bluuebunny/crossref_metadata_2025 huggingface dataset:
The necessity and utility of abuse liability evaluations in human subjects
Authors: VOCCI FRANK J.
Published: January 2006

Assessments of the abuse potential of psychoactive drugs in preclinical and clinical studies are used in regulatory decision making process in the United States under the Controlled Substance Act (CSA) and the Federal Food, Drug, and Cosmetic Act (FD & C Act). Two types of drugs are evaluated in abuse potential studies, those being developed for a therapeutic indication by the pharmaceutical industry and illicitly manufactured ‘street drugs’ of abuse. Only the former will be considered here. In the case of drugs being pursued for marketing or are amendable to study in human subjects and are of scientific, medical, or regulatory interest, preclinical data may be inadequate for drug scheduling and marketing decisions. Preclinical data assessment can suggest hypotheses which must be validated in clinical studies. Moreover, there are limitations to the feasibility of evaluating certain drugs/dosage forms in preclinical studies. Thus, clinical studies are needed for the following scientific reasons: to validate preclinical hypotheses; to assess the time‐course of subjective effects as a function of dose and route of administration; to evaluate the generalizability of drug liking in different human subject populations; and to evaluate the effects of drugs on cognitive and affective processes. Clinical studies are also needed if a claim is made regarding reduced or no abuse potential; and lack of additive or potentiative effects with alcohol.
General practitioners' experiences of patients with drug and alcohol problems
Authors: ROCHE ANN M. , GURAY COLLEEN , SAUNDERS JOHN B.
Published: January 2006

Convergent focus groups, a qualitative research methodology, were used to determine what general practitioners considered to be the main obstacles and disincentives to the effective management of persons with drug and alcohol problems. Seven groups were conducted, involving 44 general practitioners whose practices were based in representative parts of metropolitan Sydney and a rural area of New South Wales. The study revealed that most doctors are not as threatened, resistant or pessimistic about drug and alcohol intervention as much of the previous work in the area would suggest. However, they held different views according to the drug in question. General practitioners were more sympathetic to patients with alcohol problems but only some agreed that it was a legitimate area for medical involvement and one in which they were prepared to become involved. The prescribing and use of minor tranquillisers was widely tolerated and perceived to present few problems for individuals or the community. Opiate users, by contrast, were least favoured, with hostility expressed by most towards them. A provisional typology of general practitioners was developed with three distinct groupings (‘interactive problem‐solvers’, ‘traditionalist healers’ and ‘technologists’), according to the model of medical practice assumed. This scheme, whilst not definitive, provides a structure for targeting general practitioners for medical education and has implications for tailoring medical training programs at both the undergraduate and postgraduate levels. General issues relating to the development of typologies are discussed.
Smokeless tobacco: current status and future directions
Authors: HATSUKAMI DOROTHY , NELSON RICHARD , JENSEN JONI
Published: January 2006

Smokeless tobacco is addicting, can cause physical dependence, and is associated with many health risks. In spite of these concerns over its use, minimal research has been conducted to understand the effects from and factors associated with smokeless tobacco use. Additionally, relatively few studies have examined potentially effective treatments for the smokeless tobacco user. This paper reviews the existing literature in this area and considers future directions for research.
A time for conceptual stocktaking
Authors: JARVIS MARTIN J.
Published: January 2006

The Surgeon‐General's report, by redefining the nature of the tobacco problem, invites a re‐examination both of our goals and of our concepts and categories of tobacco use. A crucial pre‐requisite to the acceptability of the development of refined nicotine‐containing products, and of long‐term nicotine maintenance therapy, will be progress in understanding the health risks of nicotine use per se. A broader conceptualization of prevalence and cessation is urged, one which takes account of cigar and pipe smoking as well as cigarettes. In addition to increasing overall prevalence somewhat, this approach drastically alters estimates of cessation rates, and indicates that the often‐claimed gender difference in cessation is myth rather than reality. An analysis which combines social class and housing tenure as conjoint indicators of socio‐economic position sharpens class gradients of smoking prevalence and shows that smokers are still comfortably in the majority among substantial groups of the population in the UK. Future progress in lowering prevalence, and hence smoking‐related disease, is increasingly going to depend on reaching the most disadvantaged members of society.
Toward a comprehensive strategy for reducing the health burden of tobacco
Authors: LANDO HARRY A.
Published: January 2006

In the absence of concerted worldwide action, the annual death toll from tobacco may reach 10 million by the middle of the next century. Smoking cessation approaches represent an important, but limited, means of reducing this death toll. Needed are co‐ordinated strategies that address all facets of the tobacco issue. Especially important are advocacy campaigns targeting the tobacco industry and its supporters. Just as the Broad Street pump was isolated as the source of a cholera epidemic, the tobacco industry must be isolated as the source of a far greater epidemic.
Alcohol and drug use in a Scottish cohort: 10 years on
Authors: BAGNALL GELLISSE
Published: January 2006

