bluuebunny/crossref_metadata_2025 huggingface dataset:
The more problematic drinkers, the more alcohol clients… or not? An ecological study on neighbourhood level
Authors: Bongers Inge , van Oers Hans , Garretsen Henk , van de Goor Ien , Wierdsma André
Published: August 2011

Background: The central issue of this paper is whether the intuitive relation between problematic drinking and seeking professional help holds. To shed light on this issue an ecological study is done in which the relation between different drinking patterns, alcohol‐related harm, and help‐seeking behaviour at the neighbourhood level of Rotterdam, The Netherlands is examined. Two questions are posed:1. Are there geographical differences in drinking patterns, alcohol problems, problem drinking, and number of alcohol clients within the city of Rotterdam?2. Is there a relation between drinking patterns, alcohol‐related harm, and help‐seeking behaviour at the neighbourhood level?Methods: Ecological analyses are conducted based on individual data originating from a survey and person‐based registers. Respondents to the survey were classified as abstainers, light, moderate or excessive drinkers, and were classified as having alcohol‐related problems and/or being a problem drinker. Person‐based registers were used to obtain data on the number of ambulatory and clinical alcohol clients in Rotterdam. The number of ambulatory and clinical clients measured help‐seeking behaviour.Results: The intuitive reasoning that the more problematic drinkers, the more professional help is sought does not stand. No association was found between the number of alcohol clients and the percentage of excessive drinkers and problem drinkers at the neighbourhood level. Large differences between neighbourhoods in prevalence of excessive drinking, alcohol‐related problems and problem drinking were found. The number of alcohol clients, however, varied much less between neighbourhoods. A notable result is that the higher the percentage of abstainers, the lower the number of alcohol clients in a neighbourhood.Discussion: It was concluded that in all neighbourhoods the number of problem drinkers outnumbers those seeking professional help, indicating a friction between need and supply of help with respect to problematic drinking. It is hypothesised that besides drinking behaviour and drinking‐related problems individual, as well as social and cultural factors, play a role in the process of help‐seeking behaviour.
Alcohol screening and brief intervention in primary care: Which way now?
Authors: Hutchings Deborah , Heather Nick , Dallolio Emma , Kaner Eileen , Lock Catherine , Cassidy Paul
Published: August 2011

Excessive alcohol consumption is a major cause of health and social problems in the UK. Research has shown that alcohol‐related problems are responsive to early identification and brief intervention in primary health care. However, primary health care professionals have generally been reluctant to implement alcohol screening and brief intervention into routine practice. Addressing this issue has been the latest focus of an ongoing World Health Organization (WHO) Collaborative Project. The present study (Phase IV) is concerned with the implementation of screening and brief intervention materials and procedures for widespread and routine use in primary health care.
A modified therapeutic community‐based rehabilitation programme for heroin dependence in reformatory school: A follow‐up study
Authors: Zhao Min , Hao Wei , Yang Desen , Xiao Shuiyuan , Li Lingjiang , Zhang Yalin , Chen Weiwen , Ping Li , Deng Kai , Deng Xiaoxiong
Published: August 2011

One hundred and seventy‐eight heroin addicts in reformatory school were sent to one of two rehabilitation treatments: reform through education and labour and therapeutic community (TC)‐based rehabilitation programme. After six months of being discharged, pre‐ and post‐treatment scores on the Addiction Severity Index were compared, and relapse related factors were investigated. Results indicated improvements in both treatments, with the TC‐based rehabilitation programme showing superior improvement overall. Results support the efficacy of the TC‐based rehabilitation programme proving it to be better than reform through labour and education. It is suggested that psychosocial intervention and relapse prevention should be emphasised in the treatment of drug dependence.
The relationship between notifications to the Home Office Addicts Index and deaths of notified addicts
Authors: Corkery John
Published: August 2011

Aims This paper examines (a) the relationship between notifications to the Home Office Addicts Index and deaths of notified addicts, and (b) the survival rates of such addicts.Design and participants Data came from the Home Office Addicts Index covering (a) notifications of opiate and cocaine addicts seeking treatment in the UK between 1966 and 1996, and (b) deaths of notified addicts between 1967 and 1996.Measurement Date of first notification; date of death; numbers of notifications in different times.Findings The proportion of addicts dying compared to the number of new notifications 20 years earlier rose from 2 to 7 in 10 between 1988 and 1993. There is constancy in the relationship between numbers of death and new notifications for up to 10 years before death. The proportion of the cumulative notified population dying between 1985 and 1993 remained consistent at 0.6% or 0.7%. The average length of time between first notification and death increased by six months between 1985‐90 and 1991‐96. Whilst the absolute number of deaths rose between 1984 and 1993, the proportion of newly notified addicts dying each year fell from 2.1% to 0.5%.Conclusions An increase in notifications was directly associated with a proportionate increase in addict deaths. One can expect the number of serious‐end drug users who die to increase with time, especially given the continuing role played by opiates ‐ chiefly heroin and methadone ‐ and increasingly cocaine in drug‐related deaths. At the same time, one can expect such individuals to survive for longer periods than did addicts in past decades.
A model for preparing nurses for the challenge of substance use disorders
Authors: Marcus Marianne , Stafford Linda
Published: August 2011

