bluuebunny/crossref_metadata_2025 huggingface dataset:
Opinions of non‐pregnant New Zealand women aged 16–40 years about the safety of alcohol consumption during pregnancy
Authors: PARACKAL SHERLY M. , PARACKAL MATHEW K. , HARRAWAY JOHN A. , FERGUSON ELAINE L.
Published: August 2010

Introduction and Aims. Premenopausal women's opinions on the safety of alcohol consumption during pregnancy are not well documented. This study aims to assess the opinions of New Zealand women on the safety of alcohol consumption in pregnancy and the sociodemographic and lifestyle factors associated with these opinions. Design and Methods. A nationwide, cross‐sectional survey was conducted in 2005 on a random sample of 1109 non‐pregnant women aged 16–40 years. Data were collected via an interviewer‐administered questionnaire using a web‐assisted telephone interviewing system. Results. Overall, 44% (95% confidence interval 41–47) of women surveyed were of the opinion that no alcohol is safe in pregnancy. Those who stated that no alcohol is safe in pregnancy were more likely to be of Pacific Island ethnicity (P < 0.05) and abstainers (P < 0.001). Women who drank more than two standard drinks of alcohol on a typical occasion and/or who binged were more likely to be of the opinion that ‘more than one standard drink’ of alcohol is safe on a typical drinking day during pregnancy (P < 0.001). Discussion and Conclusions. The association of drinking style with opinions about the safety of alcohol consumption in pregnancy accentuates the need for public health education to reduce risky drinking behaviours in this population. Such efforts may also address the risk associated with many women unintentionally drinking in early pregnancy, especially if the pregnancy is unplanned.[Parackal SM, Parackal MK, Harraway JA, Ferguson EL. Opinions of non‐pregnant New Zealand women aged 16–40 years about the safety of alcohol consumption during pregnancy. Drug Alcohol Rev 2009]
The impact of more visible standard drink labelling on youth alcohol consumption: Helping young people drink (ir)responsibly?
Authors: JONES SANDRA C. , GREGORY PARRI
Published: August 2010

Introduction and Aims. In response to increasing concerns about excessive drinking among young people the Australian alcohol industry announced that it will introduce more visible standard drink labels. This study sought to examine whether young people use this information in a way that decreases, or increases, alcohol‐related harms. Design and Methods. Six focus groups with students enrolled in an undergraduate university course in a large regional city in New South Wales, recruited by direct approach on the university grounds and via an online message posted on the university bulletin board. Results: The majority of the participants reported that they are aware of the existence of standard drink labelling; notice standard drink labels; and take these into account when choosing what to purchase. However, this was predominantly to help them choose the strongest drinks for the lowest cost. Discussion and Conclusions. This study provides initial evidence to support the view that standard drink labelling, in isolation of other modifications to product packaging and marketing, is likely to serve to further increase heavy drinking among young people.[Jones SC, Gregory P. The impact of more visible standard drink labelling on youth alcohol consumption: Helping young people drink (ir)responsibly? Drug Alcohol Rev 2009]
Comorbidity of mental disorders and alcohol‐ and drug‐use disorders: Analysis of New South Wales inpatient data
Authors: XIONG LAI HARRY MAN , HUANG QI RONG
Published: August 2010

Introduction and Aims. Alcohol‐ and other drug‐use disorders have been found to be associated with mental disorders, however, complete characteristics of these comorbid mental disorders are not completely clear in early population based studies. This study aimed to explore the extent and profiles of comorbid mental disorders with alcohol‐ and other drug‐use disorders using a large inpatient dataset. Methods. The data source was the New South Wales (NSW) Inpatient Statistic Data Collection which collects the clinical data of hospital admissions in NSW, Australia. The data were coded using the International Classification of Diseases—10th Revision (ICD‐10). The data were from 1 July 2005 to 30 June 2006 the Australian financial year and statistical analysis was performed using SAS. Results. Of 1 592 156 patients admitted, 91 510 (6%) had at least one mental disorder diagnosis and 18 283 (1.1%) had at least one alcohol‐ or other drug‐related diagnosis. Of these patients, an overall 9.6% had dual diagnoses. Comorbidity was nearly five times higher in alcohol‐ and other drug‐use disorders than in mental health disorders (52.4% vs. 10.5%). Comorbidity was higher in males than females (12% vs. 7.1%) and was the most common in patients aged from 20 to 49 regardless of sex. There was a significantly increased risk of developing a comorbid condition in all age groups above 10 years. The most common mental health disorders were major depressive disorders, followed by dementia, anxiety and severe stress. Alcohol‐use disorder was the most common diagnosis, followed by cannabis and opioids. Discussion and Conclusion. This study shows the characteristics of comorbid mental and alcohol‐ or other drug‐use disorders. The study extends our understanding of issues addressed in previous population studies.[Lai HMX, Huang QR. Comorbidity of mental disorders and alcohol‐ and drug‐use disorders: Analysis of New South Wales inpatient data. Drug Alcohol Rev 2009]
Hormones and drinking behaviour: New findings on ghrelin, insulin, leptin and volume‐regulating hormones. An ESBRA Symposium report
Authors: ADDOLORATO GIOVANNI , LEGGIO LORENZO , HILLEMACHER THOMAS , KRAUS THOMAS , JERLHAG ELISABET , BLEICH STEFAN
Published: August 2010