This paper reports the findings from a survey which elicited detailed information on patterns of alcohol use amongst a cohort of young adults. It is the fourth wave of data collection in a longitudinal study which began in 1979 on a study group of 1036 15–16 year olds attending schools in the Lothian region of Scotland. The longitudinal analysis presented here suggests that for this cohort, patterns of alcohol use at age 15–16 bear little relation to those at age 24–25 years. These findings are discussed, and compared in detail with the more limited alcohol data from the larger‐scale National Child Development Study.
The social costs of smoking revisited
Authors: ELLEMANN‐JENSEN PETER
Published: January 2006

Peter Ellemann‐Jensen died after the preparation, but prior to the publication, of this article. At the time of his death he was a member of the Department of Economics, Odense University, Denmark, Remarks in response to specific points suggested fry anonymous referees have been added in the form of footnotes because we believe that Peter Ellemann‐Jensen would have readily acknowledged those points. A few more extensive suggestions, which would have required rewriting portions of the orignal text, could not be taken fully into account.

This article may be read as a comment on and extension to the recent survey of studies of the social costs of smoking in this journal by Markandya & Pearce (1989), covering some aspects of the literature not included in that survey. Inevitably, there is a considerable amount of overlap with the material in several of the listed references, including the Markandya & Pearce (1989) survey. The article argues that the published studies based on the incidence approach to the costs of smoking, even on their own terms and accepting the stated assumptions, are erroneous, yielding cost estimates that are too high. In the appendix a simple model of the use of taxation to correct for informational error concerning a risky good is presented.
A matter of moral perspective
Authors: Glaser Frederick B.
Published: January 2006

Abstract. In the USA, treatment for alcohol and drug problems is provided in both the public and private sectors. But because there is no universal health insurance scheme, access to treatment is severely limited.

This unfortunate situation may be a consequence of an historically influential moral perspective on poverty and illness. An alternative perspective is urged.
Drinking on television: a content analysis of recent alcohol portrayal
Authors: PENDLETON LAURA L. , SMITH CHRISTOPHER , ROBERTS JOHN L.
Published: January 2006

The portrayal of alcohol on British television was examined in a systematic sample of 50 programmes broadcast in 1988. Nearly three‐quarters of the programmes contained visual or verbal references to alcohol. On average, there was a reference to alcohol in every six and a half minutes of programming. Alcohol was most prominently featured in fictional programmes, particularly in one soap opera, Eastenders. A third of the programmes showed specific brands of alcohol. It is estimated that the portrayal of alcohol in Britain's most popular programmes is worth £487 million of free promotion to the alcohol industry per annum. Nevertheless, in comparison with an earlier study, carried out in 1986, there appeared to be fewer alcohol images. A number of recommendations are made for further action and monitoring of alcohol portrayal.
Selective effects of alcohol on Wisconsin card sorting test performance
Authors: LYVERS MICHAEL F. , MALTZMAN IRVING
Published: January 2006

Social drinker volunteers were randomly assigned to the four cells of a balanced placebo design, with 10 males and 10 females per cell. They consumed a beverage which contained either tonic water only, or tonic water plus sufficient vodka to induce peak blood alcohol levels of approximately 0.05%. Subjects then completed a computer version of the Wisconsin Card Sorting Test (WCST) in two runs. Compared to tonic only, beverage alcohol selectively increased per cent perseverative errors as well as other measures of perseveration and the number of trials, p<0.05. Results are interpreted in terms of an hypothesised differential action on functions of the frontal cortex in addition to possible non‐specific effects of alcohol. Issues pertaining to expectancy interpretations are also discussed.
In‐patient withdrawal from long‐term benzodiazepine use
Authors: JOUGHIN N. , TATA P. , COLLINS M. , HOOPER C. , FALKOWSKI J.
Published: January 2006

Twenty‐one patients completed an intensive in‐patient and out‐patient group‐based programme, to achieve withdrawal from long‐term benzodiazepine dependence. By 6‐month follow‐up (post‐withdrawal), eight patients (38%) had achieved a ‘good’ outcome. Generally, patients demonstrated moderate levels of psychiatric morbidity and depression in the pre‐withdrawal phase; a diagnosis of a depressive disorder being associated with either an ‘intermediate’ or ‘poor’ outcome in comparison to patients receiving a diagnosis of anxiety disorder, who showed a predominantly ‘good’ outcome. Two patients committed suicide some time after withdrawal. Additionally, older patients fared less well than their younger counterparts. We conclude that maintenance benzodiazepine prescription, rather than withdrawal, may be the preferred treatment for some dependent patients. Furthermore, more data are required regarding the association, and causality, between depression and benzodiazepine withdrawal in long‐term users.
The study of transitions in the route of drug use: the route from one route to another
Authors: STRANG JOHN , JARLAIS DON C. DES , GRIFFITHS PAUL , GOSSOP MICHAEL
Published: January 2006

