bluuebunny/crossref_metadata_2025_split huggingface dataset:
Client‐reported reasons for non‐engagement in drug and alcohol treatment
Authors: COULSON CAROLYN , NG FELICITY , GEERTSEMA MARJAN , DODD SEETAL , BERK MICHAEL 
Published: August 2010

Abstract
Introduction and Aims. To examine client‐reported reasons for missed early appointments at a drug and alcohol treatment service and to compare characteristics of those who missed appointments with those who attended. Design and Methods. Clients who missed a first or second appointment between 1 May and 31 August 2007 at a public community‐based outpatient treatment facility were invited to participate in a semistructured telephone interview. This consisted of an open‐ended question asking the reason(s) for nonattendance, followed by a questionnaire of items for therapeutic alliance and service satisfaction, perceived impact of substance use and previous treatment experience, mostly rated on Likert scales. Database information on demographic and clinical variables was gathered for all clients who were accepted for treatment within the study time frame. Characteristics of those who missed a first or second appointment (n = 66) were compared with those who attended at least their first two appointments (n = 97). Results. Of clients who missed their appointments, 80.6% provided reasons for nonattendance, which included extraneous factors (50.0%), service shortcomings (29.7%), no further need for service (16.2%) and motivational ambivalence (4.1%). They generally had high ratings of therapeutic alliance and service satisfaction and identified their substance use as having a negative impact on their lives. Clients who missed appointments were more likely to be male, unmarried and have a history of polysubstance use. Discussion and Conclusions. Extraneous issues relating to the client may be a dominant obstacle in early treatment engagement. Efforts to overcome these issues may therefore improve early engagement.[Coulson C, Ng F, Geertsema M, Dodd S, Berk M. Client‐reported reasons for non‐engagement in drug and alcohol treatment. Drug Alcohol Rev 2009;28:372–378]
Overdose deaths following previous non‐fatal heroin overdose: Record linkage of ambulance attendance and death registry data
Authors: STOOVÉ MARK A. , DIETZE PAUL M. , JOLLEY DAMIEN 
Published: August 2010

Abstract
Introduction and Aims. Experiencing previous non‐fatal overdoses have been identified as a predictor of subsequent non‐fatal overdoses; however, few studies have investigated the association between previous non‐fatal overdose experiences and overdose mortality. We examined overdose mortality among injecting drug users who had previously been attended by an ambulance for a non‐fatal heroin overdose. Design and Methods. Using a retrospective cohort design, we linked data on non‐fatal heroin overdose cases obtained from ambulance attendance records in Melbourne, Australia over a 5‐year period (2000–2005) with a national death register. Results. 4884 people who were attended by ambulance for a non‐fatal heroin overdose were identified. One hundred and sixty‐four overdose deaths occurred among this cohort, with an average overdose mortality rate of 1.20 per 100 person‐years (95% CI, 1.03–1.40). Mortality rate decreased 10‐fold after 2000 coinciding with widely reported declines in heroin availability. Being male, of older age (>35 years) and having been attended multiple times for previous non‐fatal overdoses were associated with increased mortality risk. Discussion and Conclusions. As the first to show a direct association between non‐fatal overdose and subsequent overdose mortality, this study has important implications for the prevention of overdose mortality. This study also shows the profound effect of macro‐level heroin market dynamics on overdose mortality.[Stoové MA, Dietze PM, Jolley D. Overdose deaths following previous non‐fatal heroin overdose: Record linkage of ambulance attendance and death registry data. Drug Alcohol Rev 2009;28:347–352]
The effectiveness of brief alcohol interventions in primary care settings: A systematic review
Authors: KANER EILEEN F. S. , DICKINSON HEATHER O. , BEYER FIONA , PIENAAR ELIZABETH , SCHLESINGER CARLA , CAMPBELL FIONA , SAUNDERS JOHN B. , BURNAND BERNARD , HEATHER NICK 
Published: August 2010