There is growing evidence for a role of appetite‐related peptides and volume‐regulating hormones in alcoholism. In particular, recent evidence has suggested that hormones, such as ghrelin, insulin and leptin and volume‐regulating hormones, could play a role in alcohol‐seeking behaviour. The goal of this review is to discuss the results of recent preclinical and clinical investigations on this topic. The findings indicate that neuroendocrinological mechanisms are potentially involved in the neurobiology of alcohol craving. Accordingly, research on this topic could lead to possible development of new therapeutic approaches in the treatment of patients with alcohol problems. [Addolorato G, Leggio L, Hillemacher T, Kraus T, Jerlhag E, Bleich S. Hormones and drinking behaviour: New findings on ghrelin, insulin, leptin and volume‐regulating hormones. An ESBRA Symposium report.Drug Alcohol Rev2009]
1985 and all that: The establishment of Australia's Drug Strategy
Authors: BLEWETT NEAL
Published: August 2010

A national drug summit in the mid‐1980s played a pivotal role in the establishment of Australia's National Drug Strategy. It transformed the delivery of drug policies in Australia and gave us the instruments to understand our drug problem, namely national Centres of Excellence, including the National Drug Research Institute. This paper examines how a ‘bundle of compromises’ came together in the political context of the mid‐1980s to give rise to, for the first time, a cooperative national campaign that continues to drive Australia's drug strategy today.[Blewett N. 1985 and all that: The establishment of Australia's Drug Strategy. Drug Alcohol Rev 2009;28:96–98]
Current challenges faced by efforts to prevent alcohol and other drug problems: Lessons from science‐to‐practice
Authors: HOLDER HAROLD D.
Published: August 2010

This paper identifies unresolved contemporary challenges for alcohol and other drug prevention including: (i) the perspective held by researchers and practitioners which guides prevention; (ii) the value of respectful partnerships of research and practice in prevention; (iii) the need for effective and practical research designs; and (iv) the means to institutionalise effective prevention efforts, especially at the community level. These challenges will need to be addressed now and in the future to improve prevention in the 21st century.[Holder HD. Current challenges faced by efforts to prevent alcohol and other drug problems: Lessons from science‐to‐practice.Drug Alcohol Rev2009;28:99–102]
Challenges in reducing cannabis‐related harm in Australia
Authors: HALL WAYNE D.
Published: August 2010

This paper outlines the major policy challenges in reducing cannabis‐related harm in Australia. The first is uncertainty about the health effects of cannabis, especially in young people. The second is uncertainty about the extent and severity of harms attributed to cannabis prohibition by its critics. The paper summarises and briefly states the extent of these putative harms to the degree that the data allow. The third challenge is a consequence of the first two, and the very different weightings that proponents of more liberal or restrictive policies give to harms arising from cannabis use and those arising from prohibition, namely, strong disagreements within the community about how we should respond to cannabis use by young people. In the face of such disagreement the formulation of cannabis policy necessitates a political compromise. The compromise that has emerged is a continued prohibition of cannabis production, sale and use, combined with either civil penalties for use in some states and reduced penalties or diversion in others. It concludes with suggestions about what needs to be learned about the health effects of cannabis use and the costs and benefits of cannabis prohibition if we are to develop policies that are more effective in reducing harms caused by cannabis use.[Hall WD. Challenges in reducing cannabis‐related harm in Australia. Drug Alcohol Rev 2009;28:110–116]
Views of Australian mental health stakeholders on clients' problematic drug and alcohol use
Authors: CLEARY MICHELLE , HUNT GLENN E. , MATHESON SANDRA , WALTER GARRY
Published: August 2010

Introduction and Aims. Substance misuse by people with a serious mental illness may exacerbate psychiatric symptoms and contribute to relapse. The aim of the study was to ascertain the views of a wide range of Australian mental health service providers on staff education and training, client contact and management, assessment, and treatment effectiveness and service delivery. Design and Methods. A survey was sent to a sample of 171 mental health stakeholders in Australia identified through internet searches, state and territory mental health departments and professional organisations. Results. Of the 66 respondents (39% response rate), the substances identified to be most problematic were alcohol and cannabis. Integrated service models of treatment were identified as the most preferable and effective. Barriers to treatment included client motivation to reduce substance use, poor communication and coordination between treatment services, and lack of specific services for dual diagnosis clients. Almost all indicated a need for further training in the area of dual diagnosis. Discussion and Conclusions. Dual diagnosis is common and the reality is that this vulnerable clientele will continue to challenge service providers and treatment approaches into the foreseeable future. Issues include the organization and delivery of treatment services, education and training, resource allocation, collaboration between treatment agencies and clinically relevant research evaluating the effectiveness of practice. It is thus surprising that with so much investment in this area the majority of stakeholders are still dissatisfied with access to and the level of care for dual diagnosis clients.[Cleary M, Hunt GE, Matheson S, Walter G. Views of Australian mental health stakeholders on clients' problematic drug and alcohol use. Drug Alcohol Rev 2009;28:122–128]
A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995–2005
Authors: DÉGI CSABA L.
Published: August 2010

