible reasons for the discrepancy between these conclusions and those of some previous clinical trials, in which bromocriptine was reported to reduce symptoms of alcohol withdrawal and dependence, are discussed.
A community prevention trial to reduce alcohol‐involved accidental injury and death: overview
Authors: HOLDER HAROLD D. , SALTZ ROBERT F. , GRUBE JOEL W. , VOAS ROBERT B. , GRUENEWALD PAUL J. , TRENO ANDREW J.
Published: January 2006

The 5‐year “Preventing Alcohol Trauma: A Community Trial” project in the United States was designed to reduce alcohol‐involved injuries and death in three experimental communities. The project consisted of five mutually reinforcing components: (1) Community Mobilization Component to develop community organization and support, (2) Responsible Beverage Service Component to establish standards for servers and owner/managers of on‐premise alcohol outlets to reduce their risk of having intoxicated and/or underage customers in bars and restaurants, (3) Drinking and Driving Component to increase local DWI enforcement efficiency and to increase the actual and perceived risk that drinking drivers would be detected, (4) Underage Drinking Component to reduce retail availability of alcohol to minors, and (5) Alcohol Access Component to use local zoning powers and other municipal controls of outlet number and density to reduce the availability of alcohol. This paper gives an overview of the rationale and causal model, the research design and outline of each intervention component for the entire prevention trial.
Community mobilization: evaluation of an environmental approach to local action
Authors: TREND ANDREW J. , HOLDER HAROLD D.
Published: January 2006

“Community mobilization” in the Community Trials Project refers to organizing community members to support and implement policies to reduce alcohol‐involved trauma. This paper defines the conceptual model of mobilization used in the project. In evaluating the project, we were guided by the conceptual model and we used structured materials from interviews with local staff in all three experimental communities; we found that the overall goal of mobilization (implementation of policies) was achieved. Additional observations based on naturalistic case studies of the communities include: (1) the importance of an established research base, (2) the varying role and problematic nature of coalitions, (3) the strategic advantage of early project support r among the general population, (4) the role played by key leaders in mobilization, (5) the advantages of a multi‐component design, and (6) the key role played by media advocacy.
Drinking and driving prevention in the community: program planning and implementation
Authors: VOAS ROBERT B.
Published: January 2006

This paper describes the rationale, development and implementation of the Drinking and Driving Component, which is one of five components of the Community Trials Project conducted by the Prevention Research Center, Berkeley, California (USA). It traces the background of drunk driving enforcement technology and practice against which the programs at the three sites were implemented. A conceptual model for the enforcement component of a comprehensive community alcohol‐related trauma project is presented and its implementation at the three sites is described. Limitations in the available police department resources delayed the implementation of local programs. Media advocacy tied to specific operations proved to be successful in publicizing sensors and sobriety checkpoints were only partially accepted. Overall, the community trials sites increased or held steady their arrest rates in contrast to the comparison sites where DU1 arrests declined.
Early onset cannabis use and psychosocial adjustment in young adults
Authors: FERGUSSON DAVID M. , HORWOOD L. JOHN
Published: January 2006

The relationships between early onset (prior to 16 years) cannabis use and later psychosocial adjustment was examined in a birth cohort of New Zealand children studied to age 18 years. Early onset users had significantly higher rates of later substance use, juvenile offending, mental health problems, unemployment and school dropout. The linkages between early onset cannabis use and later outcomes were largely explained by two routes that linked cannabis use to later adjustment. First, those electing to use cannabis were a high risk population characterized by social disadvantage, childhood adversity, early onset behavioural difficulties and adverse peer affiliations. Secondly, early onset cannabis use was associated with subsequent affiliations with delinquent and substance using peers, moving away from home and dropping out of education with these factors in turn, being associated with increased psychosocial risk. The implications of these results are examined.
The Swiss Hidden Population Study: practical and methodological aspects of data collection by privileged access interviewers
Authors: KUEBLER DANIEL , HAUSSER DOMINIQUE
Published: January 2006

