bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complementary and alternative medicine in the treatment of substance use disorders—a review of the evidence
Authors: BEHERE RISHIKESH V. , MURALIDHARAN KESAVAN , BENEGAL VIVEK 
Published: August 2010

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

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

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

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

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

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

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

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

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

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

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

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