Substance use disorders are considered to be the nation's number one health problem. These continue to cause more deaths, illnesses, and disabilities than do other preventable health problems, providing ample support for the need for developing health professional competence in this area. This paper describes the specific steps used by The University of Texas‐Houston Health Science Center School of Nursing to infuse substance abuse content into the undergraduate curriculum, design a graduate subspecialty in addictions nursing, and offer continuing education on substance use disorders to nurses in acute care and community settings. The paper provides guidelines for other academic institutions engaged in the important task of increasing nursing competence related to substance use disorders.
The Employee Assistance Program as a model of care for addicted colleagues: Peer Assistance, by nurses for nurses
Authors: Pace Elizabeth
Published: August 2011

In 1983 a group of nurses from the state of Colorado, US, convened to discuss the issues related to substance abuse among their colleagues. The absence of peer support for colleagues experiencing problems with addictions, and regulatory licensure sanction was of serious concern to them. They first determined that nurses themselves should provide services to nurses and students of nursing with substance abuse problems. After a review of the other state efforts, they concurred that the Employee Assistance Program (EAP) offered the comprehensive model of service delivery they envisioned. Originally incorporated in 1984 as NURSES (Nurses United for Recovery, Support and Education Successfully) of Colorado Corporation, this group also viewed the EAP as an important strategy to operationalise professional self‐regulation (Pace, 1990).This paper focuses on employee assistance programming, provided by nurses, as an effective workplace intervention strategy for the identification and referral to treatment of nurses affected by substance abuse and dependence.
Alcoholics Anonymous ‐ encouraging greater professional interest
Authors: Weegmann Martin
Published: August 2011

This paper explores some of the historical tensions between Alcoholics Anonymous (AA) or fellowship groups and the professional world and advocates the need for partnership and healthy dialogue between ideas from different traditions. A case example is presented combining psychotherapy and AA, leading to an elaboration of the concept of narrative and the importance of spiritual or value‐change.
An integrated care pathway for the problem drinker in the community
Authors: Sims John , Iphofen Ron
Published: August 2011

The provision and effectiveness of community‐based treatment packages for people with alcohol misuse problems, has been recognised and highlighted in government policy, most recently by The National Assembly for Wales (2000). Responding to ‘problem drinkers’ within the primary health care setting, is a cost‐effective treatment option. The Specialist Community Alcohol CPN Service, within The North West Wales NHS Trust, is part of the Mental Health & Learning Disabilities Directorate. It is also at the forefront of clinical governance measures and the service strives towards clinical excellence through evidence‐based practice. In a recent survey, it was found that 72% of referrals came from general practitioners (Sims et al., 2002). This integrated care pathway, for the ‘problem drinker in the community’ is designed in an attempt to smooth the referral process. Moreover, it is intended as a way of giving information to referrers, regarding the range of clinical interventions available and raising awareness regarding ‘options for change’ with the service user.
Specialist category essay: Effective strategies for managing alcohol misuse are central to the promotion of health and reducing suicide. Discuss
Authors: Littlejohn Christopher
Published: August 2011

Alcohol misuse is injurious to health, and commonly associated with suicide. However, correlation is not proof of causation: it is valid to consider that social inequalities, such as unemployment and poverty, underlie alcohol misuse, ill health and suicide. Making alcohol misuse strategies central to health promotion and suicide reduction risks a victim‐blaming culture, in which health consequences are viewed as being solely related to an individual's behaviour, ignoring external social conditions; the majority of suicides not related to alcohol misuse being failed by such a policy; and further abdication of political intervention at a societal level.
Cultural aspects of alcohol use (Part 1)
Authors: Purnell Larry , Foster John
Published: August 2011

This is the first of a two‐part article on cultural aspects of alcohol use and includes information on alcohol consumption among Koreans, British, Americans, Jews, Italians, Irish and Hispanics. Drinking practices and customs, like all other lifeways, are culture bound, multi‐faceted, and learned behaviour. People from all ethno‐cultural groups use alcohol in some form, even in those societies where drinking is highly stigmatised or tabooed. Behavioural problems with alcohol misuse are as important as the physiological and psychological variants. There is remarkably little correspondence between the amount of alcohol consumption and behavioural problems encountered when cross‐cultural comparisons of drinking are examined. Learning about cross‐culture comparisons of alcohol use and misuse can have the potential to promote more responsible and sensible drinking behaviour.
Parental substance misuse and its effect on children
Authors: Sims John , Iphofen Ron
Published: August 2011

