bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research in general practice for smokers and excessive drinkers in Australia and the UK. I. Interpretation of results
Authors: RICHMOND ROBYN L. , ANDERSON PETER 
Published: January 2006

AbstractThis review examines the role of the general practitioner in assisting patients to stop smoking and in reducing levels of excessive drinking. After over a decade of clinical trials, vie discuss what interventions work in general practice and interpret the results of clinical trials conducted predominantly in Australia and the UK. Studies have generally found a superiority of GPs’ brief advice over non‐intervention groups. Very brief GP advice results in smoking abstinence rates from 5% to 10%, reduction in alcohol consumption of around 25–35% and reduction in proportions of excessive drinkers of around 45%. The greater investment of GPs’ time and the more comprehensive interventions which include follow up usually resulted in higher abstinence rates among smokers from between 20% to 36%, and reduction in proportions of excessive drinkers of up to 60–70%. The contributions of the adjuncts nicotine chewing gum, follow up visits and the personalisation of health effects are discussed. It is difficult to make comparisons between studies and toe examine some of the reasons. The predictors of successful outcome are presented as they are of particular interest to GPs in terms of targeting health promotion activities.
A comparison of alternative measures of alcohol consumption in the Canadian National Survey of alcohol and drug use
Authors: SINGLE ERIC , WORTLEY SCOT 
Published: January 2006

AbstractBased on the results of the 1989 National Alcohol and Drug Survey in Canada, this paper compares alternative measures of alcohol consumption. Utilizing questions developed by Walter Clark, the volume of drinking in a variety of social situations is described. The results are presented in terms of aggregate consumption and the proportion of total consumption which occurs in different situations. It is found that anchoring self‐reported alcohol use in specific social contexts results in higher estimated consumption than the more commonly used quantity/frequency questions.
Chronotype and personality factors in the daily consumption of alcohol and psychostimulants
Authors: ADAN ANA 
Published: January 2006

AbstractThis paper analyses the influence of and possible interaction between chronotype (Morning‐types, Neither‐types and Evening‐types} and personality dimensions (neuroticism, extroversion and psychoticism) in the daily consumption of alcohol and psychostimulants (nicotine and caffeine). In a sample of 537 subjects (257 men and 280 women), who were students and professionals with different but fixed work schedules, there were significant differences among the chronotypes regarding the consumption of all the above. Evening‐types consumed more alcohol, nicotine and caffeine (coffee and cola), while Morning‐types consumed more caffeine from tea. Personality was only related to the consumption of cola: the greater the neuroticism the higher the consumption of this beverage. Stimulant drinks showed various types of interaction with personality types, which revealed a complex pattern of group action. The results stress the need to consider chronotype as a contributory psychological factor in a multi‐causal model of consumption of psychoactive substances.
Explanations for sharing injection equipment in injecting drug users and barriers to safer drug use
Authors: ROSS MICHAEL W. , WODAK ALEX , STOWE AARON , GOLD JULIAN 
Published: January 2006

AbstractWe examined the explanations given by a sample of 1245 injecting drug users in Sydney, Australia for accepting used injection equipment. Factor analysis of these reasons revealed three dimensions of sharing: not caring when withdrawing or intoxicated, unavailability of equipment, and not seeing it as high risk or ease of injecting. The most common reasons given were difficulty in obtaining sterile equipment (73% of cases), the dangers not seeming so important when in withdrawal (40%) and sharing being something done with friends or lovers (31%). Most common reasons for not sharing were related to health issues (91% citing AIDS and 67% hepatitis). These data suggest that interventions target provision of sterile equipment, and education which highlights risk situations such as intoxication and withdrawal.
The ability of young people to purchase alcohol without age identification in northeastern Minnesota, USA
Authors: FORSTER JEAN L. , McGOVERN PAUL G. , WAGENAAR ALEXANDER C. , WOLFSON MARK , PERRY CHERYL L. , ANSTINE PAMELA S. 
Published: January 2006

AbstractThe purpose of this study was to determine the rate at which young people can purchase alcohol without age identification in off‐premises businesses, and the factors which influence the rate of purchase. All retail outlets licensed to sell distilled spirits and/or full strength beer and wine in 28 northern Minnesota communities were visited on different occasions by three 21‐year‐old female buyers who appeared to be aged 19 or younger. These youthful buyers were able to purchase beer without age identification in 47% of the 336 purchase attempts. Almost four‐fifths of the businesses sold beer to these buyers at least once in three attempts. These results provide clear evidence that many commercial off‐sale businesses in the US supply alcohol to youthful buyers, and that practices vary significantly by community and by business. These results support the need for greater attention to availability as a factor in teenage drinking patterns.
Systemic absorption and abuse liability of snorted flunitrazepam
Authors: BOND ALYSON , SEIJAS DANIEL , DAWLING SHEILA , LADER MALCOLM 
Published: January 2006

