bluuebunny/crossref_metadata_2025 huggingface dataset:
Dutch Policy on the Management of Drug‐related Problems ⋆
Authors: ENGELSMAN E. L.
Published: January 2006

It is argued that the drug abuse problem should not be primarily seen as a problem of police and justice. It is essentially a matter of health. The Dutch acknowledge that the international repressive, prohibitive approach leads to unintentional negative side‐effects, both for the individual and for society. They try to avoid a situation in which consumers of cannabis suffer more damage from the criminal proceedings than from the use of the drug itself. They opt rather for a realistic and practical approach to the drug problem than for a moralistic and over‐dramatized one. The Dutch alternative is the normalization of the drug problem, as a pragmatic compromise between two extreme options: an intensified war on drugs and legalization. The implications of the normalization approach for the prevention and treatment policies are discussed: AIDS‐prevention, harm reduction instead of detoxification and de‐mystification. It is suggested that the policy of normalization is rather successful and does not produce an increase of drug use.
What Drives British Drug Policies ⋆
Authors: EDWARDS GRIFFITH
Published: January 2006

This paper identifies four broad types of influence which have contributed to the dynamics of British drug policy development over many decades: international influences, varieties of fear, professional entrepreneur‐ship, and the perceived tension between treatment and control. A follow‐through of these same themes to current policy concerns is traced. The need to develop a comparative and international framework for policy analysis is stressed. Policy research, it is argued, deserves to be given greater attention as the necessary means toward a more informed sense of feasibilities and policy options.
The Relationship Between Impulsivity, Empathy and Involvement in Twelve Step Self‐help Substance Abuse Treatment Groups
Authors: McCOWN WILLIAM
Published: January 2006

The relationship between impulsivity, empathy, substance‐free lifestyle and participation in Twelve Step self‐help groups is investigated. Utilizing S. B. G. Eysenck et al.s’Impulsivity Questionnaire (1–7) members of three self‐help‘clubs’were assessed for traits of empathy and impulsiveness. Impulsivity correlated positively with total number of substance abuse ‘slips’, and negatively with total months of substance abstinence. Empathy was correlated positively with length of abstinence and hours spent in Twelve Step self‐help activities per week. Possible interpretations and application of these findings to clinical recommendations are discussed.
Superior Outcome of Females Over Males After Brief Treatment for the Reduction of Heavy Drinking
Authors: SANCHEZ‐CRAIG MARTHA , LEIGH GILLIAN , SPIVAK KAREN , LEI HAU
Published: January 2006

Problem drinkers (52 males, 38 females) recruited through advertisements were randomly assigned to one of three treatments: Guidelines: three sessions of advice using a pamphlet outlining basic steps for achieving abstinence or moderate drinking. Manual: three sessions of instruction in the use of a 'self‐help’manual presenting a step‐by‐step approach for attaining abstinence or moderate drinking. Therapist: six or more sessions of instruction in the methods outlined in the 'self‐help’manual. At 3, 6 and 12 months follow‐up, no significant differences were found among the groups in reduction of heavy drinking days (i.e. days when consumption exceeded four drinks, each containing 13.6 g/ethanol). Overall, the number of heavy days were reduced from an average of 43 at intake, to 20 over the 1‐year follow‐up period. Females, however, had significantly greater reductions than males (75% versus 35%). Three months after treatment the rate of successful moderate drinkers was significantly higher for females than males in the Guidelines (60% versus 33%) and the Manual condition (63% versus 18%), but not in the Therapist condition (25% versus 35%). At 1‐year follow‐up, females were more successful than males in all conditions. Mean changes in GGT and MCV levels lended support to the change in drinking status (from heavy drinker at intake to moderate drinker at follow‐up), based on clients’self‐reports.
Treatment at Farm Place
Authors: DITZLER JOYCE M. , DITZLER JAMES R.
Published: January 2006

The authors are the original adaptors of the Minnesota experience to the United Kingdom. The history of this method of treatment for addictive illnesses in the U.S.A. and in England is given. Their philosophy of addiction is discussed, as is its practical application to the programme of treatment. The composition of the treatment team, the patient population served, and the manner in which the team addresses addictive disease within the context of the whole family system is discussed. The concept of denial as related not only to patients abuse of their current drug but also the nature of poly drug abuse, is described. Criteria for selection of outpatient versus inpatient treatment are given. There is an outline of the daily treatment regime of the inpatient programme, detoxification procedures, a description of psychological testing, and how physical fitness is integrated into the programme. Also described is the inpatient treatment of non‐addicted family members and how treatment of eating disorders is integrated into the programme, designed primarily for substance abusers. The role of the self‐help movement is discussed and its relationship with treatment and aftercare is explained.
The Social Costs of Tobacco Smoking
Authors: MARKANDYA A. , PEARCE D. W.
Published: January 2006

