bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol and other drug use issues in Australia: no place to hide
Authors: de Crespigny Charlotte
Published: August 2011

Alcohol and other drug (AOD) use is common worldwide. There is a wide spectrum of AOD issues that pose a major threat to public health, safety and the wellbeing of communities, families and individuals. There is no doubt that nurses have primary roles in identifying, preventing and addressing AOD use issues in emergency departments and general hospital units, clinics, specialist mental health and drug and alcohol services, sexual health services, youth services and community settings where people seek health care and other assistance. Nurses have credibility and are trusted by communities for their ability to address many health issues, including AOD health problems. Despite the enormous economic burden associated with AOD use across the world, the nursing profession has yet to fully acknowledge and embrace this serious issue for nurses.
Mapping the role of nurses in Methadone Substitution Therapy (MST) programmes across Europe: core competencies
Authors: Clancy C. , Oyefeso A. , Ghodse A.
Published: August 2011

The World Health Organisation and the International Council of Nurses (WHO/ICN, 1991) broadly define addiction nurses' roles into eight domains that suggest a set of core competencies required to work effectively within this challenging area of nurse practice. This paper reports on a survey of addiction centres across eight European countries. The survey explored the role of the nurse specifically within methadone substitution therapy programmes, with the intention of mapping perceived key roles against the ICN/WHO domains. While many of WHO/ICN domains were evident (provider of care; educator; counsellor; advocate) significant limitations were revealed in other domains.
People who enjoy drinking: findings from a survey of British adults
Authors: Plant Moira , Plant Martin , Mason William
Published: August 2011

This paper reports some of the findings from a survey of 2,027 British adults that was conducted in 2000. This investigation examined self‐reported alcohol consumption and the negative consequences associated with heavy or inappropriate alcohol consumption. In addition, information was elicited on the topic of the positive aspects of drinking. This paper examines the ‘drinking profile’ of those people who reported positive aspects of drinking. Most of the people surveyed reported that their past year's alcohol consumption had been enjoyable regardless of whether it had been associated with adverse consequences. In contrast, a few individuals reported drinking heavily even though they had not enjoyed their recent alcohol consumption. The relationship between alcohol consumption and its negative and positive consequences appears to be complex. There was clearly ambivalence between the adverse consequences associated with drinking and its positive effects. Many people appear prepared to tolerate some negative experiences as the price they pay for enjoying their drinking. This constitutes a major inhibiting factor in relation to preventive initiatives and therapeutic interventions related to problematic alcohol consumption.
‘Work discussion groups’ for substance misuse professionals: what are they and why are they important?
Authors: Weegmann Martin
Published: August 2011

The concept of work discussion groups, originating with Michael Balint, is explained. The contribution of such groups to substance misuse services is explained and three examples given.
Any spare change? The income and expenditure of substance users who are sleeping rough: results from a survey in London
Authors: Fountain Jane , Howes Samantha , Taylor Colin , Strang
Published: August 2011

A survey of the substance use of 389 homeless people included questions on current income and expenditure. The two sources of income most often reported were state benefits and begging. Those whose main substance was heroin or crack cocaine were more likely to have a larger financial expenditure, and to obtain this income from criminal activities, than those whose main substance was another drug or alcohol. By far the most commonly‐cited main items of expenditure were drugs and alcohol. The findings are discussed in terms of current interventions and service development.
Current practice: The development of an alcohol liaison service within a general hospital setting: the Edinburgh experience
Authors: Learmonth Louise , Leslie Helene
Published: August 2011

In 1992, a Scottish Office grant was awarded to develop a nurse‐led alcohol liaison service for patients within a busy general hospital (Leslie & Learmonth, 1994).This project was based on previous research conducted in the same hospital that concluded that early detection of alcohol problems and minimal intervention could considerably reduce long‐term alcohol‐related damage (Chick et al., 1985). A first article describing the service was published in 1994 (Leslie & Learmonth). This follow‐up article aims to describe how the service has developed and expanded since then. This includes the many issues we have encountered on our path to a greater understanding and delivery of specialist alcohol service.
How we do it: alcohol awareness group in the acute setting
Authors: Cooper Philip
Published: August 2011

This article highlights the need to provide interventions to those with mental health problems who also use alcohol or illicit substances. It identifies a group‐work package that aims to increase individuals' awareness of their use of substances, the impact this use may have upon their mental health and encourages a change in their behaviour to reduce the risk of alcohol or illicit drug related harm.
Cultural aspects of alcohol use (Part 2)
Authors: Purnell Larry , Foster John
Published: August 2011

This is the second of a two‐part article on cultural aspects of alcohol use. Part I introduced the primary and secondary characteristics of culture and the current information on drinking patterns of selected ethnocultural groups. Part 2 includes other selected primary and secondary characteristics of culture such as age, gender, religious affiliation, education, socioeconomic status, and sexual orientation. The article concludes with measures whose effectiveness has been questionable in promoting responsible alcohol use and includes some proven and new recommendations.
New South Wales Corrections Health Service: harm minimisation within a correctional centre — How do we rate?
Authors: Scerri Al
Published: August 2011