AbstractBenzodiazepine hypnotics are widely abused as pan of a polydrug misuse culture. This study set out to investigate some pharmacokinetic and pharmacodynamic characteristics of a novel method of abuse, snorting, of flunitrazepam. Twenty healthy volunteers took pan: three took 0.5 mg, three took I mg, three took l.5 mg, six took 2 mg and five took placebo. Blood was sampled and ratings of mood, bodily symptoms, strength and liking of drug effect were completed pre‐ and at 5, 15, 30, 60, 90, 120 and 240 minutes and at 24 hours post‐drug. It was found that flunitrasepam could be detected in venous blood 5 minutes after intake. As the dose increased, the peak plasma concentration was higher but also occurred progressively later, the levels reached being comparable to oral or intramuscular administration at 110 minutes. Subjects reported sedation but complained of few side‐effects. They liked the drug effects and subjective ratings of strength were correlated with liking and with plasma drug levels.
Mortality in alcoholic patients given inpatient treatment
Authors: FEUERLEIN W. , KÜFNER H. , FLOHRSCHÜTZ T. 
Published: January 2006

AbstractData on mortality during a 48‐month follow‐up period in a group of 1410 alcoholics who had received inpatient treatment were evaluated. In 1266 patients known to be either living or deceased the death rate was 7.6%. The percentage of deceased subjects was highest in the group over SO years of age. The mortality rate was higher for men (9.8%) than for women (4.8%); for those with more than one divorce (16.8%); for those who were not fit for work (18.1%) of were retired at the start of the treatment (43.3%); who were employed in the alcohol business (21. 7%); who had reduced their alcohol consumption before treatment (13.4%); who were unemployed 6 months after discharge (12.4%). The mortality rate was higher for those with high scores on a scale assessing calmness in a personality inventory (7.9%) and low scores on a questionnaire assessing motivation (10.9%) and insight into the need of change (12.4%). Alcohol‐related illness before the index treatment played an important role: the mortality rate was higher for those who had had Wemicke‐Korsakoff syndrome (40%), delirium tremens (15.3%), pancreatitis (13.9%) or cardiomyopathy (14.1%). The mortality rate was higher for treatment dropouls (12.9%) and for those who regularly or occasionally took sleeping pills (28.5%), psychoactive drugs (15.1%) or other drugs (11.5%) during treatment. In the follow‐up periods substance use had a great effect on mortality. The mortality rate or those patients who still abstained from alcohol after 6 months (4.4%) was only a third of that for the patients who had relapsed (12.4%). Patients who took drugs during the 18‐month follow‐up period also had higher mortality rates: sleeping pills, 9.6%; psychoactive drugs, 9.7%, analgesics 10.7%. Logistic regression identified significant variables at admission: not fit for work, retired, job related to alcohol, suffering from Wernicke‐Korsakoff syndrome and no insight for change.
Assessment of the alcohol withdrawal syndrome—validity and reliability of the translated and modified Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA‐A)
Authors: STUPPAECK C. H. , BARNAS C. , FALK M. , GUENTHER V. , HUMMER M. , OBERBAUER H. , PYCHA R. , WHITWORTH A. B. , FLEISCHHACKER W. W. 
Published: January 2006

AbstractThe alcohol withdrawal syndrome is a common phenomenon in psychiatric hospital care. Not only treatment strategies, but also the evaluation of the syndrome, are discussed controversially. The most widely used instrument is the Clinical Institute Withdrawal Assessment‐Alcohol (CIWA‐A) and the succeeding CIWA‐Ar. We modified the CIWA‐A and translated it into German. Validity and reliability of the modified and translated scale were analysed by several psychological tests as well as different somatic measures in 31 patients. The German version appears to be a valid and reliable instrument for the assessment of alcohol withdrawal syndrome useful for clinical routine as well as treatment trials.
Needle Park: what can we learn from the Zürich experience?
Authors: HUBER CHRISTIAN 
Published: January 2006

AbstractNeedle Park in Zürich existed as an open air drug scene from 1986 until February 1992. Within this six year period the City Government, City Parliament, governmental and non‐governmental organizations implemented a wide range of permissive and restrictive drug policies, from extensive harm reduction to closing the park. Police statistics and several studies suggest that tolerating an open air drug scene can have unforeseen and unfortunate consequences. Low drug prices, lack of law enforcement and lack of social control seem to attract drug users towards the open drug scene and the increase in problems appears to have been more rapid than the increase in the population of addicts.
Negative affect, alcohol expectancies and alcohol‐related problems
Authors: JOHNSON PATRICK B. , GURIN GERALD 
Published: January 2006