This article is concerned with establishing a methodology for the measurement of the social cost of tobacco consumption, and with using that methodology to estimate the relative quantitative importance of each of the identified components of social cost. It begins by defining social cost and explaining its relevance to policy making. The next section derives a matrix of items that need to be calculated if the social cost is to be correctly measured. The third section surveys the existing empirical literature on the social costs of tobacco consumption in the light of the methodology derived in this paper. In general it concludes that most measures of ‘social cost’ are incorrect. However, some interesting numbers do emerge from the studies and these are highlighted. Finally, the last section discusses the policy relevance of actual and potential measures of social cost and concludes with some general observations on the direction of future research in this field.
The Health Policy Implications of International Trade in Alcohol and Tobacco Products
Authors: POWELL MELANIE
Published: January 2006

The aim of national alcohol and tobacco preventive health policy is to reduce consumption in order to reduce harm. However, the level of domestic consumption depends upon the interaction of international demand and supply and the development of international trade policy. Trade policy may conflict with or act as a constraint on the implementation of preventive health policy. Trends in alcohol and tobacco trade and developments in international trade policy affecting these products are examined in this paper in relation to health policy goals. Economic models of the links between trade flows, quantities consumed and health effects are then outlined as a preliminary step towards identifying the complex interaction between alcohol and tobacco trade and production, consumption, health and welfare. It is shown that consideration of the economic trade links are an important factor in the development of international and domestic health policy.
Alcoholic Beverages in Ireland: market forces and government policy
Authors: WALSH BRENDAN M.
Published: January 2006

The changing pattern of consumption of alcoholic beverages in Ireland and the association between this and the trend in alcohol‐related problems are examined. As a result of a relatively low price and high income elasticities of demand for alcoholic beverages, the high level of taxation of alcohol in Ireland has resulted in an exceptionally large proportion of income being devoted to purchasing them rather than to a fall in their consumption. During the 1980's it became apparent that any major divergence between Irish and U.K. liquor prices generated a large cross‐border trade and was counter‐productive from a revenue perspective. Further pressure to reduce the level of taxation is coming from the move to harmonise taxes across EC member slates. The limitations of taxation policy as a means of controlling the consumption of demerit goods in a small economy are clearly illustrated by the Irish experience.
U.S. Tobacco Taxes: behavioural effects and policy implications
Authors: LEWIT EUGENE M.
Published: January 2006

This paper examines U.S. tobacco taxation, the effect of cigarette taxes on smoking and on the health effects of smoking, and equity and efficiency considerations that arise when cigarette excise taxes are used to reduce smoking. Cigarette excise taxes, imposed by the Federal Government, all Stale governments, and nearly 400 cities and counties, add approximately 34 cents per pack to the price of cigarettes. Real cigarette excise tax rates have fallen because tax increases have not kept pace with inflation. Increases in the price of cigarettes decrease smoking, particularly by adolescents. An estimated 100,000 additional persons may live to the age of 65 as a result of doubling the Federal cigarette tax in 1983. Because cigarette taxes are regressive and are borne primarily by smokers, inequities may arise when they are used to reduce smoking. Success in achieving a tobacco‐free society will require that tobacco taxes be replaced with alternative sources of revenue.
The Limitations of Econometric Analysis in Cigarette Advertising Studies
Authors: CHAPMAN SIMON
Published: January 2006

Econometric analysis of the relationship between advertising and smoking has assumed a position of prominence in debate between public health and tobacco industry interests. Econometric methods are intrinsically limited in their ability to address the essential qualitative nature of advertising because they are obliged to assign arbitrary quantitative values to a medium where such assignation is highly debatable. The same problems occur when econometric methods attempt to assign values to other qualitative variables like health education campaigns and changing cultural factors relevant to smoking. Rather than commencing with the question “what does advertising to do people”, an alternative research paradigm which asks “what do people do with advertising’ should underpin research into advertising ‘effects’.
The Effects of Tobacco Advertising on Children
Authors: SMITH GLEN
Published: January 2006

The London Based Children's Research Unit (CRU) has investigated juvenile smoking initiation and advertising in 15 countries. Each country investigated differed with respect to tobacco advertising restrictions, ranging from Norway, which has had a long‐term ban on all advertising of tobacco products, to Hong Kong and Japan, which had few advertising restrictions at the time of the research. Advertising was not found to significantly influence juvenile smoking initiation and it was also found to be a poor predictor of juvenile smoking prevalence. That is, countries with tobacco advertising did not have a higher level of juvenile smoking prevalence than countries without advertising.
Is the ‘New’ Problem Drinking Concept of Heather & Robertson More Useful in Advancing Our Scientific Knowledge Than the ‘Old’ Disease Concept?
Authors: GORMAN DENNIS M.
Published: January 2006

Heather & Robertson maintain that the problem drinking concept represents a shift from a ‘pre‐scientific’ to a ‘scientific’ paradigm within the field of alcohol studies. They consider that the usefulness of a concept can best be assessed in terms of the extent to which it facilitates the testing of hypotheses. The disease concept is of no value when judged in these terms due to the aetiological assumptions that are built into it. It is argued that since Heather & Robertson's “new’ approach incorporates a set of assumptions parallel to those of the disease concept it is equally tautological, and therefore does not represent the type of change in paradigm they propose.
An Analysis of the Clinical Relevance of Type 1 and Type 2 Alcoholics
Authors: SCHUCKIT MARC A. , IRWIN MICHAEL
Published: January 2006

