bluuebunny/crossref_metadata_2025 huggingface dataset:
Management Problems in a Small Hostel with a Controlled Drinking Programme
Authors: Gilligan Toni , Norris Hugh , Yates Fred. E.
Published: January 2006

The report describes some difficulties encountered in the management of a hostel for problem drinkers, which offered a controlled drinking programme. Compared with a similar hostel with an abstinence programme, there were more incidents of illicit drinking and consequent disruption. A number of reasons for this are discussed, in particular the difficulty of defining illicit drinking in the controlled drinking programme. The dual function of drinking limits in alcoholism treatment programmes, as both treatment aim and rule, is considered. It is concluded that the problems arose from a clash between the rule functions of the hostel and the drinking aim, not from the controlled drinking aim in itself. Suggestions for other ways of managing a controlled drinking programme are offered.
Increasing Alcohol Consumption Correlated with Hospital Admission Rates
Authors: Poikolainen Kari
Published: January 2006

Correlations between per caput alcohol consumption and male hospital admission rates for alcoholism, alcohol psychosis, alcohol poisoning, liver cirrhosis and pancreatitis were studied in 11 Finnish provinces in 1969‐1975. Since data for successive years are not independent, mean values were analysed both between years and between provinces. Between years, significant positive correlations were found between alcohol consumption and each of the diseases studied. Between provinces, similar correlations were observed for all diseases except alcohol poisoning. Increasing per caput alcohol consumption seems to be followed by rising hospital admission rates due to alcohol‐related diseases.
A Review of the Problem‐Prevention Approach to Drinking Problems and an Alternative Programme which makes use of Natural Preventive Resources within the Community
Authors: Yates Fred , Hebblethwaite David
Published: January 2006

There is now emerging a long overdue recognition that preventive work in the area of drink‐related problems has its own special responsibilities and is not simply adjunctive to the treatment of individuals with identified drinking difficulties. Upholders of this position [10, 11, 13, 14] believe that preventive work should address clearly formulated concrete problems outside treatment and design specific strategies to deal with them. Although we agree that previous preventive schemes have been misconceived, we feel that an alternative movement should do more than submit an agenda of specific social problems to prevention workers. In this article we express some doubts we have about the prevention of drinking problems as an exclusively pragmatic undertaking and develop a more general theme based on the investigation of existing community responses to drinking problems.
Alcohol Consumption During Pregnancy: Baseline Data from a Scottish Prospective Study
Authors: Plant Moira L.
Published: January 2006

The results are reported from the first of four phases of a prospective study on the association between alcohol consumption during pregnancy and fetal harm. These data revealed a generally low level of alcohol consumption amongst the 1, 008 respondents. Self–reported alcohol consumption was slightly, but significantly, positively correlated with previous obstetric problems. Evidence from other studies indicates that between 1.8 per cent and 4.8 per cent of the study group may run an enhanced risk of producing damaged babies.
Effect of Nicotine Replacement on the Cigarette Withdrawal Syndrome
Authors: West R. J. , Jarvis M. J. , Russell M. A. H. , Carruthers M. E. , Feyerabend C.
Published: January 2006

The effect of nicotine replacement on the cigarette withdrawal syndrome was investigated in 48 smokers, who were randomly allocated to chew either 2 mg or.5 mg nicotine gum over 24 hours of cigarette abstinence. Characteristic withdrawal symptoms were observed on the low dose (.5 mg) gum: i.e. increased irritability, depression, restlessness, dizziness and hunger, and decreased ability to concentrate, sociability and composure when in company. In addition there was a drop in heart rate and urinary adrenaline excretion. The 2 mg gum alleviated problems of irritability, depression, and difficulties related to social interaction but not hunger or ability to concentrate. It also reduced the drop in heart rate from 14.9 to 9.7 bpm. The results support the view that nicotine deprivation per se plays a significant role in certain withdrawal effects.
Management of Solvent Misuse: A Glasgow Community Approach
Authors: Sourindhrin I. , Baird J. A.
Published: January 2006

The broad spectrum approach to the management of solvent abuse adopted at a clinic held at a police station in the East End of Glasgow, in collaboration with members of the community involvement branch of the police, is described. The results reported in this study concern 300 children below the age of 16years, who attended the clinic between October 1978 and December 1980. The facets of the study which are of central interest are: the role of the police, the apparent resolution of the activity, the lack of physical damage, the very low incidence of associated psychiatric disorder, and the increased incidence of solvent use by children of single parent families and in those families where the father is unemployed and in only a minority of cases is there a mixed disturbance of conduct and emotions for which psychiatric intervention is warranted.
The Moderating Influence: A Review of. Trade‐Sponsored Alcohol Education Programmes
Authors: Grant Marcus
Published: January 2006

This paper reviews the aims, target audience and content of alcohol education programmes sponsored by trade associations from the beverage alcohol industry. The predominance of programmes promoting the concept of moderation directed towards young people emerges as the most striking single trend. Whilst the relative scarcity of objective evaluations of the effectiveness of alcohol education is lamentable, the author points to the possibility of establishing useful dialogue between health educators and the beverage alcohol industry over the issue of the limits of moderate consumption.
A Multivariate Analysis of Psychological, Clinical and CT Scanning Measures in Detoxified Chronic Alcoholics
Authors: Acker W. , Ron M. A. , Lishman W. A. , Shaw G. K.
Published: January 2006

