bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research and the help‐seeking process
Authors: HARTNOLL RICHARD 
Published: January 2006

AbstractRecognition of changes in the nature and extent of problem drug taking in the early 1980s led to changes in service provision and to an increased interest in help‐seeking. The advent of AIDS accelerated these changes. This paper introduces concepts from the wider field of help‐seeking and compliance with preventive health measures. It reviews the major conclusions of studies of help‐seeking by problem drug takers, and identifies areas for further research. These include the need to ‘unpack’ the concept of ‘drug problems’ and to differentiate dimensions of needs in different individuals and populations; to evaluate attempts to make services attractive and accessible and to contact out‐of‐treatment groups; to assess the role of ‘significant others’; to understand the demands that changing service roles place on agency staff; and to give greater prominence to studies of the process of help‐seeking in terms of drug users' perceptions of their drug use, of problems, of risks and of services within the wider context of their lifestyles.
Alcohol and drug abuse treatment at the University of Connecticut Health Center
Authors: KADDEN RONALD , KRANZLER HENRY 
Published: January 2006

AbstractThis article describes a multidisciplinary team approach to the treatment of alcohol and drug dependence and comorbid disorders. The principal aim of this approach is the identification and treatment of patients' chemical dependence, as well as the medical and psychiatric disorders that contribute to and/or stem from the chronic use of alcohol and drugs. The focus of treatment is on the identification of high risk and other problem situations, training coping skills to handle these situations, developing insight, and enhancing patients' motivation for sobriety and ongoing treatment. In this article we describe the features of our program that address these various goals.
Test‐retest stability of cardiovascular and subjective responses to intravenous cocaine in humans
Authors: NAGOSHI CRAIG , KUMOR KAREN M. , MUNTANER CARLES 
Published: January 2006

AbstractSixteen male i.v. cocaine users were measured on their cardiovascular and subjective responses to placebo followed on a separate day by 40 mg i.v. cocaine injections. They were retested within 2 weeks, again receiving placebo and 40 mg i.v. cocaine injections in a random order on separate days. Significant increases in baseline (pre‐injection) heart rates during the later sessions were interpreted as possibly reflecting conditioning effects. There were no significant differences in post‐injection increases in cardiovascular or subjective responses between the initial and later 40 mg conditions, which might have been indicative of tolerance or sensitization development. Test‐retest correlations, indicative of response stability, were moderate to high for any particular timepoint for blood pressure, heart rate, and subjective responses, but pre‐ vs. post‐injection change scores were stable across testings on these measures only under placebo. With the possible exception of some subjective responses, there was little evidence of test‐retest stability in responses (change scores) to the 40 mg cocaine injection.
Establishment of a liaison service for pregnant opiate‐dependent women
Authors: DAWE SHARON , GERADA CLAIRE , STRANG JOHN 
Published: January 2006

AbstractA pregnancy liaison and outreach service was developed as part of a community drug team to attract pregnant drug‐dependent women into treatment. Women were provided with information on harm reduction, safer drug use and offered treatment for drug dependence. In total, 43 women (45 pregnancies) presented to the service over a 30‐month period. Thirty‐four women began out‐patient treatment of opiate dependence. There was a significant reduction in maternal methadone dose by delivery. Of the 45 pregnancies, four women had therapeutic abortions, two first trimester and two second trimester spontaneous abortions and 34 live births (three women remained untraceable). All the pregnancies that continued to the third trimester proceeded uneventfully with a consequent live birth. Mean gestational age was 37.9 ±3.7 weeks, mean birth weight was 2863 ± 526 g, 10 of the babies were small for gestational age. Fifteen babies required medication for neonatal withdrawal symptoms; mothers whose babies exhibited withdrawal symptoms were using significantly higher doses of methadone at delivery than mothers whose babies did not withdraw. The importance of providing this type of service for women drug users in the 1990s is discussed.
Curative factors in alcohol and drug treatment: behavioral and disease model perspectives
Authors: MORGENSTERN JON , MCCRADY BARBARA S. 
Published: January 2006

