bluuebunny/crossref_metadata_2025 huggingface dataset:
Shortened time horizons and insensitivity to future consequences in heroin addicts
Authors: Petry Nancy M. , Bickel Warren K. , Arnett Martha
Published: March 2003

Aims. To investigate whether heroin addicts demonstrate shortened time horizons and decreased sensitivity to future consequences of their behavior compared to non‐drug users . Design Setting and Participants. Thirty‐four heroin addicts enrolled in a buprenorphine treatment clinic and 59 non‐drug‐using controls completed a personality questionnaire and two laboratory tasks . Measurements. The Stanford Time Perception Inventory (STPI) personality questionnaire assessed orientation to the future, and the Future Time Perspective (FTP) task elicited predictions of the timing and ordering of future events. The Bechara card task measured preferences for decks of cards that range in magnitude and probability of delayed and immediate rewards and punishers . Findings. Heroin addicts scored significantly lower than controls on the STPI scale indicative of future orientation. In the FTP, heroin addicts were less likely to predict events far into the future and less likely to systematically organize events in the future. In the card task, heroin addicts were less likely to win money than controls. They were more likely to play from a deck that contained greater immediate gains but that resulted in large, delayed punishers and overall net losses. They also made fewer selections from a deck that provided an overall net gain via relatively low immediate rewards and frequent small punishments . Conclusions. Shortened time horizons and decreased sensitivity to delayed consequences may explain drug abusers' persistent use of drugs, despite the long‐term negative consequences associated with drug use.
Positive responses to televised beer advertisements associated with drinking and problems reported by 18 to 29‐year‐olds
Authors: Wyllie Allan , Zhang Jia Fang , Casswell Sally
Published: March 2003

Aims. To examine the nature of the relationships between responses to alcohol advertisements and drinking behaviour and related problems. To examine the role of positive and negative beliefs about drinking as intervening variables . Design. Survey utilizing a CATI (computer‐assisted telephone interviewing) system, involving interviews with 1012 randomly selected respondents . Setting. Respondents were randomly selected from throughout New Zealand . Participants. Eighteen to twenty‐nine‐year‐old New Zealanders . Measurements. Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response) . Findings. An exploratory non‐recursive structural equation model, based on 791 drinkers provided tentative support for the hypothesis that positive responses to televised beer advertisements (as measured by liking) contributed to the quantity of alcohol consumed on drinking occasions, which in turn contributed to the level of alcohol‐related problems. The model, which provided a good fit to the data, was consistent with the hypothesis that liking of beer advertisements had both a direct influence on quantities of alcohol consumed and an indirect influence, via its influence on positive beliefs. These effects were present after controlling for reciprocal effects, none of which were significant. The data did not support the hypothesis that the quantities of alcohol consumed would influence the respondent's liking of beer advertisements. Recalled exposure was not a significant influence on the quantities consumed . Conclusions. The results are consistent with a number of theoretical perspectives and with a growing body of research that are suggestive of alcohol advertising having some influence on the consumption of younger people.
General practitioners' role in preventive medicine: scenario analysis using smoking as a case study
Authors: Doran Christopher M. , Pekarsky Brita , Gordon Moira , Sanson‐Fisher Rob W.
Published: March 2003

Aim. It is the purpose of this paper to develop a model which may be used in conjunction with scenario analysis to evaluate strategies which are available to assist the general practitioner (GP) in reducing smoking behaviour among their patients. Design. The scenario analysis uses a four‐step procedure which involves identifying opportunities for detection, intervention and efficacy, and assigning probabilities to outcomes to enable a range of prevention strategies to be examined in both isolation and in combination. Setting and participants. This study deals specifically with Australian general practice and the model is derived by using information for a smoker visiting their GP within a 6‐month period together with empirical evidence on the rates of detection, intervention and efficacy. Measurements. The outcome measures, which are evaluated in terms of marginal effectiveness, include the number of smoking patients detected, the number of smoking patients offered an intervention, the number of smoker patients who quit as a result of the intervention and the additional years of life saved due to an intervention. Findings. The most significant indicator for reducing smoking rates among patients is improving the efficacy of interventions. The results also suggest that although improvements in the rate of GP detection of patients' smoking status have a potentially greater effect on quit rates than increasing intervention levels, increasing both detection and intervention levels had a greater effect than each strategy alone. Discussion. General practitioners have an important role to play in preventive medicine. The knowledge, skill and attitude of practitioners toward smoking are significant, and they can be the prime motivators in persuading their patients to stop smoking. Detection, intervention and efficacious strategies are all key elements in achieving this result.
Life‐time prevalence and risk factors of tobacco/nicotine dependence in male ever‐smokers in Japan
Authors: Kawakami Norito , Takatsuka Naoyoshi , Shimizu Hiroyuki , Takai Akihiro
Published: March 2003