Psychological, clinical, and CT scanning measures of 100 detoxified male alcoholics and 30 controls are reported. There were statistically significant group differences in psychological and CT scanning measures. However, individual differences in premorbid intelligence accounted for more of the variance in psychological performance than did clinical data (drinking history) or CT scanning measures. The clinical relevance of these findings is discussed.
A Week and a Day
Authors: Older Jules
Published: January 2006

In an experiment conducted as part of Alcohol Alert Week, 30 employees of the New Zealand Department of Health were asked to abstain from alcohol for 8 days. Twelve abstained completely and two drank an only one occasion. Both abstainers and non‐abstainers learned something about their own, and New Zealand, attitudes to alcohol during the course of the experiment.
Alcohol Policy in a Crisis Situation
Authors: Wald Ignacy , Moskalewicz Jacek
Published: January 2006

The impact of the 1980 political crisis on Polish drinking is described. Alcohol prices began to rise, temporary prohibition was introduced and the military government felt it necessary to take a number of active steps to deal with excessive drinking. Long queues began to appear at liquor shops, and in late 1981 liquor rationing was introduced. All that forces combined to produce a dramatic fall in consumption. In July 1982 alcohol rationing began to be lifted. Together these events provide an interesting example of a ‘natural experiment’, illustrating the effects of multiple and acute social measures and social change on population drinking.
Tobacco Smoking Addiction: A Challenge to the National Health Service
Authors: Webster Charles
Published: January 2006

Pioneer researches concerning the connection between the smoking addiction and lung cancer provided the National Health Service with its first major test in the field of preventive medicine. It is instructive to examine how this problem was handled in the period 1950 to 1962. The NHS legislation of 1946 envisaged that the new service would take on art active preventive role and that it would respond flexibly to new demands. At the heart of the new central administration was an elaborate professional advisory machinery designed precisely for the purpose of ensuring prompt response to new needs.

The connection between smoking and lung cancer became a live issue in the immediate post‐war period through the researches of Kennaway sponsored by the British Empire Research Campaign. This work was carried to a striking conclusion in the epidemiological context by Doll and Hill in 1950. Subsequent investigations strongly supported their conclusions.

Within the Ministry of Health smoking and lung cancer was the prerogative of the Cancer Standing Advisory Committee, for which this problem was an uncongenial side issue. Positive action was precluded by strong objections within the Cancer SAC to‘cancer education'. A vociferous minority within the advisory structure campaigned to generate a more positive attitude, but once formed there was great reluctance to modify, let alone reverse, medical policy decisions. Eventually the unresponsive Cancer SAC was by‐passed. The more prestigious and broadly based Medical SAC and the Central Health Services Council gradually awoke to the importance of this issue. Crucial to keeping this issue alive was the increasing publicity in the press which resulted in persistent parliamentary questioning.

Complete conversion was rendered more difficult by virtue of lack of sympathy of Ministers and officials within the Ministry of Health. MRC generally supported the work of Doll and Hill, but a strongly positive and independent line would have prejudiced relations with the Ministry of Health. A distinct change in the official attitude awaited the 1962 report of the Royal College of Physicians, after which further procrastination seemed inadmissible. But even then, after 12years of inactivity, the National Health Service was not mobilized to make smoking and health a major issue on its agenda.
The Impact of Alcohol on Health in the General Population: A Review with Particular Reference to Experience in Malmo
Authors: Kristenson Hans , Hood Bertil
Published: January 2006

More than 30,000 individuals have been investigated in the continuous screening and intervention study in Malmo. The impact of alcohol on health has been evaluated by comparing alcohol intake as established at the initial interview with results of screening investigations, clinical records, social register data and mortality analysis. In addition, large subsamples of individuals with different levels of serum GOT (gamma‐glutamyl‐transferase) have been followed up. GGT has proved to be a useful and simple tool in identifying and treating heavy drinkers and monitoring their outcome. It also appears to be a strong risk factor for short term mortality in the male population.

In the intervention study, counselling and repeated feedback of GGT results in a group of middle‐aged heavy drinkers resulted in a significant reduction in sick absence, hospitalization and mortality, compared with that in a control group over a period of 60 months. As the intervention program seems to be effective in preventing alcoholism on an individual basis, there is need for more manpower and more intervention attempts within general medicine to reduce the enormous impact of alcohol on health.
Under‐Reporting of Alcohol Consumption in Sample Surveys: The Effect of Computer Interviewing in Fieldwork
Authors: Duffy John C. , Waterto Jennifer J.
Published: January 2006

Sources of biasin population surveys of alcohol consumption are discussed. The effect of computer interviewing in survey fieldwork is assessed on the basis of a recent population survey in Edinburgh.
A Week and a Day
Authors: Older Jules
Published: January 2006