This article explores the link between adult substance misuse and the effects such behaviour can have on children in their care. The implications for child development are considered. Child protection implications can be far reaching and children's longterm exposure to adult displays of behavioural loss of control can have detrimental effects upon their development. It is argued that parental substance misuse is not however, sufficient warrant to justify the child protection registration of children. This can act as an obstacle to enabling the parents to seek appropriate clinical intervention for their substance misuse problems (Standing Conference on Drug Abuse, 1989, now Drugscope). This article highlights the combined effect of these interactions on the development of children. Rather than an end in itself child protection assessment, with possible registration, should be viewed as a window of opportunity by agencies to respond to the needs of children with a range of possible responses dependent upon how serious the problems are.
Recommended psychosocial interventions for alcohol dependence: lessons in exclusion from the empirically supported treatment literature
Authors: Littlejohn Christopher
Published: August 2011

This year (2003) saw the Health Technology Board for Scotland publish its third Health Technology Assessment Report, entitled Prevention of Relapse in Alcohol Dependence (Slattery et al., 2003). It recommended four evidence‐based psychosocial interventions to be available to NHS patients, and recommended that other psychosocial interventions be avoided. This paper, while welcoming the support for NHS substance misuse services for people experiencing alcohol dependence, addresses the potentially reductionist consequences of such recommendations by making reference to the literature on ‘empirically supported psychological treatments’. Evidence‐based interventions are located within the experimentalist school of psychology, and alternative perspectives within epistemology and psychotherapy are considered. The search for beneficial treatments is concluded to be praiseworthy, however cautions about the privileging of experimental perspectives above all others are made.
Poppycock — opium use in the UK
Authors: Sharifi Hossein
Published: August 2011

While drugs services in the UK are busy with dangerous drugs such as crack and heroin, few are aware of the problems being faced by UK opium users. In this special report Hossein Sharifi uncovers the growing world of opium use in the UK and exposes the lack of appropriate care for this oldest of addictions.
Prejudice against heroin users
Authors: Palfreyman Laura , Moore Natalie , Hodson Gordon , Clark David
Published: August 2011

The first in a series of articles from University of Wales, Swansea on attitudes to drug users and their rehabilitation
Trauma resolution ‐ the key to addiction treatment
Authors: Shults Charley
Published: August 2011

The concept of trauma first came to light as far back as the First World War, when soldiers returned from the battlefield with debilitating shell shock. Things have moved on since then, and trauma is being recognised within the addiction field. Charlie Shults of Life Works, talks about his approach to treatment and argues for a trauma approach to all addiction therapies.
Back in control — putting controlled drinking back on the agenda
Authors: Coldwell Brenda
Published: August 2011

Harm minimisation still gets a rough ride in some circles. In the US, harm minimisation is still seen as a failure among many professionals ‐ where abstinence‐based Alcoholic and Narcotics Anonymous still hold the sway in public and political opinion. But what about the UK? Surely we have a more balanced view and put clients' needs before professional dogma. Not so says Brenda Coldwell. She reveals why some professionals are fighting to get controlled drinking back on the agenda and advocating something the drug treatment field takes for granted ‐ she makes the case for client‐centred alcohol treatment.
GP Contract killing you? Time to call a nurse
Authors: Jacksley Hannah , Dicker Andrew , Coyne Patrick
Published: August 2011

Many GPs still refuse to treat drug users, despite recent incentives and the introduction of the GP contract. Ask why and most will tell you that they fear a lack of appropriate support in treating what they see as an often complex and difficult to treat area. Hannah Jacksley and colleagues believe this can all be overcome by one person — bring on the specialist nurse.
To Russia with love: training nurses in St. Petersburg
Authors: Green Anita , Holloway David
Published: August 2011

Russia has some of the worst drug and alcohol problems in the developed world. Hepatitis and HIV are reaching epidemic proportions, while opium, heroin and amphetamines are causing misery in poverty stricken neighbourhoods. In a country that struggles to pay for many of its public services, those for drug and alcohol users are seriously struggling. In this report Anita Green, programme co‐leader and evaluator, and David Holloway, programme evaluator, explore the special relationship between Russian and British professionals in their bid to improve care for Russia's vulnerable people.
When a push is not a shove: assertive care, Dutch‐style
Authors: Roeg Diana , van de Goor Ien , Garretsen Henk
Published: August 2011

The Dutch are not afraid of getting their hands dirty in order to get things done. Faced with increasing numbers of chaotic drug users with little hope or inclination of contacting services, Dutch treatment services have developed a controversial way of getting normally out‐of‐reach clients into care. Based on a treatment model for care in the community patients, drug and alcohol services are resorting to ‘friendly’ persuasion to get people the help they need. This is a historical perspective on ‘interferential’ care and how it can be applied to treatment in the substance misuse field.
Easy does it: the evidence for slow methadone detoxification
Authors: Thompson Jez , Tiffen Louise
Published: August 2011