Issues. A tremendous growth occurred in the reported drug use and abuse in Romania from 1995 to 1999. Lack of concern by government and little policy attention contributed to the surprising delay of drug policy and drug prevention system development. General public stigmatize drug users and drug consumption is considered a matter of personal fault and responsibility. There is some but not sufficient research and evaluation on drug use, abuse problem. Approach. Drug use, abuse and prevention are discussed from research‐based, user‐focused and prevention system development perspectives. Prevalence and trends of drug use, abuse in the past decade (1995–2005) are summarized. Prevention issues are discussed based on research data from adolescents, parents and teachers. The Romanian primary drug prevention system has been evaluated based on our experiences in drug use prevention activities carried out in schools and recreational environments. Key Findings. Public and scientific perspectives on drug consumption in Romania, between 1995 and 1999, were dominated by an idealistic, non‐realistic perception. Since 1995, drug use among adolescents increased almost four times in less than 4 years. The first law against drug traffic and consumption was issued only in 2000. Now primary drug prevention strategies are in action, but in general they are lacking standard evaluation procedures. Implications/Conclusion. Conclusions are drafted for new perspectives in prevention activities. More long‐term, user‐focused, demand‐centred prevention activities should be carried out in more and more diversified settings and evaluation should be thoroughly considered.[Dégi CL. A review of drug prevention system development in Romania and its impact on youth drug consumption trends, 1995–2005. Drug Alcohol Rev 2009;28:419–425]
Complementary and alternative medicine in the treatment of substance use disorders—a review of the evidence
Authors: BEHERE RISHIKESH V. , MURALIDHARAN KESAVAN , BENEGAL VIVEK
Published: August 2010

Issues.Substance use disorders are chronic relapsing disorders, leading to significant impairment in psychosocial functioning. Conventional therapies have not been able to alter the outcome of these disorders significantly and frequent relapses continue to occur, despite the development of newer medications, like baclofen, ondansetron, etc. Hence, there is a need to look at complementary and alternate systems of medicine.Approach.This article is a review of the evidence for complementary and alternate systems of medicine in substance use disorders. Articles were searched using the Medical Subject Headings (MeSH) database of the PubMed search engine and further non‐indexed information was obtained from the Google search engine. The article is organised in parts, each reviewing a different system of medicine in the following order—alternate medical systems, biologically based therapies, energy‐based interventions and mind–body interventions; as classified by the National Center for Complementary and Alternative Medicine, National Institutes of Health, USA.Key Findings.The currently available evidence is limited and not very encouraging. At present only acupuncture, herbal therapies and mind–body interventions have shown some positive results in human trials and hold promise for the future.Implications.This review emphasises the paucity of research into this important field especially the lack of rigorous human trials.Conclusion.More systematic studies are required before these systems of medicine can be widely recommended in the treatment of substance use disorders.[Behere RV, Muralidharan K, Benegal V. Complementary and alternative medicine in the treatment of substance use disorders—a review of the evidence.Drug Alcohol Rev2009]
Improved response by peers after witnessed heroin overdose in Melbourne
Authors: KERR DEBRA , DIETZE PAUL , KELLY ANNE‐MAREE , JOLLEY DAMIEN
Published: August 2010

Introduction and Aims. In response to concerns about the prevalence of heroin‐related morbidity and mortality, overdose response training programs have been implemented in Victoria, with the aim of improving outcomes after heroin overdose. The aim of this study was to examine reported overdose response by current injecting drug users (IDU) during overdose events, in comparison with previous studies. Design and Methods. A total of 99 IDU (median age 35 years, 72% male) were administered a questionnaire that collected information on knowledge and experience regarding recognition of heroin overdose and response. The primary outcome measure was the rate of ambulance notification and expired air resuscitation during witnessed heroin overdose. Data were analysed using descriptive statistics and univariate analysis. Results. Sixty participants had overdosed at least once, and 84% had witnessed an overdose. 78% recognised altered consciousness as a sign of heroin overdose, but less were aware of depressed breathing (42%) or cyanosis (61%). Reported overdose interventions included correct positioning (39%), expired air resuscitation (32%), ambulance notification (76%) and staying with the victim (87%). Discussion and Conclusions. Our study has found improved responses to heroin overdose during witnessed heroin overdose among current IDU, compared with earlier work. However, a lack of knowledge regarding appropriate first‐aid response persists, which might improve with the development and implementation of training initiatives in this area, ranging from identification of overdose to the administration of life‐saving measures.[Kerr D, Dietze P, Kelly A‐M, Jolley D. Improved response by peers after witnessed heroin overdose in Melbourne. Drug Alcohol Rev 2009;28:327–330]
Predictors of 3‐month retention in a drug treatment therapeutic community
Authors: MULDER ROGER T. , FRAMPTON CHRISTOPHER M. A. , PEKA HATAREI , HAMPTON GAVIN , MARSTERS TAU
Published: August 2010

Introduction and Aims. To study rates of 3‐month retention in a drug treatment therapeutic community and the characteristics of residents who remain in treatment. Design and Methods. A total of 200 consecutive admissions to a therapeutic community in Christchurch, New Zealand received a structured interview and questionnaires and were prospectively followed for 3 months. Assessments included the Modified Mini‐International Neuropsychiatric Interview (MINI), Hopkins Symptom Checklist (SCL‐90), Temperament Character Inventory (TCI) and Short Form Health Survey (SF‐36). Results. A total of 107 out of 187 residents remained in the program for at least 3 months. These residents had a better baseline mental health score (SF‐36), higher lifetime depression, higher current sedative/hypnotic dependence and less lifetime stimulant dependence. The differences were modest and predicted around 18% of the variance in outcome. Discussion and Conclusions. The retention rate is consistent with other studies. Few variables predict those who discontinue treatment supporting a non‐discriminatory approach to new residents by clinicians.[Mulder RT, Frampton CMA, Peka H, Hampton G, Marsters T. Predictors of 3‐month retention in a drug treatment therapeutic community. Drug Alcohol Rev 2009;28:366–371]
Smokeless tobacco use in Australia
Authors: GARTNER CORAL E. , HALL WAYNE D.
Published: August 2010