In June 2001‐July 2002 the New South Wales Corrections Health Service was providing a range of health services for approximately 8,000 full‐time inmates. This figure is steadily increasing. A prison environment is a dynamic one and 17,000 inmates have come through our gates in the past year. A prison environment is efficient for transmission of infections such as HIV, Hepatitis C and Tuberculosis, to name but a few.The New South Wales Inmate Health Survey showed that about 80% of inmates have injected drugs at least once in their life, 40% report that they have injected drugs within a week prior to entry into gaol and 20% will continue to inject whilst in gaol. These figures appear repeatedly in both national and international figures. Some 80% of males and 70% of females have a history of illicit drug use.A comprehensive search of electronic databases, journal publications, conference presentations and discussions with experts involved with development of research and policy documents in regard to harm minimisation in a correctional setting was collected for this presentation. This paper attempts to look at a number of intervention strategies both nationally and internationally for prisoners to reduce their risks of acquiring a bloodborne virus. Methadone programs, bleach, condoms and prison‐based syringe exchange programmes are examined. How does Australia rate amongst other nations in reducing the risk?
Fixing leaks — the user involvement way
Authors: Campbell John
Published: August 2011

John Campbell gives a personal story of how his own fight with alcoholism gave him the vision for arguably the UK's biggest service user involvement programme.
Part 4: Minds, moods and behaviour: the case for cognitive behaviour therapy in addictions: Approaches to addiction series Series editor: Martin Weegman
Authors: Ryan Frank
Published: August 2011

Continuing our series on different approaches to addiction, Frank Ryan presents the latest, and possibly most potent tool, in tackling addiction. He explores the theory and benefits of cognitive behaviour therapy in treating addictions and predicts that its results ‘will stand the test of time’.
Prejudice against drug users II — the enemy within
Authors: Capo‐Bianco Sophie , Hodson Gordon , Clark David
Published: August 2011

The second study lifting the lid on negative attitudes towards drug users, from WIRED and the University of Wales, Department of Psychology.
Inner city booze — treating alcohol consumption in general practice through a nurse
Authors: Fernandez J
Published: August 2011

Alcohol consumption is on the increase, particularly among women and young men (Waller et al., 2004). The Government, in showing its concern, has published a report on the extent of binge drinking alongside its long awaited alcohol strategy. While the binge drinking report focuses on the problematic nature of alcohol consumption and associated violence, the issue of dealing with the health consequences is often overlooked. Continuing our look at specialist nurses, Jeff Fernandez explores how they can take a key role in treating arguably the UK's biggest substance misuse and health problem ‐ taking care of Britain's drinkers.
Down but not out — a survey of homelessness, substance use and service provision
Authors: Morris Mike , Thompson Caroline
Published: August 2011

Homelessness and substance misuse often go hand‐in‐hand. In this new research, we ask why those with a drink problem are less likely to seek help from services than those with drug problems and examine how services in the city of Nottingham are coping better than most.
Nerds and narcotics: drug use in a global future
Authors: Mounteney Jane
Published: August 2011

No one knows what the future holds. Not least for substance use and addictions. Few predicted the psychedelic movement in the 1960s, the crack ‘epidemic’ in the 1980s and the ‘E’ generation of the 1990s ‐ all of which had a profound influence on our culture, youth and our health. So what of the Naughties, Teenies and Twenties? With increased globalisation, new technologies, increasing spending power and the scope for increased pleasure‐seeking we are destined for more and new addictions. In this groundbreaking article, Jane Mounteney applies the technique of scenario planning to investigate a future dominated by technology, smart and nanodrugs and an ever‐increasing availability of drugs. With the emergence of the super nerd and groovy geek, who will be there to help the fallen?
Psychosocial approaches to addiction number 4: As easy as one, two, three: twelve‐step facilitation therapy
Authors: Weegmann Martin , Leighton Tim
Published: August 2011

Twelve‐step facilitation (TSF) is becoming an important approach to the therapy of addiction. It proved an equally effective method as one of the three psychosocial approaches used in Project MATCH during the 90s1‐with the added advantage of helping drinkers to replace prodrinking networks with more supportive peers2. Here Addiction Series editor Martin Weegmann and Tim Leighton share their experiences of using the twelve‐step methods and describe the skills and techniques that can be used by any therapist on almost any client.
Abstinence and controlled drinking Success under any name remains a triumph
Authors: Coldwell Brenda
Published: August 2011