In an experiment conducted as part of Alcohol Alert Week, 30 employees of the New Zealand Department of Health were asked to abstain from alcohol for 8 day3. Twelve abstained completely and two drank on only one occasion. Both abstainers and non‐abstainers learned something about their own, and New Zealand, attitudes to alcohol during the course of the experiment.
Gender and Smoking: Do Women Really Find it Harder to Give Up?
Authors: Jarvis Martin
Published: January 2006

Data are cited from national surveys of smoking in Great Britain and the United States which challenge the widely held belief that women find it harder to give up smoking than men. Men have higher cigarette cessation rates than women, but when smoking and ex‐smoking prevalences are adjusted to take account of switching to cigars, which in ex‐cigarette smokers appears to be an equally hazardous and addictive form of tobacco use, the sex difference in cessation is almost eliminated. In Great Britain in 1982 the cigarette cessation rates of 44 per cent in men and 32 per cent in women became 37 and 32 per cent respectively after adjustment for secondary cigar smoking, and there was no difference in adjusted cessation between men and women below the age of 50 (26 per cent in each case). Similarly in the U.S. in 1975 the male excess of 9 percentage points in cigarette cessation reduced to 3 per cent after adjustment. Allowance for secondary pipe smoking, tobacco chewing and snuff taking would probably reduce this difference still further. It is concluded that there is at present little evidence of a sex difference in ease of smoking cessation in the general population and it is recommended that future discussions of this issue should take into account forms of tobacco use other than cigarettes.
The Impact of a New Alcohol Sensitizing Agent (Nitrefazole) on Craving in Severely Dependent Alcoholics*†
Authors: Stockwell Tim , Sutherland Gay , Edwards Griffith
Published: January 2006

An experiment was performed to discover whether 800 mgm nitrefazole (an alcohol sensitizing agent) would block or reduce the‘priming effecf of alcohol on craving in severely dependent drinkers [12, 13].

Subjects were tested 3 days (n =8) and 6 days (n =8) after nitrefazole or placebo in balanced order. Subjective and physiological parameters were monitored beforehand after consumption of 0.25 gm/kg alcohol and also after a “speed of drinking test” of craving [17]. Significant effects occurred for tests at 3 days, but not 6 days after nitrefazole. On 3 day tests, subjects experienced lowered diastolic blood pressure, increased pulse rate and hand tremor, as well as increased drinking speed of test drinks for nitrefazole compared with placebo.

It is concluded that at 3 and 6 days after ingestion of nitrefazole, desire for alcohol is still increased when a severely dependent drinker breaks his abstinence. The possibility that nitrefazole enhances such priming effects after 3 days is discussed.
Plasma Nicotine Concentrations from Repeated Doses of Nasal Nicotine Solution
Authors: West Robert J. , Jarvis Martin J. , Russell Michael A. H. , Feyerabend Colin
Published: January 2006

A nasal nicotine solution (NNS) has been proposed as a potential cessation aid for cigarette smokers [1], the principle being similar to that underlying use of nicotine chewing gum, i.e. nicotine replacement following cessation to ease withdrawal symptoms. We conducted a study to determine the plasma nicotine concentrations resulting from eight, hourly administrations of 2 mg NNS. The peak plasma nicotine concentrations rose to an average of 16.3 ng/ml, which is higher than is normally obtained from 2 mg nicotine chewing gum. There was considerable variability in levels obtained from the NNS, with one subject obtaining levels similar to those found in heavy cigarette smokers. The initial doses produced noticeable light headedness in four of the five subjects. Nasal nicotine solution could provide more effective nicotine replacement than nicotine gum.
International Review Series: Alcohol and Alcohol Problems Research 3. Nordic Countries
Authors: Bniun Kettil , Rosenqvist Pia
Published: January 2006

This paper describes the development of alcohol research in Denmark, Finland, Iceland, Norway, and Sweden. Different organizational structures have developed. In Finland and Norway, separate research institutes carry the main research responsibility. Sweden, with its several university chairs for alcohol research, has chosen an internationally unique organizational solution. The orientation, content, and recent trends in social alcohol research are dealt with on the basis of data from the 1970s and recent research reports; the main differences between the countries are discussed. Existing Nordic cooperation is also described.
The Genetic and Cultural Transmission of Alcohol Use, Alcoholism, Cigarette Smoking and Coffee Drinking: A Review and an Example using a Log Linear Cultural Transmission Model
Authors: Curling H. M. D. , Grant S. , Dangl J.
Published: January 2006

The simplifying assumptions made by geneticists in the study of behaviour have been reviewed and their relation to the genetics of substance use and abuse have been specified. The most notable problems are the validity of genetic estimates for substance use based on twin data when within twin pair competition or mutual effects have been shown to be present and the fact that broad secular changes in alcohol consumption render heritability values valid only for certain populations at specific points in time. Behaviour genetic methods can however provide information about different sources of environmental variation and tend to show that the family is of little importance, especially for personality traits as well for some aspects of substance use. A simple model to investigate familial and cultural transmission is suggested for traits such as substance use that do not appear, on a priori grounds, to have a strong genetic predisposition.
Self‐Reported Alcohol Consumption and Adverse Consequences of Drinking in Three Areas of Britain: General Population Studies
Authors: Crawford Alex , Plant Martin A. , Kreitman Norman , Latcham Richard W.
Published: January 2006