Predictions inherent in the proposed Type I/Type 2 continuum of alcoholic subtypes were indirectly explored in 31 sons of primary alcoholic fathers. The fathers' alcoholism was rated on a 0–5 scale utilizing characteristics typical of the Type 2 extreme of the continuum. If a predisposition to Type 2 alcoholism is genetically transmitted, then we would have predicted that the sons of Type 2 alcoholics would be more likely than the sons of Type 1 men to show an earlier onset of drinking, as well as more alcohol and substance intake and associated problems. The results did not support any consistent trend in the correlation between the FHP fathers' alcoholic characteristics and the sons' problem picture. Potential explanations for this finding are discussed including the possibility that the Type 2 extreme might represent a separate diagnostic entity, the antisocial personality disorder, and not alcoholism itself.
The Distribution of Alcohol Dependence Severity among In‐patient Problem Drinkers
Authors: DOHERTY BREID , WEBB MARCUS
Published: January 2006

One hundred and sixty problem drinkers admitted to in‐patient care were rated according to the severity of their alcohol dependence by means of two standardized questionnaires (SADQ and SADD). A bimodal distribution of scores previously reported with the SADQ was not reproduced with either questionnaire, bat there was a highly significant correlation (r=0.806) between the SADQ and SADD scores. There was 59% agreement between the two questionnaires in their placing of scores within three categories of dependence severity. The results suggest a degree of caution in equating current estimates of minimal, mild to moderate and severe dependence on the SADQ with low, medium and high dependence, respectively, on the SADD. Some difficulties experienced by subjects in completing the two questionnaires are discussed.
Variations in Needle Sharing Practices Among Intravenous Drug Users in Possil (Glasgow)
Authors: RAHMAN M. Z. , DITTON JASON , FORSYTH A. J. M.
Published: January 2006

Glasgow has an intravenous drug using (IVDU) population which is probably larger but hitherto less infected with the human immunodeficiency virus (HIV) than IVDUs elsewhere in Scotland. This 1988 study of 50 Glasgow IVDUs reports disturbingly high rates of sharing injecting equipment, and points to imprisonment as a possible factor in increasing such risk taking behaviour.
The Social Image of the Young Female Smoker
Authors: COOPER W. HEATHER , KOHN PAUL M.
Published: January 2006

Community college students (N=229) read a brief narrative about a young female college student and rated her on 14 bipolar scales. Half the subjects read a version in which the protagonist smoked, and half an otherwise identical version in which she didn't. Although most subjects recalled the protagonist's smoking status, very few recognized this as the focal variable in the experiment. Subjects rated the heroine less positively for social attractiveness (p<0.001) and personal resourcefulness (p<0.01) when she was represented as a smoker. They specifically considered the smoking protagonist more masculine (p<0.01), less feminine (p<0.001), less healthy (p<0.001), a poorer student (p<0.001), less wise (p<0.001), less self‐disciplined (p<0.001), less sophisticated (p<0.001), and less gentle (p<0.02). Non‐smoking subjects also rated the smoking heroine as less (physically) attractive (p<0.05), although smoking subjects did not discriminate significantly.
Computerized Tomography and Neuropsychological Assessment in Long‐term High‐dose Heroin Addicts
Authors: STRANG JOHN , GURLING HUGH
Published: January 2006

A clinico‐radiological assessment of seven high‐dose long‐term heroin addicts was undertaken to look for the presence of neuropsychological and CT scan pathology. Definite abnormalities mere found in both neuropsychological and CT scan assessments in some individuals but the pattern of CT scan and neuropsychological deficit in relation to heroin addiction was not constant.
The Norwegian Injection Mark Study
Authors: SKRETTING ASTRID , SKOG OLE‐JØRGEN
Published: January 2006

By examining persons arrested in Oslo during a certain period, we will try to obtain a better picture of intravenous drug abuse in Oslo. A pilot project was organized for 3 months during the autumn of 1987. In addition to having their arms examined, the arrestees were asked some questions about their abuse and HIV‐testing. The paper presents some data from the pilot period: 35% of the arrestees had marks from intravenous drug abuse (almost 2/3 of the females and slightly less than 1/3 of the males); 78% of them were men, 22% were women; the majority were in the age range 21–35 years; 53% stated that they injected opiates, 35% that they injected stimulants and 12% that they injected both types. Nearly 80% stated that they had been HIV‐tested. A larger proportion of users of opiates (88%) stated that they had been tested than users of stimulants (66%). The prevalence of HIV‐seropositive cases among the arrested intravenous abusers was 13.8%. In the paper we also discuss methodological aspects of the study.
Alcohol Consumption Among Victims of Violence and Among Comparable U.K. Populations
Authors: SHEPHERD JONATHAN , IRISH MARGARET , SCULLY CRISPIAN , LESLIE IAN
Published: January 2006