Introduction and Aims. There has been little research published on the use of smokeless tobacco (SLT) in Australia. This study aimed to determine the prevalence of SLT use and the potential for harm reduction in current SLT users and smokers. Design and Methods. We undertook secondary analysis of data from a national household survey of drug use and surveyed 108 Australian SLT users about their patterns of SLT use and tobacco smoking. Results. The low prevalence of SLT use in the past year in Australia (0.57%; 95% confidence interval 0.48–0.66) might reflect the difficulty in importing these products. Prevalence of recent use was highest among males aged 18–29 who were current weekly smokers. US style oral snuffs were the most popular SLT products in Australia. Most of those surveyed were introduced to SLT by a personal contact and about half had used SLT to quit smoking. Australians who import SLT pay per can AU$21.30 on average and face substantial delays before receiving the product. Discussion and Conclusions. Cost and poor access present a substantial barrier to SLT use as a tobacco harm reduction measure for Australian smokers. Permitting low nitrosamine varieties of SLT to be sold in Australia might reduce harm in current SLT users and provide a viable alternative to cigarettes for some current smokers. [Gartner CE, Hall WD. Smokeless tobacco use in Australia. Drug Alcohol Rev 2009]
Patterns of substance use in male incarcerated drug users in Sri Lanka
Authors: DISSABANDARA LAKAL O. , DIAS SHAVINDRA R. , DODD PETER R. , STADLIN ALFREDA
Published: August 2010

Introduction and Aims. The number of illicit drug users incarcerated in Sri Lanka has been growing over the last decade. This paper presents drug‐use characteristics and risk‐taking behaviours among a group of male incarcerated drug users. Design and Methods. An interviewer‐administered structured questionnaire was completed by 278 drug users in three prisons in Sri Lanka. Results. The majority (81.3%) of interviewees were aged 25–45 years. Most of them had received low levels of education, and experienced childhood delinquency and a deprived upbringing. Drug use was largely initiated during early adolescence, then continued to chronicity and the development of drug dependence. There was a high incidence (25–35%) of family history of drug abuse. Heroin (98%) and cannabis (54%) were the main drugs of abuse in the past 30 days. Polydrug use was common (75% in the past 12 months). Tobacco and alcohol use were widespread. The prevalence of intravenous drug use was higher than officially reported (15.8% vs. 1%). There was a high prevalence (53%) of risk‐taking sexual behaviour. Discussion and Conclusion. The pattern of drug use was similar to those reported in nearby countries. However, the increasing prevalence of injecting drug use and risk‐taking sexual behaviour is a concern. There is an urgent need to develop effective treatment strategies and to prevent the spread of HIV and hepatitis in Sri Lanka.[Dissabandara LO, Dias SR, Dodd PR, Stadlin A. Patterns of substance use in male incarcerated drug users in Sri Lanka. Drug Alcohol Rev 2009]
Persistence of heroin use despite methadone treatment: Poor coping self‐efficacy predicts continued heroin use
Authors: SENBANJO RICHARD , WOLFF KIM , MARSHALL E. JANE , STRANG JOHN
Published: August 2010

Aim. To evaluate the association between coping self‐efficacy and persistent use of heroin by patients enrolled in a methadone treatment program. Design and Methods. Cross‐sectional survey. One hundred and ninety‐one patients attending outpatient methadone clinics in South‐East England, United Kingdom. Validated questionnaires were used to assess drug use (Maudsley Addiction Profile), alcohol use (Alcohol Use Disorders Identification Test), mental health (Hospital Anxiety and Depression Scale) and coping self‐efficacy (brief 8‐item Drug Taking Confidence Questionnaire). Results. Half of the participants (95/191) reported heroin use in the preceding 14‐day period. Heroin use during methadone treatment was associated with financial problems (P = 0.008), spending time with other drug users (P < 0.001), cocaine use (P = 0.002), low mood (P = 0.002) and dissatisfaction with the daily methadone dose (P = 0.014). Compared with ‘Heroin‐abstinent’ patients, the ‘Heroin’ group reported significantly lower mean coping self‐efficacy scores (t = 9.8, d.f. = 182, P < 0.001, effect size 1.17). After correcting for the effects of co‐variants in a logistic regression model, the main determinants of persistent heroin use were ‘coping self‐efficacy’[B −0.05; standard error (SE) 0.008; Wald 36.6; odds ratio (OR) 0.95, 95% confidence interval (CI) 0.94, 0.97; P < 0.001] and ‘dissatisfaction with methadone dose’ (B 0.93; SE 0.46; Wald 4.1; OR 2.5, 95% CI 1.03, 6.25; P = 0.042). Satisfaction with methadone dose showed no association with self‐efficacy. Discussion and Conclusions. While heroin use during methadone treatment can partly be explained by inadequate dosing, our data suggest a more complex picture with significant contribution from poor coping self‐efficacy. Efforts aimed at enhancing and maintaining the patients' self‐efficacy and social skills are likely to improve heroin and other drug use outcomes with added benefits for treatment completion rates and the throughput of methadone programs.[Senbanjo R, Wolff K, Marshall EJ, Strang J. Persistence of heroin use despite methadone treatment: Poor coping self‐efficacy predicts continued heroin use. Drug Alcohol Rev 2009]
Preventing relapse in incarcerated drug users in Yunnan Province, China
Authors: ZHU WEI XING , DONG JIA QIANG , HESKETH THERESE
Published: August 2010