Aims. To estimate the life‐time prevalence rate of tobacco/nicotine dependence and demographic variables and smoking habits associated with the disorder in male ever‐smokers in Japan. Design. A cross‐sectional community‐based interview study. Setting. Takayama city, Gifu Prefecture, Japan. Participants. A total of 170 male ever‐smokers aged 35 years or older selected randomly from a community in Japan were interviewed. The response rate was 85%. Measurements. The WHO Composite International Diagnostic Interview (CIDI) was used to make diagnoses of tobacco/nicotine dependence according to ICD‐10, DSM‐III‐R and DSM‐IV. The Fagerstrom Tolerance Questionnaire (FTQ) was also administered and those who had a FTQ score of 7 or above were identified. Findings. The life‐time prevalence rates of tobacco/nicotine dependence in male ever‐smokers were 42%, 26% and 32% according to ICD‐10, DSM‐III‐R and DSM‐IV criteria, respectively; 19% had a FTQ score of 7 or above. The ICD‐10 diagnosis was significantly and negatively associated with quitting smoking ( p 0.05). Multiple logistic regression analyses indicated that number of cigarettes per day when they smoked the most was significantly associated with higher life‐time risks of the disorder according to DSM‐III‐R, DSM‐IV and Fagerstrom's classification ( p 0.05). The length of cigarette smoked was associated with higher life‐time risks of ICD‐10 and DSM‐IV diagnoses, and years of smoking were associated with higher life‐time risks of ICD‐10, DSM‐III‐R and DSM‐IV diagnoses ( p 0.05). Younger birth cohorts had higher cumulative rates of the disorder according to DSM‐IV ( p for trend 0.05). Conclusions. Life‐time prevalence rates of tobacco/nicotine dependence according to ICD‐10, DSM‐III‐R and DSM‐IV in male ever‐smokers in Japan were within the range of rates reported in previous US studies; rates of FTQ score of 7 or above were lower. Fagerstrom scores and diagnostic criteria appear to reflect different aspects of dependence.
Therapist/patient race and sex matching: treatment retention and 9‐month follow‐up outcome
Authors: Sterling Robert C. , Gottheil Edward , Weinstein Stephen P. , Serota Ronald
Published: March 2003

Aims. The current study was conducted to (a) replicate previous findings regarding the effect of patient/ therapist race and sex‐matching as this relates to the early dropout rate of substance abusers, and (b) to extend previous work by examining the impact of such matching on treatment retention and 9‐month outcome. Design. Patient and therapist characteristics were crossed in a 2 2 factorial design. Matching effects were then tested using retrospective data. Participants. Participants were 967 African‐American cocaine‐dependent people. Setting. The study site was a university sponsored outpatient treatment facility located in an economically depressed section of a large Northeastern US city. Measurements. Follow‐up data were drawn from the Addiction Severity Index, the Risk for AIDS Behavior Inventory, and a questionnaire measuring post‐discharge need for treatment, employment and education. Retention was defined as the number of days inclusive between the last date of service and the date of admission. Findings. No significant differences in early dropout rates were found after initial contact with 10 different therapists. Matching therapists and patients with respect to gender and race did not decrease the premature dropout rate, but partial support for gender matching was noted. Conclusions. Matching therapists and substance abusing patients on gender and race may not be essential to improving retention and outcome.
DSM‐IV alcohol disorders in a general population sample of adolescents and young adults
Authors: Nelson Christopher B. , Wittchen Hans‐Ulrich
Published: March 2003

Aims/Design. As part of the Early Developmental Stages of Psychopathology (EDSP) study, results from the baseline cross‐sectional assessment of DSM‐IV alcohol disorders are presented for a sample of 14‐24‐yearolds resident in Munich, Germany ( N = 3021; 71% response rate). Findings. Life‐time prevalence of DSM‐IV alcohol abuse (men: 15.1%; women: 4.5%) was found to be considerably more prevalent than dependence (men: 10.0%; women: 2.5%) with few cases among respondents younger than 16 years of age; 12‐month prevalence of abuse was 8.4% among men and 2.7% among women and of dependence was 7.3% among men and 2.2% among women. Results show that peak incidence of alcohol disorders occurs at 16‐17 years of age and that early initiation into alcohol use is associated with an increasing odds of disorder onset, especially for dependence among women. Exploratory analysis of retrospectively assessed diagnostic stability show: a temporal progression to abuse and then dependence, that nearly half of past abuse diagnoses are in remission, abuse remission is more common than progression to dependence, and dependence is highly persistent, especially among women. Conclusions . Alcohol disorders are frequent in adolescents and young adults being characterized by transient abuse and less prevalent but persistent dependence syndromes. The relatively high prevalence of dependence diagnoses in this young population with few years of alcohol use is discussed with regard to the clinical validity of DSM‐IV criteria in adolescents and young adults.
Drinking patterns, psychosocial characteristics and alcohol consequences
Authors: Kunz Jean Lock , Graham Kathryn
Published: March 2003