Controlled investigations of alcohol consumption in victims of assault are lacking. A prospective survey was performed to compare victims' drinking habits with age and sex matched U.K. populations. All 539 adult victims of assault who attended an inner‐city Accident and Emergency (A and E) Department in 1986 were interviewed. Seventy‐four per cent of male victims and 42% of female victims reported alcohol consumption in the 6 hours prior to assault: 30% of males and 4% of females had consumed <10 units. Forty per cent males and 25% of females exceeded established safe‐levels of consumption while 16% of males and 26% of females demonstrated abnormally high gamma‐GT levels. Mean expenditure on alcohol by assault victims was 14% of net income, compared to 7.5% by the U.K. adult population overall. Results suggested that young male victims of assault may not be distinguishable from other young males on the basis of habitual or binge alcohol consumption. Assault victims over 25 years of age drank excessively compared to control populations and should be a priority group for alcohol education programmes.
Health Locus of Control and Health Beliefs in Relation to Adolescent Smoking
Authors: EISER J. RICHARD , EISER CHRISTINE , GAMMAGE PHILIP , MORGAN MICHELLE
Published: January 2006

Results from a survey of 10,579 schoolchildren aged 11–16 years indicated various relationships between age, smoking behaviour, health locus of control beliefs, expressed concern with different consequences of illness and beliefs in the efficacy of different strategies for staying healthy. In particular, smokers, compared with non‐smokers, showed less belief in the importance of ‘powerful others’ or ‘personal control’ but more belief in the importance of ‘chance’ as an influence on health outcomes. With regard to consequences of illness, smokers cared more than non‐smokers about not being allowed to see friends, but less about getting behind in school or being a nuisance to others; they were also less convinced of the benefits of preventive health behaviours such as eating good food and taking exercise. Implications for health education approaches are discussed.
Is the Postwar Drinking Binge Ending? Cross‐National Trends in Per Capita Alcohol Consumption
Authors: SMART REGINALD G.
Published: January 2006

Examination is made of per capita alcohol consumption data for 33 (largely developed) countries for 4 periods of time–1951–1952, 1968–1970, 1974–1976 and 1983–1984. The trends indicate that there was a large increase in consumption between 1950–1952 and 1974–1976 in most countries. However, after 1974–1976, consumption stabilized or decreased in most. Declines appear to be more common in wine‐drinking countries and in those with very high levels of consumption. The tendency for countries to have a dominant beverage has declined: the overall trend has been towards beer consumption and away from spirits consumption. Reasons for the results include demographic changes and life style changes towards greater interest in health.
Alcohol Advertising, Consumption and Abuse: a covariance‐structural modelling look at Strickland's data ⋆
Authors: ADLAF EDWARD M. , KOHN PAUL M.
Published: January 2006

Re‐analysis employing covariance‐structural models was conducted on Strickland's (1983) survey data on 772 drinking students from Grades 7, 9 and 11. These data bear on the relations among alcohol consumption, alcohol abuse, association with drinking peers and exposure to televised alcohol advertising. Whereas Strickland used a just‐identified model which, therefore, could not be tested for goodness of fit, our re‐analysis tested several alternative models, which could be contradicted by the data. One model did fit his data particularly well. Its major implications are as follows: (1) Symptomatic consumption, negative consequences and self‐rated severity of alcohol‐related problems apparently reflect a common underlying factor, namely alcohol abuse. (2) Use of alcohol to relieve distress and frequency of intoxication, however, appear not to reflect abuse, although frequent intoxication contributes substantially to it. (3) Alcohol advertising affects consumption directly and abuse indirectly, although peer association has far greater impact on both consumption and abuse. These findings are interpreted as lending little support to further restrictions on advertising.
Alcohol Taxes: do the poor pay more than the rich?
Authors: Ashton TONI , CASSWELL SALLY , GILMORE LYNNETTE
Published: January 2006

Concern has often been expressed that alcohol taxes bear more heavily on the poor than on the rich, especially if these taxes are based on quantity rather than price. However, surprisingly little is known about how the tax burden is distributed across different income groups. Utilizing survey data from 3010 respondents in New Zealand, this study calculates exactly how much alcohol tax was paid by respondents in different income groups and in different types of households. These results were applied to household expenditure survey data to estimate the incidence of alcohol taxes across different households. The results suggest that, although in dollar terms the wealthiest households paid about four times as much alcohol tax as the poorest households, when expressed as a percentage of income, alcohol taxes are distributed proportionally across the lower income brackets but decline towards the upper end of the income scale. These taxes accounted for less than 1% of household income for all income groups. Households with children generally paid less alcohol tax than households without children. It is concluded that alcohol taxes in New Zealand do not seriously conflict with the broader equity objectives of government policy.
The Increase in Alcohol Consumption among Women: a phenomenon related to accessibility or stress? A General Population Study
Authors: Hammer Torild , Vaglum Per
Published: January 2006