Abstract
Issues. Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre‐specified search strategy was used to search all relevant electronic databases up to 2006. We also hand‐searched the reference lists of key articles and reviews. We included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta‐analyses, subgroup and sensitivity analyses and meta‐regression were conducted. Key Findings. The primary meta‐analysis included 22 RCT and evaluated outcomes in over 5800 patients. At 1 year follow up, patients receiving brief intervention had a significant reduction in alcohol consumption compared with controls [mean difference: −38 g week−1, 95%CI (confidence interval): −54 to −23], although there was substantial heterogeneity between trials (I2 = 57%). Subgroup analysis confirmed the benefit of brief intervention in men but not in women. Extended intervention was associated with a non‐significantly increased reduction in alcohol consumption compared with brief intervention. There was no significant difference in effect sizes for efficacy and effectiveness trials. Conclusions. Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care. [Kaner EFS, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, Saunders JB, Burnand B, Heather N. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev 2009;28:301–323]
Rates of alcohol consumption and risk status among Australian university students vary by assessment questions
Authors: UTPALA‐KUMAR RANJANI , DEANE FRANK P. 
Published: August 2010

Abstract
Introduction and Aims. Different self‐report methods tend to produce different estimates of alcohol consumption. The present study compares differences in rates and risk levels based on responses to a modified version of the Daily Drinking Questionnaire (m‐DDQ) and quantity‐frequency (QF) questions. Design and Methods. The sample comprised 2082 university students, 61% of whom were female and 39% male with a mean age of 23.5 years. An email containing an online link to a brief six‐question survey was emailed to students enrolled in participating faculties at the University of Wollongong, Australia. Current drinkers completed m‐DDQ and QF questions about alcohol consumption. Results. QF methods identified significantly lower estimates of consumption (Mean = 9.15, SD = 12.51) compared with m‐DDQ (Mean = 13.06, SD = 14.07). Allocation to risk categories based on the Australian Alcohol Guidelines were conducted for both the m‐DDQ and QF methods. Almost twice as many students were found to be drinking at levels considered risky using the m‐DDQ method compared with QF. In addition, the relative rank order of participants varied significantly between the two methods. Discussion and Conclusions. The m‐DDQ method identified higher rates of drinking and categorised almost twice as many individuals into risky categories of drinking compared with QF. Such variations have major implications for identification of risk groups in health promotion or prevention programs.[Utpala‐Kumar R, Deane FP. Rates of alcohol consumption and risk status among Australian university students vary by assessment questions. Drug Alcohol Rev 2009]
Surveillance of drug use among young people attending a music festival in Australia, 2005–2008
Authors: LIM MEGAN S. C. , HELLARD MARGARET E. , HOCKING JANE S. , SPELMAN TIM D. , AITKEN CAMPBELL K. 
Published: August 2010

Abstract
Introduction and Aims
. In order to monitor trends in illicit drug use among youth, surveillance of drug use behaviours among a variety of populations in different settings is required. We monitored drug use among music festival attendees. Design and Methods. Cross‐sectional studies of young people's reported drug use were performed at a music festival in Melbourne from 2005 to 2008. Self‐administered questionnaires collected information on drug use, demographics and other risk behaviour. Results. From 2005 to 2008, over 5000 questionnaires were completed by people aged 16–29; 2273 men and 3011 women. Overall, use of any illicit drug in the past month was reported by 44%. After adjusting for demographic and behavioural characteristics, the prevalence of recent illicit drug use decreased significantly from 46% in 2005 to 43% in 2008 (OR 0.92, 95% CI 0.87–0.97). After adjusting for age and sex the downwards trend was repeated for amphetamines and cannabis, but a significant increase in prevalence was observed in hallucinogen, ecstasy and inhalant use. Drug use was more common among men, older participants and those engaging in high‐risk sexual behaviour. Discussion and Conclusions. Illicit drug use was much more common in this sample than in the National Drug Strategy Household survey, but the direction of trends in drug use were similar; drug use prevalences were much lower than in the Ecstasy and Related Drugs Reporting System, the Illicit Drug Reporting System or National Needle and Syringe Program Survey. Music festival attendees are a potentially useful group for monitoring trends in illicit drug use. [Lim MSC, Hellard ME, Hocking JS, Spelman TD, Aitken CK. Surveillance of drug use among young people attending a music festival in Australia, 2005–2008. Drug Alcohol Rev 2009]
Difficulty accessing syringes and syringe borrowing among injection drug users in Bangkok, Thailand
Authors: KERR THOMAS , FAIRBAIRN NADIA , HAYASHI KANNA , SUWANNAWONG PAISAN , KAPLAN KARYN , ZHANG RUTH , WOOD EVAN 
Published: August 2010