Aims. The purpose of this study was to investigate (a) the potential mediating role of alcohol consumption in the relationship between psychosocial variables and adverse consequences of drinking, and (b) the possible moderating role of psychosocial variables in the relationship between alcohol consumption and adverse consequences. Design. Multi‐stage sampling procedures were used to select households for a general population survey. Interviews were conducted with one member in each of 35 479 households and self‐administered questionnaires were left for all residents aged 12 years and older ( N = 49 164, response rate: 77.2%). Setting. Data were collected as part of the Ontario (Canada) Health Survey. Participants. The present study included 33 568 current drinkers aged 18 or older. Measurements. Analyses included the following variables: alcohol consumption, adverse consequences related to drinking, sex, age, marital status, self‐rated health, perceived stress, income, education, employment status and family dysfunction. Findings. Alcohol consumption appeared to mediate the relationship of adverse consequences with age, sex, marital status, education, income and employment, but not with health, stress or family dysfunction which were independently associated with adverse consequences. The relationship between alcohol consumption and adverse consequences was moderated by age, marital status, education and employment. Conclusions. These results help to clarify the interrelationship of alcohol consumption and psychosocial characteristics in experiencing adverse consequences related to drinking.
Patterns and correlates of cannabis dependence among long‐term users in an Australian rural area
Authors: Swift Wendy , Hall Wayne , Didcott Peter , Reilly David
Published: March 2003

Aim. To examine prevalence and correlates of cannabis dependence among long‐term cannabis users. Design. A cross‐sectional survey of patterns and experiences of cannabis use and dependence. Setting and participants. A snowball sample of 243 long‐term cannabis smokers, who were currently smoking 3‐4 times a week, were recruited from the New South Wales North Coast, an area long associated with cannabis cultivation and use. Measurements. A structured interview was administered, incorporating the following dependence measures: an approximation to a life‐time DSM‐III‐R diagnosis, an approximation to a 12‐month ICD‐10 diagnosis, and the Severity of Dependence Scale (SDS). Findings. Prevalence of a life‐time DSM‐III‐R diagnosis of cannabis dependence was 57%, while 57% received an ICD‐10 dependence diagnosis for the last year. Substantially fewer (15%) of the sample were diagnosed as dependent according to the Severity of Dependence Scale (SDS). Only 26% believed they had a problem with cannabis at least sometimes. There was general concordance between DSM‐III‐R and ICD‐10 measures, but not between these and the SDS. ICD‐10 and DSM‐III‐R dependence diagnoses were modestly correlated with age, life‐time illicit drug use and quantity of cannabis use. Principal components analyses of the dependence measures provided little evidence for a unidimensional dependence syndrome for ICD‐10 and DSM‐III‐R criteria. There was strong support for unidimensionality of the SDS. Conclusions. Symptoms of cannabis dependence were common among these long‐term users but only one‐quarter perceived that they had a cannabis problem. There was no strong evidence for a unidimensional cannabis dependence syndrome.
Maintenance treatment of opiate addicts in Germany with medications containing codeine ‐ results of a follow‐up study
Authors: Krausz Michael , Verthein Uwe , Degkwitz Peter , Haasen Christian , Raschke Peter
Published: March 2003

Aims. Outpatient maintenance treatment of opiate addicts with codeine/dihydrocodeine is a common approach in the treatment of drug addicts in Germany. This study was carried out to assess possible benefits of codeine maintenance in terms of patients' health stabilization, social rehabilitation and drug consumption. Design. Three‐year follow‐up study. Setting. Three practices of substituting physicians in large‐city areas in Germany. Participants. Of a random sample of 297 people attending for opiate outpatient treatment in 1993, 199 were successfully followed up 3 years later. Measurements. Measures of health, living conditions, employment, criminal activities and drug use were collected at baseline and follow‐up. The data were based on standardized interviews and medical examinations by the attending doctors as well as on questionnaires from the patients. Findings. Based on a 67%‐ follow‐up rate, after 3 years of codeine maintenance there was improvement in general health and mental problems. The living and working situation remained more or less unchanged and stabilized at a satisfactory level. The same applies to the consumption of drugs. Conclusion. The patients' progress shown in this study was comparable to that achieved by methadone maintenance in similar geographical regions. Codeine has a weaker pharmacological effect and our results suggest that codeine maintenance treatment deserves more attention and controlled trials to assess the benefits compared with methadone (or other opioids).
Prevalence of alcohol problems among emergency room patients in Thailand
Authors: Lapham Sandra C. , Skipper Betty J. , Brown Pamela , Chadbunchachai Wittaya , Suriyawongpaisal Paibul , Paisarnsilp Suparb
Published: March 2003