In order to recruit heroin and/or cocaine users outside treatment settings, recruitment of subjects through Privileged Access Interviewers (PAI) was tested and implemented in the Swiss Hidden Population Study, This article discusses practical aspects of the PAI method as well as issues of reliability and validity. Front June 1994 to June 1995, 31 Privileged Access Interviewers were recruited in the main regions of Switzerland. They conducted 943 standardized interviews altogether, of which 917 could be considered valid. Fifty‐four per cent of the respondents correspond to the criteria of the target population. The PAI method collects reliable data in a relatively short amount of time, given adequate means of control. Analysis of the age distribution and of the patterns of drug use in our sample shows that the question of validity is mainly linked to the diversity of the milieus from which PAIs recruit, the respondents. Encouraging PAIs to do as many interviews as possible did not skew the data. Hence, well‐founded inferences on a PAI generated database relies on the analysis of qualitative information on the ways in which the Privileged Access Interviewers have recruited their respondents.
Co‐factors for smoking and evolutionary psychobiology
Authors: POMERLEAU CYNTHIA S.
Published: January 2006

Smoking is becoming increasingly concentrated in people with co‐factors suck as depression, attention deficit‐hyperactivity disorder, anxiety disorders, and bulimia/bingeing. These behavioral or cognitive patterns may be adaptive or neutral in the conditions under which toe evolved but maladaptive in environments requiring alertness for extended periods, where a fatty mobilized fight‐or‐flight response is inappropriate, and where food availability makes lack of an “appestat” a liability. Such conditions are amenable to management by nicotine because of its ability to produce small but reliable adjustments in relevant cognitive and behavioral functions. Moreover, symptomatology may be unmasked or exacerbated by nicotine abstinence, persisting beyond the usual time‐course for nicotine withdrawal, which may explain the particular attraction of smoking and the difficulty these individuals experience in quitting without necessarily requiring that they be more nicotine‐dependent. The implications are: (1) a better understanding of the evolutionary psychobiology of smoking may promote development of tailored interventions for smokers with co‐factors; (2) nicotine may have therapeutic applications for non‐smokers with co‐factors; (3) because smoking has a fairly high heritability index, and because of evidence of assortative mating, special prevention efforts targeting children of smokers with co‐factors, as well as early identification of the co‐factor itself, may be needed.
How do genes influence marijuana use? The role of subjective effects
Authors: LYONS MICHAEL J. , TOOMEY ROSEMARY , MEYER JOANNE M. , GREEN ALAN I. , EISEN SETH A. , GOLDBERG JACK , TRUE WILLIAM R. , TSUANG MING T.
Published: January 2006

This study investigated determinants of the subjective effects of marijuana and the relationship of subjective effects to marijuana use. Subjects were 8169 twins drawn from the Vietnam Era Twin Registry. Subjects who used marijuana more than five times (n= 2513) reported whether they experienced each of 23 subjective reactions. Factor analysis identified a positive (pleasant) reaction factor and a negative (unpleasant) reaction factor. Both factors were related to duration and frequency of use. Pairs in which both members used mariguana more than five times (MZ = 352 pairs; DZ = 255 pairs) were examined to assess determinants of subjective effects. Approximately one‐quarter of the variance in each factor was determined by additive genetic influences; the remaining variance was determined by environmental factors that are not shared by members of a twin pair. The shared or family environment had no detectable influence on either subjective reaction factor.
Mortality and survival among a cohort of drug injectors in Glasgow, 1982–1994
Authors: FRISCHER MARTIN , GOLDBERG DAVID , RAHMAN MOHAMMED , BERNEY LEE
Published: January 2006