Route of administration of various drugs is an area of study to which specific attention must be paid in study of different HIV risks of drug use by various routes. If changes in route are seen in individuals or within populations, then study of these transitions in route may identify new approaches which could be developed in HIV prevention. The consideration in this paper is based around ten questions: (i) What is a transition? (ii) Do routes of administration vary by time and place? (Hi) Is choice of route influenced by availability of drug paraphernalia? (iv) How does the context influence initial choice of administration, and possible subsequent transitions? (v) Are lapse and relapse meaningful concepts? (vi) Transitions: how much of it is going on? (vii) How much does change of route (with the same drug) signify a change of drug effect, its significance, or its relationship with other risk behaviour? (viii) Is change of route of use of one drug always accompanied by the same change of route of other drugs? (ix) Injectors/non‐injectors and sharers/non‐sharers: do these behavioural characteristics exist as categories or are they distributed along a continuum? (x) Are transitions reversible? This paper is accompanied by two research reports which describe explorations into the extent and nature of transitions amongst heroin users.
Extent and nature of transitions of route among heroin addicts in treatment—preliminary data from the Drug Transitions Study
Authors: GRIFFITHS PAUL , GOSSOP MICHAEL , POWIS BEVERLY , STRANG JOHN
Published: January 2006

Preliminary data are presented here from a study of drug transitions in the UK. These support the contention that differences in route of administration are likely to be reflected in differing patterns of drug use, and associated with differing health risks for the individual drug user. Heroin ‘chasers’ were found to have robust and long‐term patterns of heroin use and could not merely be considered as pre‐injectors. They were also younger. No differences were found in the typical daily doses prior to entering treatment between chasers and injectors. Subjects who usually ‘chased the dragon’ but who would also inject were less likely to have shared injecting equipment in the past. Transitions between different routes of use were found in most directions. However, changes from ‘chasing’ to injection were most common. Year of initiation into heroin use was also related to initial route of use.
Persuading general practitioners to prescribe–good husbandry or a recipe for chaos?
Authors: GREENWOOD JUDY
Published: January 2006

Edinburgh's Community Drug Problem Service was set up three years ago in response to the high prevalence of HIV infection amongst local injecting drug users and the lack of existing statutory drug services in Lothian. From the outset, a policy of shared care and substitute prescribing by the druguser's general practitioner (GP) was adopted. Over 800 referrals later, this discussion paper looks at the methods used to persuade GPs to cooperate in longterm drug management, and examines the advantages, disadvantages and outcome of such a shared care approach.
Changes in HIV risk behaviors among intravenous drug users in San Juan, Puerto Rico
Authors: COLÓN HÉCTOR MANUEL , ROBLES RAFAELA RIVERA , SAHAI HARDEO , MATOS TOMÁS
Published: January 2006

Strategies for reaching intravenous drug users (IVDUs) not in treatment and reducing risk behaviors are urgently needed to reduce the human immunodeficiency virus (HIV) epidemic. Of special concern is the need to detect which types of risk behaviors are more likely to change and which are resistant to change. The present paper analyzes changes occurring in HIV transmission risk behaviors among 778 IVDUs not in treatment, in the city of San Juan, Puerto Rico. Results show discontinuation rates of risk behaviors to be substantial. Discontinuation rates of injection equipment sharing practices varied from 33% in shared use of cookers to 74.2% in sharing needles with strangers. Drug injection and use of shooting galleries were also reduced, although to a lesser extent (8.5% and 19.3% respectively). Among protective behaviors, use of new needles was found to increase nearly twice as much as the use of bleach (20.6% vs. 11.3% respectively). The results suggest the need to understand the factors facilitating/inhibiting change in specific behaviors and the need to study the stability of these changes over longer periods of time.
Levels of drunkenness of customers leaving licensed premises in Perth, Western Australia: a comparison of high and low ‘;risk’ premises
Authors: STOCKWELL TIM , RYDON PHIL , GIANATTI SONIA , JENKINS EVAN , OVENDEN CLAUDIA , SYED DAVID
Published: January 2006

A measure of the risk of licensed premises having customers involved in road traffic accidents and drink‐driving offences was utilised in order to identify seven ‘High Risk’ and eight ‘Low Risk’ premises in metropolitan Penh, Western Australia. This measure, or ‘Risk Ratio’, was defined as the ratio of incidents of alcohol‐related harm to an estimate of on‐premises alcohol sales for a particular establishment. A study was conducted to test the hypothesis that a High Risk status would be associated with greater levels of customer intoxication. Interviews concerning drinking behaaviour and breathalyser readings were collected from 74.2% of 414 customers exiting from the chosen premises between 8 p.m. and midnight on Friday and Saturday nights. High Risk premises had three times more customers whose readings were in excess of 0.15 mg/ml (p < 0.01). The proportion of customers with BAL's above 0.15 correlated strongly with the premises' Risk Ratio(r = 0.63, p < 0.01). There were also significantly more patrons from High than from Low Risk establishments who were rated as appearing moderately or severely intoxicated but refused to be interviewed or breath‐tested. It is argued that these results support the need for strategies which aim to reduce very high levels of intoxication on licensed premises in order to reduce alcohol‐related accidents, injuries and offences.
Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug
Authors: SOLOWIJ NADIA , HALL WAYNE , LEE NICOLE
Published: January 2006

