bluuebunny/crossref_metadata_2025 huggingface dataset:
The respiratory effects of cannabis dependence in young adults
Authors: Taylor D. Robin , Poulton Richie , Moffitt Terrie E. , Ramankutty Padmaja , Sears Malcolm R.
Published: March 2003

Aim. To evaluate the relationship between cannabis dependence and respiratory symptoms and lung function in young adults, while controlling for the effects of tobacco smoking.

Setting and participants. Nine hundred and forty‐three young adults from a birth cohort of 1037 subjects born in Dunedin, New Zealand in 1972/1973 were studied at age 21.

Measurements. Standardized respiratory symptom questionnaires were administered. Spirometry and methacholine challenge tests were undertaken. Cannabis dependence was determined using DSM‐III‐R criteria. Descriptive analyses and comparisons between cannabis‐dependent, tobacco‐smoking and non‐smoking groups were undertaken. Adjusted odds ratios for respiratory symptoms, lung function and airway hyper‐responsiveness (PC

20) were measured.

Findings. Ninety‐one subjects (9.7%) were cannabis‐dependent and 264 (28.1%) were current tobacco smokers. After controlling for tobacco use, respiratory symptoms associated with cannabis dependence included: wheezing apart from colds, exercise‐induced shortness of breath, nocturnal wakening with chest tightness and early morning sputum production. These were increased by 61%, 65%, 72% (all p < 0.05) and 144% (p < 0.01) respectively, compared to non‐tobacco smokers. The frequency of respiratory symptoms in cannabis‐dependent subjects was similar to tobacco smokers of 1‐10 cigarettes/day. The proportion of cannabis‐dependent study members with an FEV

1/FVC ratio of < 80% was 36% compared to 20% for non‐smokers (p = 0.04). These outcomes occurred independently of co‐existing bronchial asthma.

Conclusion. Significant respiratory symptoms and changes in spirometry occur in cannabis‐dependent individuals at age 21 years, even although the cannabis smoking history is of relatively short duration.
Initiation and progression of cannabis use in a population‐based Australian adolescent longitudinal study
Authors: Coffey C. , Lynskey M. , Wolfe R. , Patton G. C.
Published: March 2003

Aims. To examine predictors of cannabis use initiation, continuity and progression to daily use in adolescents.

Design. Population‐based cohort study over 3 years with 6 waves of data collection.

Participants. 2032 students, initially aged 14‐15 years, from 44 secondary schools in the state of Victoria, Australia.

Measurements. Self‐report cannabis use was categorized on four levels (none, any, weekly, daily) and summarized as mid‐school (waves 2/3) and late‐school (waves 4/5/6) use. Background, school environment, mid‐school peer use and individual characteristics were assessed.

Findings. Peer cannabis use, daily smoking, alcohol use, antisocial behaviour and high rates of school‐level cannabis use were associated with mid‐school cannabis use and independently predicted late‐school uptake. Cannabis use persisted into late‐school use in 80% of all mid‐school users. Persisting cannabis use from mid‐ to late‐school was more likely in regular users (odds ratio (OR) 3.4), cigarette smokers (OR any smoking: 2.0, daily smoking: 3.3) and those reporting peer use (OR 2.1). Mid‐school peer use independently predicted incident late‐school daily use in males (OR 6.5) while high‐dose alcohol use (OR 6.1) and antisocial behaviour (OR 6.6) predicted incident late‐school daily use in females.

Conclusions. Most cannabis use remained occasional during adolescence but escalation to potentially harmful daily use in the late‐school period occurred in 12% of early users. Transition was more likely in males, for whom availability and peer use were determinants. In contrast, females with multiple extreme behaviours were more likely to become daily users. Cigarette smoking was an important predictor of both initiation and persisting cannabis use.
Further validation and development of a screening instrument for the assessment of substance misuse in adolescents
Authors: Willner Paul
Published: March 2003

Aim. The aim of this study was to investigate the validity of the Substance Misuse in Adolescence Questionnaire, which has been proposed as a screening instrument for problem drug use in adolescents.

Participants and setting. The participants in the study were 4544 11‐16‐year‐olds attending eight secondary schools located in the north‐west midlands of England.

Procedure. Participants completed an anonymous self‐report questionnaire that incorporated a modified version of the SMAQ (the Assessment of Substance Misuse in Adolescence: ASMA), together with other questions relating to substance use and associated issues.

Results. The ASMA showed good reliability, both within the overall sample of respondents, and in a drug‐using subsample. Principal‐components analysis returned a single factor when applied either to the whole sample or to the drug‐using subsample; 1.4% of respondents met a criterion equivalent to that proposed by Swadi (1997) for 'problem drug use' (ASMA > 12). A further 6.4% reached a threshold for potentially problematic drug use (ASMA > 8) and could be considered 'at risk'. In regression analyses, ASMA scores were predicted by drug‐related variables, and by low resistance to peer influence (RPI), but not by alcohol‐related variables. The highest ASMA scores and lowest levels of RPI were found in heroin users. Respondents' perceptions of their future risk of drug or alcohol problems were predicted by RPI and by frequency of drug use and drunkenness.