Offering controlled drinking as opposed to abstinence‐only treatment continues to cause controversy in the alcohol field. Typically, the US diverges from Europe on the feasibility of controlled drinking as a treatment goal ‐ in the US alcohol dependence is typically depicted as a ‘recurring disease’ and the ‘successful abstainer’ as a ‘recovering’ though never ‘recovered’ alcoholic. Here Brenda Coldwell, an experienced clinician in the alcohol field, offers a critical review of the persistence of old arguments and, in doing so, proposes the provision of abstinence and controlled drinking in the name of ‘best clinical practice’. For if we don't, as Coldwell argues, people will do as they have always done and make their own choices ‐ but without the benefit of tried and tested therapeutic interventions.
A road less travelled ‐ Sweden's pursuit of abstinence
Authors: Farbring Carl
Published: August 2011

To many Europeans, Sweden is the odd member in the global effort to tackle drug problems. At a time when most countries stress a perspective of public health and almost entirely rely on harm reduction measures, Sweden almost exclusively directs its efforts towards abstinence. Carl Åke Farbring, a key policy maker, explains why abstinence is the driving force in Sweden, highlighting claims that it is the lowest drug‐using nation in the western world.
Up in smoke ‐ the future of medical cannabis
Authors: Witton John
Published: August 2011

The future's bright, the future's green. Well almost. Just when things were looking up for medical cannabis, the Government pulled the plug and refused it a license. Is this just a blip on the rocky road to legal cannabis products? Or, as many fear, does it signal the end of medical cannabis and possible liquidation for GW Pharmaceuticals, the developer? John Witton, the UK's leading voice on cannabis, speaks to the key players and asks just what got up the nose of the regulators and what, if anything, GW can do to recover.
Cannabis‐related problems and their management
Authors: Copeland Jan
Published: August 2011

Despite being the most common illicit drug in the Western world, treatment for cannabis use is not readily available. Primary health care and even specialist drug treatment services have often under‐recognised, and undertreated, cannabis‐related problems. Australian researcher Jan Copeland is one of the few people to test cannabis treatment models. Here she outlines the most effective models for treating cannabis and how they can be applied to other services.
Innovate to intercept: dealing with dealers
Authors: Mason Peter
Published: August 2011

A unique venture called the Middle Market Drug Project has been raising more than a few eyebrows. Based in the City of London, the new police project is taking out an impressive amount of supply and distribution of Class A drugs. The force behind this success is innovation. Peter Mason of the Centre for Public Innovation (CPI) explains how innovation and the entrepreneurial spirit are changing the shape of policing and efforts to tackle the resourceful drug dealing gangs.
Under any other name: the trade and use of khat in the UK
Authors: Carrier Neil
Published: August 2011

Kenyan khat arrives in the UK four days a week and much of it, having arrived at Heathrow from Nairobi and been cleared through customs, is delivered by van to a depot in Southall. There it is collected by distributors who speed it on to retailers. It is estimated that around seven tonnes of khat enters the UK each week.
Working with Somali khat users
Authors: Isse Hassan
Published: August 2011

People usually gather in the afternoon between five or six o'clock to chew. Many look tired, suffering the qaadiro or hangover from the previous night's session. For many this becomes a daily routine, and is rationalised with there being no other form of entertainment.
A view from the refugee camps: new Somali khat use in Kenya
Authors: Beckerleg Susan , Sheekh Nuur
Published: August 2011

Catha edulis, known in the drugs literature as khat and in Kenya as gat, miraa, murungi, veve, gomba, abounds with paradoxes. One of the curious features of khat is that it has become so closely associated with Somalis, both at home and in the diaspora, that consumption of twigs and leaves of miraa are widely assumed to be part of Somali culture and tradition. Yet, khat consumption by Somalis only gained wide popularity in the second half of the twentieth century (Goldsmith, 1997). So, how did miraa use and distribution in Kenya come to be a marker of Somali identity?
Coercing change: balancing rights, justice and health
Authors: Hunt Neil
Published: August 2011

Britain is undergoing its biggest change in drug policy and practice ever — and most of it without a shred of evidence to back it up. Despite mountains of evidence that community treatment works, criminal interventions, such as DTTOs, are still being extended, expanded and re‐invented across the UK — at huge cost to the UK taxpayer and at the expense of other forms of treatment. Neil Hunt is part of a pan‐European research study looking at coercive treatment within the criminal justice system. We reveal what the government is not telling us about their crime agenda.
Why the UK needs drug courts
Authors: French Peter
Published: August 2011

Peter French has worked as a police officer and chief inspector for over 30 years. His experience in dealing with drug‐related crimes and a recent visit to the States has convinced him that the UK needs more, not less, criminal justice interventions. Drug Courts, he argues, increase treatment retention and offer greater flexibility to help people stay the course. Though they work for the US, with up to 75% success rates, will they work for the UK? Find out why Peter French thinks they will, with bells on.
Beyond terrorism: The real impact of Afghan drugs trafficking on northern neighbours
Authors: Walker Justine
Published: August 2011