In light of the investigation by the General Medical Council on prescribing practices at a well‐respected treatment centre, we present the case for slow detoxification.
Part 5: Approaches to addiction series Series editor: Martin Weegman: Trust me, I'm a client — embracing motivational interviewing
Authors: Kent Rosemary
Published: August 2011

Practitioners working within alcohol and other drug services are often delighted when they ‘discover’ motivational interviewing (MI). Some regard it as confirmation of a style they believe they are using already, while others see it as representing a radically different approach. Whatever the response, no one can argue that MI is one of the most influential developments to hit social care in decades. Rosemary Kent explains why it has had such an impact and describes how it can be applied to almost all areas of support.
Ibogaine ‐ poison or panacea?
Authors: Hayes Gary
Published: August 2011

Ibogaine is hailed as a miracle cure for addictions, with reports of up to 90% effectiveness, while others talk of violent reactions and an increased potential of overdose. In this overview, we look at its potential as a treatment for addictions. We talk to those who administer it and use it and ask why so little research has been carried out in the UK to establish its safety and uncover political and commercial reluctance to investigate its potential.
First and second generation generic Indians on drug use: using cultural norms and yoga in drug prevention
Authors: Kumari Nirmal
Published: August 2011

Services still have a long way to go in attracting and meeting the needs of black and ethnic minority drug users, while messages of health and prevention often go unheard or unheeded. In this new research Nirmal Kumari talks to young and old generic Indians1 to uncover very different perceptions of drug use. Understanding differences is vital to drug prevention and treatment. In this pioneering study, Kumari demonstrates how services can become culturally competent through research and training and by embracing new approaches to health and well‐being. Discover the practicalities of yoga and Ayurdeva in this unique blend of research, practice, mind, body and spirit.
Psycho‐educational approach to addiction — a case study
Authors: Steel Alan , Ritchie Gordon
Published: August 2011

What hope is there for a young, unemployed man with learning disabilities and a lifetime of drug and alcohol problems? For many like this, services can prove reluctant or unhelpful due to a lack of motivation and complex needs. In this unique case study we explore the potential of a psycho‐educational approach to help Mr A increase knowledge and motivation in order to begin to regain control and confidence in his life.
Crack use in Sheffield survey
Authors: Strange Janine , McGauley Alan
Published: August 2011

Sheffield is a high crack area. Tackling Crack: A National Plan identified it as such and several studies have highlighted the problems the area faces (Home Office, 2002; McGauley, 1994; Foers, 2001; Heal, 2002). Though much is being done to address the problem, little is known about who is using what and how. Strange and McGauley uncover a worrying increase in crack use among the homeless and the increasing use of crack among problem alcohol and opiate users.
Making plans for Nigella ‐ the cases for, and against, harm reduction
Authors: Don Lesley
Published: August 2011

Deciding the best course of treatment for a drug or alcohol user can be a complex one. Continuing our look at harm reduction and abstinence, we ask what the best plans are for Nigella, a young woman with mental health problems who uses heroin to prevent recurring self‐harm. In a refreshing and challenging critique Lesley Don explores the decision‐making process towards that treatment. Should Nigella stop her heroin use? If she does, will she self‐harm? Which harm is more desirable? And why, as professionals, do we seek one solution over another?
Bending the wind ‐ psychodynamic approaches to addiction
Authors: Reading Bill
Published: August 2011

Addiction is never a straightforward matter. There are hundreds of models and thousands of commentators. Many models have profound implications on the interventions encountered by people with drug problems. The school of psychodynamics is one such school. It has its own language and its own set of understandings, interventions and theoretical underpinnings. In this, the fifth of our series, Bill Reading outlines some of the defining characteristics of psychodynamic approaches. In this concise summary we look at how the different approaches can be used to good effect in the demanding world of addiction.
Living the high life. The role of drug taking in young people's lives
Authors: Moore Karenza , Miller Steven
Published: August 2011

The vast majority of young drug users see substance use as a positive experience. Why else would they continue to take them? Most research on the other hand pathologises drug use by looking solely at the negative consequences, contributing to the misunderstanding that young people are increasingly self‐indulgent and, in a meaningless world, hell‐bent on self‐destruction. In this refreshing new article Karenza Moore and Steven Miles try to understand the social roles of drug use in the everchanging lives of young people and come up with an alternative view. Rather than seeing drugs as a destructive force, Moore and Miles portray drug‐taking as a stabilising factor in the volatile world of growing up.
The new face of racism and the challenge facing services
Authors: Fernandez Jeff
Published: August 2011

In 2004 we brought you the story of a London PCT's efforts in tackling poor service engagement among Asian groups. The result of local interviews made for uncomfortable reading and the service had to make a number of changes on many fronts ‐ from changing opening times to working outside the medical model. Now a year on, after all the changes, Jeff Fernandez shares his experiences and highlights the dos and don'ts in one of today's biggest challenges ‐ understanding the changing face of racism.
Herbal therapies and substance use
Authors: Dean Angela , McGuire Treasure
Published: August 2011

