bluuebunny/crossref_metadata_2025 huggingface dataset:
Drinking context and other influences on the drinking of 15‐year‐old New Zealanders
Authors: CONNOLLY GARY M. , CASSWELL SALLY , STEWART JOANNA , SILVA PHIL A.
Published: January 2006

This study investigated the influence of the situational characteristics of the drinking setting and a number of parental, personal and demographic variables on adolescents’alcohol use. The sample were 15‐year‐old participants in a multidisciplinary longitudinal study carried out in New Zealand. Measures of alcohol consumption were self reported amount of alcohol consumed on the most recent drinking occasion and amount usually consumed. All of the situational variables investigated had an effect on the amount of alcohol consumed on the most recent occasion. Greater amounts of alcohol were consumed if the alcohol was obtained from peers or by the 15‐year‐olds themselves, if the drink was consumed away from their own home, in the presence of peers only, and during the evening. More money to spend each week and lower SES were also associated with reports of greater alcohol consumption on the most recent drinking occasion. Adolescents with female friends who approved of drinking reported greater amounts of alcohol, the effect of female friends was most marked in the lower amounts reported by males who had female friends that disapproved of drinking. For amount of alcohol usually consumed, reports of larger amounts of alcohol were associated with more money available to spend each week and with lower SES. Furthermore, both males and females reported greater usual amounts if their male friends approved of drinking; female friends’approval was associated with greater amounts of alcohol usually being consumed, this effect was strongest for males. Sixty‐eight per cent of the 15‐year‐olds indicated that they thought they definitely or probably would get drunk in the future.
Drug abuse related emergency room episodes in the United States
Authors: KOPSTEIN ANDREA
Published: January 2006

Drug‐related hospital emergency room cases provide one measure of the morbidity associated with drug abuse. Over time, they indicate if problems associated with particular drugs are increasing or decreasing. These trends may be influenced by a number of factors including increased prevalence of use, increased dosages, increased potency, increased frequency of use, the aging of drug addicts, the use of more dangerous routes of administration, and the combined use of two or more drugs. The primary source of this information in the United Stales is the Drug Abuse Warning Network (DAWN). This paper will present statistics on the drug‐related emergencies reported to the DAWN system for 1989 and 1990. In addition to numbers of drug‐related emergencies, this paper includes the population based rates for drug‐related emergencies in 1990
Effects of a saliva test pipeline procedure on adolescent self‐reported alcohol use
Authors: WAGENAAR ALEXANDER C. , KOMRO KELLI A. , McGOVERN PAUL , WILLIAMS CAROLYN L. , PERRY CHERYL L.
Published: January 2006

Self‐reports on alcohol use collected via school‐based questionnaires, telephone surveys, and household interviews are central measures in many studies in the alcohol field. The validity of such self‐reports remains an issue. Use of biological pipeline procedures is one way in which the quality of self‐reports might be improved. The current study tested the effectiveness of a saliva test pipeline procedure in increasing drinking disclosure rates among adolescents in the sixth and eighth grades. Two sixth‐grade classes from each of 14 elementary schools (n = 828) and four eighth‐grade classes from each of 8 middle schools (n = 754) were selected. Half of the classes in each school were assigned to the pipeline condition and half to the control condition. Each student in the pipeline condition was asked to provide a saliva sample via dental roll before completing a questionnaire that all students (pipeline and control) received. Pipeline students were told that “some of the saliva we collect today will be tested in a laboratory and will provide a biological measure of alcohol use.” Sixth‐ and eighth‐grade students exposed to the alcohol procedure reported 5 to 7% higher alcohol use prevalences than students in the control group. While the pattern of improved reporting tinder the pipeline condition held across four alcohol‐use measures and two grade levels, the effect was statistically significant for only one measure. The pipeline procedures used here had small effects on adolescent self‐reported alcohol use.
A comparison of doctors' practice in notifying addicts to the Home Office and reporting them to the North Western Drug Misuse Database
Authors: MOTT JOY , CADDLE DIANE , DONMALL MICHAEL
Published: January 2006

Doctors have been required to notify named addict patients to the Chief Medical Officer at the Home Office since 1968, and since 1990 have been encouraged to report voluntarily all their drug misusing patients to anonymized NHS regional databases. The North Western Drug Misuse Database, set‐up for research purposes in 1985, was the forerunner of these databases. Compliance by doctors from three North Western District Health Authorities with both data collection systems between 1986 and 1989 was assessed by matching the names of notified addicts with the attributors of individuals reported to the NWDMD as users of notifiable drugs. By 1989 72% of addicts notified were also reported to the NWDMD although doctors working in hospital general departments still tended only to notify them. There was no evidence that particular general practitioners consistently did not notify their addict patients while reporting them to the NWDMD. The findings suggest that it will take some time for doctors to become accustomed to reporting all their drug misusing patients to the regional databases as well as notifying to Home Office those who met the notification criteria.
Brief interventions for alcohol problems: a review
Authors: BIEN THOMAS H. , MILLER WILLIAM R. , TONIGAN J. SCOTT
Published: January 2006