Conclusions. The ASMA may be a useful screening instrument for identifying problem drug use in adolescents unknown to treatment services.
The effect of mode of data collection and of non‐response on reported alcohol consumption: a split‐sample study in Switzerland
Authors: Gmel Gerhard
Published: March 2003

Aims. To examine (a) effects of different modes of data collection on the reporting of alcohol consumption and non‐response rate, and (b) differences in reported consumption between respondents and non‐respondents. Design. Two versions of a health questionnaire survey were assigned to two random samples, one version to each sample. Version 1 consisted of a telephone interview without alcohol questions, followed by a mailed questionnaire with alcohol questions. Version 2 consisted of a telephone interview with alcohol questions, followed by a mailed questionnaire without alcohol questions. Setting. Participants were recruited randomly in eight Swiss cantons. Participants. Five hundred and thirty‐seven (404) respondents to the telephone interview (and subsequent mailed questionnaire) with version 1, and 451 (360) with version 2. Measurements. Alcohol‐use variables derived from a quantity‐frequency measure. Results. Respondents to the mailed questionnaire (version 2) did not differ significantly in alcohol consumption from non‐respondents. Response rate was not affected by inclusion of alcohol questions, but respondents asked by telephone about their alcohol use were more often abstainers and less often hazardous drinkers than respondents to the mailed question. Conclusion: The study gives no indication that interviews are refused because alcohol consumption is a questionnaire topic, but suggests that postal questionnaires give slightly greater disclosure of alcohol consumption.
Does exercise aid smoking cessation? A systematic review
Authors: Ussher Michael H. , Taylor Adrian H. , West Robert , McEwen Andy
Published: March 2003

Aims: To assess the effectiveness of exercise‐based interventions in smoking cessation. Design: A systematic review was conducted of articles published between 1980 and 1999. The review focused on randomized controlled trials (RCTs) in which the specific effects of exercise on smoking abstinence were examined. The primary dependent variable was smoking abstinence. Other studies which had both exercise programming as an independent variable and smoking behaviour as a dependent variable are briefly discussed. Participants: The review included interventions targeting both healthy individuals and those with specific medical conditions. Settings: The interventions were delivered in both community and inpatient settings. Measurements: Information extracted from each article included details of the participants, exercise and smoking cessation programmes, control conditions, exercise adherence rates, length of follow‐up and outcomes. Findings: Of the eight trials satisfying our inclusion criteria, only two trials found a positive effect for exercise on smoking abstinence. The others showed no effect. Conclusions: There is some evidence for exercise aiding smoking cessation. Of the two trials finding a positive effect one was rigorously designed, the other was found to have numerous methodological limitations. Trials showing no effect lacked sensitivity. This was principally because of small sample sizes and inadequate measurement and control of exercise adherence. There is a need for more rigorously designed studies in this area.
Effects of telephone versus face‐to‐face interview modes on reports of alcohol consumption
Authors: Greenfield Thomas K. , Midanik Lorraine T. , Rogers John D.
Published: March 2003

Aims and design: In order to assess the effects of survey modality on alcohol consumption estimates, data from two surveys using different interview modes (face‐to‐face and telephone) were compared on several alcohol measures. Setting and participants: Face‐to‐face survey data were drawn from the 1990 National Alcohol Survey, while the telephone data came from the 1990 Warning Labels Survey. Both surveys used a probability sampling of the US adult general population in the 48 contiguous states. Measurements: Measures of alcohol use derived from an identical graduated frequencies series included estimates of any drinking in the past 12 months, overall volume, and heavy (5+) drinking days. Findings: Abstention rates did not differ by survey mode, nor did distributions of alcohol consumption by volume and reported frequency of drinking five or more drinks in a day. Multiple regression models including demographic‐mode interaction terms were used to examine how mode effects might differ across demographic subgroups. Lower income respondents were under‐represented in the telephone sample, and were associated with lower reports of volume and (5+) days, compared to respondents in the face‐to‐face mode. Conclusions: The results suggest that although there are few differences in alcohol consumption estimates by interview mode, telephone samples may need to be supplemented or estimates adjusted by income level in order to attain equivalent results.
Quality of heroin and heroin‐related deaths from 1987 to 1995 in Vienna, Austria
Authors: Risser Daniele , Uhl Alfred , Stichenwirth Martin , Honigschnabl Selma , Hirz Walter , Schneider Barbara , Stellwag‐Carion Carl , Klupp Nikolaus , Vycudilik Walter , Bauer Georg
Published: March 2003