Aims. To determine prevalence rates of alcohol problems among emergency room patients. Design. This was a cross‐sectional survey including patient interviews and record reviews. The questionnaire included the Alcohol Use Disorders Identification Test to screen for hazardous or harmful alcohol use (alcohol problems). It also contained questions regarding the chief complaint and factors precipitating the admission . Setting. Emergency rooms of three regional hospitals in Thailand . Participants. Consecutive emergency room admissions aged 14 and older, admitted from 18.00‐02.00 h . Findings. Risk factors for alcohol problems included male gender, age 20‐49, higher monthly income, less than university graduate education status and admission to the northeast regional ER. Among non‐trauma patients, those with alcohol‐related diagnoses and certain gastrointestinal disorders had the highest rates of alcohol problems. Patients with transportation injuries were twice as likely, and those with assault‐, fall‐, or burn‐related injuries were at least three times more likely to screen positive compared to the non‐injured comparison group. The estimated overall prevalence rate of alcohol problems for this population, adjusted for age and diagnostic classification, was 0.39 for males and 0.08 for females. Conclusion. Especially among patients with specified diagnoses, the emergency room is an ideal setting for implementing alcohol screening and intervention programmes in Thailand.
Images and realities of alcohol
Authors: Sulkunen Pekka
Published: March 2003

The paper discusses the relationship between the images of alcohol and society, on one hand, and the reality of drinking and drinking problems on the other hand, from the point of view of policy‐relevant research. Images of alcohol influence policy but they also depend on the social and cultural environment of policy‐making. The epidemiological total consumption theory of alcohol‐related problems is used as an example. The theory is embedded in the modern welfare state's ideals and its policy relevance presupposes that these ideals‐universalism, consequentialism and public planning‐are respected. If the approach today receives less attention by policy‐makers than its empirical validity merits, it may be due to an erosion of these ideals, not of the epidemiological model itself. Images of alcohol influence behaviour and drinking problems but they also articulate the social context in which the images are constructed. This paper demonstrates the point, applying Levi‐Straussian cultural theory to an analysis of a recent beer advertisement addressed to young people. The advertisement not only reflects the images associated with youthful drinking but also the ambiguous status of youth as non‐adults in contemporary society. The author stresses that for social and cultural research alcohol is a two‐way window, to look at society through alcohol and to look at alcohol through society. Both directions are necessary for policy‐relevant research.
The use of acute and preventative medical services by a general population: relationship to alcohol consumption
Authors: Cryer P. Colin , Jenkins Linda M. , Cook Adam C. , Ditchburn James S. , Harris Colin K. , Davis Alison R. , Peters Timothy J.
Published: March 2003

Aims. To investigate the hypothesis that increasing alcohol consumption is accompanied by increasing use of acute, but decreasing use of preventative, medical services among the general population.

Design and participants. Health and life‐style survey of 41 000 randomly‐sampled adults in SE England who self‐completed a validated questionnaire covering socio‐demographics, alcohol and tobacco usage and use of acute (A&E department and general practitioner) and preventative (dental, optician, mammography and cervical cytology) services: the response rate was 60%.

Measurements. Comparative use of acute and preventative health care services by patients with varying consumption of alcoholic beverages. This was estimated by the odds ratio for service use, after correcting for the following confounding variables; age, social class, ethnic group, employment status, whether lives with children or with other adults, whether is a carer, limiting long‐term illness, depression status, smoking habit and use of private health insurance.

Findings. There was increased use of accident and emergency services by the harmful and intermediate drinking groups compared with the safe drinking group. Male abstainers attended their A&E departments more frequently than 'safe limit' drinkers. With respect to preventative services, both male and female abstainers and harmful drinkers used dental services less than safe limit drinkers. For females, mammography and cervical cytology services were less frequently used by abstainers and by harmful drinkers.

Conclusions. This study supports the generally held view that heavy alcohol consumers are disproportionate users of acute medical services but they are relative under‐users of preventative medical care services. Alcohol abstainers are also over‐users of acute services, but under‐users of preventative services. These latter observations are relevant to the claims that moderate alcohol consumers have lower apparent morbidity and mortality rates compared to abstainers.
Correlates of benzodiazepine abuse in methadone maintenance treatment. A 1 year prospective study in an Israeli clinic
Authors: Bleich Avi , Gelkopf Marc , Schmidt Vladimir , Hayward Rachel , Bodner Gershon , Adelson Miriam
Published: March 2003

Aims. This study addressed the following questions for patients after 1 year of methadone maintenance treatment (MMT); (1) What are the demographic features and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepatitis C (HCV) and do they have more HIV/HCV risk‐taking behaviors than non‐abusers? (4) Do BZD abusers have more psychopathology and more emotional distress than non‐abusers?

Design. All 148 patients who completed 1 year of MMT underwent random and twice‐weekly observed urine analysis for various drugs of abuse, responded to self‐report questionnaires (SCL‐90‐R; POMS; HIV/HCV risk‐taking behaviors), interviews (ASI) and underwent testing for hepatitis C. Abuse in this study is defined as any use during the 12th month of treatment.

Findings. After 1 year of MMT, more BZD abusers ( n = 63) were single, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non‐abusers ( n = 85). They had started using heroin and cocaine earlier and currently abused more cocaine, heroin and cannabis. They had significantly more psychopathology and negative mood. They had significantly more HCV and reported more HIV/HCV risk‐taking behavior.