It is clear that illicit drug trafficking affects the security of societies and states in a number of ways — Afghanistan is a prime example. But while the majority of international attention is given to the link between more traditional security threats, such as the relationship between drugs and terrorism, less attention has been focused towards what we might consider ‘new’ security threats related to the international drugs trade. Such threats include the spread of addiction, HIV/AIDs, corruption, trans‐national organised crime and the development of illegal black market economies. For Central Asia the impact of such threats is likely to pose one of the most significant challenges yet to be faced by these post communist states.
Drinking across China: lessons from a complex culture
Authors: Arthur David
Published: August 2011

China is the one of the biggest producers and consumers of alcohol in the world. With as many secrets as there are languages, we take a unique look at the drinking habits of a country yet to come to terms with increasing alcohol problems. David Arthur presents for the first time findings from his pioneering research into Chinese drinking habits and their cautious moves in dealing with its consequences.
Teaching temperance ‐ lessons for today's drinking culture
Authors: Berridge Virginia
Published: August 2011

Society and government policy currently demonstrate contradictory tendencies in relation to alcohol. Government policy promotes longer opening hours, but also more stringent control of public drinking through ASBOs and alcohol dispersal zones. Young people favour heavy drinking and the ‘night time economy’, while older generations oppose the extension of pub opening hours. The media debates rationing treatment for those with self‐inflicted disease, but portrays national mourning at George Best's death. In an attempt to learn from the efforts of the past, Virginia Berridge uncovers the strikingly familiar world of temperance and ponders whether we are perhaps at a ‘tipping point’ in culture in relation to alcohol?
Determining addiction ‐ genes and substance use
Authors: Phillips Tamara , Crabbe John
Published: August 2011

Does having alcoholic parents make you more susceptible to alcohol problems? Why do some people develop drink or drug problems while others in the same family do not? How much can genetic research tell us about why drink and drugs can affect people in so many different ways? With genetic research discovering increasing links with behaviour we invited two of the leading addiction and gene researchers to explain the science. Tamara Phillips and John Crabbe uncover the ever‐emerging world of genetic research and addiction theory.
Alcohol and pregnancy: Experts warn that inconsistent messages are causing harm
Authors: Constantinou Alexandra
Published: August 2011

Foetal alcohol spectrum disorders is the term for the range of complications that can arise when alcohol and pregnancy mix. As Alexandra Constantinou reports, women are receiving different messages about what is safe to consume, and what isn't.
What number 10 doesn't want you to know about drugs
Authors: Rolles Steve
Published: August 2011

Ever since the Prime Minister's leaked report on drug policy, the UK government has repeatedly refused to reveal its most damning figures on drug trafficking and failed efforts to stop it. More figures are out now in a new report. Despite the spin, it makes for equally bleak reading and because of the spin, it smacks of a cover up. Steve Rolles reveals just how many billions of pounds of drug‐profit the Government doesn't want us to know about and what the Government admits they can't do to stop it.
Regaining control: a critique of drug legalisation policies
Authors: Steel Alan
Published: August 2011

Global drug control is coming under increasing criticism. Failures to stop or even reduce drug use and the increasing power of the black market highlight prohibition. Alan Steel explores the potential benefits of licensing drug sales using models from alcohol and tobacco licenses. In a time of consumer choice and increasing disregard for unworkable policies might it be time to regain control?
Chinese traditional medicine as an effective pharmacological treatment for heroin addiction
Authors: Wang Wei
Published: August 2011

Chinese herbal medicine is effective in treating some addictions using, for example, aural acupuncture. Its application outside of China is limited due to a lack of clinical trials and ‘scientific’ evidence. U'finer™ is one of the first herbal remedies to undergo clinical trials, and is so far demonstrating a remarkable ability to improve brain function, restore physical health and enhance recovery from opiate addiction. The drug's pioneer Dr Wei Wang explains his methods and the drug's unique ability to treat the body and mind.
Home truths — how close are we really to helping children of addicted parents?
Authors: Barlow Joy
Published: August 2011

A spate of well‐publicised deaths of children of drug‐using parents in Scotland led to a so‐called new policy for protecting young people of substance‐using parents. Amid calls for children to be taken away from such parents Joy Barlow asks what has changed since the government's much acclaimed report Hidden Harm and how, if at all, can social services better protect young people without threatening the family unit and removing the human rights of not just the parents but us all?
How many more steps for Hidden Harm?
Authors: Dean Susan
Published: August 2011

Hidden Harm was designed to end the misery of children of drug‐using parents. Now just three years down the line we are told we need a second ‘Next Steps’ approach. Susan Dean asks what happened to the original recommendations, what's new in the second report and how far do we really need to go to prevent children from being harmed by their parents AND an over‐zealous nanny state?
Thicker than water — revolutionising blood borne virus treatment
Authors: Wilkinson Mandie
Published: August 2011

When Mandie Wilkinson's patients ran a mile after tests for hepatitis and HIV, she had no idea her efforts would lead to a highly successful blood borne virus clinic. There were many hurdles. Not only are patients reluctant to test for potentially fatal diseases such as hepatitis C, but the options for treatment are limited. Working with drug users is not everyone's cup of tea either and finding staff proved equally difficult. Now six years down the line, Mandie's nursing team has treated over 40 high‐risk patients, tests for liver cancer, provides community treatment programmes and is developing new screening methods for deep vein thrombosis and cervical cancer.
Uncovering the two‐year rule
Authors: Gordon Andrew
Published: August 2011