Aims. To investigate the quality of heroin seized in Vienna between 1987 and 1995 and to examine whether there was a relationship between the quality of heroin and the rate of drug‐related deaths. Design. Reports of heroin seizure analysis and post‐mortem reports of heroin‐related deaths in Vienna from 1987 to 1995 were analysed. Results. There were 386 seizures of heroin comprising a total weight of 25 640.12g heroin. All the seizures were in the base form. All seizures also contained a diluent, mainly lactose. Additionally, in 95 seizures caffeine, in four seizures paracetamol and in three seizures metaqualon were detected. Of a total of 764 drug‐related deaths 506 cases were classified as heroin‐related deaths. In 336 cases other central nervous system‐depressant drugs and/or alcohol could be detected in the blood in addition to morphine (polydrug heroin‐related deaths). There was evidence of a trend towards greater polydrug involvement during the study period. The age of victims of polydrug heroin‐related deaths remained unchanged over time while the age of victims of pure heroin‐related deaths decreased significantly. The morphine concentration in the medulla oblongata in heroin‐related deaths decreased significantly. Finally, there was no statistically significant relationship between the rate of heroin‐related deaths per year and the diacetylmorphine concentration of heroin seizures in that year. Conclusion. The results did not substantiate the widely held belief that increases in heroin‐related deaths could be explained by an increase in the quality of heroin.
Prevalence, incidence and risk factors of anaemia in HIV‐positive and HIV‐negative drug users
Authors: Werf Marieke J. Van Der , Benthem Birgit H. B. Van , Ameijden Erik J. C. Van
Published: March 2003

Aims. To determine the prevalence of anaemia among HIV‐positive and‐negative drug users, estimate the incidence of anaemia among HIV‐positive drug users and study risk factors for prevalent anaemia with emphasis on HIV infection, gender and drug use behaviour. Design, setting and participants. Cross‐sectional study among HIV‐positive and HIV‐negative drug users (n = 360) and a longitudinal study among HIV‐positive drug users (n = 175, 860 visits) participating in a cohort study of drug users in Amsterdam. Measurements. Self‐reported data on socio‐demographics, drug use behaviour and zidovudine and protease inhibitor therapy on regular cohort visits. Laboratory determinations of haemoglobin concentration, CD4 + ‐cell counts and HIV‐1 RNA. Findings. The prevalence of anaemia was 21.1% among participating drug users according to the WHO definition. The incidence of anaemia in HIV‐positive individuals was 33.0/100 person‐years. The main risk factor for anaemia was high frequency of injecting drugs. A Quetelet body mass index <20 and female gender were also positively and significantly related to anaemia in the cross‐sectional study. In the longitudinal study among HIV‐positive drug users progression of HIV infection indicated by low CD4

+ ‐cell count and AIDS diagnosis were predictive of anaemia. Conclusion. The results indicate that drug users in the Amsterdam cohort study have a high prevalence of anaemia, which can be explained mainly by high frequency of injecting drugs and HIV infection progression. Reduction or cessation of injecting drug use should reduce anaemia.
Youth escaping limits on drinking: binging in Mexico
Authors: Lange James E. , Voas Robert B.
Published: March 2003

Aims. In Tijuana, Mexico, a loosely enforced age‐18 law and inexpensive drinks have given rise to a nightclub district frequented by thousands of young Southern Californians each weekend night. Surveys were designed to characterize the extent of the cross‐border binge‐drinking traffic and to support and evaluate the community’s response. Design. Over 1 year, two anonymous and voluntary breath‐test surveys were done. Drivers and pedestrians were pulled randomly from the stream of northbound border crossers and recruited to participate. Setting. Surveys occurred between 12 a.m. and 4 a.m. on randomly selected Wednesdays, Fridays, and Saturdays. Participants were recruited within the Port of Entry building. Participants. Of the 5849 border crossers recruited, 87.4% participated in the survey. Measurements. Information was obtained through a standardized verbal interview. All participants were asked to take an alcohol breath test. Findings. On weekend nights, more than 6500 people cross back into the United States between 12 a.m. and 4 a.m. after drinking or visiting a bar or restaurant. Pedestrians represent the highest concentration of drinkers, with more than 30% having BACs of 0.08 or greater. Most of these pedestrians return to parked vehicles on the US side and drive or ride home. Conclusions. The flow of young binge drinkers at the Tijuana border is substantial and translates into a significant public health problem for the region as crossers use their vehicles to drive home. There are many such binge‐drinking locales. However, the border is unique in that it is amenable to scientific estimations of the problem with relatively high precision.
Cognitive, dissociative and psychotogenic effects of ketamine in recreational users on the night of drug use and 3 days later
Authors: Curran H. Valerie , Morgan Celia
Published: March 2003

Aims. Recreational use of the N‐methyl‐D‐aspartate (NMDA) receptor antagonist, ketamine, is increasing. The present study aimed to examine both the acute and residual effects of this drug on cognitive function, dissociation and schizotypal symptomatology in recreational users . Design and participants. A parallel group design was used to compare 20 volunteers who reported having taken ketamine with 19 volunteers who reported no consumption of ketamine on the relevant night (day 0). All 39 participants were tested on day 0 and again 3 days later. On each test occasion a battery of tests was administered which tapped a wide range of memory functions, attention, dissociation, schizotypal symptomatology and mood. Findings. Groups were broadly matched for polydrug use apart from ketamine. Acute effects on day 0 replicated previous laboratory studies showing a broad spectrum of cognitive impairments following ketamine administration as well as marked dissociative effects and schizotypal symptomatology. Three days later, ketamine users had significantly higher scores than controls on both dissociation and schizotypal symptomatology. On some cognitive measures there were no group differences on day 3; however, on tests tapping semantic memory, the ketamine users showed persisting impairments compared with controls. Conclusions. Ketamine appears to induce acute and severe impairments of working, episodic and semantic memory as well as psychotogenic and dissociative effects. Three days after drug ingestion, recreational users display semantic memory impairment and dissociative and schizotypal symptomatology which could reflect chronic or residual effects of taking the drug or pre‐existing differences in ketamine users.
Effects of increasing income on polydrug use: a comparison of heroin, cocaine and alcohol abusers
Authors: Petry Nancy M.
Published: March 2003