Implications. We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment.
The 12‐month prevalence of substance use and ICD‐10 substance use disorders in Australian adults: findings from the National Survey of Mental Health and Well‐Being
Authors: Hall Wayne , Teesson Maree , Lynskey Michael , Degenhardt Louisa
Published: March 2003

Aims. To present the prevalence of substance use and ICD‐10 substance use disorders in the adult Australian population using data from the National Survey of Mental Health and Well‐Being (NSMHWB).

Design. A cross‐sectional survey assessing substance use and ICD substance use disorders (harmful use and dependence).

Setting and participants. A household survey of a nationally representative sample of 10 641 Australian adults (aged 18 years or older).

Measurements. Trained survey interviewers administered a structured interview based on the Composite International Diagnostic Interview (CIDI).

Findings. In the past 12 months 6.5% of the sample had an ICD‐10 alcohol use disorder (95% CI: 6.2, 6.9), and 2.2% had another drug use disorder (95% CI: 2.0, 2.4). More males than females had substance use disorders: 9.5% of males (95% CI: 8.5, 10.5) and 3.6% of females (95% CI: 3.2, 4.0) met criteria for an alcohol use disorder, and 3.2% of males (95% CI: 2.8, 3.6) and 1.3% of females (95% CI: 0.9, 1.7) met criteria for another drug use disorder within the past 12 months. The prevalence of substance use disorders decreased with increasing age: 10.5% of respondents aged 18‐34 years met criteria for an alcohol use disorder and 4.8% met criteria for a drug use disorder. The rates of these disorders among those aged 55 years or older were 1.8% and 0.1%, respectively. Substance use disorders were more prevalent among the unemployed, those who had never married and those who were Australian‐born.

Conclusions. The prevalence of substance use disorders in the Australian population is comparable to that in other English‐speaking countries.
Using cue reactivity to evaluate medications for treatment of cocaine dependence: a critical review
Authors: Modesto‐Lowe Vania , Kranzler Henry R.
Published: March 2003

Aims. The aim of this article is to examine the validity of a cue‐reactivity paradigm for evaluating medications to treat cocaine dependence and to critically review cocaine pharmacotherapy studies that use this method. Methods. A Medline computerized search was performed to identify randomized, controlled medication studies for cocaine dependence that employed a cue‐reactivity paradigm. Relevant bibliographies of these articles were also reviewed. Eleven placebo‐controlled studies were identified in the English language literature. Four of these studies used agents that block dopaminergic neurotransmission, two studies used agents that modify the serotonergic system, and two studies used nicotinergic agents. The other three studies employed a mood stabilizer, an opioid antagonist or a psychostimulant. Results. There has been little research examining the theoretical basis of the cue‐reactivity model, as applied to the screening of medications to treat cocaine dependence. From a methodological viewpoint, most studies have shown that exposure to cocaine‐related stimuli increases subjective and physiological reactivity in cocaine‐dependent patients, but methods used to present the cues and to measure cue reactivity have not been consistent across studies. Similarly, the observed increase in subjective and physiological reactivity to cocaine cues has varied within and across studies. Conclusions. If a cocaine cue‐reactivity paradigm is to be used to evaluate medications for treatment of cocaine dependence, the validity of the model must first be demonstrated and a consistent methodology for cue presentation and measurement of responses must be developed.
Estimating the prevalence of problem drug use in inner London: a discussion of three capture‐recapture studies
Authors: Hickman Matthew , Cox Stuart , Harvey Julie , Howes Samantha , Farrell Michael , Frischer Martin , Stimson Gerry , Taylor Colin , Tilling Kate
Published: March 2003

Aims. To provide an evidence base of estimates of the prevalence of problem drug use in inner London. Design. Re‐analysis of three capture‐recapture studies using subjects aged 15‐49 years, that aim to estimate the hidden population from analysing the overlaps between three data sources. Setting. Newham (1995) Camden and Islington (C&I) (1993/4) and Lambeth, Southwark and Lewisham (LSL) (1992). Participants. Each study collected data from three sources of problem drug users including: the Regional Drug Misuse Database, specialist drug agencies, HIV tests, social services, police arrests and court records. In LSL opiate users were analysed separately. The studies identified 1832 individuals in LSL, 543 in Newham, and 1321 in C&I. Measurements. Poisson models were fitted to the data testing different interactions between the data sources representing potential dependencies. The simplest model was selected on the basis of its AIC score and log‐likelihood ratio tests. Findings. The number of hidden problem drug users were estimated to be 12 500 (95% CI 9600‐16100) in LSL with 4400 (3200‐6100) opiate users; 7000 (5000‐10000) in C&I and 3800 (2000‐7200) in Newham. The prevalence of problem drug use in those aged 15‐49 was estimated to be 3.1% (2.5‐3.9%) in LSL with 1.3% (1.0‐1.6%) opiate users; and 3.6% (2.7‐4.9%) and 3.3% (1.9‐5.7%) in C&I and Newham, respectively. Conclusions. Despite the inherent problems with capture‐recapture methods, our three studies establish an evidence base for estimates of problem drug use in London. It is important that a larger study is carried out in London.
Covariates of cannabis use progression in a representative population sample of adolescents: a prospective examination of vulnerability and risk factors
Authors: Hofler Michael , Lieb Roselind , Perkonigg Axel , Schuster Peter , Sonntag Holger , Wittchen Hans‐Ulrich
Published: March 2003