Official rates of alcohol‐related problems are highest in the North, and lowest in the South of Britain. As pan of a wider study of regional variations, surveys of self‐reported levels of alcohol consumption and adverse consequences of drinking were simultaneously conducted within 3 areas of Britain. These were Highland and Tayside Regions in Scotland, and part of the South East Thames Area Health Board in England. These areas have markedly different rates of alcohol related problems. It was found that these variations were not reflected in differences in either levels or patterns of self‐reported alcohol consumption. It is suggested that care has to be exercised when interpreting official statistics relating to area differences in problem‐drinking.
Tar and Nicotine Yields of U.K. Cigarettes 1972–1983: Sales‐weighted Estimates from Non‐industry Sources
Authors: Jarvis M. J. , Russell M. A. H.
Published: January 2006

We have estimated sales‐weighted tar and nicotine yields of cigarettes in the United Kingdom from 1972 to 1983 using sources outside the tobacco industry. Our estimates are shown to be valid and accurate, and can be quickly updated.

The data show a substantial decline of 27 per cent in overall sales‐weighted tar yields from an average of 20.5mg per cigarette in 1972 to 15.0mg in 1983, whereas the sales‐weighted nicotine yields over this period have remained static at about 1.3mg per cigarette. Likewise, the proportion of smokers who smoke a low‐tar brand (<11mg) has stuck at about 15 per cent since 1977. This suggests a barrier to consumer acceptability which appears to be linked mare closely to nicotine than to tar. Finally, there has been an overall 26 per cent reduction in the ratio of tar yield to nicotine yield, from a sales‐weighted average of 15.5 in 1972 to 11.5 in 1983. Thus it appears that, without having to reduce their nicotine intake, British smokers may now be exposed to about a quarter less tar than in 1972, and this includes the majority who have not switched to a low tar brand.
Alcoholism and the Nature of Outcome
Authors: Duckitt Anita , Brown David , Edwards Griffith , Oppenheimer Edna , Sheehan Margaret , Taylor Colin
Published: January 2006

A great deal of previous work has been directed to conceptual and methodological issues relating to descriptions of outcome’ in studies of career, natural history, and treatment of alcoholism. There is still no consensus even on basic measures of drinking behaviour which would allow comparison between reports, and the ‘dynamic’ of relationships between variables remains obscure. This paper uses data from a 10–12 year follow‐up of 68 interviewed male alcoholics to explore simple and partial correlations between outcome variables, relating both to the total follow‐up period and the 12 months prior to interview. In several instances significant correlations are found between outcomes in different domaines, but the levels of correlation which are reached suggest that outcome cannot be conceived as a simple unitary dimension, while the pattern of partial correlations begins to reveal the underlying dynamic of relationships. Outcome may need to be conceived not just in terms of end points or scores, but in terms of the processes in which the individual becomes caught up.
Alcohol and Alcohol Problems Research 8. Scotland
Authors: PLANT MARTIN , PLANT MOIRA L.
Published: January 2006

Scotland is part of the United Kingdom. In spite of this Scotland has a considerable degree of autonomy in relation to the provision of help for problem drinkers. It is noted that traditionally Scottish culture is ambivalent towards the use and misuse of alcohol. Scientific interest in this topic has been evident since the early Nineteenth Century and a disproportionately high percentage of U.K. alcohol research has been conducted in Scotland.
The Severity of Alcoholism and its Relation to Intellectual Impairment and Cerebral Atrophy
Authors: MELGAARD B. , DANIELSEN U. T. , SØRENSEN H. , AHLGREN P.
Published: January 2006

The seventy of alcoholism has been evaluated in a group of chronic alcoholics by means of a modified Missouri Alcohol Seventy Scale and an alcohol exposure index. No correlation could be established between severity scores and intellectual impairment or cerebral atrophy.
The Validity of the Short Alcohol Dependence Data (SADD) Questionnaire: a short self‐report questionnaire for the assessment of alcohol dependence
Authors: DAVIDSON ROBIN , RAISTRICK DUNCAN
Published: January 2006

The evidence for the unitary nature of alcohol dependence is discussed and the usefulness of existing instruments to measure dependence is reviewed. Three separate studies are presented that support the validity of SADD. Several measures of construct and concurrent validity are investigated including comparison with the SADQ and EADS. Attention is drawn to the discriminating characteristics of SADD in the mild/moderate dependence range.
How Much is Too Much? Estimates of hazardous drinking based on clients' self‐reports
Authors: SANCHEZ‐CRAIG MARTHA
Published: January 2006