Abstract Aims. To assess how income affects hypothetical drug and non‐drug purchasing decisions. Participants and setting. Ninety‐four subjects (26 heroin abusers, 28 cocaine abusers, 15 alcohol abusers and 25 non‐drug using controls) were recruited from advertisements. Intervention. Subjects were exposed to six conditions in which they “purchased” drugs as well as food, housing, and entertainment as income rose from $30 to $560 per day. Findings. Heroin abusers selected significantly more hypothetical heroin and cocaine as income rose and demand for these two drugs was income elastic, with purchases rising in greater proportion than income. Cocaine abusers significantly increased purchases of, and showed income elastic demand for, cocaine and alcohol. Among alcohol abusers, significant increases in purchases and income elastic demand were found for alcohol and cigarettes, but not for other drugs. Across all four groups, demand for rent and food were income inelastic, such that purchases did not rise in proportion to the changes in income, while demand for entertainment was income elastic. Hypothetical choices were reliable between and within subjects, and drug choices were correlated with urinalysis results and life‐time years of drug use. Conclusions. Income is an important variable in understanding choices for drug and non‐drug commodities across a variety of substance‐abusing populations.
The assessment of alcohol expectancies in school children: measurement or modification?
Authors: Wiers Reinout W. , Sergeant Joseph A. , Gunning W. Boudewijn
Published: March 2003

Aims. Earlier research has suggested that measuring children’s positive alcohol‐related expectancies could have the undesirable side effect of increasing them. This has been reported for an instrument that only measured positive expectancies and used a puppet‐reference. The present study investigated whether this increase was still found using an unbiased instrument. Further, it was tested whether the assessment method with puppets influenced children’s expectancies. Design. Children were assigned randomly to respond on an unbiased expectancy questionnaire in one of two assessment conditions: with reference to a puppet (P) or without reference to a puppet (Q). One month later, children were again administered one of the two assessment conditions, resulting in four assessment orders (PP, PQ, QP, QQ). Setting and participants. Three hundred and ninety‐five second‐ to fifth‐graders were administered one of the two methods in their schools and 260 children were measured a second time, 1 month later. Measurements. A questionnaire measuring children’s positive and negative expectancies was developed that could be administered with or without a puppet‐reference. Findings. A large direct response‐effect was found: in the puppet condition, children scored higher on positive but not on negative expectancies. A smaller indirect measurement‐effect was found at borderline significance: children who had used the puppet method 1 month earlier had significantly stronger positive expectancies than children who had used the questionnaire earlier. Conclusions. The present results confirm earlier indications that measuring children’s positive expectancies may have the undesirable side effect of increasing them. This can be avoided by measuring children’s expectancies with an unbiased questionnaire without a puppet‐reference.
Studies on natural recovery from alcohol dependence: sample selection bias by media solicitation?
Authors: Rumpf H.‐J. , Bischof G. , Hapke U. , Meyer C. , John U.
Published: March 2003

Abstract Aims. To assess the selection bias of recruiting participants in studies on natural recovery from alcohol dependence through media solicitation. Design. Two samples with different recruitment strategies are compared. Setting. Media solicitation and general population. Participants. Sample 1 consists of 176 alcohol‐dependent individuals remitted without formal help and recruited through media solicatation, sample 2 consists of 32 natural remitters derived from a representative general population study with a sample size of 4075 respondents and a response rate of 70.2%. Measurements. Several triggering mechanisms and maintenance factors of remission were assessed in a personal interview using standardized questionnaires. Findings. Results of logistic regression analyses show that media‐solicited subjects were more often abstinent in the last 12 months, were more severely dependent, were less satisfied with eight life domains prior to remission and showed higher scores in a coping behaviour measure. Besides these major differences from the multivariate analysis, media subjects revealed more health problems prior to remission, experienced more social pressure to change drinking behaviour, and showed differences in reasons for not seeking help. Conclusions. Media solicitation leads to a sample selection bias in research on natural recovery from alcohol dependence. When measures to foster self‐change are derived from such studies, findings from representative samples have to be considered.
Evaluating theories of alcohol‐related aggression using observations of young adults in bars
Authors: Graham Kathryn , West Paulette , Wells Samantha
Published: March 2003

Aims. The objective of the present study is to evaluate 36 explanations of alcohol‐related aggression that have been proposed in the research literature in terms of their relevance to naturally‐occurring incidents of aggression involving alcohol.

Design. The study involved content analysis of descriptions of 105 incidents of aggression.

Setting and participants. Bars frequented by young adults.

Measurements. Step‐by‐step descriptions of incidents of aggression reported by researcher‐observers based on 93 nights of observation in bars between midnight and 3 a.m.