Relatively brief interventions have consistently been found to be effective in reducing alcohol consumption or achieving treatment referral of problem drinkers. To date, the literature includes at least a dozen randomized trials of brief referral or retention procedures, and 32 controlled studies of brief interventions targeting drinking behavior, enrolling over 6000 problem drinkers in both health care and treatment settings across 14 nations. These studies indicate that brief interventions are more effective than no counseling, and often as effective as more extensive treatment. The outcome literature is reviewed, and common motivational elements of effective brief interventions are described. There is encouraging evidence that the course of harmful alcohol use can be effectively altered by well‐designed intervention strategies which are feasible within relatively brief‐contact contexts such as primary health care settings and employee assistance programs. Implications for future research and practice are considered.
Heavy drinking in hospital patients
Authors: SEPPÄ KAIJA , MÄKELÄ RAUNO
Published: January 2006

The study examines the prevalence of high consumption of alcohol among the patients of a large university hospital, and the ability of physicians to detect heavy drinking. According to self‐report, the results of CAGE questionnaire or the physicians' opinion, 25% of the male and 11% of the female patients were heavy drinkers. The physicians identified 43% and 26% of the men and women who screened positively either according to CAGE or self‐report. On the other hand, 17% of the men and 14% of the women who were identified by the physicians as heavy drinkers had a negative screening result. Heavy drinking was most often connected with psychiatric disorders, but it was present in all specialities. A wide range of diagnoses were found among abusers. It is concluded that all patients in all clinics should be asked about their drinking habits instead of relying solely on the physician's instinct or on the patient's self‐report or CAGE. More individual interviews should be done to make possible early intervention in heavy drinking.
Depressive symptoms and DSM‐III‐R alcohol dependence: general population results
Authors: HASIN DEBORAH S. , CLICK HILLARY
Published: January 2006

The Data Notes series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism.

The DSM‐III‐R diagnostic criteria for alcohol dependence differ considerably from older criteria. We examined the association of depressive mood and symptoms with alcohol dependence as defined by DSM‐IH‐R in a national sample of 2627 current drinkers. Depressive mood and symptoms were measured with the Center for Epidemiologic Studies Depression scale (CESD). A significant univariate association between CESD scores and DSM‐III‐R alcohol dependence was confirmed in a multivariate analysis that controlled for demographic characteristics, regular use of drugs, alcohol consumption and recent serious interpersonal loss. Issues in the study of depression and alcohol dependence are considered, and potential future research directions suggested.
Reaching hidden populations of drug users by privileged access interviewers: methodological and practical issues
Authors: GRIFFITHS P. , GOSSOP M. , POWIS B. , STRANG J.
Published: January 2006

The methodological issues surrounding the use of a privileged access interviewer team to generate a network sample of drug users are examined. Traditionally network samples have tended to be used by qualitative researchers. Privileged access interviewing provides a mechanism for the application of a structured instrument to a network sampling model. In doing so some problematic issues in this area for structured methodology are overcome, reduced or standardized. The use of this method is appraised in terms of meeting the methodological requirements of the Drug Transitions study. The practical experiences of our group in using a privileged access interviewer team to interview more than 400 heroin users, many of whom were not in contact with treatment services, are discussed. This method is most appropriate for the quick collection of data, from diverse networks of drug users, by use of a structured instrument. Success is likely to be dependent cm careful implementation. The ongoing monitoring of data quality is of particular importance, as is good management practice and the establishment of supportive and non exploitative relationships with the interviewer team.
Time to alcohol dependence after abstinence and first drink
Authors: BESANCON FRANÇOIS
Published: January 2006

The first relapse into alcohol dependence after abstinence is characterized by sudden immoderate drinking. The time after abstinence to re‐establishing dependence has never been compared to the time taken to establish dependence initially. Thirty one subjects who had been dependent on alcohol, had subsequently been abstinent for at least 2 months, and had had a relapse into dependence were interviewed. The median time to first dependence on alcohol was 13 years (Mean (SD) 14.7 (8) years); median time to dependence when relapsing was 7 days, a 700‐fold acceleration (p < 0.00003). Only three subjects drank for more than 30 days (range 90‐1825 days) before re‐establishing dependence; the average was 82 (330) days overall and 9.3 (8.0) days if these subjects were excluded. Times to initial and subsequent dependence were not correlated nor related to the duration of abstinence (median 9, mean 16.9 (22) months). While abstinent the subjects had felt as if they were healed. It should be emphasized to abstinent patients that alcohol dependence has a latent sequel: they are at risk of accelerated dependence after recurrent drinking, which should be regarded as an emergency.
Comparison of DSM‐III‐R and draft DSM‐IV alcohol abuse and dependence in a general population sample
Authors: GRANT BRIDGET F.
Published: January 2006