Denied by practitioners and erased from all official documents, the requirement that ex‐users be clean for two years before being employed is supposedly no longer with us. But, as Andrew Gordon reveals, despite the denials, the two‐year rule is alive and kicking and doing its best to keep ex‐users out of work.
My name's Scoop and I'm a runaholic
Authors: Skupien Scoop
Published: August 2011

Most of us try it and give it up. Hospitals and services treat thousands of its victims every year. Annually, tens of thousands gather in city centres to binge on it for hours on end ‐ many ending up in hospital or, if they are really unlucky, the mortuary. Its victims come from all walks of life, many of whom fall for its addictive powers. Scoop Skupien is the founder of Runaholics Anonymous and pioneer of the 12‐step recovery programme. He is also a recovering runaholic. In this exclusive article he calls for endorphin junkies everywhere to stand up, raise their sweaty hands and confess ‘I am a runaholic’.
Addressing negative attitudes toward substance use in nursing: A peer‐led approach in nurse education
Authors: Harling Martyn , Overy Christine , Beckham Gavin , Denby Rachel , Goddard Steven , O'Connor Carolyn , Piotrowski Emma , Prout Teri , Tully David
Published: August 2011

Substance use tends to be overlooked in nursing training. As a possible consequence, many nurses harbour ill‐informed or even negative attitudes towards drug and alcohol users. The upshot can be poor care. In a bid to tackle this problem, a group of students developed a peer‐led workshop by encouraging open debate on issues associated with illicit drug use and access to healthcare for those with substance misuse problems. What ensued was an open and frank debate that increased awareness and the thirst for more knowledge.
Heroin use in Zanzibar: a survey
Authors: Beckerleg Susan , Sadiq Ahmed , Telfer Maggie
Published: August 2011

Heroin has been a street drug along the East African coast for 25 years (Beckerleg, 1995) but it has only recently been recognised and documented (Kilonzo et al, 2001; Jones & Needle, 2005). Heroin use is risky and HIV transmission an increasing problem (McCurdy et al, 2005). Susan Beckerleg and colleagues uncover high rates of unprotected sex, excessive needle sharing and continued re‐use of old and dirty needles often kept in old tins, pockets, or as most do, hidden under rocks.
Spotlight on services series: A brave new world: one man's fight against prohibition
Authors: Kushlick Danny
Published: August 2011

Continuing our spotlight on services we bring you the incredible story of the UK's most outspoken and influential organisation on drug law and policy. Transform campaigns to remove prohibition and replace it with legal controls. After 12 years of campaigning, near bankruptcy and six months on the dole Danny Kushlick gives here a personal account of his rise from a drug counsellor to leading voice and foundation director in the pursuit of better, braver and more responsible drug policies.
Ketamine use: minimising problems and maximising pleasure
Authors: Moore Karenza , Measham Fiona
Published: August 2011

In January 2006 ketamine shifted from medical regulation through the Medicines Act to a Class C drug through an amendment to the Misuse of Drugs Act. In the debate surrounding this criminalisation, interest has grown in prevalence and patterns of ketamine consumption. Such information is scarce however, particularly given that ketamine has yet to be included in the British Crime Survey or most other surveys of youth and young adult drug use. Here Karenza Moore and Fiona Measham reveal the true extent of ketamine use, who is using it and how.
Attracting women: adopting a psychological approach in primary care
Authors: Fernandez Jeff
Published: August 2011

There has been much written on gender in the academic world and its impact on society. Women suffer disproportionately from inequality (Haralambos & Holborn, 2000) and substance use treatment is no different. The workplace and affluence are key areas where this problem has been tackled, though with limiting results. Here Jeff Fernandez asks why women are less likely to seek help for substance use and how, using common psychological techniques, we can entice them back again.
The rising need for opium licensing: the only weapon to fight the Taliban in Afghanistan
Authors: Reinert Emmanuel
Published: August 2011

In July 2006 Emmanuel Reinert warned of the danger of opium eradication in Afghanistan. While the world suffers a shortage in opioid painkillers, military operations to destroy poppy fields are wrecking lives and turning the Afghan people against NATO troops. Now six months later, the situation in Afghanistan is much worse. Thousands of farmers and their families are starving and support for the Taliban is growing stronger by the day. In his second report Emmanuel Reinert offers financial support to pilot opium licensing schemes in order to divert the tons of illicit opium headed for our streets.
Mental health, drugs and the call to reinstate harm reduction
Authors: Chaisty David
Published: August 2011