AbstractUsing data from the first epidemiological study of mainland Puerto Rican drinking, the authors explore the relationships between negative affect, alcohol expectancies and drinking problems. Results revealed that the co‐occurrence of depressed mood and drinking problems was strongly moderated by alcohol expectancies. More specifically, the co‐occurrence was strongest among those Puerto Ricans who most expected alcohol to elevate their mood. Findings are discussed in terms of their explication of the co‐morbidity of depressive symptomatology and alcohol abuse.
Correlates of sexual risk‐taking among gay male substance abusers
Authors: PAUL JAY P. , STALL RON D. , CROSBY G. MICHAEL , BARRETT DONALD C. , MIDANIK LORRAINE T. 
Published: January 2006

AbstractThis paper examines sexual risk‐taking within a sample of sexually active gay and bisexual men entering substance abuse treatment (n= 383), and identifies correlates of unprotected anal sex within this group. Sexual risk‐taking was high, with 55% of these men engaging in anal intercourse without a condom within a 90–day period. Correlates of unprotected anal sex varied somewhat when looking at unprotected anal sex with a primary partner only and with non‐primary partners; substance use variables (number of drugs used, use of inhalant nitrites or stimulant drugs with sex, length of time since use of alcohol/drugs, loss of control problems associated with alcohol/drug use) appear to play more of a role in unprotected anal sex with non‐primary partners. Overall, logistic regression analyses indicated that sexual risk was greater for those who were more sexually active, enjoyed unprotected anal sex with withdrawal prior to ejaculation, did not approve of sex outside of a love relationship, and identified themselves as more risky. In addition, those who reported more social problems due to substance use had fewer expectations that substance use increased risk, had been HIV‐tested, and used reappraisal/problem‐solving coping strategies showed greater risk with a primary partner only. Sexual risk with non‐primary partners was greater for those who used more drugs, reported more difficulty avoiding high‐risk sex when aroused and were HIV + The paper discusses the implications of these findings for the design of sexual risk‐reduction interventions.
Alcohol and drug intoxication during police interrogation and the reasons why suspects confess to the police
Authors: SIGURDSSON JON F. , GUDJONSSON GISLI H. 
Published: January 2006

AbstractThis study investigates the effects of alcohol, drug intoxication and withdrawal symptoms on the mental state of criminal suspects and the nature of their confession. A total of 359 sentenced prisoners were approached on admission and 96% agreed to participate in the study. They completed a specially designed Confession Questionnaire, which asked them questions about their reasons for confessing to the police, their attitude towards their confession, their mental state at the time of the confession and the extent to which they had been under the influence of alcohol and drug intoxication at the time of crime and police interview. The confession rate for the sample was very high (92%), with serious traffic violators having the highest confession rate (95%) and sex offenders the lowest (83%). The findings illustrate that the “perception of proof”, “internal need to confess” and “external pressure” are the main reasons why suspects confess. However, subjects were identified who had experienced a typical “prisoner's dilemma” phenomenon during the police interview because of a co‐defendant. Alcohol and drug intoxication was very commonly reported both at the time of the offence and the police interview, but these were related to the nature of their offence. Although intoxication and withdrawal symptoms did not appear to seriously impair their coping during the police interview it was consistently reported as having made them confused.
Current concepts of ethanol dependence
Authors: LITTLETON JOHN , LITTLE HILARY 
Published: January 2006

AbstractAlcohol dependence is considered to be divisible into two types (although the divisions between these are indistinct). These are psychological dependence, in which the rewarding effects of alcohol play a primary role, and chemical dependence, in which adaptive changes in the brain initiate punishing effects on withdrawal of alcohol, and suppression of these becomes the primary motive for using the drug. The neurochemical basis for the rewarding effects of alcohol may be the potentiation of GABA at GABAA receptors (causing relaxation) and release of dopamine from mesolimbic neurones (causing euphoria). The adaptive changes which cause the alcohol withdrawal syndrome are not known for certain, but alterations in GABAA receptors, NMDA receptors and voltage‐operated calcium channels all have a claim. However, it is distinctly doubtful whether these all contribute to the negatively reinforcing effects of alcohol that are important in chemical dependence, although they may be important in other pathological effects of alcohol abuse. Current research badly needs better communication between basic scientists and clinicians to establish research goals and to improve current models.
Neural mechanisms underlying nicotine dependence
Authors: BALFOUR D. J. K. 
Published: January 2006