There has been much speculation about the nature and extent of mortality among drug injectors in Glasgow. In order to determine injectors’ mortality rate and compare this rate to the general population, identifier information from 459 drug injectors who received treatment for drug misuse in Glasgow between 1982 and 1994 was linked to the Scottish Mortality Register. The average duration of follow‐up from cohort entry was 5.5 years and 10.2 years from commencement of drug injection. By the end of 1994, 53 cohort members had died. The average annual mortality rate of 1.8% was the same as that observed in a London cohort followed‐up from 1969 to 1991. However, the excess mortality ratio (EMR) of 22.0 was almost double the London rate (11.9) because of the much lower average age of mortality (26.3 vs. 3S.2 years). There was no significant time trend in EMR. Kaplan‐Meier hazard analyses show that younger patients and those who were HIV positive had significantly elevated mortality rates. The main cause of death was overdose, although it is unclear how many were accidental and how many intentional. Three of the six fatalities among HIV positive injectors were AIDS related. This study enables the first realistic assessment of the hypothesis that drug‐related deaths in Glasgow are especially high. In relation to other populations of drug injectors, the annual mortality rate is comparable, although the average age of mortality is much lower in Glasgow. Consequently, in comparison to the general population, the mortality rate of drug injectors is higher in Glasgow compared to other cities.
Community psychiatric nurse aftercare for alcoholics: a five‐year follow‐up study
Authors: PATTERSON D. G. , MACPHERSON J. , BRADY N. M.
Published: January 2006

The aim of this study was to determine if community psychiatric none (CPN) aftercare for 1 year improved the 5‐year outcome in patients following inpatient treatment for alcohol dependence. A 5‐year follow‐up study, observer blind, with non‐random allocation of subjects to aftercare by CPN for 1 year or standard outpatient care, was used. Subjects had all received inpatient treatment for 6 weeks in a rural alcohol treatment unit. Subjects were traced and assessed in the community 5 years after the index admission. The participants consisted of 127 white male alcoholics. All were first admissions, who had been selected for inpatient treatment and who completed a 6‐week inpatient stay. Seventy‐three subjects received intensive aftercare by CPN for 1 year, 54 subjects received standard outpatient appointments not due to random allocation but because no CPN was available. Data were collected by semi‐structured interview at entry to the trial, namely background epidemiological information, details of drinking history, previous hospital admission, educational, employment and criminal information. At 5‐year follow‐up, data on drinking status, use of other drugs, hospital admissions, criminal behaviour and gambling, attendance at self‐help groups, relationships and employment were collected. Thirty‐six per cent of the CPN aftercare group was completely abstinent during the 5 years after treatment compared to 6% of the standard aftercare group (p> O.OOJ). Subjects receiving CPN aftercare were less likely to report blackouts (p > 0.05) or gambling (p > 0.05). They were more likely to attend hospital meetings (p> 0.0001). CPN aftercare is an effective way of maximizing the effects of inpatient treatment. The effects endured for 5 years after treatment.
Inequality, deprivation and alcohol use
Authors: MARMOT MICHAEL
Published: January 2006

There are major social inequalities in health within societies. Alcohol and tobacco are major preventable causes of ill health. Using data from the United Kingdom, this paper examines the social distribution of tobacco and alcohol consumption; the role that tobacco and alcohol may play in mediating or modifying social inequalities in health; and the implications of social distribution for policies to reduce harm associated with consumption of alcohol and tobacco. In the United Kingdom, as in many other countries, there is clear inverse association between socio‐economic position and consumption of cigarettes. Over the past three decades, the decline in smoking has been more rapid in men and women in higher socio‐economic groups. United Kingdom suggest that among employed men and women, the prevalence of non‐drinking shows an inverse association with occupational status; heavy drinking differs little; and moderate drinking is more common among those of higher socio‐economic status. Smoking accounts for perhaps 25% of the social class difference in coronary heart disease (CHD) mortality, more for lung cancer, less for some other diseases. Healthier patterns of drinking may contribute to the lower CHD rates of higher social classes. Although other factors are clearly important in generating social inequalities, it is important to take the social distribution of alcohol and tobacco into account when formulating policy. For cigarette consumption, there is evidence that in lower socio‐economic groups demand is more sensitive to price; higher socio‐economic groups are more responsive to health education. There has been less research of this nature for alcohol. Available analyses suggest that price responsiveness of heavy drinking may be greatest in young men and in those with lower incomes. A pricing strategy has important equity implications.
What does science have to say?
Authors: MOSKALEWICZ JACEK
Published: January 2006