There is a risk that harm reduction is being taken for granted. Despite saving many hundreds of thousands of lives from HIV and AIDS and the ongoing value it provides to drug and alcohol treatment, its principles have not travelled well ‐ and at worst are being forgotten or shunned by some hardliners. Here, David Chaisty champions the logic and power of harm reduction to reassert its use not just among drug or alcohol problems, but also for people with mental health issues.
Spotlight on services series: Involving the public in EU drugs policy
Authors: Charlois Thierry , Schatz Eberhard
Published: August 2011

This issue's Spotlight travels to Amsterdam with a look at EU drug and alcohol policy. Though it seems far away and at times irrelevant, EU policy is moving fast to raise the standards of intervention. It also influences funding and the types of services and policies for the coming decades. Here the EADPP discusses their pivotal role in driving user and public involvement to the centre of national drug and alcohol policy making.
Policing cannabis as a Class C drug: an arresting change?
Authors: May Tiggey , Duffy Martin , Hough Mike
Published: August 2011

In the first study of its kind, researchers from King's College expose the consequences of reclassifying cannabis. Just how much time have the police saved, what does the Bobby on the beat think about the change, and what would be the consequences if it were put back to Class B?
Profile of secondary care attendees with identified alcohol misuse problems
Authors: Sims John , Kristian Marc , Iphofen Ron
Published: August 2011

Alcohol misuse leads to a massive drain upon an already stretched NHS budget. High numbers of individuals with alcohol related physical and health needs are being admitted into the secondary health care setting at great financial cost. This paper examines a profile of this population presenting to the secondary care setting over a 12‐month period. It is suggested that the misuse of alcohol does not take place in isolation. It is often accompanied by other problematic behaviours such as domestic violence, inappropriate, neglectful parenting, or child abuse, offending behaviour, and psychological problems. Evidence for the nature and extent of these associated behaviours is reported and discussed. Comparisons are made particularly with data related to tobacco smoking, and the positive aspects of smoking cessation programmes are outlined. Almost all of the population reported on over the 12‐month period were tobacco smokers. The re‐emergence of the incidence of smoking with the reduction of smoking cessation programmes is noted. The challenge for substance misuse services is how best to respond to the needs of this growing population who often present withalcohol misuse together with smoking behaviours. A collaborative model of response is outlined and suggested as the best way forward. This involves substance misuse services working together with professional colleagues within the acute hospital environment and community to ensure sustainable positive clinical outcomes following hospital discharge.
A brief history and motivation of an entheogenic chemist
Authors: Hardison Casey
Published: August 2011

Casey Hardison was arrested in spring 2004 for the production of psychedelictype drugs ie. LSD, 2C‐B and DMT. In the three years since, not one person from ‘authority’ had bothered to ask him what motivated him to synthesise psychedelic drugs. It was as if the a priori assumption that ‘all illegal drugs are bad’ had provided the answer. Hence, the Judge asserted that Hardison did it for ‘that basest of human emotion, greed’ as though the psychospiritual benefits of an alchemical path dedicated to expanding consciousness and personal transformation, through insights integrated into action, upon which he had expounded at great lengths during trial, were some elaborate ‘portmanteau defence’, just some ruse to get him out of the dock. It was not, it was a committed stand for ‘cognitive liberty’ and for a world full of people who understand the fine line between alone and all one.
Sacrament or substance of abuse?
Authors: Wells Hattie
Published: August 2011

The debate concerning the religious use of psychoactive substances may seem an unlikely candidate for revival in the current prohibitionist climate. Drug consumption is far more likely to incite public concern over the harmful and habit forming properties of certain substances, than conjure up an enthusiasm born of the 1960s for their potential to produce a sincere mystical experience. However, the recent emergence of religious movements who consume plant hallucinogens as their sacrament, and the growth of drug tourism for the spiritually inclined, reflects a renaissance in the use of psychoactive plants and chemicals for spiritual inspiration. This trend presents a challenge to the way in which certain drugs are culturally and legally defined, and brings the concept of religious freedom into the sphere of drug policy.
Back to the front: the future of user involvement as a potent political force
Authors: Garratt Daren
Published: August 2011

This article will explore many of the challenges facing the future of effective user involvement as we prepare ourselves for a new government drug strategy and National Treatment Agency era, which on first viewing appears to have turned its back on a movement that it has long paid lip service to as a valued and respected partner and component of effective drug treatment. The tone of this article is intentionally opinionated and provocative and is based on 10 years experience of being an illicit drug user (although admittedly never a service user) working in the harm reduction and user involvement field as a coalface worker, strategic co‐ordinator and presently, manager of a national charity. If this piece polarises opinion and stimulates debate then it has been successful; user involvement used to be dictated by personal politics and passion, not a pension, and in order to survive, it may need to rediscover that.
Treatment for opioids dependence: prisoners' experiences in Wandsworth prison
Authors: Broderick Clarissa , Kouimtsidis Christos
Published: August 2011