Findings. Some explanations relating to the effects of alcohol (e.g. focused on the present, reduced anxiety about sanctions or danger, heightened emotionality) and the environment (e.g. generally permissive environment, expectation by patrons that aggression will be tolerated) were found to be relevant to most incidents, while other explanations (e.g. crowding, release of pent‐up anger) were directly relevant to only a few or no incidents. Incidents involving male‐to‐male aggression were more likely than incidents involving both males and females to be attributable to expectations, acceptance of aggression, power concerns, male honor and “macho” values. Principal components analysis identified five groupings of explanations: risk‐taking effects of alcohol, cognitive impairment from alcohol, hyperemotional effects of alcohol, “macho” subculture, and permissive environment.

Conclusions. The findings are consistent with a model of alcohol‐related aggression that involves multiple contributing factors including alcohol effects and situational contexts. The greater relevance of certain explanations and the natural groupings of explanations point to directions for future research.
Drinking patterns and health outcomes: occasional versus regular drinking
Authors: San José B. , Van Oers J. A. M. , Van De Mheen H. , Garretsen H. F. L. , MacKenbach J. P.
Published: March 2003

Aims. To compare the health of drinkers with different drinking patterns and particularly drinkers with comparable average intakes and different drinking frequency.

Setting. General population survey conduced in Eindhoven, the Netherlands (n = 18 973).

Measurements. Chronic conditions, perceived general health, and health complaints were the outcome measures. Drinking categories were constructed by taking into account the frequency and amount of alcohol consumption (up to six glasses per sitting).

Findings. Drinking 3–5 days per week/3–5 glasses per occasion and drinking 6–7 days/1–2 glasses were associated with lower likelihood for reporting health complaints and for perceiving one’s health as less than good compared to those drinking 1–2 days/1–2 glasses (reference group). Drinking 1–2 days/6 glasses was associated with being more likely to report chronic conditions, compared to the reference group. Those drinking 1–2 days/6 glasses were significantly more likely to report > 3 health complaints than those drinking 6–7 days/1–2 glasses. Although no differences were observed for any of the other comparison groups, at high levels of consumption (18–35 units/week), occasional drinkers (3–5 days/6 glasses) seemed to have better health outcomes compared to their counterparts (6–7 days/3–5 glasses).

Conclusion. In addition to average alcohol intake, drinking pattern is also related to health.
Reactivity to alcohol‐related stimuli in the laboratory and in the field: predictors of craving in treated alcoholics
Authors: Litt Mark D. , Cooney Ned L. , Morse Priscilla
Published: March 2003

Aims. (1) To search for predictors of alcohol craving in treated alcoholics; (2) to evaluate the relationship between craving and drinking immediately after treatment.

Design. Alcoholic patients in treatment underwent cue–reactivity trials in the laboratory and then recorded craving in the field using hand‐held computers. Laboratory craving was correlated with craving in the field, and moods and situations recorded in the field were correlated with contemporaneous craving ratings using a multi‐level correlational design.

Setting. A VA Medical Center substance abuse treatment program provided the treatment and laboratory settings. The patients’ home environment was the field setting.

Participants. Male alcohol‐dependent veterans ( N = 26) treated in a VA inpatient or intensive outpatient program. Intervention. Participants underwent two cue–reactivity laboratory sessions prior to discharge to measure craving. Following discharge, participants recorded drinking and cravings eight times per day for 21 consecutive days.

Measurements. Craving ratings in the laboratory and multiple recordings per day of surroundings, craving and mood state in the field.

Findings. Desire to drink in the laboratory accounted for 8–10% of the variance in later drinking and urges to drink recorded in the field—a modest correlation. Frequency of positive urges in the field was significantly correlated with drinking frequency. Those who reported urges in the field had greater alcohol dependence and higher trait anger and anxiety scores than non‐reporters.

Conclusions. Craving is related to drinking immediately following treatment, and is most likely in those who have more severe dependence and greater mood disturbance. These individuals may benefit most from interventions for coping with cravings after treatment.
Medical education in substance‐related disorders: components and outcome
Authors: El‐Guebaly Nady , Toews John , Lockyer Jocelyn , Armstrong Susan , Hodgins David
Published: March 2003

Aims. To analyze the process of acquisition by physicians of a body of knowledge and skills in the management of substance abuse.

Design. A comprehensive search of English‐speaking literature was conducted over 20 years. Articles assessing the outcome of educational strategies in undergraduate, graduate and continuing medical education were examined to determine the targeted sample, the educational strategies involved and the outcomes assessed.

Findings. Nine studies in undergraduate education, 11 in graduate and 11 in continuing education met the inclusion criteria. They were generally difficult to compare in design, strategy and outcome analysis. Cognitive knowledge and behavioral skills appear to be easier to obtain compared to more complex attitudinal shifts.

Conclusions. There is growing consensus in the selection of a combined didactic and interactive educational strategy but few empirical data as to the more cost‐effective learning interventions. Training must be reinforced at regular intervals. While the expanding panoply of interventions available to physicians should enhance the perceptions of role legitimacy and treatment optimism, cohort studies across levels of education, specialty groups and across‐substance and other addictive behaviors are required to determine cost‐effective educational strategies.
Desire for alcohol and outcome expectancies as measures of alcohol cue‐reactivity in social drinkers
Authors: Schulze Daniela , Jones Barry T.
Published: March 2003

Aims. To assess the responsiveness of questionnaire measures of desire to drink and alcohol outcome expectancies.