‘Ecstasy’ (3,4‐methylenedioxymethampketamine or MDMA) is a recreational drug that is gaining popularity world wide. There is a paucity of research regarding the ways in which Ecstasy is used and the nature of its effects. A ‘snowball’ peer network technique was used to recruit 100 users who completed anonymous questionnaires. The research revealed that Ecstasy is primarily used by infrequent recreational drug users for ‘fun’ at dance parties and social gatherings. The primary reported effects of Ecstasy were a ‘positive mood state’ and feelings of intimacy and closeness to others. The secondary effects of Ecstasy were the stimulant effects of energy and activation, and the psychedelic effects of insight and perceptual and sensual enhancement. Ecstasy was reported to share the properties of both amphetamines and hallucinogens in the nature of its side effects and residual effects which were no more severe than those of the latter two classes of drug. It appeared Ecstasy was not conducive to regular and frequent use, because tolerance was reported to develop to the positive effects of Ecstasy, while negative effects increased with use. Although few problems associated with the recreational use of Ecstasy have surfaced to date, animal research has shown it to be neurotoxic to serotonergic nerve terminals. Caution must be observed until further research can determine the level of hazard in humans.
Early onset of drinking as a risk factor for lifetime alcohol‐related problems
Authors: CHOU S. PATRICIA , PICKERING ROGER P.
Published: January 2006

The Data Note Series is edited by Dr Bridget Grant, Chief of Biometry at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), USA

Heavy drinking among students has been a major public health concern over the past decade. A nationally representative 1988 survey on drinking practices and related problems examined the effect of age of onset of drinking on lifetime alcohol‐related problems. Prevalence estimates were obtained for major demographic subgroups of the population. Results and implications are discussed in the context of minimum legal drinking age.
Bromocriptine and cocaine cue reactivity in cocaine‐dependent patients
Authors: KRANZLER HENRY R. , BAUER LANCE O.
Published: January 2006

Based on previous reports that bromocriptine, a postsynaptic dopamine agonist, reduced cocaine craving and prevented relapse in cocaine‐dependent subjects, effects of the drug were evaluated in 20 cocaine‐dependent males in an inpatient drug rehabilitation programme. The subjective and physiologic effects of exposure to both cocaine‐associated and neutral stimuli, presented using videotapes, were measured at one‐week intervals. Between laboratory sessions subjects received either bromocriptine (1.25 mg bid) or a matched placebo, administered in double‐blind fashion. Compared with the neutral videotape, the cocaine videotape elicited both a greater desire to use cocaine and more symptoms associated with cocaine self‐administration. These results support an appetitive conditioning model of cocaine effects. Bromocriptine, however, had no effect on the cocaine‐cue‐associated reactivity, which declined over the 1‐week interval in both treatment groups. Methodological differences among studies that have examined the effects of bromocnptine in cocaine‐dependent subjects may explain the variable findings observed.
The consequences of a change in formulation of methadone prescribed in a drug clinic
Authors: STEELS M. D. , HAMILTON M. , MCLEAN P. C.
Published: January 2006

Methadone mixture DTP (Img in 1 ml) is a safe non‐injectable alternative to methadone tablets (5mg). It also allows for a more gradual detoxification from opiate dependence. For these reasons it was decided to ‘rationalise’ our prescribing so that methadone in mixture form only would be dispensed. At the beginning of 1989, 66 opiate‐dependent patients were receiving methadone tablets, 61 the methadone mixture. We report the consequences of instituting a policy change which was clearly very unpopular with patients. Of the 66 patients receiving methadone tablets prior to the change to mixture, 53 were represcribed tablets by the end of the 3‐month follow‐up period. In many cases this was because of an intense resistance to the change over, physical complications of methadone mixture occurred in very few. We were able to observe a decline in social stability and an increased use of non‐prescribed drugs in some patients who changed to methadone mixture. More far‐reaching consequences of the change included an increase in chemist break‐ins, an increase in the street value of methadone tablets and greater hostility and threatening behaviour towards staff. These changes reflect psychological rather than pharacological or pharmacokinetic effects.
Knowledge of AIDS and HIV among various groups
Authors: RALSTON G. E. , DOW M. G. T. , ROTHWELL B.
Published: January 2006

To date, no cure has been found for HIV/AIDS. Prevention has therefore been the immediate principal aim and a didactic approach has been given a primary role. Studies from the USA indicate that knowledge level may be dictated by membership of particular subcultural groups and the perceived relevance of HIV/AIDS to these groups. This study investigates knowledge among four groups: homosexual; single heterosexual; IV drug users; and a ‘married’ group. Results indicate some gaps in knowledge and a greater knowledge base among one of the high risk groups, the homosexual group.
Motivation to withdraw from heroin: a factor‐analytic study
Authors: MURPHY PHILIP N. , BENTALL RICHARD P.
Published: January 2006