This population survey of Norwegian women (N=3997) and their husbands explore the relative importance of accessibility and stress variables in explaining the level of women's alcohol consumption. Among the accessibility‐variables, population density and husbands’alcohol consumption have a significant impact on the women's consumption. Employment among women is not significantly related to their alcohol use when controlling for the husbands’consumption. Stress variables (work stress, nervousness) have no significant influence on consumption when controlling for accessibility variables. The findings show that the increase in women's consumption of alcohol is more specifically related to accessibility, variables with a close relationship to lifestyle, rather than to general accessibility to alcoholic beverages.
OKT4/OKT8 Ratio in Asymptomatic Heroin Addicts
Authors: Marra Roberto , SCHIFANO FABRIZIO , RINALDO EMANUELA , FAVARO WALLY , GAVIOLI ARTEMISIO
Published: January 2006

The OKT4 (helper) and OKT8 (suppressor) lymphocytic subpopulations were enumerated in a sample of 60 asymptomatic drug addicts and in 17 controls. No significant differences in the ratio could be found that could not be explained by the action of HIV. It can be concluded that heroin itself was not responsible for any alteration in the T4/T8 ratio in the population considered.
Drug Abusers' Perceptions of their Parents
Authors: SCHWEITZER ROBERT D. , LAWTON PATRICIA A.
Published: January 2006

Many clinicians in the area of drug addiction believe that emotional problems arise from particular styles of parenting. To investigate this link, 63 young male and female addicts who had sought treatment completed the Parental Bonding Instrument which tapped their perceptions of their relationship with each parent. Addicts reported early parental experiences differing from those of a control group. Drug abusers judged their parents as cold, indifferent, controlling and intrusive. In addition, these perceptions were shared by male and female addicts. These results, together with previous research suggest that these perceptions might well point to a general risk factor for the development of a broad range of psychological and psychiatric disorders. In addition, the issue of family factors in the design and implementation of drug treatment programs needs to be addressed.
Alcohol and Liver Injury: dose‐related or permissive effect?
Authors: SØRENSEN THORKILD I. A.
Published: January 2006

The studies addressing the risk of development of cirrhosis of the liver in relation to alcohol consumption have been based on comparisons at the aggregate population level and at the individual level, on case‐control studies and cohort studies, and on retrospective and prospective assessment of alcohol consumption. The ideal, but unfeasible, study design for estimation of the risk function is a prospective monitoring of alcohol consumption and recording of rate of development of cirrhosis per unit of time. Two recent studies, approaching this design, suggested that above a rather low, but not precisely determined, level of alcohol consumption, the risk of development of cirrhosis is not further influenced by the amount of alcohol consumed. A critical analysis of previous studies suggests that this risk function actually is compatible with their findings. The contention that alcohol abuse has a permissive rather than a dose‐dependent role in the development of alcoholic liver injury encourages research into the additional factors that must act before the liver injury occurs.
Withdrawal‐oriented Therapy for Smokers
Authors: HAJEK PETER
Published: January 2006

The treatment approach of the Maudsley Hospital Smokers Clinic is described. It stems from the notion that smokers seeking help are dependent on nicotine, and that withdrawal discomfort is a major block to their success in quitting. Accordingly, therapy focuses on helping clients overcome nicotine deprivation. It uses nicotine replacement and a special format of group treatment. Details are given of preparation of clients, use of nicotine chewing gum, use of group‐oriented groupwork, use of information about withdrawal, and training in withdrawal‐oriented therapy. Data are presented concerning characteristics of the clientele, treatment adherence, and treatment results. A number of controversial issues are addressed, such as the optimal duration of treatment, timing of the quit date, the value of educational input, and the value of individualization of treatment goals.
Alcoholic and Non‐alcoholic Liver Disease in Relation to Alcohol Consumption in Scotland, 1978–84.
Authors: KREITMAN NORMAN , DUFFY JOHN
Published: January 2006

A common strategy in epidemiological studies linking alcohol consumption in the general population with liver cirrhosis mortality is to use non‐specific cirrhosis mortality rates in which alcoholic and non‐alcoholic causes of death are not distinguished. Evidence is presented from Scottish mortality data for 1979 to 1984 that the two forms of cirrhosis have quite different epidemiological profiles. Similar findings emerge from morbidity data. The two forms of disease should be distinguished in future studies in which liver cirrhosis is used as a proxy for consumption, despite the manifest shortcomings of currently available data.
Peers as Perceived by Drug Abusers in their Drug‐Seeking Behaviour
Authors: ONG TECK‐HONG
Published: January 2006

This paper is pan of a major study in drug abuse. It attempts to investigate from the social learning perspective the importance of peers in the interpersonal relationship and in drug‐seeking behaviour among a group of drug abusers including adolescents and adults. The subjects included 100 drug abusers randomly selected from those registered with voluntary organizations for treatment and rehabilitation, and 100 non‐abusers individually matched for sex, approximate age, ethnic group, educational stream, and neighbourhood. A questionnaire was constructed to collect biosocial and drug‐use data and 11 items of them common to those on the official record were used to check the veridicality of the responses of drug abusers. Exact agreement ranged from 83% to 100%.