The utility of an empirically determined criteria of consumption for determining problem from problem‐free drinking in treated clients was assessed. The criterion used was an average of four or more drinks/on an average of 3 or more days per week. Subjects were 55 early‐stage problem drinkers followed‐up after treatment and categorized as ‘problem’ or ‘problem‐free’ on the basis of their self‐reports. Significantly higher levels of alcohol consumption were obtained for the problem group. While the mean quantity and frequency of drinking of this group were above both criterion levels, the mean quantity and frequency of the problem‐free group were below. Self‐reported drinking was corroborated by independent measures of GGT (gamma glutamyl transpeptidase). Of the subjects who exceeded both criteria 77% reported problems, of those who were below both criteria 4.5% had problems, and of those who were above only one criterion about 40% reported problems. These findings can be useful to clinicians, as a rule of thumb, in assisting problem drinkers who wish to reduce their alochol intake to non‐hazardous levels.
Use of Urinary Nicotine Concentrations to Estimate Exposure and Mortality from Passive Smoking in Non‐Smokers
Authors: RUSSELL M. A. H. , JARVIS M. J. , WEST R. J.
Published: January 2006

Data on urinary nicotine concentrations in smokers and non‐smokers were used to estimate exposure and risks from passive smoking in non‐smokers. The average concentration in 188 urban non‐smokers was 10.8 ng/ml which was 0.7% of the average of 1471 ng/ml in a sample of 229 cigarette smokers. This suggests that the amount of nicotine that non‐smokers absorb from passive smoking is about 0.7% of the intake of smokers. The proportionate intake of tar and gases such as carbon monoxide is likely, if anything, to be higher. If the risk of death is in direct proportion to dose, passive smoking may account for the premature death of about 1000 non‐smokers a year in Britain and more than 4000 per year in the United States.
Monoamines and Alcohol
Authors: NUTT DAVID , GLUE PAUL
Published: January 2006

For many years alcohol (ethanol) has been known to interact with the three major CNS neurotransmitters, noradrenaline, dopamine, and 5‐hydroxytryptamine. This work, originally based on animal studies, has more recently been extended into man with interesting findings both on the effects of alcohol on monoamine neurotransmitters and possibilities that abnormalities of these substances may act as pre‐disposing factors for alcoholism. Studies on noradrenaline show that it seems to be affected by alcohol in all phases of administration with an overall tendency to increasing turnover, and is most obviously manifest by the withdrawal signs. Drugs which affect noradrenergic receptors to reduce turnover, e.g. clonidine, seem to be of value in treating alcohol withdrawal. Abnormalities of dopamine function may contribute to the paranoid psychosis which may develop in alcoholism, and also to the hallucinosis and confusion seen in withdrawal. 5‐HT seems to be involved in alcohol appetite and preference. It may also be involved in the development of tolerance. The possibility that reduced noradrenaline and/or 5‐HT function may predispose to alcoholism is supported by a number of observations. However, much further work in this direction is needed before we can be certain of the role of either of these neurotransmitters.
Neuropsychological Deficits in Alcoholics: the relative contributions of gender and drinking history
Authors: ACKER CLARE
Published: January 2006

Alcoholic inpatients at Bexley Hospital Treatment Unit were selected for cognitive assessment on a routine ‘consecutive admission’ basis. The male and female alcoholic groups performed significantly worse on the cognitive tests than matched controls.

The ‘consecutive admission’ samples of 72 males and 33 females differed widely on drinking history data; males having significantly severer histories. The females performed worse on tests of immediate recall, and psychomotor speed. This performance difference endured whether the male and female groups were equated for drinking history differences statistically (by co‐variance analysis), or by selection criteria (subject matching).

The finding is discussed in the context of a greater vulnerability in women to the deleterious effects of alcohol, while noting the methodological complexities which prevent firm conclusions about causality. One possible conclusion is that females are more susceptible than males to the harmful effects of prolonged heavy drinking on cognitive performance. Alternatively, it may be that those females who become alcoholic are ‘at risk’ in some unspecified way which is reflected in the present performance differences.
Cannabis Psychosis in Young Psychiatric Inpatients
Authors: ONYANGO RICHARD S.
Published: January 2006

A survey of 25 consecutive admissions to a psychiatric hospital of patients aged 35 and under reveals that cannabis use is reported by up to 48% of patients, but that it could be verified by urine tests in only 17.4%. The presence of cannabis in the urine appeared to play little part in the phenomenology of the illness in all except one patient. A case history of this one identified patient with cannabis psychosis is described and discussed.
‘I Need Heroin’. Thirty Years’ Experience of Drug Dependence and of the Medical Challenges at Local, National, International and Political Level. What Next?
Authors: CONNELL PHILIP H.
Published: January 2006

This lecture reviews the experiences of the author over some 30 years of work in the field of drug misuse at local, national and international levels. Attention is drawn to the situation existing in the late 1960's when the Dangerous Drugs Act 1967 came into force. The thinking behind the then new approach is reviewed. Developments since 1968 are reviewed and in particular the work of the Advisory Council on the Misuse of Drugs is highlighted in that it has produced important reports which have been accepted by government and on which published government policies have been based. The creation of the Institute for the Study of Drug Dependence and the Standing Conference on Drug Abuse is noted. Nevertheless, grave anxiety is expressed that because of problems in financing, problems of co‐ordination, problems of setting up evaluation and the paucity of experts in this field the situation may arise that in 20 years’ time the urgent and present need for evaluation has not been met and clinical practice remains personal and idiosyncratic. The new factors of AIDS and ‘designer drugs’ are referred to and the presence at any one time of a large handicapped population of drug misusers who do not accept treatment but require basic health care in society is stressed.
Cannabis Psychosis
Authors: GHODSE A. HAMID
Published: January 2006