The purpose of this Data Note was to compare DSM‐III‐R and Draft DSM‐IV formulations of alcohol use disorders in terms of prevalence and overlap in a representative sample of the United States general population. The prevalence of DSM‐III‐R and DSM‐IV alcohol abuse and dependence combined were strikingly similar, despite discrepancies in the separate component diagnoses of abuse and dependence. The major finding of this study showed a reversal of the abuse‐to‐dependence ratio associated with the DSM‐IV classification. Unlike previous surveys using DSM‐III‐R definitions, the prevalence of DSM‐IV abuse exceeded that of dependence in this general population sample. Reasons for this discrepancy were discussed in terms of the differences in the number and content of abuse and dependence criteria and the relationship between abuse and dependence categories. The need for an explicit statement justifying the changes in the DSM‐IV classification is highlighted.
The tail of the alcohol consumption distribution
Authors: Skog Ole‐Jørgen
Published: January 2006

The consumption containment rate (CCR), proposed by Taylor as a way of characterizing the upper tail of the alcohol consumption distribution, is analyzed and estimated from a collection of data sets from different countries. It is found that CCR curves for different countries are highly different at low consumption levels. However, at high consumption levels, they are remarkably similar across cultures. It is proposed that this may be due to cross‐cultural similarities in heavy drinking careers.
Alcohol and injuries: a review of international emergency room studies
Authors: CHERPITEL CHERYL J.
Published: January 2006

This paper reviews emergency room (ER) studies from a number of countries which have focused nn the association oj alcohol and casualties. The review emphasizes studies which used probability sample of patients to represent the population of the emergency facility where the data were collected, and which separated injured patients from patients with medical conditions not due to injuries (the ‘non‐injured’). Reviewed here are studies concerned with: (1) estimated prevalence of positive blood alcohol at the time of the ER visit; (2) self‐reported alcohol consumption prior to the event resulting in a need for ER treatment; (3) patients' descriptions of their usual drinking patterns and alcohol‐related problems; (4) predictions of casualties and of alcohol'related casualties. Comparisons of findings from several countries are also presented. Comments on limitations of ER studies as well as other issues pertaining to the usefulness and interpretation of such data, and future directions for research in emergency room populations are discussed.
Individual differences in differentiation among alcohol expectancy domains
Authors: FRONE MICHAEL R. , RUSSELL MARCIA , COOPER M. LYNNE
Published: January 2006

Prior research indicates that alcohol‐related outcome expectancies represent important etiological factors in the understanding of alcohol use/abuse. Although current multidimensional measures assess several substantively different domains of alcohol‐related outcome expectancies, there is growing evidence that they may not possess adequate levels of discriminant validity. Therefore, the present study sought to examine whether reliable between‐person differences exist in the ability to differentiate among alcohol expectancy domains. The focus of the study was on three sets of intrapersonal characteristics: cognitive resources, cognitive constraints, and alcohol‐related experience. Data were collected via household interviews with a random sample of 1125 adults. Multiple regression analysis revealed that higher levels of cognitive resources were associated with increasing levels of differentiation among alcohol expectancy domains. Results are discussed in terms of implications for the development of new or revised multidimensional alcohol expectancy questionnaires. Directions for future research are also discussed.
Genes, environment, and addictive behavior: etiology of individual differences and extreme cases
Authors: RENDE RICHARD
Published: January 2006

There is considerable interest in assessing the role of genetic factors in the aetiology of addiction. This paper reviews the possible contribution of a new quantitative technique, termed DF analysis after its originators DeFries & Fulker. DF analysis provides a way of examining whether aetiological factors relating to addiction as a discrete disorder (manifest as extreme scores on a diagnostic instrument) are similar to or different from those that relate to it as a continuum. For example, it is possible to estimate the contribution of familial factors to the development of a clinical condition defined in terms of an extreme score on an instrument by examining the extent of regression towards the unelected population mean of siblings' scores on that instrument. At the same time it is possible to estimate familial influences on the full range of values by examining the correlation between the scores of siblings. Insofar as the two methods produce different estimates, it is possible to infer different levels of involvement of familial factors for extreme cases than for the continuum as a whole. Information provided by such analyses could be critical when constructing models of addictive disorders and help direct more specific studies isolating particular mechanisms.
The formulation of Australia's National Health Policy on Alcohol
Authors: HAWKS DAVID
Published: January 2006

The formulation of a health policy in relation to alcohol is described by the Chairman of the Committee responsible for its drafting in the context of Australia's pursuance of a National Campaign Against Drug Abuse. The fate of particular proposals included in the draft document, but excluded from the final endorsed policy, is discussed in relation to the activities of the alcohol industry and, in particular, the intervention of the Minister for Health in South Australia, Australia's premium wine growing region. Inferences are drawn about the negotiation of public health policy in this area, the role of research and the need to demonstrate widespread public support for the recommendations of such research.
Random breath testing in Australia: getting it to work according to specifications
Authors: HOMEL ROSS
Published: January 2006