Herbal medicines are commonly‐used complementary therapies and are available through pharmacies, supermarkets, health food shops, the internet, or from complementary practitioners such as naturopaths.Although many people perceive that herbal products are not ‘medicines’, research shows that herbal medicines have the potential to interact with other medicines or produce side effects, in addition to potential therapeutic effects.
Cracks in the glass: polydrug use in rural areas
Authors: Duffin Michelle
Published: August 2011

We have already looked at the emerging crack and heroin problems in inner cities. But are the polydrug using practices catching on in rural areas? In this special research summary, we expose the spreading taste for crack among heroin and methadone users and uncover the familiar inability of services to cope.
Khat and mental health — a new perspective
Authors: Ajab Aboker , Warsa Nasir
Published: August 2011

There is increasing concern about the physical, social and mental effects of khat in the UK and abroad (Woods, 2005). While the potentially detrimental consequences of khat use on physical health have been documented, its effects on mental health remain poorly understood. Two leading khat researchers question the validity of current research, pointing to a greater need to understand the traumatic experiences of war and immigration.
Institute of Alcohol Studies: the modern face of temperance
Authors: McNeill Andrew
Published: August 2011

Temperance has moved on since the 1800s, though its aims to reduce consumption and related harm haven't. Its biggest influence is in the form of the Institute of Alcohol Studies (IAS). We asked Andrew McNeil, director of IAS to discuss the work of the Institute and to explain its role within the current political and social context.
Between genes and addiction: a critique of genetic determinism
Authors: Reinarman Craig
Published: August 2011

The quest for a genetic component to addiction is promising and its evidence irresistible. But just how resistible? What does it tell us about the condition of heroin addiction or why some people drink to excess and others don't? Writer and academic Craig Reinarman believes that our thirst for the simplicity of determinism is thwarting our understanding of addiction. Here, Reinarman explains why addiction will continue to be a complex and misunderstood phenomenon, with or without genetic research.
Forces of habit ‐ why it is time to reduce the harm of drug prohibition
Authors: Shaftoe Henry
Published: August 2011

Continuing our look at drug policy and crime, we ask just how damaging our current drug laws are? With the ever increasing and expensive fight to stop drug use by force, are we causing more harm than good, and who is paying the price? Henry Shaftoe explains why prohibition is not only dangerous but it may also be responsible for encouraging drug use among the young.
Rural drug misuse ‐ practical responses and lateral thinking
Authors: Stonebridge Anni
Published: August 2011

Living in remote rural areas is a form of social exclusion. Some people travel hundreds of miles to make long awaited treatment appointments ‐ often missing them due to late or non‐existent buses or trains. The challenge is to embrace self‐efficacy with new technology. Anni Stonebridge explores treatment and consultation over the internet.
Towards a comprehensive theory of addiction
Authors: West Robert
Published: August 2011

Why do we behave as we do? The answer most of the time is, ‘because we think it will be in our best interests’. But this isn't always the case. Why? The most obvious reasons are, ‘because we judge it to be morally right’, ‘we put other interests above our own’, ‘we miscalculate’, ‘we act without thinking’ and ‘we lack self‐control’. These answers reflect a number assumptions about human motivation, but how do they explain addiction? Robert West exclusively presents his multilayered theory of addiction.
Opium licensing — rising to the Afghan opium challenge
Authors: Reinert Emmanuel
Published: August 2011

Emmanuel Reinhert investigates why, in a time of severe opium shortage in developing countries, western powers refuse to license Afghan opium.
Addictions without substance series: The conundrums of gambling
Authors: Milton Simon
Published: August 2011

Continuing our series on addiction without substance, Simon Milton explores the misunderstood world of gambling addiction. Using his years of experience as a gambling therapist, Simon discusses the most likely theories for this often problematic behaviour and argues for the best treatment options.
Under threat: patient confidentiality and NHS computing
Authors: Anderson Ross
Published: August 2011

The bedrock of patient and doctor trust is under threat. Government moves to centralise patient records are putting the security of medical records at risk, which in turn is jeopardising patient confidentiality. This is being felt most among those with sensitive medical records such as substance users, young people and those with mental health problems. In a scathing article, Ross Anderson exposes the government's rush to create an unwieldy database at the expense of security. He reveals a deliberate avoidance to seek patient consent and uncovers a worrying exposure of our most intimate details to exploitation by commerce, police and criminals.
Addictions without substance series: Past caring: treating the family and beyond
Authors: Weegmann Martin
Published: August 2011