This plenary session had particular character. Ten representatives of the research world briefly presented what science has to say on different aspects of alcohol policy. Major research‐based generalizations from a variety of policy experiences were brought to the discussion. The panel's composition reflected the global map of alcohol studies; the group consisted of four people from English‐speaking countries, four from northern Europe and the Nordic countries and two from the Mediterranean pan of Europe. The session focused on population‐orientated strategies including political and economic controls on the availability of alcohol, advertising and public information campaigns. There was discussion of drink driving measures, and of how individual treatment interventions relate to the broad field of public health. Contributions from the world of nutrition and tobacco control policy were also drawn into the debate.
Changes in alcohol consumption in a general population in The Netherlands: a 9‐year follow‐up study
Authors: HAJEMA KLAAS‐JAN , KNIBBE RONALD A. , DROP MARIA J.
Published: January 2006

Changes in drinking patterns are described for men and women and per age group using data from a 9‐year follow‐up study in The Netherlands (n = 1327). Aspects of drinking patterns in our study are drinking status, level of consumption and frequency of heavy drinking. The average consumption and average frequency of heavy drinking are used to examine changes at aggregate level. Changes at individual level are examined in terms of adopting certain drinking patterns (incidence) and continuing certain drinking patterns (chronicity). A small decrease is found in the proportion of drinkers for both sexes. Only women show a decrease in mean consumption. Average frequency of heavy drinking is stable for both sexes. At individual level, proportions of chronicity and incidence of drinking patterns are higher among men. Small aggregate changes in drinking patterns are accompanied by rather large shifts in individual's up‐and‐down level of consumption and frequency of heavy drinking. No or only very small period effects are observed and little evidence is found for a cohort effect among men. A negative association between incidence and age is found for dunking status among women, for low, moderate and high level of consumption and for heavy drinking for both sexes. In terms of chronicity, negative associations with age are found for drinking status of both sexes, and for high level of consumption and heavy drinking among men.
A trial of relapse prevention with severely dependent male problem drinkers
Authors: ALLSOP STEVE , SAUNDERS BILL , PHILLIPS MIKE , CARR ADRIAN
Published: January 2006

Over the last two decades, relapse prevention has emerged as a major focus of the treatment of drug problems. Few studies have demonstrated any impact on generally high relapse rates. In this paper the outcome of a controlled trial of a relapse prevention programme with male problem drinkers (n = 60) attending an Alcohol Treatment Unit is reported. Subjects who met the inclusion criteria were allocated to a relapse prevention (n − 20) procedure or a discussion (n = 20) or no‐additional treatment (n = 20) control procedure. Subjects were followed‐up at 6 and 12 months by the first author. The relapse prevention programme was associated with significantly greater increases in pre‐ and post‐treatment self‐efficacy compared to the discussion control group and significantly greater probability of total abstinence than all controls over the first 6‐month follow up. In addition, the relapse prevention programme was associated with significantly longer survival time to an initial lapse and relapse than the controls. At 12‐month follow‐up, treatment effects had been eroded. It was concluded that the relapse prevention programme was an effective treatment in the short term and that longer‐term impact may require greater focus on maintenance factors, such as the individual's environment.
Confidentiality, disseminated regulation and ethico‐legal liabilities in research with hidden populations of illicit drug users
Authors: Fitzgerald John L. , Hamilton Margaret
Published: January 2006

An assurance of confidentiality is at the core of trusting relationships in outreach, ethnographic research and patient/client encounters. In the past, centralized State health care services have provided assurances of confidentiality to those engaged in health‐related research either through common law or by statute. However, unless specific confidentiality legislation is in place, no assurances of confidentiality can now be made to research subjects involved in either longitudinal, interview‐based or ethnographic research. The consequences of this situation become more serious given the recent emergence of the use of peer and community outreach. A significant problem with the outreach model is the failure to provide adequate legal and ethical support for those in outreach roles. Additionally, unless research subjects can be granted assurances of confidentiality, they will not engage in research for fear of later prosecution. At this time when outreach models are the modus operandi, the lack of a fundamental commitment to sustain confidentiality may seriously undermine further research. This paper will draw on the experiences of some Australian qualitative research and will review some of the ethical and legal liabilities for research that arise when an assurance of confidentiality cannot be given to those participating in research.
Economic and cultural correlates of cannabis use among mid‐adolescents in 31 countries
Authors: Ter Bogt Tom , Schmid Holger , Nic Gabhainn Saoirse , Fotiou Anastasios , Vollebergh Wilma
Published: January 2006

Aims  To examine cannabis use among mid‐adolescents in 31 countries and associations with per‐capita personal consumer expenditure (PCE), unemployment, peer factors and national rates of cannabis use in 1999.