After reading the deterrence literature, particularly the work of H. Laurence Ross, I concluded in the late 1970's that many road accidents could be prevented through the whokhearted implementation of random breath testing (RBT). RBT is a system of drink‐drive law enforcement which aims to increase the perceived likelihood of apprehension through the use of mass breath testing techniques at roadblocks which are highly visible, are unpredictable in their locations and give the impression of ubiquity. As the result of public pressure, RBT was introduced in NSW in December 1982, with spectacular results. The law was intensively enforced and extensively advertised, partly due to the advocacy of researchers such as myself, but also because there was an acute political need for instant results. Since RBT is a difficult enforcement technique for police to sustain in effective form, researchers must strive to improve their understanding of what works, and remain in close contact with police, policy makers and politicians. Although this process is costly in terms of time and, possibly, academic ‘pay‐off’, it is essential if the fragile understanding of deterrence principles amongst these groups is not to lead to superficially attractive, but probably ineffective techniques such as low visibility mobile RBT.
Research affects public policy: the case of the legal drinking age in the United States
Authors: WAGENAAR ALEXANDER C.
Published: January 2006

After receiving little attention from 1940 to 1970, minimum‐age laws were a focus of debate and policy change in the United States from 1970 to 1985. In the 1970s, 29 states lowered the legal age, and in the late 1970s and early 1980s, all states with an age below 21 raised the legal age to 21 for all types of alcoholic beverages. Research on the effects of such policy changes were a central component in the political debates on minimum‐age laws. The process by which research results influenced public policy deliberations is discussed. Characteristics that facilitated research results being taken into account in the policy debates included: (1) research of high interval validity that withstood challenge, (2) dissemination of the research results beyond networks of scientists, and (3) participation of bridging individuals who learned of the research results, and condensed and communicated key findings to policy‐makers.
The interaction between research and policy—alcohol and general practice in the United Kingdom
Authors: ANDERSON PETER
Published: January 2006

Research evidence is considered for the effectiveness of screening for alcohol consumption in general practice and for the effectiveness of brief interventions in general practice. Evidence is then considered for the effectiveness of dissemination of brief interventions throughout general practice. The example of dissemination of smoking interventions is used as similar data is not yet available for alcohol. The structure of the UK contract for general practice is discussed and its relationship to research findings considered. Finally, future directions for both research and policy are highlighted.
Behavioural correlates of alcohol intoxication
Authors: NARANJO C. A. , BREMNER K. E.
Published: January 2006

Alcohol is used in most cultures despite knowledge of the physical, psychological and social problems associated with its abuse. Behavioural impairment is a function of several factors, including blood alcohol concentration (BAC) and the rate of alcohol metabolism by alcohol dehydrogenase and the microsomal ethanol‐oxidizing system. Their availability and activity depend upon alcohol use history, ethnicity, other drug use and gender. Adverse social consequences related to alcohol intoxication include impaired driving, acts of aggression and violence towards self and others, and various types of accidents. About 40% of all fatal traffic accidents in Canada and the US in 1986‐1987 were alcohol‐related. Similar statistics have been reported in the UK and Europe (e.g. Sweden). The risk of a fatal car accident increases exponentially with a driver's BAC, prompting recommendations to lower the legal BAC limit for driving and piloting aircraft. Risks of falls, drownings, and fires and bums may also be increased by alcohol intoxication. At least 22% of work‐related accidents may have involved alcohol use. These data are probably conservative estimates as under‐reporting of alcohol use is likely. Alcohol facilitates aggressive behaviours, but it is difficult to separate the pharmacological effect from psychosocial effects or some other common factor (e.g. low CSF levels of the serotonin metabolite 5‐H1AA have been reported in alcoholics, suicide attempters, violent offenders). In addition, alcohol interacts with other drugs to increase or decrease their behavioural and therapeutic effects. An acutely high BAC inhibits the metabolism of other CNS depressants (e.g. benzodiazepines), but long‐term alcohol use increases the metabolism of most drugs. A potential amethystic agent, to block or reverse alcohol's effects, has been identified in preclinical studies (Ro15‐4513, an imidazobenzodiazepine). Some clinical studies indicated that naloxone, lithium, ibuprofen, zimeldine and catecholamine agonists may reduce ethanol‐induced behavioural or cognitive effects but the results have not been consistently replicated. More research is needed to determine the potential clinical use of amethystic agents and other pharmacotherapies in the prevention and treatment of problem behaviours associated with alcohol abuse and intoxication.
Effects on mortality of alcohol consumption, smoking, physical activity, and close personal relationships
Authors: REHM JURGEN , FICHTER MANFRED M. , ELTON MARTIN
Published: January 2006