Aims/design. This study reports findings concerning risk factors for first, "repeated" and "regular" use of cannabis in respondents (N = 1228) who were aged 14‐17 years at the outset (i.e. at "baseline") as part of a longitudinal prospective community study (EDSP). Risk factors were assessed at baseline or by separate interviews with the respondents' parents. Cumulative life‐time cannabis use was the main outcome measure in this study‐assessed by information from both the baseline and the follow‐up investigation at an average of 19.7 months later. A cumulative logistic regression model was used to estimate associations. Findings. Using seven of a total of 25 variables examined, the final model classified 72.1% of respondents correctly. Family history of substance use disorders, self‐esteem and competence, unconditional commitment to not using drugs, immediate availability of drugs, peer group drug use and previous history of nicotine dependence and alcohol use disorders all contributed significantly to the final model, predicting the progression to cannabis use from "no use", to "one time only", "repeated use", and "regular use". Conclusion. In addition to well‐documented risk factors such as peer group pressure, availability, low self‐esteem and competence, findings suggest that family history and prior experiences with legal drugs play a significant role in the early development of cannabis consumption in teenagers.
Transitions between the injection of heroin and amphetamines
Authors: Darke Shane , Kaye Sharlene , Ross Joanne
Published: March 2003

Aims. To assess in current injecting heroin and amphetamine users to what extent their history of injecting represents a transition from amphetamine to heroin. Design. Cross‐sectional survey. Setting. Sydney, Australia. Participants. One hundred and fifty‐one primary heroin injectors and 145 primary amphetamine injectors recruited through advertisements, needle exchanges, methadone maintenance clinics and by word of mouth. Findings. Six major transition patterns were detected: heroin‐heroin (n = 61), amphetamines‐heroin (n = 60), heroin‐amphetamines‐heroin (n = 30), amphetamines‐amphetamines (n = 80), amphetamines‐heroin‐amphetamines (n = 41) and heroin‐amphetamines (n = 24). A logistic regression analysis predicting presence or absence of a transition from the original primary drug indicated that length of injecting career, years of education and original drug injected were independent predictors. Thus, the longer the injecting career, the greater the likelihood of a transition. If the original drug injected was amphetamine, the greater the likelihood of transition; and the more prior years of education, the lower the chances of a transition. Conclusions. While there was a small preponderance of movement from primary amphetamine injecting to primary heroin injecting, there was also movement in the other direction. Heroin use is not necessarily a stable endpoint for injecting careers.
Narratives of recovery from addictive behaviours
Authors: Hanninen Vilma , Koski‐Jannes Anja
Published: March 2003

Aims. The purpose of this study was to look for the ways in which people who have recovered from various addictions understand and present their change process. Materials. The research material consisted of 51 autobiographical stories of people who had been able to quit their addiction to alcohol, multiple drugs, binge eating, smoking, sex and gambling. Methods. The basic logic of each narrative was first defined. The narratives were then categorized according to what they presented as the key to recovery. Composite stories were then constructed and analysed with regard to their emotional, causal, moral and ethical meanings. Findings. The analysis revealed five different story types among these self‐narratives: the AA story, the growth story, the co‐dependence story, the love story and the mastery story. All of them helped to make the addiction and recovery understandable, they released the protagonist from guilt and had a happy ending by which the values of the story were realized. Each story type was told predominantly by representatives of a particular gender and addiction. Conclusions. As there are several ways out of addictive behaviours there are also several ways to construe the change. People who try to quit addictive behaviours could be encouraged to make full use of the cultural stock of stories in creating an account that fits their own experience of defeating their particular addiction.
Behavioral monitoring of DUI offenders with the Alcohol Ignition Interlock Recorder
Authors: Marques Paul R. , Voas Robert B. , Tippetts A. Scott , Beirness Douglas J.
Published: March 2003