Introduction and Aims. The mainstay of drug control in China is compulsory incarceration and detoxification, but relapse rates following release are very high. The aim of the study was to explore factors which would help prevent relapse in injecting drug users following release from detoxification centres. Design and Methods. Semi‐structured interviews were carried out at three compulsory detoxification centres in Derhong prefecture, Yunnan Province, which has the highest proportion of injecting drug users in China. Results. Interviews were completed with 235 men and 125 women aged between 15 and 64 years. They had been injecting heroine for between 3 months and 25 years; the median number of times of previous compulsory detoxification was four, with 11% having undergone this more than 10 times. All but six wanted to quit permanently, but almost all acknowledged that relapse on release was almost inevitable. The month immediately following release was identified as most vulnerable time for relapse. Respondents identified three measures which would help decrease the rate of relapse. First, the environment of the detoxification centres should emphasise support and counselling rather than punishment. Second, families should be provided with support to help the user immediately after release. Third, arrangements could be made to help those individuals who request relocation, to find work elsewhere away from accustomed drug‐using social networks. Discussion and Conclusions. While a combination of these measures could help in some way to reduce rates of relapse following detention, given the failure of the detoxification/detention regimes to reduce drug use, consideration must be given to other approaches.[Zhu WX, Dong JQ, Hesketh T. Preventing relapse in incarcerated drug users in Yunnan Province, China. Drug Alcohol Rev 2009]
Mortality and cause of death among 1705 illicit drug users: A 37 year follow up
Authors: STENBACKA MARLENE , LEIFMAN ANDERS , ROMELSJÖ ANDERS
Published: August 2010

Introduction and Aims. To examine the overall mortality and causes of deaths of a large cohort of users of illicit drugs in Stockholm over 37 years. Design and Methods. People with substance abuse were identified through records collected by different institutions in Stockholm in 1967. Subjects were followed in registers recording mortality and cause of death and in‐patient care stays until 2003. Results. More than half (n = 860) of the 1705 identified substance abusers died at an average age of 47 years, 25–30 years younger than the general population. The standardised rate ratio (SRR) for mortality was 3.3 among men and 3.5 among women. Incidence of mortality per 1000 person‐years was also increased, but somewhat lower for women. The difference between these two measures is mainly explained by a lower mortality among women in general. In‐patient care stays with both alcohol and drug‐related diagnoses were associated with higher risk of dying among women than men: SRR = 14.5 and SRR = 4.0, respectively. Accidents and suicide were the most common cause of death among the youngest subjects (15–24 years) and cardiovascular diseases and tumours among the oldest (≥55 years). Discussion and Conclusions. Accidents and suicide, especially at a young age, are two common causes of death that might be prevented by increased awareness in medical personnel, along with better treatment and supportive measures.[Stenbacka M, Leifman A, Romelsjö A. Mortality and cause of death among 1705 illicit drug users: A 37 year follow up. Drug Alcohol Rev 2009]
Non–response bias in alcohol and drug population surveys
Authors: ZHAO JINHUI , STOCKWELL TIM , MACDONALD SCOTT
Published: August 2010

Introduction and Aims. This proposed study was to assess non‐response bias in the 2004 Canadian Addictions Survey (CAS). Design and Methods. Two approaches were used to assess non‐response bias in the CAS which had a response rate of only 47%. First, the CAS sample characteristics were compared with the 2002 Canadian Community Health Survey (CCHS, response rate 77%) and the 2001 Canada Census data. Second, characteristics of early and late respondents were compared. Results. People with lowest income and less than high‐school education and those who never married were under‐represented in the CAS compared with the Census, but similar to the CCHS. Substance use was more prevalent in the CAS than the CCHS sample, but most of the CAS and CCHS estimates did not exceed±3% points. Late respondents were also significantly more likely to be male, young adult, highly educated, used, have high income, live in different provinces and report substance use. Multivariate logistic regression found significant non‐response bias for lifetime, past 12 months, chronic risky, acute risky and heavy monthly alcohol use, lifetime and past year cannabis use, lifetime hallucinogen use, any illicit drug uses of lifetime and past year. Adjustment for non‐response bias substantially increased prevalence estimates. For example, the estimates for lifetime and past 12 month illicit drug use increased by 5.22% and 10.34%. Discussion and Conclusions. It is concluded that non‐response bias is a significant problem in substance use surveys with low response rates but that some adjustments can be made to compensate.[Zhao J, Stockwell T, Macdonald S. Non‐response bias in alcohol and drug population surveys. Drug Alcohol Rev 2009]
Assessing the accuracy of self‐reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation
Authors: GILLIGAN CONOR , SANSON‐FISHER ROBERT , EADES SANDRA , WENITONG MARK , PANARETTO KATHRYN , D'ESTE CATHERINE
Published: August 2010