It is found that peers were identified significantly more by the drug abusers than by the non‐abusers to be the person they most associated with, and that peer group influence is a strong motivator in the trigger mechanism of drug‐taking.
The Response of New Zealand Boys to Corporate and Sponsorship Alcohol Advertising on Television
Authors: WYLLIE ALLAN , CASSWELL SALLY , STEWART JOANNA
Published: January 2006

A survey of a random sample of 302 New Zealand boys aged 9–14 years investigated responses to two recent television advertisements featuring alcohol companies. Alcohol product advertising is not allowed on New Zealand television but a corporate advertisement which was allowed was perceived by most of the children to be advertising beer and to be encouraging drinking. A corporate sports sponsorship advertisement had lower association with alcohol, which may have been because of children's limited understanding of the concept of sponsorship. Most of the children remembered both advertisements and many expected their peers to take notice of them. There was strong support for both advertisements being broadcast on television. Overall, the survey suggested that this television advertising was creating strong positive associations between the companies' products and significant cultural and emotional elements, thus contributing to a climate that was not supportive of alcohol education.
Patterns of Drug Use by Young People in the Rural Community of Spain
Authors: ALVAREZ F. J. , QUEIPO D. , DEL RIO M. C. , GARCIA M. C.
Published: January 2006

The patterns of drug use were studied in 188614‐30‐year‐olds in rural (less than 10,000 inhabitants) Spain in 1987. Cannabis was the most frequently consumed drug. For the“past month”, the frequency of drug consumption was 10.07% of the population for cannabis, and ranged between 1.01% for amphetamines and 0.11% for inhalants. Drug consumption was more frequent among males than among females. The earlier start in consumption was among inhalants (15.3 years) whereas cocaine consumers started later (20years). ‘New sensations and curiosity’ was the most frequently reported reason for the initial consumption of the various drugs, whereas the ‘search for pleasure and happiness, and’ to relax'(for tranquillizers) were the principal reasons given for continuing use. ‘Euphoria’ and ‘well‐being’ were the principal effects felt under the influence of the different drugs. The present data show that drug consumption is common among young people in Spanish rural communities.
NMR T1 Relaxation Time of the Brain During Alcohol Withdrawal and its Lack of Relationship with Symptom Severity
Authors: MANDER A. J. , YOUNG A. , CHICK J. D. , RIDGWAY J. , BEST J. J. K.
Published: January 2006

A significant fall in brain T1 relaxation time, consistent with a reduction in brain water of approximately 0.3%, occurred in 19 chronic alcoholic patients admitted for detoxification. There was no correlation between T1 and the severity of withdrawal symptoms and hence no evidence that changes in brain water levels contributed to the abstinence syndrome.
Increased Plasma Carnitine in Severe Alcohol Dependence
Authors: GLASS ILANA B. , CHALMERS R. , BARTLETT S. , LITTLETON J.
Published: January 2006

Carnitine plays a central role in lipid metabolism. There have been several suggestions that camitine metabolism is affected in alcoholism. In the present study plasma camitine levels in severely dependent alcoholic patients were investigated. The results show that total and free plasma camitine in 11 out of 14 patients were raised above those found in normal control subjects. This may be indicative of changes central to the disease process. We suggest that plasma free camitine represents a useful test which can be added to those currently used to assess alcohol dependence.
Cross‐cultural and Cross‐temporal Explanations of Drinking Behavior: contributions from epidemiology, life‐span developmental psychology and the sociology of aging
Authors: HARTKA ELIZABETH , FILLMORE KAYE MIDDLETON
Published: January 2006

A review is presented of the contributions to understanding historical and cultural variation in drinking practices from three disciplines—epidemiology, life‐span developmental psychology and the sociology of aging. It is concluded that while these disciplines have made major methodological contributions to understanding these variations, theory is lacking. Reasons for the paucity of theory and the lack of hypotheses are advanced, as are frameworks in which to test competitive hypotheses across temporal and cultural boundaries.
Undergraduate Medical School Training in Psychoactive Drugs and Rational Prescribing in the United Kingdom
Authors: FALKOWSKI J. , GHODSE A. H.
Published: January 2006

The present study examines the extent and form of teaching on psychoactive drugs and the rational prescribing of them given to undergraduate medical students in the United Kingdom. All the 21 schools which replied taught on psychoactive drugs. The average was 15.4 hours of formal teaching (lectures, seminars, tutorials). The teaching on psychoactive drugs compares favourably with the average of 4.2 hours teaching given on alcohol related problems and 3.5 hours on drug dependence. It emerged that there was a great deal of variation in the amount of teaching on psychoactive drugs and many schools felt their teaching on rational prescribing was inadequate. There is a need to promote better co‐ordination between medical school departments and to identify the key concepts which all medical schools should teach. These steps would help to ensure improved teaching on psychoactive drugs and rational prescribing.
Towards a sociology of tranquillizer prescribing
Authors: GABE JONATHAN
Published: January 2006