Little research has been done on treatment for opioids dependence in prisons in the UK. Treatment programmes are coercive and are abstinence‐orientated, and maintenance substitution treatment is rarely offered. This research aimed to investigate prisoners' perceptions of existing treatment and treatment choices offered by the service.A qualitative methodology was used with eight semi‐structured interviews with prisoners who were currently or had recently completed an opioid detoxification regime. The study took place in Wandsworth prison in south London, and interviews were recorded and analysed using theme analysis.Prisoners felt that substance misuse assessment failed to identify their needs. They had little if any input into the decision regarding substitute prescribing and they felt that their current treatment regime did not meet their needs. Not all prisoners felt coerced into treatment, however, they all described coercive measures. Homelessness compounded prisoners' substance use and treatment progress.There is significant dissonance between the services offered and the prisoners' own perceptions of service need. Many prisoners are not yet ready to achieve abstinence, the predominant treatment opportunity available. If coercion into substance misuse treatment is to be integral to the criminal justice system, treatment services should be tailored to clients' needs.
How should the effectiveness of treatment for alcohol problems be evaluated?
Authors: Heather Nick
Published: August 2011

In times of information overload, researchers have found ways to synthesise a large amount of data from numerous studies bearing on the effectiveness of treatment for alcohol problems. Two of these ways are discussed: formal meta‐analysis and the box‐score ‘mesa grande’. It is concluded that meta‐analysis cannot answer questions regarding which treatments give the best results in the alcohol field. The mesa grande has certain limitations, which are described, but is useful for the formation of treatment policies when a clear summary of the research evidence on treatment effectiveness is needed. By contrast, large multi‐centre randomised controlled trials with enough statistical power to detect small effects of treatment should normally be preferred when a decision has to be made as to which of two or more specified treatments should be implemented in practice. Unfortunately, two multi‐centre trials, one in the USA and one in the UK, have given rise to the ‘dodo bird’ verdict of equivalent effectiveness of four treatment modalities. The findings of the UK Alcohol Treatment Trial cannot be used to advise treatment providers and practitioners which one of two treatments, MET or SBNT, should be preferred in practice. In the absence of relevant research findings, four possible ways of making this decision are outlined, including the suggestion that MET should serve as the first step in a stepped‐care model of treatment provision.
Controlling alcohol problems: different approaches or different priorities?
Authors: Plant Martin
Published: August 2011

The adverse effects of alcohol consumption are massive. Alcohol is deemed to be the major factor in four per cent of the global burden of disease mortality (World Health Organisation, 2004). It has been suggested that there are two quite separate approaches to alcohol control policies. These supposedly different approaches are called the ‘public health approach’ and ‘harm minimisation’ or ‘harm reduction’. In fact, while there has been a clear difference in emphasis between some expressions of these two approaches, so much of what their exponents advocate is the same that there would appear to be no merit in continuing to regard them as mutually exclusive or in conflict. The public health approach emphasises curbing the level of alcohol‐related problems by reducing the per capita alcohol consumption (eg. Bruun et al, 1975; Edwards et al, 1995; Babor et al, 2003). Harm minimisation or harm reduction is intended to reduce the level of alcohol's adverse effects without necessarily reducing per capita alcohol consumption (Plant et al, 1997).
Not enough published research! What does that mean?
Authors: Gaunekar Gaurish
Published: August 2011

Discrimination against people with addictive disorders is well known. Research in addictions is not immune to discrimination. A survey of six general psychiatry journals over the period of 2000‐2005 showed that some journals persistently published fewer research reports on additive disorders than others. This has further impact on literature review and also the status held about this addiction within psychiatry. Publication bias reduces the likelihood of funding for researchers of addictive disorders.
A survey of Zanzibari heroin users
Authors: Beckerleg Susan , Sadiq Ahmed , Telfer Maggie
Published: August 2011

This paper reports on a questionnaire survey of 300 heroin users in Zanzibar town, in Tanzania. It was found that about 13% of respondents were current injectors of heroin, but that 38% of respondents reported have ‘ever injected’ heroin. Many injectors reported hiding their needles and syringes and almost half of them had shared their equipment during the past four weeks. Most of the respondents reported that they had not had sexual intercourse during the past four weeks. Of those who were sexually active most reported not having used a condom the last time they had intercourse. These findings highlight the need for a wider recognition of the extent of heroin use in East Africa as well as the urgent need to provide harm reduction and treatment services.
How alcohol may precipitate violent crime
Authors: Marteau David
Published: August 2011

The article examines the interrelation between alcohol consumption, behaviour mediation and violent offending, including murder. Whilst a correlation may be drawn between intoxication and some acts of violence, a causal link between drinking and murder is less certain.
UK drug‐related mortality ‐ issues in definition and classification
Authors: Corkery John
Published: August 2011