Design. A subjective alcohol cue‐reactivity paradigm (alcohol cue: sight, smell, taste) was used with a 2 X 2 between‐subject design (n = 88), drink type (soft/alcoholic) and order of assessment (desire‐expectancy/expectancy‐desire). Covariance analysis controlled for quantity of recent alcohol consumption.

Setting. A quiet alcohol research suite.

Participants. Eighty‐eight male and female social drinking students, recruited for a 'taste preference' survey.

Measures. Three composite measures using questionnaire totals and subscales: of desire (DAQ), positive expectancy (AEQ) and negative expectancy (NAEQ). Timeline Follow‐back procedure for recent consumption .

Findings. Subjective cue‐reactivity was found for the DAQ total score and the subscales 'strong intentions and desires' and 'negative reinforcement'. Expectancies did not demonstrate alcohol cue‐reactivity.

Conclusion. The DAQ and subscales are sensitive measures of alcohol cue‐reactivity in social drinkers. Potential uses of the subjective cue‐reactivity procedure with multi‐factorial representations of cue reaction are identified.
Early results from a school alcohol harm minimization study: the School Health and Alcohol Harm Reduction Project
Authors: McBride Nyanda , Midford Richard , Farringdon Fiona , Phillips Mike
Published: March 2003

Aims. The School Health and Alcohol Harm Reduction Project aims to reduce alcohol‐related harm by enhancing students' abilities to identify and deal with high‐risk drinking situations particularly likely to be encountered by young people.

Design. The SHAHRP study has adopted a quasi‐experimental research design, incorporating intervention and control groups and measuring change over a 3‐year period.

Setting. The study is set in metropolitan, government secondary schools (13‐17‐year‐olds) in Perth, Western Australia. The 14 schools involved in the SHAHRP study represent approximately 23% of government secondary schools in the Perth metropolitan area.

Participants. The sample was selected using cluster sampling, with stratification by socio‐economic area, and involves over 2300 intervention and control students from junior secondary schools. Seventy‐three per cent (73.7%) of students completed surveys at both baseline and first follow‐up .

Intervention. The intervention incorporated evidence‐based approaches to enhance potential for behaviour change in the target population. The intervention is a curriculum‐based programmeme with an explicit harm minimization goal and will be conducted in two phases over a 2‐year period.

Measures and findings. The early results of the study demonstrate initial knowledge and attitude change, predicted by the students' involvement in the intervention. A surprising impact of the first phase of SHAHRP was the significant difference in alcohol consumption and harms between control and intervention groups, with the SHAHRP group demonstrating a significantly lower increase in alcohol consumption than the control group. Students who were supervised drinkers at baseline and who received the SHAHRP intervention were overwhelmingly represented in the change results.

Conclusions. Results from phase one of the SHAHRP study suggest that classroom‐based alcohol education programmemes can reduce harm, particularly in students who are supervised drinkers prior to the intervention.
Substance dependence, family history of alcohol dependence and neuropsychological functioning in adolescence
Authors: Tapert Susan F. , Brown Sandra A.
Published: March 2003

Aims. It was hypothesized that adolescent substance dependence moderates the relationship between family history of alcohol dependence and neuropsychological functioning.

Design. This study compared the neuropsychological functioning of nonabusing and alcohol and drug‐dependent adolescents with and without a family history of alcohol dependence using hierarchical multiple regressions and general factorial analyses.

Setting. Substance‐dependent adolescents were recruited and tested in inpatient alcohol and drug abuse treatment programs after 3 weeks of abstinence. A matched sample of non‐abusing adolescents was recruited from the same San Diego‐area communities.

Participants. Substance‐dependent adolescents (n = 101) met DSM‐III‐R criteria for dependence on alcohol and at least one other substance. Non‐abusing adolescents (n = 50) had no substance use disorders. Groups were comparable on socio‐economic status. Participants were 44% female, ages 13‐18, and had no serious head injuries or neurological disorders.

Measurements. Information was gathered on demographics, family history, substance involvement, and conduct disorder behaviors and adolescents were administered neuropsychological tests covering language, visuospatial, verbal memory, attention and executive functioning domains.

Findings. The hypothesis was supported for language and attention tests. Substance involvement interacted with family history of alcohol dependence to predict language and attention functioning. Family history negative non‐abusers performed better than the other adolescents.

Conclusions. The pattern of results suggests that family history of alcohol dependence and adolescent substance use are separate risk factors for poorer neuropsychological performance in youth.
HIV risk behaviour correlates among injecting drug users in Greek prisons
Authors: Koulierakis George , Gnardellis Charalambos , Agrafiotis Demosthenes , Power Kevin G.
Published: March 2003

Aims. To identify the correlates of injecting drug use within prison.

Design. A national cross‐sectional study, participation being voluntary and anonymous.

Setting. Ten Greek prisons.

Participants. A representative sample of 1000 male inmates; 861 questionnaires were completed and analysed.

Measurement. A self‐report questionnaire for demographics, penal history, drug use and sharing injecting equipment.