This paper outlines a sociological approach to benzodiazepine tranquillizer prescribing. The analysis focuses on both the micro level of the doctor‐patient relationship and the macro level of those political, economic and cultural factors which structure the prescribing process. This makes it possible to account for both the overall decline in benzodiazepine prescriptions in the 1980's and the fact that they are still being prescribed on a long‐term basis to ‘a significant number of people’.
Alcohol education for 13 year olds‐does it work? Results from a controlled evaluation
Authors: BAGNALL GELLISSE
Published: January 2006

This paper presents the findings from a controlled prospective study of the effectiveness of a school‐based alcohol education package for 13 year olds. The research had three phases: (1) baseline survey of alcohol‐related knowledge, attitudes and behaviour; (2) development and teaching of a short alcohol education package and (3) follow‐up survey. The results indicate that the students who received the alcohol education knew more about alcohol than the controls. In addition, the educational intervention was found to have influenced the self‐reported last consumption of alcohol and maximum consumption, with the ‘educated’ youngsters generally exhibiting more restrained behaviour. There has been little scientific evidence that past alcohol education has been effective in changing young people's drinking behaviour. The outcome of this research reinforces some recent studies which suggest the way forward may lie in an educational approach which takes account of social influences on substance use and misuse.
A survey of general practitioners' opinion and attitude to drug addicts and addiction
Authors: ABED R. T. , NEIRA‐MUNOZ E.
Published: January 2006

A survey was carried out to investigate general practitioners’ attitude towards drug addicts and addiction. A questionnaire was sent to all GPs in the Norwich Health District and obtained an 87% response rate. A range of negative and positive attitudes was identified. The implications of these findings are discussed with particular reference to current government policy of encouraging GPs to extend their role in treating drug addiction.
Treatment for alcoholics in German speaking countries
Authors: FEUERLEIN WILHELM
Published: January 2006

In this specially commissioned BJA series experienced clinicians give their personal and frontline views as to how the practical business of treating people with substance problems is best handled.

This article was triggered by suggestions given by the editors of the British Journal of Addiction (Edwards, 1989). The main question addressed teas: what do therapists really know and believe about how (alcoholic) patients are helped? In addition some more detailed issues were borne in mind, namely: the underlying philosophy of alcoholism (disease concept) and its treatment; patients’ socio‐cultural background and abuse practices; the special socio‐cultural factors which influence the therapists’ practice and patients’ expectations; treatment goals and outcome definitions; the therapists’ approaches to the patients’ assessments; the treatment modalities (attempts to strengthen motivation; the form of initial contact, duration, termination and intensity of treatment).
The ‘methadone by bus’ project in Amsterdam
Authors: BUNING E. C. , VAN BRUSSEL G. H. A. , VAN SANTEN G.
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.

One of the methadone programmes of the Amsterdam Municipal Health Service is the ‘methadone by bus’ project. Two mobile clinics cruise the city, stopping at six different locations daily. The liquid methadone is consumed on the spot and clean needles and condoms are available. This project is based on the principles of ‘harm‐reduction’, i.e. if it is not (yet) possible to ‘cure’ a hard drug user, one should at least try to minimize the harm they cause to themselves and their environment. As soon as a client refrains from the use of illegal drugs, the client can ‘graduate’ to other methadone programmes with a higher threshold. To prevent double prescription, all Amsterdam methadone programmes participate in the central methadone registration. The Amsterdam Municipal Health Service has contact with over 50% of the drug users. The estimated number of hard drug users has remained stable over the last 5 years, whilst the average age of drug users has increased to 32 years. In the future, increasing the average dosage and the provision of injectable drug users will be discussed to assess their role in further harm reduction.
Is alcohol a carcinogenic risk?
Authors: TURNER CHARLOTTE , ANDERSON PETER
Published: January 2006

Consumption of alcoholic beverages has been implicated as a risk factor for the development of various cancers including oesophageal, oral, pharyngeal, laryngeal, liver and breast cancers. This article is a commentary on an earlier paper entitled ‘Alcohol: a carcinogenic risk? which challenges some of the evidence relating alcoholic beverage consumption to risk for these cancers. In the course of commenting on this paper, evidence is reviewed which shows a relationship between these cancers and consumption of alcoholic beverages, which is often found to be dose‐related.
The definition of dependence and behavioural addictions
Authors: MIELE GLORIA M. , TILLY SARAH M. , FIRST MICHAEL , FRANCES ALLEN
Published: January 2006

DSM‐III‐R and ICD‐10 have incorporated a much broader definition of chemical dependence than was included in DSM‐III. This broader definition no longer requires the presence of tolerance and withdrawal, and places greater emphasis on aspects of compulsive use. Using this broader definition, a number of behavioral syndromes, especially compulsive and impulse disorders, appear to share descriptive similarities with chemical dependence. Although these similarities in overt presentation may reflect underlying similarities in pathogenesis and treatment response, such a non‐specific definition may also obscure important differences. Given the available knowledge, it is unclear if it is more useful to highlight the similarities among chemical dependencies and other behavioral syndromes or to maintain their distinction.
Reply to comments on ‘behavioural (non‐chemical) addictions’
Authors: MARKS ISAAC
Published: January 2006