A 30‐item motivation scale and a locus of control scale were given to 165 heroin users within the first 2 days of a new attempt to withdraw from heroin. Factor analysis of the motivation items revealed three factors, the largest of which was labelled ‘private affairs motivation’ (factor one), and accounted for 26.5% of the variance. A significant positive correlation was found between scores on this factor and the I sub‐scale for locus of control. The other two factors were labelled ‘external constraints’ (7.2% of the variance) and ‘negative effects of heroin use’ (6.6% of the variance). There was a tendency for subjects attending community drug teams to have lower scores on these factors than those attending other types of agencies, especially inpatient detoxification wards. Further research is required to examine the relationship between the different motivations to withdraw from heroin and other important variables such as withdrawal outcome.
‘Enabling’ of male problem drinkers in work groups
Authors: ROMAN PAUL M. , BLUM TERRY C. , MARTIN JACK K.
Published: January 2006

Theoretical understanding of the effects of groups on the development and the maintenance of adult problem drinking is sparse. Sociological theories predict that adult problem drinkers find support for their behavior among those with similar drinking patterns. By contrast, a widely diffused clinical conceptualization posits that ‘significant others’ who are not problem drinkers facilitate the maintenance of problem drinking. Several previous lines of research lead to the hypothesis that observed delays in identification and referral of problem drinkers in the workplace may be due to supportive relationships between problem drinkers and their co‐workers and supervisors. Data from the 1973–77 Quality of Employment Panel Survey are utilized to provide a longitudinal test of this hypothesis among employed men. Results support the existence of enabling in the workplace. Data comparing ‘enabled’ and ‘non‐enabled’ problem drinking workers fail to support four possible explanations of enabling.
Alcohol consumption among Israeli youth—1989: epidemiology and demographics
Authors: BARNEA ZIPORA , RAHAV GIORA , TEICHMAN MEIR
Published: January 2006

Epidemiological and sociodemographic findings on alcohol (wine, beer, hard liquor) consumption among the Israeli youth are presented. Three samples of adolescents, aged 12–18, were studied by means of an anonymous self‐report questionnaire: a nationwide representative sample of high school students; a sample of detached youth; and a sample of inmates in institutions for juvenile delinquents. Alcohol consumption was assessed by three indices: frequency of use during the last year, use during the last month and use during the last week. Since alcohol is imbibed ceremonially in the Jewish tradition, only non‐ritualistic consumption of alcoholic beverages was considered. Prevalence of drinking during the last year was 58%, during the last month 42% and during the last week 25%. Thus, it appears that Israeli youth are approaching the drinking prevalence of European adolescents. The results clearly indicate that alcohol consumption is concentrated among groups of deviant adolescents. These adolescents consume all types of alcoholic beverages at rates considerably exceeding those found among high school students. As for the effect of sociodemographic variables, the results strongly support previous findings showing that the patterns and contexts of alcohol use among Israeli youth are similar to those found among youth in other cultures.
Life‐style factors and social circumstances of syringe sharing in injecting drug users
Authors: DONOGHOE MARTIN C. , DOLAN KATE A. , STIMSON GERRY V.
Published: January 2006

Measures taken to reduce HIV risk by injecting drug users have been reported in many countries, but a minority of injectors continue to engage in risky practices. In an ongoing cohort study, 207 drug injectors were interviewed and anonymously tested for HIV antibodies in saliva in 1989. Injectors reporting recent syringe sharing were compared with those not recently sharing; injecting events where sharing did and did not take place were examined. Those recently sharing syringes differed significantly from the non‐sharers on several factors, including: use of heroin, dihydrocodeine and temazepam; injection of heroin, temazepam and prescribed methadone; accommodation and contact with other injectors; means of financial support and recent involvement in crime; secondary sources of injecting equipment and unsafe disposal; employment of HIV protective strategies; treatment contact with general practitioners; number of sexual partners and injecting status of sexual partners. The two groups were not significantly different in terms of attendance at syringe‐exchange schemes and self‐reported HIV antibody status. Syringe sharing would appear to be related to social circumstances and life‐style factors rather than just individual choices and motivation.
Drug and alcohol medical education: evaluation of a national programme
Authors: ROCHE ANN M.
Published: January 2006

In recognition of inadequacies in drug and alcohol medical education, funds were allocated to all Australian medical schools in 1988 to appoint co‐ordinators to develop and implement drug and alcohol curricula. This programme was broadly modelled on the Career Teacher Programme successfully implemented in North America in the 1970s and early 1980s. During 1989 all but one of Australia's 10 medical schools made drug and alcohol co‐ordinator appointments. Appointees came from diverse backgrounds including general practice, psychiatry, internal medicine, psychology and social work. The present study is a process evaluation and forms the first examination of the programme. Overall, findings indicated the programme to have achieved a 158% increase in drug and alcohol teaching hours, a 383% increase in the number of electives and a 109% increase in student places for elective!. These effects occurred even though the average duration of co‐ordinators’appointments was only 15 months. Implications of these recent developments are discussed in terms of teaching strategies, clinical experience and the inclusion of key educational issues such as early intervention. Recommendations are made for a continuation of the programme and for future outcome evaluation.
Trends in the development of alcohol and drug treatment services in Ontario: a replication and extension of a previous study
Authors: RUSH BRIAN , TYAS SUZANNE
Published: January 2006