Abstract
Introduction and Aims.
Thailand's longstanding HIV epidemic among injection drug users (IDU) has been attributed, in part, to the Thai government's unwillingness to implement evidence‐based HIV prevention interventions. This study was undertaken to examine risk factors for syringe borrowing among a community‐recruited sample of Thai IDU. Design and Methods. We examined the prevalence of syringe borrowing among 238 IDU participating in the Mit Sampan Community Research Project, Bangkok. Multivariate logistic regression was used to identify independent predictors of syringe borrowing in the past 6 months. Results. A total of 238 IDU participated in this study; 66 (26.2%) were female, and the median age was 36.5 years. In total, 72 (30.3%) participants reported borrowing a used syringe in the past 6 months, with 47 (65.3%) of these individuals reporting multiple borrowing events. In multivariate analyses, syringe borrowing was positively associated with difficulty accessing syringes [adjusted odds ratio (AOR) = 2.46; 95% confidence interval (CI): 1.08–5.60] and injecting with other people on a frequent basis (AOR = 3.17; 95% CI: 1.73–5.83). Primary reasons offered for experiencing difficulty accessing syringes included being too far from syringe outlets (34.1%), pharmacies being closed (13.6%) and being refused syringes at pharmacies (9.1%). Discussion and Conclusions. We observed an alarmingly high rate of syringe borrowing among a community‐recruited sample of Thai IDU. Various lines of evidence indicate that poor access to sterile syringes is driving the high rate of syringe borrowing observed in this study. Immediate action should be taken to increase access to sterile syringes among Thai IDU. [Kerr T, Fairbairn N, Hayashi K, Suwannawong P, Kaplan K, Zhang R, Wood E. Difficulty accessing syringes and syringe borrowing among injection drug users in Bangkok, Thailand. Drug Alcohol Rev 2009]
Ineligibility and refusal to participate in randomised trials of treatments for drug dependence
Authors: MELBERG HANS O. , HUMPHREYS KEITH 
Published: August 2010

Abstract
Issues. The aim of this study is to examine the extent to which drug‐dependent patients are ineligible for or unwilling to participate in randomised clinical trials. This is important because unrepresentative sample selection is a potentially important problem for randomised trials in the drug dependence field and little is known about the magnitude of the problem. Approach. A total of 98 clinical trials were drawn for analysis from a systematic review of the drug dependence treatment literature. Key Findings. The trials reviewed excluded an average of 29% of potential subjects as ineligible; a further 29% of the eligible subjects were unwilling to participate. Trials comparing widely different treatments had a higher proportion of ineligible and unwilling subjects than did studies comparing more similar treatments. Experiments with large samples enrolled a smaller proportion of patients from their sampling pool than did experiments with small samples. Implications. Drug‐dependent trial subjects are a minority of all drug patients seen in real‐world clinical practice. It is necessary to improve the reporting of these potential problems in randomised trials. Systematic reviews of the literature ought to use this information to distinguish reliable from less reliable findings. Conclusion. Unrepresentative sample selection is a serious problem for randomised trials in the drug dependence field.[Melberg HO, Humphreys K. Ineligibility and refusal to participate in randomised trials of treatments for drug dependence. Drug Alcohol Rev 2009]
Phytocannabinoids, CNS cells and development: A dead issue?
Authors: DOWNER ERIC J. , CAMPBELL VERONICA A. 
Published: August 2010