AbstractUnlike the general psychotherapy field which has been subjected to extensive process analysis, there are no systematic studies of treatment processes in the alcohol and drug treatment literature. As a necessary first step to study treatment process, the alcohol and drug literature was culled for references to treatment processes. Thirty‐five separate processes were identified and were broadly categorized as either disease model, behavioral or general psychotherapy processes. A national survey of treatment expert's views on treatment processes was conducted to determine whether certain processes would be considered as most important in the treatment of alcohol or drug problems. Results of this survey indicate that experts tend to rate certain processes as most important in the resolution of alcohol and drug problems. Results suggest that it is possible to identify core disease model and behavioral treatment processes. These processes might be used to assess the relative effectiveness of each therapeutic approach. Finally, results indicated that while disease model and behavioral experts tended to differ strongly on their ratings of the importance of some processes, there seems to be a trend toward integrating behavioral processes into a traditional disease model framework. The use of these results in constructing an instrument to measure processes used in alcohol and drug treatment is discussed.
Eating disorders and alcohol abuse in women
Authors: GOLDBLOOM DAVID S. , NARANJO CLAUDIO A. , BREMNER KAREN E. , HICKS LISA K. 
Published: January 2006

AbstractTheory and empircal evidence support a relationship between the eating disorders (anorexia nervosa and bulimia nervosa) and alcoholism. This study examines the co‐prevalence and characteristics of these disorders among two populations of adult women: those presenting for treatment of alcoholism and those referred to a specialized eating disorders programme. Twenty‐two of 73 females (30.1%) with alcohol problems met psychometric cut‐off scores for eating disorder, while 25 of the 96 eating disorder females (26.9%) gave psychometric evidence of alcohol dependence. These rates exceed general population norms. While certain clinical and psychometric features distinguish subgroups with both disorders, the basis for co‐prevalence and the implications for treatment are unknown.
Do smokers of lower tar cigarettes consume lower amounts of smoke components? Results from the Scottish Heart Health Study
Authors: WOODWARD MARK , TUNSTALL‐PEDOE HUGH 
Published: January 2006

AbstractData on 1133 men and 1621 women who smoke solely cigarettes with a known tar yield are extracted from the baseline population survey of the Scottish Heart Health Study. The expired‐air carbon monoxide (CQ‐E), serum thiocyanate and serum cotinine values are compared between smokers in three tar groups: low (below 13 mg/cig.), middle (14–15 mg/cig.) and high tar (above 15 mg/cig.). An index of tar consumption is calculated assuming that the intake of different smoke components relative to one another is in proportion to their concentration in the smoke. CO‐E and cotinine are found to peak in the middle tar group. Thiocyanate only tends to increase from low to middle tar group for women and from middle to high tar group for men. Tar consumption increases with tar yield of the cigarette smoked, but the increase is much lower than would be expected. We conclude that the tar yield of a cigarette is not an accurate guide to the amount of smoke components consumed by its smoker. Health professionals should be aware of these limitations of tar yield as a measure of cigarette strength.
Negative and positive expectancies in lone and group problem drinkers
Authors: JONES BARRY T. , McMAHON JOHN 
Published: January 2006

AbstractIn this experiment we show that measuring positive expectancy of alcohol use does not discriminate between lone and group problem drinkers whereas measuring negative expectancy does. Reliably, lower measures in group drinkers is consistent with; (i) our view that negative expectancy provides the motivation for problem drinkers to quit and that anything which inhibits the translation of negative experience into negative expectancy will correspondingly inhibit motivation; and with (ii) the observations of others that social (or group) support can, indeed, often inhibit recovery.
Ideology, history and changing models of liver cirrhosis epidemiology
Authors: HERD DEMISE 
Published: January 2006