This paper summarizes the major trends in the development of alcohol and drug treatment services in Ontario from 1979 to 1989. Data were obtained from all treatment services in the province by surveys undertaken in 1980, 1983, 1986 and 1989. Supplementary archival data are included on the use of American treatment programs by Ontario residents over a similar time period. Across the period of analysis, there has been a rapid increase in the number of alcohol and drug programs (130 to 217), their total cost ($44.4 million to $77.1 million) and the total treatment caseload (30356 to 61 622). With respect to different types of services, the largest growth in capacity has occurred for specialized assessment/referral centres. Use of short‐term residential resources within the province has risen slightly but this has been augmented by a rapid increase in the use of similar programs in the United States. Contrary to expectations from research evidence and provincial policy initiatives, only modest gains have been experienced with non‐residential treatment alternatives compared to the increases in availability and utilization of residential treatment programs.
ADH and ALDH genotype profiles in Caucasians with alcohol‐related problems and controls
Authors: GILDER FAY J. , HODGKINSON STEVE , MURRAY ROBIN M.
Published: January 2006

Eighty‐two Caucasian patients receiving treatment for alcohol‐related problems and eighty four controls were DNA typed for variants in the alcohol dehydrogenase (ADH2 and ADH3) and mitochondrial aldehyde dehydrogenase (ALDHJ gene loci. No association was observed between individual, or combined gene frequencies and the presence of alcohol‐related problems.
Criminal involvement of cocaine users enrolled in a methadone treatment program
Authors: KANG SUNG‐YEON , LEON GEORGE DE
Published: January 2006

This was a study of criminal activities of cocaine users versus non‐users enrolled in a methadone treatment program in New York City. Of those 140 methadone clients studied, 100 (71%) were cocaine users. There were no demographic differences between the two groups except marital status. Married clients (including common‐law married) were more likely than never‐married single clients to be non‐users. Cocaine users were significantly more depressed, using the subscale of the Symptom Checklist‐90. Although numbers of lifetime arrests and criminal involvement (in the year immediately preceding the research interview) of cocaine non‐users were distinctively lower than those of users, the differences were not significant. In a multiple regression analysis, length of stay in the methadone program was the strongest predictor of criminal involvement. Those who were retained longer in the treatment were significantly less likely to be involved in criminal activities, regardless of cocaine use.
HIV risk among women injecting drug users who are in jail
Authors: MAGURA STEPHEN , KANG SUNG‐YEON , SHAPIRO JANET , O'DAY JOANNE
Published: January 2006

Female offender populations and females in jail include large proportions of injecting drug users (IDUs), who are at high risk of contracting or transmitting HIV. Women IDUs (n = 165) were recruited and interviewed at New York City's central jail facility for women. The study examined these women's patterns of HIV risk behaviors related to drugs and sex and identified behavioral and attitudinal correlates of HIV serostatus. The women typically used both injectable and non‐injectable drugs prior to arrest, primarily heroin, cocaine powder, crack, and illicit methadone. Self‐reported HIV seropositivity was 43%. Variables correlated with HIV serostatus in the bivariate analysis were: cocaine injection frequency; lifetime injection risk behavior; providing oral sex during male crack use; Hispanic ethnicity; sharing of needles/syringes; sharing of cookers; sharing injection equipment with friends; heroin smoking (negative); injection risk acceptance; peer norms and behavior; lifetime sexual risk behavior; frequency of sex with men; provision of sex for money or drugs; and knowing people with AIDS. The first four variables listed retained statistical significance in a multiple logistic regression analysis. The paper considers the need to tailor AIDS prevention interventions for woman IDUs in jail, including taking into account risk behaviors that occur within frequently reported same‐sex partnerships.
The effect of parents' alcohol problems on children's behaviour as reported by parents and by teachers
Authors: CONNOLLY GARY M. , CASSWELL SALLY , STEWART JOANNA , SILVA PHIL A. , O'BRIEN MARY K.
Published: January 2006

Associations between parents' alcohol problems when children were aged 9 and children's behaviour at ages 9 and 13 as reported by parents and teachers were investigated. The sample consisted of participants in a multidisciplinary longitudinal study, data were collected by face‐to‐face interview. When compared to children with no or mild parental alcohol problems, children classified as having severe parental alcohol problems were more likely to display high levels of problem behaviour at age 9 as reported by teachers and at age 13 as reported by parents. Poorer family relationships, lower verbal and reading proficiency and being male were also associated with high levels of behaviour problems.
The influence of perceived social support on the relationship between family history of alcoholism and drinking behaviors
Authors: OHANNESSIAN CHRISTINE MCCAULEY , HESSELBROCK VICTOR M.
Published: January 2006