Addictions without substance editor Martin Weegmann explains why treating a substance user in isolation risks failure ‐ unless family, friends and the wider circle of interested parties are taken into account. Martin outlines well‐tried methods to help the carers of substance users help themselves and in so doing help the user.
Spotlight on services series: Involving service users at the Blenheim Project
Authors: Clarke Michael
Published: August 2011

This edition's spotlight on services tells the story of how two service users got involved with the Blenheim Project, a London‐based programme designed for crack/cocaine users. The Blenheim Project encourages users to get involved with the Project, offering invaluable experience, supervision and support alongside counselling and alternative therapies, day programmes and dropins. After decades of drug addiction, Tim Sampey and Terry Swinton, two former drug users tell Michael Clarke their personal accounts of the chain of events that led to their involvement with the Project.
Confrontation as a form of social support and feedback
Authors: Polcin Douglas
Published: August 2011

Few debates in the addiction field have been more controversial than the harm and benefit of confronting individuals about their substance use. This article reviews recent publications suggesting confrontation in the addiction field has been poorly defined and unfortunately limited to therapist‐client interactions. A definition of confrontation is presented that focuses on potential harm to the individual using substances. The Alcohol and Drug Confrontation Scale (ADCS) is discussed as a broad, comprehensive assessment of confrontation including an examination of individuals' perceptions of confrontational interactions. The preliminary research of individuals' experiences of confrontation in sober living recovery houses indicated that confrontation is often experienced assupportive and accurate. Previously reported findings are elaborated here by specifying implications for practitioners, families/friends, and users of services. Of particular importance is the confronter's ability to recognise when confrontation is counterproductive and to adjust their interactions accordingly.
Detection of the drug impaired driver
Authors: Collier Stephen
Published: August 2011

The problem of driving while under the influence of drugs has been a growing problem for many years. The police service recognised this more than 10 years ago, and has introduced a system of impairment testing to detect the drug impaired driver. Driving under the influence of drugs is detectable and offenders will be prosecuted.
Getting out and staying out
Authors: Berens Jessica
Published: August 2011

The government spends millions of pounds on delivering treatment services to chemically dependent offenders while they are serving sentences for drugrelated crimes ‐ but what happens to those offenders when they leave the prison gate? As RAPt (The Rehabilitation for Addicted Prisoners Trust) bids to raise charitable funds to pay for an aftercare team, Jessica Berens looks at good intentions and practical realities.
Bridging custody to community: the Swansea Community Chaplaincy project
Authors: Emery David
Published: August 2011

Reoffending by prisoners returning to the community is a key driver in crime and prison statistics. The Community Chaplaincy project targeted at the three‐month bridging period has produced promising results in engaging clients, supporting resettlement and promoting rehabilitation. The Spider Assessment System has proved invaluable both as an assessment tool and as a therapeutic instrument, as it is easy to apply, interactive and provides clients a form of self‐expression.
Stop and search or stop and engage?: Factors influencing community—police engagement around drug supply issues
Authors: Fountain Jane , Roy Alastair , Crompton Nicole , Anitha Sundari , Patel Kamlish
Published: August 2011

The police service in London report a commitment to inspiring confidence from, and responding to the needs of black and minority ethnic communities. They are also committed to tackling the supply of crack cocaine and heroin, with which members of the Jamaican and Turkish communities respectively are strongly identified. Members of these communities report concerns about drug supply issues, but are extremely reluctant to co‐operate with the police to address them because they perceive that they are unfairly targeted, particularly by the stop and search strategy. The challenge is to implement a long‐term, community engagement programme with strategic level commitment.
Dual diagnosis: a challenging therapeutic issue of our time
Authors: Askey Jane
Published: August 2011

Dual diagnosis (DD) has become a challenging therapeutic issue of our time. As a substance misuse practitioner, I, like many of my colleagues have often been frustrated with the difficulties that service users face in trying to address their issues, often being bounced between services that are unable to meet their needs. This article looks at some of the challenges that face staff working in both substance misuse services and mental health services as they work to deliver services to a group of service users with multiple and complex needs. It will look at the way in which we define dual diagnosis, the challenges that face both services and service users, how new government guidance could impact upon improved working practice and outcomes in the future and what some of the barriers are to the successful implementation of this guidance.
A project description of Outlook
Authors: Wilson Alison , Paylor Ian
Published: August 2011

The Outlook project based in Manchester offers a range of activities, support and skills training to people over the age of 17 with ongoing or previous drug or alcohol issues. The programme was originally implemented in 2002 in response to identified need for a comprehensive dedicated outreach service to cater for the diverse needs of problematic drug and alcohol users across the east Manchester area (Iredale, 2002). The catchment area for service users has since been extended to include the rest of Manchester city centre (ONS census 2003 estimates that the Manchester city area has a population of approximately 432,400 people).The programme is based on a community model, reaching out especially to ‘hard to reach’ groups of local people in many socially excluded areas of Manchester. The indices of Multiple Deprivation show that Manchester has an exceptionally low ranking position in the North West compared with the rest of the UK when accounting for factors of income, employment, education, health, skills and training, barriers to housing and services, and crime.
Policy forum: The diamorphine shortage: The course, lessons, and implications of the diamorphine ‘shortage’
Authors: Albert Eliot
Published: August 2011