There is clear evidence from countries where heavy use of cannabis is common, that it can cause a short‐lived, toxic psychosis characterized by confusion, delusions, hallucinations and emotional lability. This clinical experience is supported by laboratory experiments showing that, A‐P tetrahydrocannabinol (THC), the most active constituent of cannabis, has dose‐related psychotomimetic effects. Evidence that cannabis causes a functional, paranoid psychosis or a chronic psychosis that persists after drug use ceases, is much less convincing although regular, heavy users may suffer repeated short episodes of psychosis and effectively maintain themselves in a chronic psychotic condition. Prolonged effects such as flashbacks and depersonalization may occur because cannabis and its metabolites are eliminated only very slowly from the body. Reports of such consequences, at present often dismissed as anecdotal, therefore, warrant careful attention and analysis.
Abstinence or Controlled Drinking in Clinical Practice: a test of the dependence and persuasion hypotheses
Authors: ORFORD JIM , KEDDIE ALISTAIR
Published: January 2006

Forty‐six clients of a clinical psychology service were assigned, in accordance with a three‐step design which involved a random element, to abstinence (ABST) or controlled drinking (CD), and were followed up to 12 months after initial assessment. No support was found for the dependence hypothesis: those with higher levels of dependence/severity assigned to CD and those with lower levels assigned to ABST were just as likely as other clients to do well, and there was no relationship between level of dependence/severity and the type of drinking outcome (ABST or CD). There was tentative support for the hypothesis that experience in the follow‐up year would be related to initial beliefs and preferences, although these were not independent of treatment type. The present report is not able to comment on the prediction of outcome in the longer term.
Sex Differences in Alcohol Consumption and its Associated Morbidity in Young Civil Servants
Authors: JENKINS RACHEL
Published: January 2006

An examination of alcohol consumption and its relationship with minor psychiatric morbidity, general practitioner consultations, sickness absence and labour turnover in a cohort of young white collar employees revealed substantial sex differences in the quantity of alcohol consumed in the previous week, and also in the degree to which consumption of more than 30 units/week was associated with increased levels of psychological symptoms, general practitioner consultations sickness absence and labour turnover. These findings underline the need for urgent revaluation of what is a safe quantity of alcohol to consume for either sex.
Aspects of the Provision of a Drug Screening Service for a Therapeutic Community
Authors: ANNESLEY R. , FORREST A. R. W. , JENNER F. A.
Published: January 2006

A system for providing a drug screening service to a Therapeutic Community is. described. It has proved acceptable to both clinical and laboratory staff, being economical in its use of expensive reagents, whilst generating rapid and reliable results.
Female Alcoholics: a controlled CT brain scan and clinical study
Authors: JACOBSON ROBIN
Published: January 2006

A consecutive series of 26 female alcoholics and 41 controls were interviewed and examined with a CT brain scan. Alcoholics had greater ventricular enlargement, and widening of sulci and conical fissures than controls. These abnormalities occurred after a much shorter drinking history and at a lower peak alcohol consumption than usually reported in male alcoholics. The clinical associations of the CT scan changes are described, and the implications are discussed.
The Distribution of Alcohol Consumption—30 years on
Authors: DUFFY J. C.
Published: January 2006

The Ledermann theory and its implications for alcohol control policy have been the source of considerable controversy. This paper describes the original theory and subsequent modifications, and a brief review of the extensive debate on the subject is presented. It is concluded that the implications of the Ledermann theory concerning alcoholism and the experience of alcohol‐related harm are based on an inadequate foundation. More precise estimation of risk functions relating harm to consumption will be of importance in the development and acceptability of alcohol control policy.
Alcoholism and the Patterning of Outcome: a multivariate analysis
Authors: TAYLOR COLIN , BROWN DAVID , DUCKITT ANITA , EDWARDS GRIFFITH , OPPENHEIMER EDNA , SHEEHAN MARGARET
Published: January 2006

This study takes a particular data set deriving from 10‐year follow‐up information on 68 male alcoholics as basis for exploring patterns of outcome in multivariate terms. A Principal Components Analysis demonstrates that degree of dependence is intrinsic to the patterning of outcome. The overall relationship between dependence and holistic outcome is a ‘Janus’ effect: high dependence may be related either to good or to bad outcome in different circumstances. When there is good outcome in terms simply of abstinence, dependence then further predicts within abstinent patients the overall quality of outcome which will be achieved. The need for a multivariate model is underlined.
Data Note—6. The U.K. Alcohol and Tobacco Industries
Authors: BOOTH MARK , HARDMAN GEOFFREY , HARTLEY KEITH
Published: January 2006

The Data Note series is edited by David Robinson, ESRC Addiction Research Centre, University of Hull, Hull HU6 7RX to whom all comments and suggestions for future notes should be sent.
The Concept of Control and Alcoholism
Authors: BERGMARK ANDERS , OSCARSSON LARS
Published: January 2006

Clinical perspectives, as e.g. the Alcohol Dependence Syndrome and the position stated by the advocates of controlled drinking suffer from a defective analysis of how the concept of control is used within their own theoretical framework. The basic problem seems to stem from the absence of an articulated and unambiguous definition of the concept control. In order to avoid theoretical inconsistencies we here propose, as an analytic device, a distinction between teleological and causal explanations of human behaviour. This distinction leads to two basic connotations of the control concept which are not compatible within a particular scientific discourse. Our main point is not that just one version of control is possible, but rather that the two basic interpretations of control which we propose create confusion when used as if they referred to the same phenomenon, or as if they were compatible.