The present study examined the effect that perceived social support has on the relationship between having a family history of alcoholism and alcohol use in a sample of 85 adult children of alcoholics and a control group (n = 68). Social support from both peers and from family members were assessed for their potential differential effects. Gender differences were also examined. Overall, perceived social support from friends significantly moderated the relationship between family history of alcoholism and several indicators of alcohol use. In contrast, perceived social support from family members did not moderate any of the relationships examined. These findings emphasize the importance of considering different sources of social support when using social support as a moderating variable and the need to examine the underlying processes and variables involved in the relationship between having a family history of alcoholism and alcohol use.
An interview study of participants in the Tacoma, Washington, syringe exchange
Authors: HAGAN HOLLY , JARLAIS DON C. DES , PURCHASE DAVID , FRIEDMAN SAMUEL R. , REID TERRY , BELL THOMAS A.
Published: January 2006

Although European and Australian studies of syringe exchange programs have reported safer injection among participants and no increase in drug use, the generalizability of these findings to the US is uncertain. We report on the operations and potential effectiveness of the longest‐operating syringe exchange in the US and compare our results to studies of exchange programs outside the US. The sample of 204 study subjects reported no change in the frequency of injection, from 155 to 152 injections per month, and a decline in the frequency of unsafe injections, from 56 to 30 times per month, while participating in the program. In all studies, participants report reduction in unsafe injections, and no increase in illicit drug use. However, the comparison also suggests that a high proportion of Tacoma exchangers have higher initial rates of drug injection, unsafe injection and homelessness, all of which were associated with unsafe injection while using the exchange. These indicate a need for additional services but that the Tacoma program is no less effective than European and Australian programs.
Patterns of drug use and risk‐taking among injecting amphetamine and opioid drug users in Sydney, Australia
Authors: HALL WAYNE , DARKE SHANE , ROSS MICHAEL , WODAK ALEX
Published: January 2006

Data are presented on the patterns of drug use and HIV risk‐taking of daily amphetamine and opioid injectors among 1245 injecting drug users who were interviewed in Sydney in 1989. About one‐third of the sample had injected amphetamines during a typical month of injecting, and 12% were using amphetamines on a daily basis. Daily amphetamine injectors were younger, less well educated, and less likely to have engaged in drug treatment, but they were no more likely than daily opioid users to have shared injection equipment or to have engaged in other behaviour likely to transmit HIV. Although there seemed to be no special cause for concern about HIV risk‐taking among amphetamine injectors, there was nonetheless a high prevalence of sharing injecting equipment, with over half of daily amphetamine and heroin injectors having shared in the past several months. In addition, approximately a third of amphetamine injectors were injecting on a daily basis, a pattern of use which increases the risk of developing a severe dependence syndrome, and of experiencing an amphetamine‐induced psychosis.
Effect of low and moderate doses of alcohol on driving hazard perception latency and driving speed
Authors: WEST ROBERT , WILDING JOHN , FRENCH DAVINA , KEMP RICHARD , IRVING ALEX
Published: January 2006

Both driving speed and speed of detection of potentially hazardous events while driving have been found to correlate positively with accident rates across individuals. Alcohol ingestion is also known to increase risk of a traffic accident. This paper reports two double‐blind, placebo‐controlled studies: one on the effect of alcohol on driving speed and the other on the effect of alcohol on time taken to detect potential traffic hazards. Moderate drinkers aged between 30 and 55 took part. Each subject underwent three experimental conditions on separate days: no alcohol, low alcohol (0.025% BAC) and moderate alcohol (0.05% BAC). The order of conditions was counterbalanced. The moderate alcohol dose increased mean time taken to respond to hazards (2.5 s in no alcohol condition compared with 3.2 s in moderate alcohol condition) but did not affect mean driving speed (indexed by time taken to travel sections of a fixed route; 19.3 s in no alcohol compared with 19.0 s in moderate alcohol). The results support the view that at least part of the excess risk of accident associated with alcohol ingestion is attributable to an increase in the time taken to respond to traffic hazards.
Sensation seeking, gambling and gambling addictions
Authors: COVENTRY KENNY R. , BROWN R. IAIN F.
Published: January 2006

Male off‐course bettors were assessed using: the Sensation‐Seeking Scale (SSS) Form V, two measures of subjective arousal while betting, and questions concerning chasing, preferences for gambling activities and other aspects of betting behaviour. The SSS was also administered to a random sample of the male general population of Glasgow, together with questions concerning preferences for gambling activities to allow comparison between regular gamblers and the general population. In comparison with the general population and with non‐gamblers, off‐course bettors scored lower on SSS; gamblers preferring the casino and/or the race‐track scored higher on SSS; gamblers betting on many different forms scored higher on SSS. A further analysis produced a cluster of variables among off‐course betters associated with impaired control of gambling, among which both SSS scores and chasing were prominent features.
Gender differences in the individual characteristics and life contexts of late‐middle‐aged and older problem drinkers
Authors: BRENNAN PENNY L. , MOOS RUDOLF H. , KIM JULIA Y.
Published: January 2006