For most of those affected, the entrance into the 18‐month to two‐year long nightmare roller coaster ride precipitated by the onset of the diamorphine ‘shortage’ in late December 2004 was sudden. Alarmingly, as one patient's representative put it, most patients only found out that there was a problem on New Year's Eve of 2004 when they walked in to their pharmacists to make their regular collection of diamorphine ampoules only to be told either that there weren't any, or that supplies were becoming extremely scarce and hard to source.
Solvent use among young Irish adolescents — a growing concern for youth workers, teachers and parents?
Authors: Van Hout Marie , Connor Sean
Published: August 2011

The research aimed to identify ‘(1) current volatile solvent use practices, (2) health beliefs and perceived effects of volatile solvent use, (3) social dynamics of volatile solvent use, (4) significance of reputation, and (5) barriers to volatile solvent use intervention’ in a sample of Irish adolescents (Carroll et al, 1998, p1; Anderson & Loomis, 2003). Semi‐structured interviews were conducted with 20 adolescents who reported inhaling volatile solvents, during the course of doctoral research (n=1,400) investigating substance misuse among adolescents aged 12 to 18 years in Ireland. Their average age was 13.2 years, and they used a range of substances. Solvent users were found to be most commonly congregated in small peer and sibling groups and one young male also reported using alone. These young people indicated their average age of initiation of inhalant use as 10.3 years and most did not use inhalants after the age of 13 years. This coincided with first‐time alcohol use, at an average age of 12.5 years and experimental use of cannabis in some. All reported some awareness of short‐term medical risks involved in solvent use, and most commented on negative effects, such as headaches, dizziness and vomiting. Teachers, probation and juvenile liaison officers, health promotion and drug education workers, youth workers, social workers, and parents should ‘familiarise themselves with the real world experiences of adolescent volatile solvent users’; in order to develop appropriate and timely drug education interventions (Carroll et al, 1998 p6).
Danish drug policy—shifting from liberalism to repression
Authors: Frank Vibeke
Published: August 2011

In the course of the 2000s Denmark has experienced a shift in drug policy in general and of cannabis policy in particular. Danish drug policy used to be known as liberal, but is now saturated with ‘zero‐tolerance’ and ‘tough on crimes’ rhetoric. What happened, and what have the consequences been? This article describes recent changes, focusing on the closing of Pusher Street in Christiania, Copenhagen, one of northern Europe's largest open cannabis markets. This most spectacular outcome can also be seen as a conquered symbol of a former liberal ‐ and for many too lenient ‐ drug policy.
Addressing substance misuse in a medium secure unit
Authors: Owen Rossi , Hughes Paul , Baker Catherine , Chesterman Laurence
Published: August 2011

Individuals diagnosed with severe mental illness have higher rates of alcohol and substance misuse than the general population. This can present the client and the care team with a variety of issues around physical and psychological well‐being, as well as social and occupational functioning. In forensic psychiatry, the effect of comorbid substance misuse on offending behaviour is particularly pertinent. There have, however, been few studies examining the treatment of alcohol and substance misuse within this particular patient group.At a regional secure unit in North Wales, a group for inpatients was set up to provide education on alcohol and substance misuse over a course of six informal meetings, and to then evaluate participants' attitudes towards substance misuse. Of the six participants, five reported that their knowledge of substances had increased, and that they had no intention to use drugs again after discharge. Staff and client participants also suggested useful future topics for the group.
A ‘Latin’ approach to harm reduction: some suggestions from the Italian experience
Authors: Zuffa Grazia
Published: August 2011

Following the example of many northern European countries, harm reduction strategies were introduced in Italy at the beginning of the 90s in response to the spread of HIV/Aids. The peculiarities of Italian culture and tradition led to the adoption of a ‘Latin’ model, while in northern countries the culture of pragmatism and evidence‐based practices, together with a long tradition of public health policy were determinant in promoting harm reduction. In Italy, the ‘social perspective’ on the drug problem adopted by a large part of professionals working in public services and by most non‐governmental organisations (NGOs), has prompted a synergy between ‘cure’ and ‘care’ (ie. treatment and harm reduction), leading to the ‘integration’ of harm reduction and the traditional drug‐free work on addiction. As a result, since the mid 90s, public services and therapeutic communities have been cooperating to build a complex system of low to high threshold facilities. Until the 90s, most NGOs only ran drug‐free programmes in therapeutic communities, but from then onwards many began running harm reduction programmes as well, especially street units and needle exchange programmes, secondary prevention units at rave parties, drop‐in centres, and low‐threshold detoxification centres. Similarly, there has been an increase in methadone maintenance in public services, after the ‘retention in treatment’ of clients was established as the primary objective in the effort to protect users from drug related death and HIV infection. Though harm reduction interventions are far from being fully implemented, data shows that in the past 15 years the harm reduction/treatment system has reduced health risks for drug users and has been instrumental in referring a remarkable number of injecting drug users into treatment programmes. In the mean time, drugs of choice, patterns of use and ways of drug consumption have substantially changed. Now the question is, will the Italian approach be able to address these new challenges?
The social and institutional context of throughcare and aftercare services for prison drug service clients, with a focus on Black and minority ethnic prisoners
Authors: Roy Alastair , Fountain Jane , Anitha Sundari
Published: August 2011