By analyzing the concept control–and the negation of it–within the Alcohol Dependence Syndrome and the theoretical framework which surrounds controlled drinking as a therapeutic goal, we attempt to point out the practical and theoretical problems generated by the use of an unarticulated control concept.
The Feasibility of Effective Psychopharmacological Treatments for Alcoholism
Authors: SINCLAIR J. D.
Published: January 2006

The effects of lithium, anxiolytics, dopaminergic compounds, serotonin uptake inhibitors, opiates, opiate antagonists, and alcohol‐sensitizing drugs on the alcohol consumption of human alcoholics and laboratory animals are reviewed. There is increasing evidence that each of these classes of drugs might be beneficial in reducing alcohol abuse, including recent controlled studies on alcoholics with lithium, serotonin uptake Mockers, and disefulram. The usefulness of all of the current drugs, however, appears limited, and the ideal drug for use in treating alcoholism awaits discovery. Nevertheless, the fact that some drugs acting on the central nervous system are able to promote abstinence supports the feasibility of psychopharmacological treatment for alcoholism. Furthermore, since the known drugs that appear beneficial against human alcohol abuse also suppress voluntary alcohol selection by experimental animals, it seems likely that studies with animals could be used for screening other potentially effective drugs.
The Specific Gravity of the Brains of Alcoholic and Control Patients: a pathological study
Authors: HARPER CLIVE G. , KRIL JILLIAN J. , DALY JOHN M.
Published: January 2006

In recent pathological studies the authors have shown that the brain shrinkage seen in alcoholics is due to a loss of tissue from the white matter and not the cortical grey matter. In order to address the question of the pathogenesis of this shrinkage the Specific Gravity (SG) of the frontal, parietal and occipital grey and white matter of alcoholics and age‐ and sex‐matched controls was measured. The alcoholics were found to have a consistent, but not significant, reduction in SG. Alcoholics with Wernicke's encephalopathy (WE) showed similar changes. The decrease in SG in alcoholics with cirrhosis was significant. This pattern of change, in the absence of a large variation in brain water content, suggests that the loss of tissue is probably balanced so that protein/lipid/ carbohydrate ratios are not appreciably different in controls and alcoholics.
The Economic Cost of Alcohol‐related Health Care in New Zealand
Authors: RAYNER TONY , CHETWYND JANE
Published: January 2006

This paper estimates the economic cost of the extra health care in New Zealand associated with the misuse of alcohol. From a range of different studies it was estimated that 7.8% of hospital operating costs were attributable to alcohol consumption. These additional costs formed 85.5% of the total increase in health costs related to excess alcohol consumption. The estimate of this total, NZ$108.3m., represented 0.4% of New Zealand GNP for 1981–82.
The Impact of Per Capita Consumption on Swedish Cirrhosis Mortality
Authors: Norström Thor
Published: January 2006

On the basis of Swedish data for the period 1931–80 the impact of per capita consumption on male cirrhosis mortality is estimated. The lag structure which is specified takes the short‐term as well as the long‐term effect into consideration. According to the findings, a one litre increase in per capita consumption leads to an increase in male mortality from cirrhosis of about 60% when enough time has passed for the total effect to have been established. This estimate appears to be quite large, e.g. it is approximately five times greater than one which was estimated from Danish data. The discrepancy will be a subject for further research.
The Detection of Problem Drinkers in the Accident & Emergency Department
Authors: YATES D. W. , HADFIELD J. M. , PETERS K.
Published: January 2006

Demographic, clinical and biochemical information relating to alcohol use was obtained from every patient aged 16 and over attending two Accident & Emergency (A & E) departments over a 2‐week period (1693 cases) in an attempt to identify characteristics of patients with alcohol‐related problems. Measurement of the Blood Alcohol Concentration (BAC) alone fails to detect the majority of heavy drinkers attending an A & E department and clinical assessment of drunkenness is not accurate in many cases. A combination of questionnaire and BAC measurement is more accurate. Many patients attend A & E departments in an inebriated state during the evening. However, many more, with alcohol problems, present at other times of the day. The latter are often sober, with none of the florid stigmata of physical, psychological, or social complications of alcohol abuse. Particular attention should be paid to male patients, those who claim to have been assaulted, those arriving by taxi and the unemployed. Casualty Officers should be advised to take a very brief alcohol history in such cases. Any patient thereby identified as having an alcohol‐related problem should be encouraged to discuss the issue at greater length with his or her general practitioner.
The Use of Hospital Beds for the Treatment of Excessive Drinkers Without Serious Medical Complications
Authors: OGBORNE ALAN C. , ADRIAN MANUELLA
Published: January 2006