AbstractThere is little doubt that many habitual smokers find it difficult to quit the habit because they have become addicted to the nicotine present in the smoke. This paper addresses some of the pharmacological mechanisms underlying this addiction and discusses how an understanding of these mechanisms may contribute to the more effective use of nicotine replacement therapy during smoking cessation. It considers critically the evidence that the “rewarding” properties of nicotine, which serve to reinforce drug‐seeking behaviour, are related to stimulation of the mesolimbic dopamine system of the brain. The critique focuses specifically on the evidence that many central nicotinic receptors, including those which mediate the effects of the drug on dopamine secretion, are readily desensitized by chronic exposure to agonist and that hypotheses which assume that nicotine inhaled from tobacco smoke invariably results in stimulation of the receptors must be treated with caution. Nicotinic receptors in the brain are, however, heterogeneous in nature with different molecular structures and pharmacologies. It is concluded that the reinforcing properties of nicotine sought by smokers may reflect both stimulation and desensitization of the different nicotinic receptor populations, and that smokers may adjust their smoking habits to achieve the balance of receptor stimulation and desensitization which they find most reinforcing. It seems likely that the efficacy of the different nicotine formulations during the treatment of smoking cessation may also reflect their ability to stimulate or desensitize brain nicotinic receptors.
Alcohol withdrawal: an adaptation to heavy drinking of no practical significance?
Authors: STOCKWELL TIM 
Published: January 2006

AbstractMarkedly differing views can be found among both clinicians and researchers regarding whether alcohol withdrawal is a phenomenon of any practical or theoretical importance. Evidence has mounted that alcohol withdrawal, even in a severe form, is rarely life–threatening and the great majority of cases can be managed in non–medical settings, including the home. There is also a widely held view among clinicians that withdrawal symptoms have little motivational significance and may be best regarded as but epiphenomena of prolonged heavy drinking. There are also experimental data from both human and animal laboratory studies to the effect that withdrawal symptoms do not readily trigger further alcohol consumption. Against this most unpromising background a case is presented for alcohol withdrawal being but one manifestation of important biological and psychological adaptive processes which occur almost whenever alcohol is consumed with any regularity. It is proposed that understanding this more general phenomenon is critical to a better understanding of the factors which maintain heavy and problematic drinking. Recent evidence also suggests that minor alcohol withdrawal symptoms are far more common in the general population than had previously been realized, and that this has important implications for prevention policy.
The benzodiazepine withdrawal syndrome
Authors: PÉTURSSON H. 
Published: January 2006

AbstractPhysiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes. Instances are also reported within the high‐dosage category of more serious developments such as seizures and psychotic reactions. Withdrawal from normal dosage benzodiazepine treatment can result in a number of symptomatic patterns. The most common is a short‐lived “rebound” anxiety and insomnia, coming on within 1‐4 days of discontinuation, depending on the half‐life of the particular drug. The second pattern is the full‐blown withdrawal syndrome, usually lasting 10–14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted. Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses or short‐acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence, but it has proved difficult to demonstrate unequivocally differences in the relative abuse potential of individual benzodiazepines.
Preventive strategies for alcohol‐related problems
Authors: RITSON BRUCE 
Published: January 2006

AbstractPreventive strategies for alcohol‐related problems need to be in keeping with their socio‐political context. Prohibition is inappropriate except where it has widespread support within the culture. Preventive strategies focus on the population and/or high risk groups and behaviours. Primary prevention can be achieved by control policies, education and provision of alternatives. Fiscal measures are of proven value. Legislative approaches influence availability and context of drinking, such as drinking and driving. Advertising control, server training and server liability are further approaches. Encouraging the provision of alternative beverages and promoting alcohol‐free environments is a further approach which should be seen as pan of an integrated community response. Secondary prevention linked with early recognition of hazardous drinking at primary level is of known efficacy and would form part of a coordinated strategy.
The prevention of tobacco‐related disease
Authors: RAW MARTIN , McNEILL ANN 
Published: January 2006

AbstractThe key components of a strategy to prevent tobacco–related disease are outlined. These measures aim to increase the cessation of tobacco use and reduce its uptake. Components are wide–ranging, including a taxation policy, a ban on advertising and promotion, a comprehensive health promotion programme including advice from primary health care professionals and the development of campaigning skills, particularly by the medical profession. The prevention of tobacco–related disease has moved into the domain of campaigners and lobbyists at political, economic and international levels. The key target is countering the activities, especially the unethical trade practices, of the wealthy and powerful tobacco industry.
Opiate treatments
Authors: JOHNS ANDREW 
Published: January 2006

AbstractOne of the greatest of challenges facing medicine is to devise effective and appropriate treatments for opiate problems. Such treatments are based on principles derived from the disciplines of pharmacology and psychology, but are also shaped by social issues and even by the views of practitioners. There are many misconceptions about opiate problems. In this review it is suggested that there are good reasons for stating that opiate users do change over time, treatment can also lead to change and psychological interventions are of great importance. However, current methods of opiate detoxification are of low efficacy and methadone maintenance, although of benefit for some, is not a panacea for opiate problems.