Findings. Two hundred and ninety inmates (33.7%) reported injecting drugs at some time in their lives, of whom 174 (60%) had injected while imprisoned. Among those who had injected while imprisoned, 145 (83%) had shared equipment while incarcerated. Logistic regression analysis suggested that total time in prison, previous drug conviction, being a convict (as opposed to on remand) and having multiple female sexual partners 1 year before incarceration were significant HIV risk behaviour correlates. For every year of imprisonment, the risk of injection in prison increased by about 17% \[OR = 1.17 (95% CI: 1.07‐1.27)]. Inmates with a previous drug‐related conviction were about twice as likely to inject within prison \[OR = 1.97 (95% CI: 1.16‐3.33)]. Finally, convicted inmates were marginally significantly more prone to inject in prison \[OR = 1.58 (95% CI: 0.92‐2.74)].

Conclusions. Variables related to the inmates' prison career influence HIV risk behaviours within prison. There is a need to assist IDUs in reducing the likelihood of high‐risk behaviour by considering factors such as frequency of incarceration, length of time incarcerated and availability of detoxification programmes within prison.
Experience and knowledge of young people regarding illicit drug use, 1969–99
Authors: Wright J. Denham , Pearl Laurence
Published: March 2003

Aims. To monitor young people's experience and knowledge of illicit drugs between 1969 and 1999 at intervals of 5 years.

Design. The same confidential anonymously completed questionnaire was used throughout.

Setting. Three secondary schools in Wolverhampton, an English Midlands town.

Participants. Two hundred and seventy‐four pupils aged 14‐15 completed the questionnaire in 1999. Previous sample sizes were 471 in 1969, 523 in 1974, 648 in 1979, 540 in 1984, 380 in 1989 and 392 in 1994.

Measurements. Self‐reported levels of experience and knowledge of illicit drugs.

Findings. Over 30 years the proportion of pupils who knew someone taking drugs more than quadrupled from 15% (71/461) in 1969 to 65% (254/392) in 1994 and decreased to 58% (157/273) in 1999. The proportion who had been offered drugs increased nine‐fold from 5% (24/462) to 45% (175/392) and levelled to 48% (131/274) in 1999. The proportion mentioning “ecstasy”, LSD and amphetamines increased while amyl nitrite decreased significantly. “To feel big, grown up” was the main perceived reason for taking drugs. “To escape problems” increased significantly in 1999. Television remained the main source of information closely followed by friends and talk in school.

Conclusions. The experience of illicit drugs, after increasing dramatically to a peak in 1994, has levelled out in 1999. Although the knowledge of the names of drugs has steadily increased, knowledge of the effects has remained limited. Social and group pressures remain the main perceived reason for taking drugs and many may see drugs as a way of coping with stress. Progress in education about drugs must take account of wider issues in society.
A longitudinal study of male buprenorphine addicts attending an addiction clinic in India
Authors: Basu Debasish , Mattoo Surendra K. , Malhotra Anil , Gupta Nitin , Malhotra Rama
Published: March 2003

Aim. There is a lack of longitudinal studies of buprenorphine dependence, an important opioid dependence in several countries. We investigated the course and outcome of buprenorphine dependence in an Indian clinic‐attending cohort.

Design. Retrospective longitudinal study.

Setting. An addiction clinic in northern India.

Participants. Ninety‐four male patients with buprenorphine dependence, registered for treatment between 1987 and 1993. Follow‐up analyses were conducted for the 52 patients (55% of the index cohort) who completed more than a year of follow‐up. In 48% of these 52 patients data were obtained from their clinical records of follow‐up, while 52% were contacted specifically to obtain the required data on follow up.

Measurement. Baseline demographic and clinical variables; time spent in various phases of use or abstinence; outcome at the latest follow up; transition to other drugs during follow‐up period.

Findings. Over an average follow‐up duration of 3 years, 56% of the time was spent in dependent use, 12% in non‐dependent use and 32% in abstinence. By the end of follow‐up, 6% of patients were dead (annual death rate 1.9%), 33% were unchanged and 61% were classified as 'improved'. The proportion of patients with 'improved' outcome increased over the years. Patients with poor outcome had shorter follow‐up and hospital stay, and had used pentazocine and/or antihistaminic injections in the buprenorphine 'cocktail' more often than those with better outcome. Thirty‐two patients shifted to other drugs over the years, notably heroin or polydrug use. These 'transition' patients had a family history of drug use more often, started their drug career earlier, had marital and legal complications more often, spent more time in dependent phase of drug use, underwent multiple hospital admissions but stayed for a shorter period and faced more deaths, when compared to those who did not shift.

Conclusion. In clinic‐attending male patients with buprenorphine dependence who were followed‐up although dependent pattern of use of the drug continued for a long time in their career, there was a slow but progressive improvement. Transition to other drugs was associated with a worse course and outcome as compared to being stable on buprenorphine.
Alcohol sales to underage adolescents: an unobtrusive observational field study and evaluation of a police intervention
Authors: Willner Paul , Hart Kenneth , Binmore John , Cavendish Margaret , Dunphy Elizabeth
Published: March 2003

Aims. The aims of this study were to assess the ease with which adolescents in the United Kingdom are able to buy alcohol, to obtain information concerning vendors' perceptions of alcohol sales to adolescents, and to evaluate a police intervention intended to reduce underage alcohol sales.