This study focuses on gender differences in the individual characteristics and life contexts of late‐life problem drinkers. Late‐middle‐aged women with drinking problems (n = 183) consumed less alcohol, had fewer drinking problems, and reported more recent onset of drinking problems than did their male counterparts (n = 476). They also used more psychoactive medications, were more depressed, and were less likely to seek alcohol treatment. Consistent with a gender role perspective on alcohol abuse, problem‐drinking women had more family‐related and fewer financial stressors than did problem‐drinking men. Contrary to expectation, however, problem‐drinking women reported more support from children, extended family members, and friends than did problem‐drinking men. Moreover, women who continued to have drinking problems over a 1‐year interval reported some unexpected short‐term benefits at follow‐up, including reduced spouse stressors. Women who had remitted at follow‐up experienced less spouse support, and more family‐related stressors and depression than did remitted men. They also lost support from extended family members over the 1‐year interval. The results suggest a need for screening and treatment efforts tailored more closely to the life circumstances of women with late‐life drinking problems.
Methodological approaches and problems in research into alcohol‐related accidents and injuries
Authors: REHM JÜRGEN
Published: January 2006

A classification system for methodologies and problems in research on alcohol‐related accidents and injuries is introduced. On the basis of this system, possible designs and statistical methods are presented, and their possible contributions to research on alcohol‐related accidents/injuries are evaluated. Special consideration is given to potential biases in secondary data sources, and to methods of overcoming these biases. Finally, the need for more theory‐driven research is established.
Personal willingness to pay for prevention: evaluating the consequences of accidents as a basis for preventive measures
Authors: JONES‐LEE M. W.
Published: January 2006

This paper argues that if scarce resources are to be allocated efficiently and to greatest advantage then it is necessary to have explicit monetary measures of the benefits of reduced accident rates so that these benefits can be weighed against costs in the process of determining the appropriate amount to expend on alcohol‐related accident prevention programmes. The conceptual issues related to the definition and estimation of monetary values of safety are discussed and the case in favour of basing such values on individual willingness to pay for safety is developed. The paper then summarises existing empirical estimates of wittingness‐to‐pay based values for the prevention of fatalities and reports the preliminary results of recent work aimed at estimating willingness‐to‐pay based values for the prevention of non‐fatal injuries. The paper concludes by examining the applicability of existing empirical estimates of the value of safety in the alcohol‐related accident context and the transferability of estimates derived in developed countries to the developing country context.
The occurrence and epidemiologic features of alcohol‐related occupational injuries
Authors: STALLONES LORANN , KRAUS JESS F.
Published: January 2006

This paper presents a review of published literature on alcohol‐related occupational injuries. Based on the information presented the true magnitude of the problem of alcohol‐ and work‐related injuries has not been accurately assessed and the epidemiologic features of this problem have not been properly evaluated. There is some evidence, albeit incomplete, that alcohol contributes to work‐related injuries, but the extent is not known. Further, the risk of injury by specific industry and occupation has not yet been elucidated. Analytic studies which include control groups and which assess confounding variables are needed so as to aid in the design of effective countermeasure strategies. Even when alcohol is detected, its role in the causal pathway from the worker‐energy interaction to injury onset (or exacerbation) has not been studied.
Issues in cross‐national comparisons of crash data
Authors: VOAS ROBERT B.
Published: January 2006

While national accident record systems appear to provide an attractive method of comparing the effectiveness of traffic safety programs, differences in definitions, data collection methods and file structure may lead to misleading conclusions. Variations in crash definitions and methods for measuring alcohol involvement are described and illustrated with data from US crash files. Examples of international comparisons are provided.
The role of alcohol providers in prevention: an evaluation of a server intervention programme
Authors: Gliksman Louis , McKenzie Diane , Single Eric , Douglas Ronald , Brunet Suzanne , Moffatt Kenneth
Published: January 2006

Server intervention is a relatively new approach in the attempt to reduce the incidence of drinking and driving. Although a number of evaluations have suggested that the approach may be effective, there have been few comprehensive evaluations of such programmes. The present study utilized process evaluation techniques to assess reactions to a programme developed by the Addiction Research Foundation, and a quasi‐experimental design to determine the impact of the programme on the serving practices of servers. Actors portrayed behaviors often faced by servers, and observers rated the reactions of the servers, who were unaware of the simulations, to these situations. The programme appears to have been effective in changing behavior, in that trained servers exhibited less inappropriate responses than did untrained servers. In addition the results suggested that the programme increased servers' knowledge about their obligations and potential strategies for dealing with these situations. The implications of these findings for future implementations of such programmes are discussed.