During fiscal year 1983–84, Ontario general hospitals admitted 2651 patients with a primary diagnosis of alcohol dependence or non‐dependent use of alcohol but with no secondary diagnoses requiring treatments only available in hospital. These averaged 10.7 days in hospital and the total cost of their hospitalization (excluding medical services) was estimated at $7.4 million. Many of these admissions appear to have been for alcohol detoxication or for psychosocial treatments of alcohol abuse. Because alternative, more cost‐effective methods for detoxication and treatment are suggested by the research literature, efforts to use and develop such alternatives in local communities are recommended.
Alcohol Problems in General Practice
Authors: AASLAND OLAF GJERLØW , BRUUSGAARD DAG , RUTLE OLAV
Published: January 2006

A survey was conducted among 179 general practitioners and 3497 of their patients on the role of alcohol with regard to general health. 11.2% of the patients were considered by their doctors to be in a ‘possible alcohol problems group’, and an even higher proportion of the patients themselves felt this to be the case.
Large Decreases in Alcohol‐related Problems Following a Slight Reduction in Alcohol Consumption in Ontario 1975–83
Authors: SMART REGINALD G. , MANN ROBERT E.
Published: January 2006

In Ontario, per capita consumption of alcohol rose steadily from 1963 to 1975. Beginning in 1975, constomption stabilized and declined slightly (2.6%) to 1983. Correlational analyses of the data during the period of consumption increase demonstrated significant associations between consumption and all problem indices. During the period of consumption stabilization the linear relationships between consumption and problem indices appeared to break dozen; most of the problem indices declined more than would be expected. The possible contributions of changes in demographic factors, consumption patterns, and prevention treatment efforts to these declines are discussed.
Cognitive Processes in Addiction
Authors: WILSON G. TERENCE
Published: January 2006

In recent years there has been a large increase in the number of theoretical papers and empirical studies which focus upon the cognitive processes involved in addiction. This paper is intended simply to illustrate selected theories and concepts and to highlight some of the avenues of research which are helping to change our models of addiction. The main conceptual framework is that which has come to be known as social learning or cognitive social learning theory but concepts of self awareness, perceptual narrowing and self‐handicapping are also described. Implications for the understanding of craving, loss of control, treatment and relapse are also considered.
Change Processes in Psychotherapy
Authors: SHAPIRO DIANA , SHAPIRO DAVID A.
Published: January 2006

Efforts to understand the processes of change in psychotherapy have typically been based on either clinicians' experiences or on empirical studies somewhat removed from the day‐to‐day work and concerns of psychotherapists. This paper reviews selected examples of insights and issues derived from each of these sources. It is suggested that our understanding of change processes in psychotherapy will be enhanced by the growing convergence between the two approaches.
Government Prevention Policy and the Relevance of Social Cost Estimates
Authors: WAGSTAFF ADAM
Published: January 2006

Estimates of the social costs associated with the consumption of hazardous commodities such as alcohol, cigarettes and illicit drugs feature prominently in the current debate on prevention policy. Such figures are being increasingly used to urge greater government action on prevention. This paper presents an introduction to the welfare economics of government intervention in markets for hazardous commodities and concludes that—contrary to what is often presumed—social cost estimates can never identify situations where greater government involvement is warranted. Policy‐makers would therefore seem to be justified in ignoring campaigns for greater government action which are based on social cost figures.
A Double‐blind Placebo Controlled Study of Male Alcoholics Given a Subcutaneous Disulfiram Implantation
Authors: JOHNSEN JON , STOWELL ALLAN , BACHE‐WIIG JON ERIK , STENSRUD TORE , RIPEL A°SE , MØRLAND JØRG
Published: January 2006

Twenty‐one alcoholics participated in a double blind study to elicit information of the clinical effect of implanted disulfiram. They were randomized to either of two groups, 11 patients to the placebo group and 10 patients to the disulfiram group. Each patient was subjected to seven sessions of intravenous ethanol challenge, once before and six times during the first 20 weeks after implantation. The acute ethanol challenge did not result in any differences between the groups with respect to blood ethanol and acetaldehyde concentrations. No patient showed any clinical signs of disulfiram‐ethanol reaction. After a study period of 20 weeks no significant differences were found between the groups with regard to the reduction in average ethanol consumption, days from implantation to the first drink and number of abstinent weeks. Our results do not support the idea that a 1 g disulfiram implant has any pharmacological or clinical action.
The Application of the SODQ to the Measurement of the Severity of Opiate Dependence in a British Sample
Authors: PHILLIPS G. T. , GOSSOP M. R. , EDWARDS G. , SUTHERLAND G. , TAYLOR C. , STRANG J.
Published: January 2006

It has been suggested that opiate dependence may be regarded as a separate dimension independent of drug‐related problems. A self‐administered multiple choice questionnaire has been developed to assess the severity of opiate dependence. In the present study the questionnaire was administered to 107 British opiate addicts. Two factors emerged from an analysis of the structure. Various measures of validity were taken and these are reported and discussed. The relationship between these findings and the results obtained from a previous study of American addicts is discussed.