Aims. To evaluate patterns of blood alcohol concentration (BAC) and driving logged on the ignition interlock recorder and to assess whether this event record is a useful outcome measure for a behavioral intervention. Design. Descriptive analyses of recorder data and multivariate analysis of the predictors of high BACs associated with a motivational intervention for driving‐under‐the‐influence (DUI) offenders using an interlock. Setting. Two interlock service centers in Alberta, Canada. Participants. 1309 first‐time and multiple DUI offenders who agreed to participate during interlock installation. Intervention. A humanservices (supportive guidance) intervention based on motivational interviewing and pragmatic counseling was delivered to interlock users in Calgary, but not to interlock users in Edmonton, Canada. Measurements. This report summarizes the patterns and predictors of BAC warnings (0.02‐0.039%) (20‐39 mg/dl) and failures ( \>= 0.04) ( \>= 40 mg/dl) from more than 3 million in‐vehicle breath tests. Data come from three sources: driver records, questionnaires and the interlock. Findings. From the beginning to the end of the interlock use period, there was a significant linear decline in the proportion of positive BAC driving to total driving. After controlling for prior offenses, demographics and reported drinking levels, offenders in the intervention site (Calgary) were less likely to have recorded fail BACs than were offenders in the control site (Edmonton). The temporal patterns of BAC fails with the interlock mimic the high‐risk periods for DUI arrests and alcohol‐involved fatal crashes. Conclusions. The interlock successfully blocks drinking and driving during high‐risk periods. Preliminary recorder data suggest the services intervention may be affecting DUI behavior.
Do the rich really die young? Alcohol‐related mortality and social class in Great Britain, 1988‐94
Authors: Harrison Larry , Gardiner Eric
Published: March 2003

Aims. To determine whether social class is a major influence on alcohol‐related mortality in the general, economically active population of Great Britain. Design and participants. Poisson regression of rates of mortality known to be directly caused by alcohol consumption by age, sex and social class in England, Wales and Scotland. Measurements. The measure of alcohol‐related mortality is total deaths from ICD‐9 categories 291; 303; 357.5; 425.5; 535.3; 305; 790.3; and 571.0‐571.3 over the 7‐year period 1988‐94. (It excludes deaths for which alcohol‐attributable fractions would need to be calculated.) The measure of social class is the British Registrar General's six‐fold occupational classification, used to code census and death certification data. Findings. Alcohol‐related mortality rates are higher for men in the manual occupations than in the non‐manual occupations, but the relative magnitude depends on age. Men aged 25‐39 in the unskilled manual class are 10‐20 times more likely to die from alcohol‐related causes than those in the professional class, whereas men aged between 55 and 64 in the unskilled manual class are only about 2.5‐4 times more likely to die. For women in paid employment there is no consistent class gradient; younger women in the manual classes are more likely to die from alcohol‐related causes, but for older women it is those in the professional class who suffer elevated mortality . Conclusions. Social class is a risk factor for alcohol‐related mortality in Britain, although it is mediated by age and sex. Alcohol appears to be similar to other psychoactive substances, therefore, in that problem use is linked to social structural factors such as poverty, disadvantage and social class. This suggests that social interventions aimed at reducing poverty and inequality have the potential to reduce current levels of alcohol‐related harm among the poorest groups in the community.
Transitions between routes of heroin administration: a study of Caucasian and Indochinese heroin users in south‐western Sydney, Australia
Authors: Swift Wendy , Maher Lisa , Sunjic Sandra
Published: March 2003

Aim. To examine patterns and correlates of routes of heroin use among Caucasian and Indochinese heroin users. Design. A cross‐sectional survey. Setting and participants. Two hundred heroin users resident in South West Sydney. The sample was divided between Caucasian and Indochinese users (each n="100)," with half of each group on methadone maintenance. Measurements. A semi‐structured interview was administered, based on previous studies of transitions between routes of administration. Measures included patterns of drug use, transitions, social, health and legal issues and cultural correlates of use. Findings. Almost two‐thirds (61%) had smoked heroin. Smoking was more common among the Indochinese (40% were predominantly or exclusively smokers), although injecting was the dominant route for both groups. More than one‐quarter (29%) had made a transition from smoking to injecting, primarily due to drug effect and perceived cost‐effectiveness. Reverse transitions were rare. Smoking appeared to be more culturally acceptable than injecting among Indochinese users. Among both groups, there was a small but significant risk for the transmission of HIV and other blood‐borne viruses. Polydrug use and age were positively associated with having experienced a non‐fatal overdose. Conclusions. This research documents the existence of smoking as a popular route of administration among both Indochinese and Caucasian heroin users in the study sample. There is an urgent need to provide smokers and injectors with information explaining the potential risks and ways to minimize harms associated with both routes of use.
An experimental intervention with families of substance abusers: one‐year follow‐up of the focus on families project
Authors: Catalano Richard F. , Gainey Randy R. , Fleming Charles B. , Haggerty Kevin P. , Johnson Norman O.
Published: March 2003