Design, participants and measurement  Nationally representative, self‐report, classroom survey with 22 223 male and 24 900 female 15‐year‐olds. Country characteristics were derived from publicly available economic databases and previously conducted cross‐national surveys on substance use.

Findings  Cannabis use appears to be normative among mid‐adolescents in North America and several countries in Europe. The life‐time prevalence of cannabis use was 26% among males and 15% among females and was lowest for males and females in the former Yugoslav Republic (TFYR) of Macedonia: 2.5% and to 2.5%, respectively; and highest for males in Switzerland (49.1%) and in Greenland for females (47.0%). The highest prevalence of frequent cannabis use (more than 40 times in life‐time) was seen in Canada for males (14.2%) and in the United States for females (5.5%). Overall, life‐time prevalence and frequent use are associated with PCE, perceived availability of cannabis (peer culture) and the presence of communities of older cannabis users (drug climate).

Conclusions  As PCE increases, cannabis use may be expected to increase and gender differences decease. Cross‐national comparable policy measures should be developed and evaluated to examine which harm reduction strategies are most effective.
A comparison of contingency management and cognitive‐behavioral approaches for stimulant‐dependent individuals
Authors: Rawson Richard A. , McCann Michael J. , Flammino Frank , Shoptaw Steven , Miotto Karen , Reiber Chris , Ling Walter
Published: January 2006

Aims  Previous research has reported that both contingency management (CM) and cognitive‐behavioral therapy (CBT) are efficacious interventions for the treatment of stimulant abusers. The present study sought to directly compare the effectiveness of (CM) and (CBT) alone and in combination in reducing stimulant use.

Design  Randomized clinical trial.

Participants  Stimulant‐dependent individuals (n = 171).

Intervention  CM, CBT or combined CM and CBT, 16‐week treatment conditions. CM condition participants received vouchers for stimulant‐free urine samples. CBT condition participants attended three 90‐minute group sessions each week.

Measurements  Participants were interviewed at baseline and weeks 17, 26 and 52. Measures included psychiatric disorders and alcohol and drug use and concomitant social problems.

Findings  CM procedures produced better retention and lower rates of stimulant use during the study period. Self‐reported stimulant use was reduced from baseline levels at all follow‐up points for all groups and urinalysis data did not differ between groups at follow‐up. While CM produced robust evidence of efficacy during treatment application, CBT produced comparable longer‐term outcomes. There was no evidence of an additive effect when the two treatments were combined.

Conclusions  This study suggests that CM is an efficacious treatment for reducing stimulant use and is superior during treatment to a CBT approach. CM is useful in engaging substance abusers, retaining them in treatment and helping them achieve abstinence from stimulant use. CBT also reduces drug use from baseline levels and produces comparable outcomes on all measures at follow‐up.
Substance abuse and dependence in prisoners: a systematic review
Authors: Fazel Seena , Bains Parveen , Doll Helen
Published: January 2006

Aims  To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody.

Design and method  A systematic review of studies measuring the prevalence of drug and alcohol abuse and dependence in male and female prisoners on reception into prison was conducted. Only studies using standardized diagnostic criteria were included. Relevant information, such as mean age, gender and type of prisoner, was recorded for eligible studies. The prevalence estimates were compared with those from large cross‐sectional studies of prevalence in prison populations.

Findings  Thirteen studies with a total of 7563 prisoners met the review criteria. There was substantial heterogeneity among the studies. The estimates of prevalence for alcohol abuse and dependence in male prisoners ranged from 18 to 30% and 10 to 24% in female prisoners. The prevalence estimates of drug abuse and dependence varied from 10 to 48% in male prisoners and 30 to 60% in female prisoners.