This article summarises different approaches to defining what constitutes a drug‐related death (DRDs) and how they can be classified. DRDs usually fall into two broad categories: (a) those directly attributable to the consumption of drugs (both illegal and licit) eg. overdose and poisoning, and (b) indirect ‐ those which occur as a consequence of having a drug habit that exposes individuals to the risk of dying in some other way, eg. blood‐borne infections, accidents. Most attention is currently given to direct or ‘acute’ DRDs rather than the long‐term consequences of drug abuse. Problems associated with accurately deriving DRD statistics are outlined. Despite their limitations, such information is essential for identifying issues related to drug use and measuring progress against targets set for reducing DRDs.
The culture of the ban on cannabis: is it political laziness and lack of interest that keep this farcical blunder afloat?
Authors: Cohen Peter
Published: August 2011

From a paper given at the Tweelanden conferentie Cannabisteelt in de Lage Landen, at the University of Ghent, on 3‐4 December 2007, the author explores the culture of the ban on cannabis and defines its goals.
Policy forum: The role of drug testing in the criminal justice system
Authors: Singleton Nicola
Published: August 2011

Despite a considerable increase in drug testing within the criminal justice system (CJS) through schemes such as the drug interventions programme, research is equivocal about its added value, as a recent series of reports from the UK Drug Policy Commission highlighted. The role of drug testing needs to be clarified and its cost‐effectiveness confirmed through studies with comparative regimes. Any further expansion of drug testing within the CJS should be undertaken with caution.
Parents who misuse substances: implications for parenting practices and treatment seeking behaviour
Authors: Huxley Adam , Foulger Sarah
Published: August 2011

This paper considers parents who misuse substances. The potential impacts of their substance misuse on their ability to parent effectively and safely (parenting capacity) are explored, as are some of the barriers many parents face when attempting to seek treatment for problematic substance misuse. The terms ‘use’ and ‘misuse’ are used interchangeably in this paper and ‘substances’ refers to alcohol, illicit drugs and overuse of prescribed medicines. It is important to make the distinction between parents whose use of substances does not constitute dependency and might be best described as ‘recreational or hazardous’. Such individuals might not seek treatment and estimates of prevalence rates of use among this cohort are difficult as they remain hidden from services. Parents who might already be in treatment services or who might be seeking treatment might be described as ‘problematic or dependent’ although presentation at services is neither necessary nor sufficient to assume that the individual's misuse of substances is problematic or indicative of a dependency. The use of substances is associated with numerous harms to the individual: psychologically, socially, interpersonally and physically, and is a risk factor towards negative parenting practices. The use of substances in itself is not an indication of neglectful or harmful parenting, as many parents who use substances have adequate parenting skills, however, it is more frequently associated as a risk rather than a protective factor when considering potential harms. Most of the research refers to mothers although we are aware that some fathers may have sole parenting responsibility for their children. Parents, in particular mothers, face many barriers when trying to access substance misuse treatment services. When they are in treatment, services often lack the skills and experiences to be able to balance managing child protection issues and engaging the parent in treatment. A full review of the issues associated with parenting and substance misuse is beyond the scope of this paper and the reader is referred to Fowler (2003), Cleaver et al (1999), Velleman and Templeton (2007) and Day and George (2005) and the British Psychological Society's Child Protection Portfolio (2007) for further discussion.
MDMA powder, pills and crystal: the persistence of ecstasy and the poverty of policy
Authors: Smith Zoë , Moore Karenza , Measham Fiona
Published: August 2011

Commonly known as ecstasy, MDMA has been central to the British acid house, rave and dance club scene over the last 20 years. Figures from the annual national British Crime Survey suggest that ecstasy use has declined since 2001. This apparent decline is considered here alongside the concurrent emergence of a ‘new’ form of ecstasy ‐ MDMA powder or crystal ‐ and the extent to which this can be seen as a successful rebranding of MDMA as a ‘premium’ product in the wake of user disenchantment with cheap and easily available but poor quality pills. These changes have occurred within a policy context, which in the last decade has increasingly prioritised the drugs‐crime relationship through coercive treatment of problem drug users within criminal justice‐based interventions, alongside a focus on binge drinking and alcohol‐related harm. This has resulted in a significant reduction in the information, support and treatment available to ecstasy users since the height of dance drug harm reduction service provision pioneered by the Safer Dancing model in the mid‐1990s.
Drug use among rural Irish adolescents ‐ a brief exploratory study
Authors: Van Hout Marie
Published: August 2011

Semi‐structured interviews were undertaken with a random sample of 220 students from schools and youth training centres within a rural area of the south eastern region of Ireland. The results show that against the backdrop of rising drug use prevalence, the attitudes towards drug use of both adolescent users and abstainers have become more liberal and ‘normalised’.
Media resource round up
Authors: Goodair Christine
Published: August 2011

This column is a selection of recent publication, reports, journals, databases and websites over the past few months. We hope it will be useful.
Nutrition and addiction — can dietary changes assist with recovery?
Authors: Grotzkyj‐Giorgi Margherita
Published: August 2011

While many of the most widely used treatment interventions engage with the psychological, social and spiritual dimensions of addiction, some of the biological aspects can at times be neglected. It is increasingly being recognised that there is a close, exacerbating relationship between problematic substance use and poor nutrition.