Aims. Children whose parents abuse drugs are exposed to numerous factors that increase the likelihood of future drug abuse. Despite this heightened risk, few experimental tests of prevention programs with this population have been reported. This article examines whether intensive family‐focused interventions with methadone treated parents can reduce parents' drug use and prevent children's initiation of drug use. Design. Parents were assigned randomly into intervention and control conditions and assessed at baseline, post‐test, and 6 and 12 months following the intervention. Children were assessed at baseline, and 6‐ and 12‐month follow‐up points. Setting. Two methadone clinics in Seattle, Washington. Participants. One hundred and forty‐four methadone‐treated parents, and their children ( n = 178) ranging in age from 3 to 14 years old. Intervention. The experimental intervention supplemented methadone treatment with 33 sessions of family training combined with 9 months of home‐based case management. Families in the control condition received no supplemental services. Measurement. Parent measures included: relapse and problem‐solving skills, self‐report measures of family management practices, deviant peer networks, domestic conflict and drug use. Child measures included self‐report measures of rules, family attachment, parental involvement, school attachment and misbehavior, negative peers, substance use and delinquency. Findings. One year after the family skills training, results indicate significant positive changes among parents, especially in the areas of parent skills, parent drug use, deviant peers and family management. Few changes were noted in children's behavior or attitudes. Conclusions. Programs such as this may be an important adjunct to treatment programs, helping to strengthen family bonding and to reduce parents' drug use.
Meta‐analysis of cue‐reactivity in addiction research
Authors: Carter Brian L. , Tiffany Stephen T.
Published: March 2003

Aims. The cue‐reactivity procedure exposes addicts to a variety of drug‐related stimuli while self‐report of craving and physiological responses are monitored. The present review sought to determine the magnitude and overall pattern of responses typically found in cue‐reactivity research and which, if any, learning‐based model of cue reactivity is best supported by the findings. Design. Meta‐analytical techniques were used to select and evaluate results from 41 cue‐reactivity studies that compared responses of alcoholics, cigarette smokers, cocaine addicts or heroin addicts to drug‐related versus neutral stimuli. Effect sizes were calculated, separately by addict type, for self‐report of craving and physiological responses (heart rate, sweat gland activity and skin temperature). Findings. Across all addict groups, the effect size for craving was +0.92. Alcoholics had a significantly smaller craving effect size (+0.53) compared to other addict groups (+1.18 to +1.29). Relatively smaller effect sizes were found for physiological responses. The general profile of effect sizes across all addict groups was increased heart rate (+0.26) and sweat gland activity (+0.40) and decreased skin temperature (‐0.24) when addicts were presented with drug‐related stimuli. Conclusions. The cuereactivity paradigm can produce a stable profile of significant effects and, therefore, has a number of potential applications for investigating addictive phenomena. The implications of these findings for conditioning‐based models of cue‐reactivity phenomena are discussed.
The relationship between alcohol sales and assault in New South Wales, Australia
Authors: Stevenson Richard J. , Lind Bronwyn , Weatherburn Don
Published: March 2003

Aims. This paper explores the relationship between alcohol sales and assault in New South Wales (NSW), Australia. Design. The design was a cross‐sectional analysis of the relationship between alcohol sales and assault, taking into account spatial autocorrelation. Setting. The analyses were carried out separately on data from metropolitan Sydney and country NSW. Participants. The unit of analysis was local government areas (178 in NSW). Measurements. The dependent variable was assault rates. The independent variables were overall alcohol sales and sales disaggregated by alcohol and outlet type and relevant demographic and socio‐economic factors. Findings. Multiple regression analyses revealed a significant relationship between overall alcohol sales in an area and its incidence of assault for both Sydney and country NSW. There were few effects of outlet or alcohol type for Sydney, but the effect of alcohol sales from hotels and off‐licences accounted for most of the alcohol‐assault relationship for country NSW. Conclusions. Although the current research cannot exclude an opportunity account of the role of alcohol in assault, the results are entirely consistent with alcohol consumption as a causal agent.
Changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics
Authors: Aubin Henri‐Jean , Laureaux Chantal , Tilikete Samir , Barrucand Dominique
Published: March 2003

Aims. To assess the changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics. Design. Evaluation at admission and an average 16 days following discharge. Setting. Alcohol detoxification inpatient programme. Participants. Seventy‐three alcohol dependent (DSM‐III‐R) inpatients . Measurements. Average number of cigarettes and of cups of coffee per day; urine cotinine level. Smokers were classified as moderate on the basis of consuming fewer than 30 cigarettes per day at the time of admission; heavy smokers were those who smoked 30 cigarettes per day or more. Findings. As a group, the smokers (N=58) did not significantly change their cigarette consumption and there was no change in urine cotinine level. Heavy smokers (N=34), however, significantly decreased their cigarette consumption, but urine cotinine was unchanged. Moderate smokers (N=24) significantly increased their cigarette consumption but urine cotinine was not significantly changed. All patients‐non‐smokers, moderate and heavy smokers‐significantly increased their coffee intake. Conclusions. The results suggest that heavy smokers may react to alcohol cues and thus reduce smoking activity when sober. Moderate smokers may increase their smoking rate to cope with alcohol abstinence. These changes appear only to reflect a behavioural adjustment, without modification of patients' nicotine‐seeking. Alcoholics may increase their coffee intake to cope with alcohol abstinence.