Design, setting, subjects. An unobtrusive naturalistic field study was conducted in two urban locations. Pairs of 13‐ and 16‐year‐old boys and girls were trained to attempt the purchase of different types of alcohol (alcopops, beer, cider, wine, spirits) from four different types of retail outlets (corner shops, off‐licence, public houses and supermarkets), under the supervision of a researcher and typically a parent. The assessment was repeated, with the omission of the 13‐year‐old boys, following a police intervention in one of the performance sites, consisting of warning letters and visits to vendors, and the issue of a small number of police cautions. A total of 62 underage confederates in all attempted 470 test purchases in phase 1 and 348 in phase 2. Between the two waves of test purchases a sample (

n= 95) of the same vendors was surveyed by telephone.

Findings. In phase 1, sales resulted from 88.1% of purchase attempts by 16‐year‐old girls, 77% of attempts by 16‐year‐old boys, 41.6% of 13‐year‐old girls and 4.1% of 13‐year‐old boys. These figures were generally comparable across locations, alcohol types and outlet types. Refusals were more likely when another vendor was present. Eighty per cent of sales to 16‐year‐olds and 65% of sales to 13‐year‐old girls were made without challenge. 'Prove‐It' ID cards were requested in fewer than 12% of purchase attempts in both age groups. Overall, there was no evidence that the police intervention reduced sales of alcohol to 16‐year‐olds. There was a hint that the intervention may have caused a very short‐lasting decrease in sales to 13‐year‐old girls, but this was contained within an overall increase in sales to this group. Alcohol vendors reported that they rarely encountered underage customers or refused sale though 90% of vendors said that if they became suspicious, they would request ID. Only two vendors believed that they were likely to suffer adverse consequences if they sold alcohol to minors.

Conclusions. These data suggest that 16‐year‐olds, and girls as young as 13, have little difficulty in purchasing alcohol, and that there is little difference between different types of outlets in their willingness to sell alcohol to minors. Vendors perceive little risk in selling alcohol to adolescents. The fact that the police intervention failed to decrease sales suggests that vendors do not change their behaviour in response to the threat of legal action.
Maternal addiction, child maladjustment and socio‐demographic risks: implications for parenting behaviors
Authors: Suchman Nancy E. , Luthar Suniya S.
Published: March 2003

Aims. In this study we examined three parenting dimensions (involvement, autonomy, and limit‐setting) and three potential determinants (maternal addiction, low SES and its correlates, and mothers' perceptions of their children's maladjustment) in order to disentangle features of parenting that are uniquely related to maternal addiction from those related to contextual determinants. We also examined conditional effects of low SES and its correlates on parenting.

Design. Based on a literature review and predictions arising from an ecological model of parenting, we expected that maternal addiction would be related with problems in parental involvement, but that the other parenting dimensions would be related with mothers' perceptions of children's maladjustment and low SES. Accordingly, we examined variance in each parenting dimensions accounted for by each of the three determinants, respectively.

Participants. Subjects included 120 (69 opiate‐addicted and 51 SES‐matched comparison) mothers with children under 16 years of age.

Measurements. Children's maladaptive behavior was assessed with the Behavioral Assessment System for Children, and parental adjustment with the Parent Child Relationship Inventory.

Findings. Direct effect predictions were confirmed and two conditional effects involving single status and family size were also found.

Conclusions. Although many parenting problems have previously been attributed to maternal addiction, only parental involvement is directly related to being an addict; other parenting dimensions may be better explained by contextual factors.
Comparison of methadone and high dosage buprenorphine users in French care centres
Authors: Barrau Karine , Thirion Xavier , Micallef Joëlle , Chuniaud‐Louche Christine , Bellemin Béatrice , San Marco Jean Louis
Published: March 2003

Aims. In France, maintenance programmes for opiate users were adopted later than in other countries. Two maintenance treatments are available: methadone is only delivered in specialized centres while high dosage (HD) buprenorphine can be prescribed by all general practitioners and in specialized centres. The aim of this study was to compare the socio‐demographic profiles, the practices and drug consumption patterns of the two groups attending specialized centres.

 Methodology. The Oppidum Programme (observation of illegal drugs and misuse of psychotropic medications), a multi‐centric survey, surveys drug‐dependent subjects attending specialized care centres throughout France annually. Data were collected by questionnaire on socio‐demographic variables and drug use during the preceding week.

 Results. During October 1998, 46 centres took part in the survey. The methadone group (

n = 424) was older, with a better economic situation; 16% used cocaine regularly. The HD buprenorphine group (

n = 616) consumed more heroin (12% vs. 8%) and engaged in more misuse, such as intravenous use, illicit acquisitions or irregular consumption. These practices were more frequent for patients consuming the drug "outwith protocol" or for patients obtaining the drug from a general practitioner.

 Conclusion. Our results suggest that patterns of consumption of methadone and buprenorphine are different in several respects: concomitant use of licit or illicit psychoactive substances, route of administration, and illegal acquisition. They also suggest that the behaviours of maintenance treatment users depend less on the nature of the maintenance drug (methadone or high dosage buprenorphine), than the nature of the delivery and monitoring practices.