Introduction and Aims. A significant level of misreport or error occurs during questionnaire‐based assessment of smoking behaviour. Failure to measure environmental tobacco smoke, and participant's inclination to under‐report their smoking raise questions as to the accuracy of assessment. In order to establish an estimation of the possible error associated with such assessment, the accuracy of self‐reported smoking status among a group of pregnant Aboriginal and Torres Strait Islander women was examined. Design and Methods. Women attending two Aboriginal Medical services in Far North Queensland for antenatal care were invited to participate. Women completed an interviewer assisted questionnaire relating to their smoking status and a 24 h diary of their exposure to nicotine and consumption of alcohol. Urine samples were analysed for cotinine using an Enzyme Linked Immunosorbent Assay. Results. Cotinine analysis indicated that 17% of women who reported that they were non‐smokers were likely to have misreported this status, or be exposed to high levels of passive smoke. The only significant predictors of cotinine level were self‐reported nicotine exposure (including passive smoke) and number of cigarettes smoked in the previous 24 h. Other individual and environmental variables had no significant influence on cotinine level using this analysis technique. Discussion and Conclusions. The level of potential error in smoking assessment among this group was substantial. Exposure to environmental tobacco smoke might explain part of this error, but the reasons for misreport can only be speculated. This rate of misclassification should be taken into consideration in routine screening of antenatal women in primary health care.[Gilligan C, Sanson‐Fisher R, Eades S, Wenitong M, Panaretto K, D'Este C. Assessing the accuracy of self‐reported smoking status and impact of passive smoke exposure among pregnant Aboriginal and Torres Strait Islander women using cotinine biochemical validation. Drug Alcohol Rev 2009]
Issues for sustainability of non‐government organisations in the alcohol and other drugs sector
Authors: SPOONER CATHERINE , DADICH ANN
Published: August 2010

Introduction and Aims. The study aimed to identify issues for sustainability of non‐government organisations in the alcohol and other drugs sector (AODS) in Australia within the current neoliberal context. Design and Methods. Six key‐informant group consultations were conducted in Sydney, Melbourne, Darwin (Australia). Participants were professionals working in the AODS from non‐government AOD organisations, government departments, philanthropic organisations and academic institutions (n = 40). Qualitative data were collected according to a discussion guide. Results. Issues related to problems with workforce capacity, independence, governance and funding. Factors contributing to these issues related to the competitive tendering funding model, for example: accountability requirements and tied funding. Discussion and Conclusions. Issues identified by the AODS were mostly similar to those identified by the broader non‐government organisations sector. There is much to learn from outside the AODS. Strategies to improve sustainability will include workforce development, improving governance and developing relationships within the sector and with government. These require a commitment to innovation and will entail movement of resources from service provision in the short term to organisational development for the long term.[Spooner C, Dadich A. Issues for sustainability of non‐government organisations in the alcohol and other drugs sector. Drug Alcohol Rev 2009]
Offer of financial incentives for unprotected sex in the context of sex work
Authors: JOHNSTON CAITLIN L. , CALLON CODY , LI KATHY , WOOD EVAN , KERR THOMAS
Published: August 2010

Introduction and Aims.
Commercial sex workers (CSW) are often portrayed as vectors of disease transmission. However, the role clients play in sexual risk taking and related decision making has not been thoroughly characterised. Design and Methods. Participants were drawn from the Vancouver Injection Drug Users Study, a longitudinal cohort. Analyses were restricted to those who reported selling sex between June 2001 and December 2005. Using multivariate generalised estimating equation, we evaluated the prevalence of and factors associated with being offered money for sex without a condom. Results. A total of 232 CSW were included in the analyses, with 73.7% reporting being offered more money for condom non‐use, and 30.6% of these CSW accepting. Variables independently associated with being offered money for sex without a condom included daily speedball use [adjusted odds ratio (AOR) = 1.21, 95% confidence interval (CI): 0.23–0.62], daily crack smoking (AOR = 1.51, 95% CI: 1.04–2.19), daily heroin injection (AOR = 1.76, 95% CI: 1.27–2.43) and drug use with clients (AOR = 3.22, 95% CI: 2.37–4.37). Human immunodeficiency virus seropositivity was not significant (AOR = 0.98, 95% CI: 0.67–1.44). Discussion and Conclusions. Findings highlight the role clients play in contributing to unprotected sex through economic influence and exploitation of CSW drug use. HIV serostatus has no bearing on whether more money is offered for sex without a condom. Novel interventions should target both CSW and clients. [Johnston CL, Callon C, Li K, Wood E, Kerr T. Offer of financial incentives for unprotected sex in the context of sex work. Drug Alcohol Rev 2009]
Anxiolytic and hypnotic drug misuse in Thailand: Findings from a national household survey
Authors: ASSANANGKORNCHAI SAWITRI , SAM‐ANGSRI NISAN , RERNGPONGPAN SIRINPORN , EDWARDS J. GUY
Published: August 2010