AbstractIssues.Marijuana and hashish consist of at least 66 distinctive plant‐derived (phyto‐) cannabinoid compounds, with tetrahydrocannabinoids proving the most effective phytocannabinoid psychotropically. Despite the known pharmacological effects of phytocannabinoids, their role in controlling the cell survival/death decision in cells of the CNS continues to be unravelled.Approach.In this review, we examine the influence of phytocannabinoids on neural cell fate, with particular emphasis on how the time of marijuana exposure (neonatal vs. pubertal vs. adult) might influence the neurotoxic activities of phytocannabinoid compounds.Key Findings.Evidence in the literature indicates that exposure to phytocannabinoids during the prenatal period, in addition to the adolescent period, can alter the temporally ordered sequence of events that occur during neurotransmitter development, in addition to negatively impacting neural cell survival and maturation. Regarding the effect of marijuana consumption on brain composition in adults the evidence is contradictory.Implications.Exposure to marijuana during pregnancy might impact negatively on brain structure in the first years of postnatal life. Furthermore, early‐onset (before age 17) marijuana use might also have damaging effects on brain composition.Conclusion.The neonatal and immature CNS is more susceptible to phytocannabinoid damage. In the adult CNS the data are conflicting and the continued development of methods to assess whether marijuana consumption results in brain atrophy or morphometric changes will determine if structural changes are occurring. [Downer EJ, Campbell VA. Phytocannabinoids, CNS cells and development: A dead issue?Drug Alcohol Rev2009]
Promoting tobacco dependence treatment in nursing education
Authors: SARNA LINDA , BIALOUS STELLA A. , RICE VIRGINIA H. , WEWERS MARY ELLEN 
Published: August 2010

Abstract
Issues. There are 17.3 million nurses worldwide, the largest group of health‐care professionals, and they have great potential to address the epidemic of tobacco use and its related morbidity and mortality. However, the evidence indicates that the educational preparation of nurses for tobacco control remains inadequate. Approach. This paper provides an overview of the efficacy of nurses in the delivery of smoking cessation interventions, existing tobacco control content in nursing educational programs, model curricula, teaching resources and strategies for reducing barriers to curricular change. Key Findings. Despite the efficacy of nursing intervention for tobacco cessation, lack of appropriate knowledge and/or skill presents a major problem for implementation. An important factor fostering this lack of preparation is limited tobacco control content in current nursing educational programs. Barriers to enhancing and building this curricula include lack of preparation of educators, low priority for this content in an already overloaded curricula, negative attitudes, continued smoking by nursing students and/or faculty and lack of tested curricula. The availability of new tobacco control resources, including those specifically tailored for nurses can assist educators in teaching this content and nurses in implementing interventions. Implications. Research and changes in policy are needed to ensure that nursing education includes essential content on tobacco control. Conclusion. Nurses can be effective in delivering tobacco cessation interventions. Efforts are needed to promote curriculum that ensures that all nursing students and practicing nurses receive tobacco control content and are competent in the delivery of interventions; and to disseminate resources to nursing educators.[Sarna L, Bialous SA, Rice VH, Wewers ME. Promoting tobacco dependence treatment in nursing education. Drug Alcohol Rev 2009;28:507–516]
Evidence‐based practice or imperfect seduction? Developing capacity to respond effectively to drug‐related problems
Authors: ALLSOP STEVE J. , STEVENS CLARE F. 
Published: August 2010