The study analyses the risks of mortality associated with alcohol consumption and smoking, as well as possible counteracting effects of physical activity and social support through close personal relationships. Data are based on the Upper Bavarian Study, a longitudinal epidemiological study of a representative community sample (n = 1668) in a rural area. Extensive semistructural psychiatric interviews by research physicians were conducted between 1975 and 1977 (n = 1536). Thirteen years after psychiatric assessment, information was obtained from the community register concerning death in the interval, date of death and cause of death according to ICD 9. Tins information could be ascertained for 93.1% (n= 1430) of those who had been interviewed, thus providing a good basis for generalizing the findings. Results indicate that alcohol intake and cigarette smoking increased mortality while physical activity and the availability of a steady partner had protective effects. There were no interactive effects between the four variables studied, except far a dramatically increased risk for women drinking more than 20 ml of pure alcohol a day and reporting no physical exercise at wave one assessment. The relative risks of alcohol intake and smoking, and the counteracting effects of physical activity and partnership, are exemplified in the cases of a 40‐year‐old female and a 40‐year‐old male. Specific analyses of the relationship between alcohol consumption, smoking, physical exercise and personal relationships, on the one hand, and, on the other, different causes of death, are presented.
Attitude of the Norwegian population to drug policy and drug‐offences
Authors: SKRETTING ASTRID
Published: January 2006

A national survey on people's conceptions of various intoxicants and their attitudes towards such substances shows a high degree of support in Norway for the current very restrictive drug policy. Only 6% were in favour of a more liberal practice with regard to use of cannabis. The attitudes had changed little from 1968, when a similar study was carried out. Even a majority of those who reported having used cannabis themselves said that all use should be prohibited. A comparison of the crime of possessing quite a small quantity of cannabis with other commonplace violations of the law showed that the drug offence was considered a serious crime. Although the penalties for drug offences have been raised dramatically several times since the end of the 1960s, a majority still said that the punishment prescribed by the Norwegian law for being involved with drugs is too mild.
Patterns of alcohol consumption: beverage effects on gender differences
Authors: DAWSON DEBORAH A.
Published: January 2006

This Data Note reports findings from 22 102 current drinkers who responded in the US National Interview Survey in 1988. Mean estimated alcohol intake of males exceeded that of females by a factor of two. Males drank more per occasion (ratio 1.45) and drank on more occasions (1.41). Mean ethanol content per drink was slightly less for males (ratio 0.95) attributable to a decreased proportion of drinks being wine and liquor. When beverage preferences were taken into account, the drinking patterns of males and females showed no meaningful differences among persons with similar levels of overall ethanol intake. The results do not support the view that the difference between ethanol consumption of males and females are due primarily to males drinking more per occasion. Apparent differences in drinking patterns are attributable to differences in preferred beverage.
Alcohol dependence—an illness with a treatment?
Authors: CHICK JONATHAN
Published: January 2006

Unlike some countries, Britain may have experienced a rise rather than a fall in alcohol‐related illness during a decade when consumption has not risen. Objections to the “illness concept” may impede our vision and the range of services we develop. It is possible to agree with objectors to the illness concept that a unidimensional view is unhelpful; that explanations are often only attributions; that the construct “illness” is not needed for help to be offered, its use could undermine self‐mastery, and its misuse can breach civil fights. Learning can explain much over‐drinking. However, the concept need not imply bimodality of drinkers; the syndrome of alcohol dependence has uses and does not imply a cause; physical and mental explanations are not incompatible; genetic and biochemical research has promise. Developments in treatment are still limited, but the mysteries of the free‐will dilemma should not prevent us seeing physiological, psychological and social contributants of partners rather than rivals.
Continued risk behaviour among HIV positive drug injectors in London: implications for intervention
Authors: RHODES TIM J. , DONOGHOE MARTIN C. , HUNTER GILLIAN M. , STIMSON GERRY V.
Published: January 2006

Findings are reported on the risk behaviour of 104 confirmed HIV‐1 antibody positive drug injectors in London. Findings indicate that 41.3% of respondents had never received treatment or help for their drug use, and that 52.0% had never received a named test for HIV antibodies. The majority of confirmed HIV positive respondents (70.1%) were unaware of their HIV positive status. Respondents unaware of their HIV positive status were less likely to use condoms with primary sexual partners than respondents aware of their HIV status, and were marginally (though not significantly) more likely to report borrowing and lending used injecting equipment. Overall levels of risk‐taking were similar to those reported in UK studies of injecting drug use as a whole. The paper concludes by emphasising the high potential for HIV transmission among the equipment sharing and sexual partners of HIV positive drug injectors and by stressing the importance of low‐threshold HIV testing, education and treatment interventions in the community. If significant proportions of HIV positive drug injectors remain unaware of their antibody status, and if they also continue to engage in behaviours of risk to others, the spread of HIV among drug injectors and their partners may escape current efforts of prevention and prevalence control.
A preliminary survey of Italian intravenous heroin users in London
Authors: LIPSSEDGE MAURICE , DIANIN GIANNI , DUCKWORTH EBLISH
Published: January 2006