Introduction and Aims.
The non‐medical use of prescription drugs, such as anxiolytics and hypnotics, has become a growing public health problem in Thailand. The objective of this study was to examine the patterns of non‐medical use of these drugs, using data from a nationally representative sample of Thais interviewed in 2007. Design and Methods. A nationwide, multi‐stage, household survey of 26 633 respondents aged 12–65 years living in 11 348 households throughout Thailand using a face‐to‐face structured interview questionnaire was carried out. Results. In 2007, 1.58% (734 288) and 1.58% (733 318) of Thais indicated that they had misused anxiolytics or hypnotics, respectively, at some time during their lives. Less than 1% had misused these drugs during the 12 months preceding the interview (426 170 or 0.92% for anxiolytics, 372 920 or 0.80% for hypnotics), fewer during the preceding 30 days (234 871 or 0.50% for anxiolytics, 225 638 or 0.48% for hypnotics).The highest prevalence of past 30 day use was in Bangkok, the lowest in Southern Thailand. More women than men, older than younger respondents, and subjects who considered they were in poor physical health or had emotional problems than those who thought otherwise used the drugs during the 30 days before the interviews. Discussion and Conclusions. The prevalence of anxiolytic/hypnotic misuse/abuse appears to be lower than that reported from more developed countries, but a small increase in problems resulting from the use of these substances has a disproportionately large effect on the overstretched resources of a developing country. [Assanangkornchai S, Sam‐Angsri N, Rerngpongpan S, Edwards JG. Anxiolytic and hypnotic drug misuse in Thailand: Findings from a national household survey. Drug Alcohol Rev 2009]
Alcohol consumption and alcohol‐related problems among Vietnamese medical students
Authors: PHAM DIEP B. , CLOUGH ALAN R. , NGUYEN HIEN V. , KIM GIANG B. , BUETTNER PETRA G.
Published: August 2010

Introduction and Aims.
This study examined prevalence and predictors of alcohol consumption and alcohol problems in a sample of medical students in Vietnam. Design and Methods. A cross‐sectional survey using a multi‐stage cluster sampling approach was conducted in 2007 in two universities in Vietnam. The students (n = 619, 100% response rate) completed questionnaires based on the Alcohol Use Disorder Identification Test. A score of ≥8 defined presence of alcohol problems. Data analyses adjusted for the cluster sampling approach. Results. Overall 65.5% of students had drunk alcohol during the previous year while alcohol problems were detected in 12.5%. Male students, students who reported that their family members drank and students who reported that their flat mates were drinking were more likely to be current drinkers. Male students were 14.3 times more likely to have an Alcohol Use Disorder Identification Test score of ≥8 compared with female students (P = 0.005). Discussion and Conclusions. Intervention programs focusing on male students and their social environment are warranted. As Vietnamese society rapidly modernises prevention programs for female students may also be needed. [Pham DB, Clough AR, Nguyen HV, Kim GB, Buettner PG. Alcohol consumption and alcohol‐related problems among Vietnamese medical students. Drug Alcohol Rev 2009]
The Andalusian trial on heroin‐assisted treatment: A 2 year follow‐up
Authors: OVIEDO‐JOEKES EUGENIA , MARCH JOAN C. , ROMERO MANUEL , PEREA‐MILLA EMILIO
Published: August 2010

Introduction and Aims. In 2003, a randomised controlled trial comparing injected diacetylmorphine and oral methadone was carried out in Andalusia, Spain. The subsequent follow‐up study evaluated the health and drug use status of participants, 2 years after the completion of the trial. Design and Methods. This follow‐up cohort study was carried out between March and August 2006. Data collected included information on socio‐demographics, drug use, health and health‐related quality of life. We compared data collected before randomisation and at 2 years for the following three groups: those currently on heroin‐assisted treatment (C‐HAT), those who have discontinued HAT (D‐HAT), and those who have never received HAT (N‐HAT). Results. From the total 62 randomised participants in 2003, 54 (87%) were interviewed for this study. Participants were distributed as follow: C‐HAT 44.4% (24), N‐HAT 22.2% (12) and D‐HAT 33.3% (18). Illicit heroin use had a statistically significant decrease in the three groups from baseline to 2 years post trial. Mean days of heroin use were 2.42 (SD = 3.02); 6.56 (SD = 9.48) and 13.92 (SD = 12.59) for the C‐HAT, D‐HAT and N‐HAT groups, respectively. Those currently on HAT were the only group that sustained at 2 years, their marked improvement in health after 9 months of treatment during the trial period. Discussion and Conclusions: Patients who received HAT showed better outcomes compared with those not on HAT. The results of this study strengthen the evidence showing that HAT can improve and stabilise the health of long‐term heroin users with severe comorbidities and high mortality.[Oviedo‐Joekes E, March JC, Romero M, Perea‐Milla E. The Andalusian trial on heroin assisted treatment: A 2 year follow‐up. Drug Alcohol Rev 2009]
Benzodiazepine use among heroin users: Baseline use, current use and clinical outcome
Authors: DARKE SHANE , ROSS JOANNE , MILLS KATHERINE , TEESSON MAREE , WILLIAMSON ANNA , HAVARD ALYS
Published: August 2010