Abstract
Issues. The last two or three decades have seen some valuable investment in workforce development. However, significant challenges remain in developing effective practice across various systems. Despite the relevance alcohol, tobacco and other drug use have for a range of staff across diverse organisations, adoption of cross‐sector and collaborative effective practice is not widespread. The most common response involves a rather singular focus on strategies that develop practitioner knowledge and skills, with much less consideration given to the complex nature of the work environment and the belief systems of people who work in these environments. Approach. This paper explores the barriers to and facilitators of effective practice, extending beyond the common focus on education and training initiatives. A model of capacity building is explored as a template to inform workforce and organisational development strategies. Key Findings. Numerous barriers, outside education and training, must be considered in order to develop and maintain effective practice across various systems of prevention and treatment. The paper culminates with recommendations on how to overcome such challenges. Implications. Workforce and organisational development must extend beyond education and training initiatives. Along with a focus on organisational and system factors, we must also attend to the marginalisation of people affected by drug use and associated pejorative attitudes. Conclusion. Developing effective practice in the drug field involves changing the structures, and expected outcomes of these structures, in which people work, not just encouraging a few to use new ways of working in spite of the system.[Allsop SJ, Stevens CF. Evidence‐based practice or imperfect seduction? Developing capacity to respond effectively to drug‐related problems. Drug Alcohol Rev 2009;28:541–549]
The acceptability of combined methadone‐naloxone treatment: Consumer and provider views on the potential utility of methadone‐naloxone
Authors: SHEARER JAMES , MAMMEN KRISTIE , BELL JAMES 
Published: August 2010

Abstract
Introduction and Aims. The aim of the study was to investigate the acceptability of methadone‐naloxone through interviews with potential consumers and treatment providers about their attitudes and beliefs about combining methadone with naloxone. Design and Methods. Qualitative study with structured surveys and individual interviews with nine consumers and 11 treatment providers. Results. Fear and issues around trust were identified as barriers to consumer acceptance of methadone‐naloxone. Respect for the choices that consumers made about their treatment and drug use, and clear and open communication were identified as necessary to win consumer acceptance. Both groups had concerns about the safety and efficacy of methadone‐naloxone compared with methadone, but also most identified potential benefits from a new opioid treatment option. Discussion and Conclusions. For both groups, the acceptability of methadone‐naloxone depended upon an informed assessment of risks and benefits best addressed by further research into the efficacy, tolerability and safety of methadone‐naloxone.[Shearer J, Mammen K, Bell J. The acceptability of combined methadone‐naloxone treatment: Consumer and provider views on the potential utility of methadone‐naloxone. Drug Alcohol Rev 2009]
Process evaluation of the implementation of a screening and brief intervention program for alcohol risk in primary health care: An experience in Brazil
Authors: AMARAL MICHAELA B. , RONZANI TELMO M. , SOUZA‐FORMIGONI MARIA LUCIA O. 
Published: August 2010

AbstractIntroduction and Aims.Screening and brief intervention (SBI) are considered good prevention strategies for alcohol‐related problems in Primary Health Care (PHC). The aim of this study was to evaluate the process of an SBI implementation program for alcohol risk use and evaluate the factors that facilitated or impeded this implementation, in two PHC settings at the Brazilian city of Juiz de Fora.Design and Methods.Case 1 public PHC services and case 2 the PHC service of the Military Police. Participants were trained on SBI strategies and supervised during 6 months. The qualitative methodology of action research was used. Data were analysed using thematic analysis.Results.Case 1: 70 participants; facilitating factors: good expectations about the project; simplicity of SBI technique; collaborative way the project was planned. Barriers: lack of time; discomfort in dealing with alcohol issues; focus on alcohol‐dependence; unstable political environment; other priorities; difficulties in patients' referral. Case 2: nine participants. Facilitating factors: simplicity of SBI technique; collaborative way the project was planned; importance of alcohol issues; data confidentiality and the voluntary work to do SBI. Barriers: only one health professional in the group; the variability of the institutional support; organisational culture about alcohol use.Discussion and Conclusions.The barriers and facilitators were related to two main factors: organisational culture and personal attitudes. The action research provided the opportunity to bridge the gap between research and practice, but it also showed that SBI faces significant challenges before it can be implemented as a routine procedure in PHC settings in Brazil. [Amaral MB, Ronzani TM, Souza‐Formigoni MLO. Process evaluation of the implementation of a screening and brief intervention program for alcohol risk in primary health care: An experience in Brazil.Drug Alcohol Rev2009]