The present study analyses the phenomenon of the migration to London of Italian intravenous drug users. Using structured questionnaires and prevalence data it was estimated that a significant number of Italian intravenous drug users (at least 1000) were living in London at the time of the study (1990), of whom 30% were HIV positive. Risk‐taking behaviour was disturbingly high. The reasons for migrating were identified, and the implications of recent Italian legislation are briefly discussed. The data indicated that the living conditions of these immigrants in London were precarious and that these vulnerable individuals had little access to services. As the barriers to travel within the European Community disappear, the public health problems represented by the migration of problem‐drug users are likely to become more acute.
Characteristics of men with alcoholic hallucinosis
Authors: TSUANG JOHN W. , IRWIN MICHAEL R. , SMITH TOM L. , SCHUCKIT MARC A.
Published: January 2006

The goal of this study was to evaluate the characteristics of primary alcoholics with alcoholic hallucinosis. Six hundred and forty‐three primary alcoholic men were recruited from a 28‐day Alcohol and Drug Treatment Program at the San Diego VA Medical Center. Subjects only experiencing perceptual abnormalities during alcohol withdrawal, drug‐related hallucinosis, as well as those having abnormal sensations that did not meet criteria for hallucinations were excluded from the present study. The remaining 532 subjects were divided into Group 1 {n =48}, which consisted of subjects with a DSM‐HIR and ICD‐10 diagnosis of alcoholic hallucinosis, and Group 2 (n –484) which consisted of those without any history of hallucinations. A comparison of the two groups revealed that Group 1 men were younger at the onset of alcohol problems, consumed more alcohol per occasion, developed more alcohol‐related life problems, and had higher rates of drug experimentation as well as more different types of drugs used. This study suggests that primary alcoholics who consume more drugs and/or alcohol might be at an increased risk for developing alcoholic hallucinosis.
The measurement of alcohol dependence and impaired control in community samples
Authors: STOCKWELL TIM , SITHARTHAN THIAGARAJAN , McGRATH DAVID , LANG ERNIE
Published: January 2006

The concept of the Alcohol Dependence Syndrome has been influential in the field of alcohol studies in the 1980s. The Severity of Alcohol Dependence Questionnaire (SADQ) is one of a generation of alcohol problem scales developed to measure degree of dependence rather than presence or absence of‘alcoholism’. This paper describes the development of a form of the SADQ for community samples of drinkers (SADQ‐C) and its relationship to a brief scale designed to measure impaired control over drinking. In a sample of 52 problem drinkers, SADQ and SADQ‐C correlated almost perfectly (r = 0.98). In a larger sample of 197 attenders at a controlled drinking clinic, Principal Components Analysis revealed one major factor accounting for 71.7% of the total variance. High internal reliability was indicated with a Cronbach's Alpha of 0.98. Application of this instrument in a random survey of Western Australian households is then described. It was necessary to remove items relating to‘reinstatement of dependence’for this sample. A single major factor was identified by principal components analysis, accounting for 69.1% of the total variance. In both the clinic and the community samples SADQ‐C scores correlated highly with Impairment of Control scores. The findings are interpreted as supporting the view that there is a single dimension of alcohol dependence upon which all persons who drink alcohol with any regularity may be located.
Longitudinal changes in injection behaviors in a cohort of injection drug users
Authors: SAXON ANDREW J. , CALSYN DONALD A. , JACKSON T. RONALD
Published: January 2006

To determine haw the injecting behaviors of injection drug users (IDUs) change over time in the context of the epidemic of acquired immunodeficiency syndrome (AIDS) and what factors may be associated with such changes, a cohort of IDUs (n = 313) initially in treatment provided structured interviews regarding drug injecting behaviors. Repeat interviews in 18 months assessed behavior change in subjects who could be contacted for follow‐up (n = 220, 70.3%). The study occurred in a state where sterile syringes can be purchased without prescription in drug stores. Injection drug use occurred for 180 (81.8%) of the 220 subjects in the 12 months prior to the initial interview but in only 121 (55.0%) in the 10 months prior to the follow‐up interview (p < 0.0001). Similarly, sharing of equipment decreased from 63.1% to 31.8% (p < 0.0001). Sharing with multiple partners declined from 41.9% to 10.6% (P < 0.0001). Factors associated with ongoing risk included use of injected and non‐injected psychoactive substances, less time in drug dependence treatment during follow‐up interval, having a sexual partner who was an IDU and not using a drug store as the primary source of syringes. Factors associated with multiple‐partner sharing included use of psychoactive substances, younger age and nonwhite race.
Retention in methadone maintenance and heroin addicts’risk of death
Authors: CAPLEHORN JOHN R. M. , DALTON M. STELLA Y. N. , CLUFF MARGARET C. , PETRENAS ANN‐MARIE
Published: January 2006