Introduction and Aims. Benzodiazepine use is associated with elevated levels of harm. The current study aimed to ascertain the long‐term nature of the relationship between benzodiazepine use and clinical profile among heroin users. Design and Methods. Longitudinal cohort, with follow‐up at 3, 12, 24 and 36 months. Participants were 615 heroin users recruited for the Australian Treatment Outcome Study. Results. At baseline, current benzodiazepine users were more likely to be committing crime, had poorer psychological health and poorer physical health. Baseline benzodiazepine use was not associated with the likelihood across follow‐up of heroin use (P = 0.44), committing crime (P = 0.17), poorer psychological health (P = 0.31) or poorer physical health (P = 0.48). Current benzodiazepine use was, however, associated with a greater likelihood of concurrent heroin use (OR 2.77), crime (OR 2.04), poorer psychological health (β = −4.47) and poorer physical health (β = −2.33). Discussion and Conclusions. Clinicians should be aware that reductions in benzodiazepine use are associated with reductions in harm, and that baseline benzodiazepine status does not equate to poor long‐term outcome. [Darke S, Ross J, Mills K, Teesson M, Williamson A, Havard A. Benzodiazepine use among heroin users: Baseline use, current use and clinical outcome. Drug Alcohol Rev 2009]
Achieving professional practice change: From training to workforce development
Authors: ROCHE ANN M. , PIDD KEN , FREEMAN TOBY
Published: August 2010

Issues.
The traditional approach to increasing the capacity of health and human service professionals to deliver alcohol, tobacco and other drug interventions has been to build relevant knowledge, skills and attitudes through the provision of education and training. However, as a stand alone strategy, education and training is likely to have limited impact. Approach. This paper examines not only the features and characteristics of successful training programs and approaches, but also the wider array of systems and structural factors that might act as impediments to the implementation of new knowledge, skills and clinical behaviours. Key Findings. There is a constellation of factors that extend beyond traditional notions of ‘training’ that fall under the rubric of ‘workforce development’. Implications and Conclusions. A workforce development approach requires three levels of action—system‐wide, capacity building and professional development to ensure effective responses. [Roche AM, Pidd K, Freeman T. Achieving professional practice change: From training to workforce development. Drug Alcohol Rev 2009;28:550–557]
Multidisciplinary antenatal care for opiate‐using women: Child‐care issues
Authors: ADENIJI ADERONKE A. , PURCELL ALISON , PEARSON LORRAINE , ANTCLIFFE JAN M. , TUTTY SUSAN , SINHA CHITRA , PAIRAUDEAU PETER W. , LINDOW STEPHEN W.
Published: August 2010

Introduction and Aims. The fact that particular parents suffer afflictions limiting their ability to care does not mean that they should automatically be deemed unsuitable parents. Prompted by neonatal team concerns about child‐care issues, a local multidisciplinary group was set up to care for substance‐abusing pregnant women in our region. Design and Methods. This project was conducted in order to review the records of all the women who had been discussed at our management planning meetings over the past 5 years. Our assessment tool records were reviewed and analysed using spss. Results. A total of 233 women were assessed. The majority of patients booked before 20 weeks (62%) and 96 women (41%) attended over 80% of their antenatal appointments. There was little change in substance use during the course of pregnancy. Overall, at delivery, 196 of the 233 women (84%) used methadone and 89(38%) used heroin. There was no correlation between usage and foster care of the baby (methadone: χ2 = 0.5, P = 0.8 NS) (heroin: χ2 = 3.1, P = 0.08 NS). There was an absolute correlation between social services involvement and foster care (χ2 = 2.33, P < 0.0001). Adherence with planned antenatal appointments significantly increased the likelihood of a child being discharged with his mother (χ2 = 6.7, P = 0.009). Discussion and Conclusions. The majority of newborns were discharged home with their mothers directly with the most significant factor in placing a child in foster care being prior involvement of social services. However, many of these families will continue to need support during the children's early years.[Adeniji AA, Purcell A, Pearson L, Antcliffe JM, Tutty S, Sinha C, Pairaudeau PW, Lindow SW. Multidisciplinary antenatal care for opiate‐using women: Child‐care issues. Drug Alcohol Rev 2009]
Interaction of life quality with alexithymia, temperament and character in male alcohol‐dependent inpatients
Authors: EVREN CUNEYT , DALBUDAK ERCAN , DURKAYA MINE , CETIN RABIA , EVREN BILGE
Published: August 2010

Introduction and Aims. The aim of this study was to investigate the relationship of life quality with alexithymia, temperament and character dimensions of personality. Design and Methods. Participants were 156 consecutively admitted male alcohol dependents. Patients were investigated with the Toronto Alexithymia Scale, the Temperament and Character Inventory, the Michigan Alcoholism Screening Test and the Medical Outcomes Study Short Form 36‐item health survey. Results. Among alcohol‐dependent inpatients 30.1% were considered as alexithymic. Severity of alcohol related problems was higher in alexithymic group, whereas quality of life (QoL) was lower. Alexithymia, novelty seeking (NS) and harm avoidance (HA) were negatively, reward dependence, self‐directedness and cooperativeness were positively correlated with QoL scores. ‘Difficulty in identifying feelings’ (DIF) factor of alexithymia and HA were the determinants of physical dimension of Life Quality in Linear Regression model, whereas DIF, HA and NS were the predictors of mental dimension score. Discussion and Conclusions. Among alcohol‐dependent men, DIF factor of alexithymia and personality dimensions, particularly HA and NS are associated with impairment of QoL. Direction of this relationship and factors that may mediate this relationship is unclear. [Evren C, Dalbudak E, Durkaya M, Cetin R, Evren B. Interaction of life quality with alexithymia, temperament and character in male alcohol‐dependent inpatients. Drug Alcohol Rev 2009]