Behavioural addictions involve routines of dysfunctional and purposeful behaviour. Taxonomy is a program for action and coloured by values. This is obvious in ‘panic disorder’ and may affect the classification of addictions. Biologically minded psychiatrists may attach less weight than do behavioural scientists to overarching similarities across chemical and nonchemical addictive syndromes. There is no foolproof guide to classification, be it response to therapy, aetiology, maintaining mechanism, or phenomenology. Communalities across behavioural and chemical addictions do not exclude potentially important differences among them. Both pharmacological and behavioural interventions may be useful in different cases. Control over an addictive routine is reduced rather than lost and may rise with treatment. Broadening one's repertoire of activities may be preventive and therapeutic. Motivation to change is a multifactorial state that may vary with time and be augmented by therapy; lay organisations can have useful lessons for clinicians. Relevant political influences can be crucial and hard to modify.
Teaching about substance abuse in medical school
Authors: WALLER JULIAN A. , CASEY RICHARD
Published: January 2006

Physicians often fail to diagnose and treat (or treat properly) alcoholism and other chemical dependence in patients. This failure may result from inadequate training, a sense of futility about effectiveness of treatment, belief that this is a social problem rather than disease or denial because the physician him/herself is from a family with substance abuse. A survey of 81 first year medical students identified six (7%) with past or present patterns suggesting abuse of alcohol or other drugs, five (6%) reporting both personal and immediate family abuse patterns, and 25 (31%) who reported such patterns in parents, grandparents or siblings. Students who are adult children of alcoholics (ACOAs) often need emotional support while learning about alcoholism and its treatment. Medical school training about substance abuse must take these needs into consideration and provide services approved by, but insulated from, the dean's office to help students cope with effects of personal or family substance abuse.
Development of a District Training Strategy
Authors: TOBER GILLIAN , RAISTRICK DUNCAN
Published: January 2006

This paper reiterates the need for training in addiction for primary care workers and proposes motivational and structural explanatory frameworks to further our understanding of the difficulties in recruitment of staff from the variety of occupational groups to substance misuse training. This analysis is applied to inform the design and delivery of training locally. The basic tenets of a district training strategy are derived from this analysis and the training strategy for the two Leeds District Health Authorities is described. The strategy is based upon identification of the specific occupational needs of each primary care worker group at each stage of their career, and upon the utilization of available resources to fulfil their training needs in the occupation specific context. The different occupational groups have different roles to play in the prevention and management of substance misuse and the specific skills required will be closely tied into their particular role and based upon pre‐existing skills. The resources for and methods of implementing the strategy are described.
The unofficial history of drug use: a study in a Brazilian sample
Authors: GALDURÓZ JOSÉ CARLOS FERNANDES , MASUR JANDIRA
Published: January 2006

Interviews were conducted with 59 former intensive users of illicit drugs with no evidence of current social or behavioural dysfunction. Data were gathered by in‐depth standardized interviews through which, past and current psychoactive substance use (including alcohol, tobacco and tranquillizers) were assessed. Special attention was given to the subjects' attributions as to what had caused the change in the drug use pattern. Events attributed for ending or substantially decreasing drug use were categorised as follows: ‘physical‐mental problems/disliked side effects’ (27.1% of respondents), ‘developmental/maturational/existential reasons’ (27.1%), formal or informal drug treatment system’ (11.8%), ‘interpersonal reasons’ (10.2%), ‘job or school/performance lowering’ (10.2%), “religious/spiritual involvement” (6.8%), and ‘legal/financial problems’ (6.8%). The major finding was that only 7 out of the 59 respondents (11.8%) reported having ever been in any formal or informal drug treatment system.
Drug use, injecting practices and sexual behaviour of opioid users in Sydney, Australia
Authors: DARKE SHANE , HALL WAYNE , CARLESS JACQUELINE
Published: January 2006

This paper examines drug use, injection practices, and sexual behaviour in a sample of 100 opioid users, both in and out of current opiate treatment. Approximately three‐quarters of subjects reported that they had used more than one illicit substance in the month prior to being interviewed. Needle sharing was common, with 29% of subjects having used a needle in the past month after it had been used by someone else, and 25% having passed on a needle after they had used it. The level of condom use was low, with 66.7% of subjects never having used a condom with their regular partner in the month prior to interview, and 20.7% of subjects who had engaged in sex with a casual partner during this period not having used a condom. Variables which were predictive of HIV risk‐taking behaviour in relation to needle use were poly‐drug use, not being in current treatment, and level of heroin use. Only age was predictive of risky sexual behaviour, with younger subjects being associated with more risk‐taking behaviour. It was concluded that while opiate treatment was associated with lower levels of risky injecting practices, there was no association between treatment and safer sexual practices. Given the importance of sexual transmission of HIV more attention needs to be given to the sexual risk‐taking behaviour of intravenous drug users.