A long‐term follow‐up was made of a cohort of 307 heroin addicts admitted into a high‐dose, Australian methadone maintenance programme in the early 1970s. Using data from clinic records, official death records and methadone treatment histories, it was found that subjects were nearly three times as likely to die outside of methadone maintenance as in it (95% CI RR 1.45 to 5.61). Data were further analyzed using Cox regression to investigate the association of maximum daily methadone dose and a change in clinic policy with retention in maintenance treatment. It is estimated that subjects given a maximum daily dose of 80 mg were nearly twice as likely to be discharged during the first three years of maintenance as those given 120 mg (95% CI RR 1.3 to 2.2). The estimated median time in maintenance for subjects given a maximum dose of 120 mg mas 1150 days while for 80 mg it was 660 days. It is further estimated that the change in clime policy from abstinence to indefinite maintenance reduced to one‐third subjects’risk of leaving after three years’of treatment (95% CI RR 0.19 to 0.54). It is concluded that, in order to minimise heroin addicts’risk of death, they should be offered indefinite, high‐dose methadone maintenance.
Naloxone‐induced withdrawal in patients with buprenorphine dependence
Authors: NIGAM ANIL K. , SRIVASTAVA R. P. , SAXENA SHEKHAR , CHAVAN B. S. , SUNDARAM K. R.
Published: January 2006

Naloxone‐induced withdrawal was studied in seven patients currently dependent only on injecting buprenorphine, within 3 to 6 hours of their last dose. Withdrawal severity began to rise from 5 minutes and reached a peak at 60 minutes after 1.2 mg naloxone given intravenously. The mean withdrawal severity score was significantly higher at 30, 60 and 90 minutes compared to the baseline. The most frequent withdrawal signs and symptoms were mydriasis, systolic hypertension, tachypnoea, muscle pains, yawning, anxiety, restlessness and craving.
Consumption indicators of alcohol dependence
Authors: DAWSON DEBORAH A.
Published: January 2006

This Data Note evaluates various dichotomous measures of alcohol consumption as screeners for past‐year alcohol dependence. The analysis is based on data from 22 102 current drinkers interviewed in the 1988 US National Health Interview Survey. The consumption indicators include measures of average daily intake, frequency of heavy drinking, usual quantity and frequency of drinking and various combinations of these measures. The measures based on frequency of heavy drinking are the most strongly correlated with dependence, but none of the consumption indicators have the sensitivity or specificity of screeners based on alcohol‐related problems. Most of the consumption items considered in this analysis screen for dependence more successfully among men than among women.
Risk factors for HIV–1 seroprevalence among drug injectors in the cocaine–using environment of Rio de Janeiro
Authors: LIMA ELSON S. , FRIEDMAN SAMUEL R. , BASTOS FRANCISCO I. , TELLES PAULO R. , FRIEDMANN PATRICIA , WARD THOMAS P. , JARLAIS DON C. DES
Published: January 2006

To determine risk factors for HIV–1 among drug injectors in Rio de Janeiro, where cocaine is the dominant drug of injection, subjects were recruited using the criteria and interview instrument of the World Health Organization's Cross–National Study of HIV infection and risk behaviour in injecting drug users. HIV antibody test results were derived both from serum tests and from self–reports of previous tests (documented evidence of self–reported seropositivity was required). The analytical sample consists of 123 subjects, recruited both at drug abuse treatment sites and at street locations. Of 27 subjects with both serological and self–reported antibody status data, 20 reported previous negative tests; of these three had positive sera and may have seroconverted. Seven subjects reporting prior positive serostatus all tested positive. For the 123 subjects, seroprevalence was 34%. Independent significant risk factors in multivariate logistic regression with backwards elimination are: years of injection greater than 5; being a male who has had sex with men in the previous 5 years; and not having taken deliberate steps to protect oneself against AIDS. These findings indicate that homosexual/bisexual male drug injectors may be a bridge group through which HIV is entering drug–injecting networks in Rio de Janeiro. Efforts by drug injectors to reduce their risk of infection seem to have protective effects. This underscores the importance of HIV prevention efforts aimed at drug injectors.
Exposure to hepatitis B and C and to HTLV‐1 and 2 among Israeli drug abusers in Jerusalem
Authors: MAAYAN S. , SHUFMAN E. N. , ENGELHARD D. , SHOUVAL D.
Published: January 2006