Conclusions  The prevalence of substance abuse and dependence, although highly variable, is typically many orders of magnitude higher in prisoners than the general population, particularly for women with drug problems. This highlights the need for screening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow‐up on release. Specialist addiction services for prisoners have the potential to make a considerable impact.
Subclass distribution of natural salivary IgA antibodies against pneumococcal capsular polysaccharide of type 14 and pneumococcal surface adhesin A (PsaA) in children
Authors: Simell B , Kilpi T , Käyhty H
Published: January 2006

A number of studies have shown that the ratio of IgA1 and IgA2 subclasses in secretions can depend upon the nature of the antigen inducing their production. In order to evaluate the effect of the nature of the antigen on the subclass distribution of the naturally occurring salivary IgA antibodies against Streptococcus pneumoniae, we used enzyme immunoassay to measure the levels of natural IgA, IgA1 and IgA2 antibodies to pneumococcal capsular polysaccharide type 14 (PS14) and pneumococcal surface adhesin A (PsaA) in saliva of children during their first 2 years of life. The sum of anti-PS14 and anti-PsaA IgA1 and IgA2 correlated significantly with the antigen-specific total IgA, which showed that IgA1 and IgA2 add up to IgA. IgA1 was the predominant subclass for both antigens. The median of anti-PS14 and anti-PsaA IgA1 was higher than that of IgA2, and the antigen-specific IgA1 was found in a larger proportion of samples than IgA2. The ratio of IgA1 to IgA2 (IgA1/IgA2 ratio) was lower for anti-PS14 than for anti-PsaA, suggesting that the PS antigen induced more IgA2 than the protein antigen. The possible impact of the IgA subclass distribution on protection of mucosal surfaces by natural or vaccine-induced antibodies needs to be determined.
The historical spread of Ambrosia artemisiifolia L. in France from herbarium records
Authors: Chauvel Bruno , Dessaint Fabrice , Cardinal‐Legrand Catherine , Bretagnolle François
Published: January 2006

Aim  The problems in public health and field management in France caused by Ambrosia artemisiifolia L. require a better knowledge of the introduction and naturalization of this species in both the past and present.

Location  France.

Methods  The pattern of spread of A. artemisiifolia was investigated through the study of herbarium specimens. More than 1200 specimens were found in 58 herbaria and virtual herbaria in France and in bordering countries. The spread was analysed by mapping the localities for each 30‐year period since 1863. Specific indications as ‘new plant’ were used to determine the timing of the introduction of the species into a new area.

Results  It seems that the spread of A. artemisiifolia is not linked to its presence in botanical gardens. The study of specimen labels indicates that this species has been introduced in France in seed crops at various independent geographical points and at various times since its introduction in natural habitats. Commercial trade and American troops have contributed to its spread.

Main conclusions  The spread of the species in area and in time over France showed no clear front: new localities separated by large distances were colonized simultaneously. Cumulative numbers of localities show a continuous increase during the twentieth century. Herbarium specimens can be used to follow the spread of A. artemisiifolia.
Systematic position of copepods of the genus Achtheres (Crustacea: Copepoda: Siphonostomatoida) parasitizing perch, Perca fluviatilis L., and zander, Sander lucioperca (L.)
Authors: Kempter J , Piasecki W , Więski K , Krawczyk B
Published: January 2006

Parasitic copepods of the genus Achtheres commonly infect perch, Perca fluviatilis, and zander, Sander lucioperca, in Europe. The aim of this study was to verify the specific identity of these copepods. The parasites were examined morphologically, biometrically and genetically. Statistical processing of the biometrical data was based on both empirical measurements and transformed data related to total length and genital trunk width. Principal component analysis was applied to both sets of data. DNA of both parasite ‘forms’ was amplified using two sets of primers (EU5.8S + EU18S and 18SF1 +28SR) and the products were subjected to restriction fragment length polymorphism (RFLP). Morphological differences were found in the overall shape of the copepod bodies as well as in the details of the armament of some appendages. The morphometric study emphasized the importance of second maxillae and genital process as the variables most distinctly distinguishing the two ‘forms’. The two ‘forms’ of Achtheres differed in the DNA sequence amplified by one set of primers. RFLP revealed even more extensive differences between these two copepods. We concluded that the copepods parasitizing perch should be referred to as Achtheres percarum von Nordmann, 1832, whereas a long‐forgotten name, A. sandrae Gadd, 1901, should be applied to the copepods from zander.