This paper examines the social and institutional context of barriers to drug service throughcare and aftercare for prisoners in England and Wales, including those that specifically affect Black and minority ethnic prisoners. A research project in 2004 reviewed relevant literature and statistical data, mapped prison drug services, and sought the perspectives of relevant stakeholders: in total, 334 individuals were recruited to the study. The methodology facilitates analysis of the structure of services and the agency prisoner in accessing them. Recommendations are made for changes to the structure and delivery of prison drug services.
Alcohol and older people
Authors: Simmill‐Binning Cheryl , Paylor Ian , Wilson Alison
Published: August 2011

This article presents a review of the literature on alcohol and older people, noting that this subject has received very little research attention. In this short review, we offer a synopsis of the physical changes and health problems caused by alcohol use among older people. We then present a typology of drinking in later life, before discussing the findings and shortcomings of recent research knowledge. Reference is also made to the implications for alcohol policy, and solutions around training, health promotion and education are discussed.
The perspectives of drug users within the social context of drug prohibition
Authors: McPhee Iain , Duffy Tim , Martin Colin
Published: August 2011

This study explored the perspectives of low‐level drug market users on the availability, purchase and consumption of illicit drugs within the social context of drug prohibition. A snowballing technique was used to recruit 16 participants consisting of nine males and seven females aged between 17 and 43. A semi‐structured interview process elicited their views on their use of drugs, where they obtained them, their views on the impact of the criminal justice system on their drug use and finally their views on how drug users were perceived by non‐drug users. While some negative consequences of using drugs were reported, no participant considered that their use of drugs made them an addict, a criminal or antisocial. The findings from this study suggest that current punitive drug policy, which links drug use with addiction, crime and antisocial behaviour was inconsistent with the experience of the participants.
Policy forum
Authors: Edwards Griffith , Babor Tom , Darke Shane , Hall Wayne , Marsden John , Miller Peter , West Robert
Published: August 2011

This editorial will contend that the execution of people convicted of drug trafficking and other drug‐related offences is a penalty that should be abolished, as it is both ineffective as a policy measure and abhorrent in terms of human rights violation (Lines, 2007). That conclusion will be offered after due examination of contrary arguments, and with respectful acknowledgement of the fact that different cultures have different beliefs as to what constitutes justice. The editorial will go on to argue that the international addictions science community has a responsibility to support the abolitionist cause ‐ silence cannot be an appropriate response in the face of such continued and irrational judicial killings.
Substance misuse: the relationship between attachment styles, personality traits and coping in drug and non‐drug users
Authors: Davidson Sarah , Ireland Carol
Published: August 2011

This study examined an individual's drug use in relation to their coping styles, personality traits and attachment style. A total of 98 participants (46 females and 52 males) took part in the study. Analysis did not show a significant difference in insecure/ambivalent attachment in the drug‐using group. Yet, there was evidence to suggest that the drug‐using group exhibited higher levels of personality disorder traits, based only on self‐report. Individuals with more personality disorder traits had a more insecure attachment style. Participants who use drugs had a more avoidant coping style. The results are discussed with reference to previous research and the implications of the current research on attachment theory and personality disorder etiology, as well as implications for drug treatment.
Nice people take drugs
Authors: Rubin Claudia
Published: August 2011

Explaining the purpose behind Release's Popular Nice People Take Drugs campaign, this article suggests that drug policy organisations need to engage more widely with the public to generate greater support for policy reform. The stigma currently attached to drug use and drug users stifles debate and prevents constructive discussion taking place about the approach that society should be taking towards drugs.
From Helmand to the high street: a four‐year study to systematically prioritise and map illicit drug markets in Lancashire
Authors: Kirby Stuart , Billsborough Ian , Steele Lisa
Published: August 2011

For local law enforcement agencies, the subject of illicit drugs can appear all‐pervasive. Any multifaceted problem situated in an intrusive media and political environment raises difficult challenges concerning the allocation of resources. This article explores the process behind Lancashire Constabulary's decision to highlight Class A open drug markets as an operational priority, and looks at how a multi‐agency intelligence process, based on geographic mapping methodology (GIS), was initiated to direct enforcement and preventative activity.