The incidence of exposure to hepatitis B (HBV) and C (HCV) viruses and to that of HTLV 1 and 2 were investigated in a group of 181 illicit drug users attending a drug rehabilitation centre in Jerusalem. In this predominantly male group, 28% were intravenous drug abusers (IVDAs) and 72% non‐IVDAs; 92% of the individuals were of Middle Eastern descent (of which 40% were of a Moroccan descent). Antibodies to hepatitis C virus (anti‐HCV) were found in 54% of the IVDAs compared with 4.5% in the non‐IVDAs (p < 0.001), indicating the presence of a significant reservoir of HCV among this IVDA group. Evidence for previous hepatitis B (HBV) infection was found in 26% of the IVDAs and 33% of the non‐IVDAs (p = NS) with no HbSAg positivity. The similar prevalence of previous HBV infection in both drug abuser groups, which was also observed when the groups were analysed according to their ethnic origin, suggests that a vertical transmission of HBV rather than an exclusive association with intravenous drug abuse may have been the source of exposure to HBV. HTLV‐1 rates were 2% among IVDAs and 0% among non‐IVDAs (p = NS). No serologic evidence for HTLV‐2 was detected in this cohort. The present study supports previous observations in other countries and indicates the exceptionally high prevalence of HCV infection among Israeli i.v. drug abusers. It also suggests that using HBV seropositivity as an indicator for needle exchange among drug abusers may be of limited value in geographic areas where vertical transmission of HBV is common. HCV antibodies might become more suitable markers for this purpose.
The relationship between cocaine‐induced paranoia and compulsive foraging: a preliminary report
Authors: ROSSE RICHARD B. , FAY‐MCCARTHY MAUREEN , COLLINS JOSEPH P. , ALIM TANYA N. , DEUTSCH STEPHEN I.
Published: January 2006

Two prominent behavioral syndromes associated with chronic cocaine use that have been described in the literature are cocaine‐induced paranoia (CIP) and cocaine‐induced compulsive foraging (CICF) for cocaine. To help to clarify the relationship between the two cocaine‐induced syndromes, the concordance and sequence of onset of the two cocaine‐induced behaviors over the course of the patients' lifetime use of cocaine and during the course of a binge was examined in 62 crack cocaine‐dependent men. Winy‐four (54.8%) reported experiencing both CIP and CICF. In 18 (29%) of the patients, only one of these cocaine‐induced behavioral syndromes was reported. Ten (16.1%) of the subjects reported neither CIP nor CICF. Patterns of cocaine or other substance use and degrees of tolerance to cocaine were not significantly different between the groups endorsing different patterns of cocaine‐induced behaviors. CIP typically preceded the onset of CICF both over the course of the patients' lifetime use of cocaine and over the course of a binge. The study results suggest varying thresholds for the expression of these behaviors in chronic cocaine‐abusing individuals.
Lifetime DSM‐IV diagnosis of alcohol, cannabis, cocaine and opiate dependence: six‐month reliability in a multi‐site clinical sample
Authors: LANGENBUCHER JAMES , MORGENSTERN JON , LABOUVIE ERICH , NATHAN PETER E.
Published: January 2006

Psychiatric research increasingly emphasizes the diagnosis of symptoms and syndromes on a longitudinal basis. This study tests the reliability of lifetime DSM‐IV diagnoses of alcohol, cannabis, cocaine and opiate dependence. The CIDI‐SAM was administered at intervals not less than six months apart to a multi‐site sample of 201 clinical respondents. The reliability of lifetime diagnosis of the syndromes, of the criteria which constitute the syndromes, and of the ages of onset reported for the criteria and for the dependence syndromes as a whole, were studied and the effects of patient characteristics suspected to degrade reliability were examined. There was generally good agreement, statistically, at both the syndrome and criterion level between the two interviews. Lifetime diagnoses for three of the drugs–alcohol, cannabis and opiates–were made at or near levels of agreement generally considered excellent under less strict testing conditions, and cocaine dependence was only marginally below this level. Most criteria showed good reliability and all delivered about equal results when averaged across the four substances, although a relationship between reliability and centrality of the symptom to the individual drug abuse pattern was found. Age of onset was almost uniformly highly reliable. Most patient characteristics bore no detectable relationship to reliability, although patients with multiple drug use patterns may warrant more careful probing by interviewers. Overall, these data indicate that lifetime symptoms and diagnoses can be queried reliably, although they must be reported with less confidence than current slate diagnoses.
Alcohol dependence criteria in DSM‐III‐R: presence of symptoms according to degree of severity
Authors: ANDREATINI ROBERTO , GALDURÓZ JOSÉ CARLOS FERNANDES , FERRI CLEUSA PINHEIRO , DE SOUZA FORMIGONI MARIA LÚCIA OLIVEIRA
Published: January 2006

According to DSM‐III‐R a positive diagnosis of alcohol dependence requires the presence of at least three of nine symptoms of a core dependence syndrome. In this study the presence of the nine symptoms according to degree of the severity of dependence is examined in 99 patients (mild, n=23; moderate, n = 26; and severe, n = 50). It is shown that although the cut‐off point far a positive diagnosis of dependence is the presence of “any three” out of nine DSM‐III‐R criteria, specific symptoms (“excessive drinking”, “desire or efforts to control drinking”, and “drinking despite major problems”) have a high probability of occurrence across the dependence seventy range (mild, moderate or severe). Conversely, other symptoms appear prominently only in the more were cases (“much time devoted to alcohol”, “important activities given up”, and “drinking to relieve withdrawal”). The results suggest that in the DSM‐III‐R criteria for alcohol dependence name symptoms are mare frequently associated with the diagnosis, white other symptoms are associated with seventy of the alcohol dependence disorder.