AbstractThis analysis describes changes in assumptions about beverage alcohol use as a major cause of liver cirrhosis since the turn of the century. The findings reveal that social and political views shaped by the temperance movement, Repeal era and modern alcoholism movement have had a profound impact on medical and public health interpretations of the role of alcohol use in liver disease. Current clinical and epidemiological approaches that stress the importance of alcohol as a direct etiological agent for liver cirrhosis were popular during the 19th century in the wake of the temperance and prohibition movements, but were greatly modified to attribute a secondary role to alcohol use as a cause of cirrhosis during the Repeal and post‐World War II eras. The changes during the Repeal and post‐World War II eras coincided with the expansion of alcohol consumption and the liberalization of drinking norms in US society. As a result, the role of alcohol in causing cirrhosis among the general population was minimized and the disease was attributed to industrial toxins and air pollution. Contemporary research has affirmed the importance of beverage alcohol as a causal agent of liver cirrhosis using both clinical and epidemiological studies.
Managing service change in post HIV drugs services–a case study from Inner London
Authors: CRANFIELD S. , FEINMANN C. , FERLIE E. , WALTER C. 
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.AbstractThe advent of HIV/AIDS has presented a major ideological challenge to established drug treatment agencies, where the incorporation of HIV‐prevention strategies has proved problematic. This case study analyses the response to the HIV/AIDS epidemic by the drug misuse services of one Inner London district health authority (Bloomsbury) during the period 1985–89. While innovation and enthusiasm were much in evidence, a number of special problems prevented an effective and coherent strategic response. Key factors in the management of change in drugs/HIV services are identified which may be of special importance to clinicians, managers and funders and a number of key organizational and managerial competencies are suggested.
Classical conditioning and cognitive determinants of subjective craving for opiates: an investigation of their relative contributions
Authors: POWELL JANE , BRADLEY BRENDAN , GRAY JEFFREY 
Published: January 2006

AbstractSubjective craving for drugs is frequently reported by detoxified addicts. Explanatory models emphasizing classical conditioning (CC) and cognitive mechanisms have been proposed, and the mechanisms postulated by the two approaches are discussed here. There are three major variants of the CC model, arguing that craving is associated with conditioned changes which are respectively drug‐agonistic, opponent‐process, or withdrawal reactions. The cognitive model highlights the role of ‘outcome expectancies’ as determinants of both appetitive and avoidant motivations. The present investigation has identified correlates of craving predicted by the above models, and tested them empirically. Detoxified opiate addicts participated in a Craving Test requiring them to rate their craving, physical state, and emotions during exposure to both neutral and drug‐related material. Other measures, including personality and outcome expectancies for drug use, were also taken, and interrelationships among the variables were explored statistically. Whilst some of the predictions of the CC formulations were borne out, the cognitive model received more consistent support. The theoretical and treatment implications of these data are considered.
Smoking habits in relapsed subjects from a smoking cessation trial after one year
Authors: NØRREGAARD JESPER , TØNNESEN PHILIP , SIMONSEN KÅRE , PETERSEN LARS , SÄWE URBAIN 
Published: January 2006

AbstractReports of smoking cessation studies often claim that many relapsed subjects reduce their smoking. We investigated the smoking habits of relapsers 1 year after quitting in a smoking cessation trial using nicotine or placebo patches. All 289 participants in that study were summoned to a 1‐year follow‐up visit–148 (57%) of 259 relapsers attended, as did all 30 sustained abstainers. Fewer than 1% of the subjects had quit spontaneously after the primary relapse. Daily cigarette consumption, standard nicotine yield per cigarette, saliva cotinine concentration, expired carbon monoxide level and two nicotine dependency scales were assessed at entry and at the 1‐year follow‐up. In five of these six smoking‐related characteristics, there was a small but significant mean reduction of 7%‐27%. A significant weight gain of 0.5 ± 2.9 kg (mean ± SD) was recorded in the relapsers compared with 4.8 ± 4.2 kg for abstainers (p < 0.001). It is concluded that smoking habits in relapsers are relatively unchanged, and thus the most important outcome measure in smoking cessation trials is abstinent subjects.
HIV risk of transmission behaviour amongst HIV‐infected prisoners and its correlates
Authors: O'MAHONY PAUL , BARRY MYRA 
Published: January 2006

AbstractThirty‐eight from a total of 42 known HIV‐positive prisoners in the Irish prison system voluntarily cooperated in a survey of psychological attitudes, knowledge of risk behaviour, intentions with respect to future risk behaviour, and actual past risk behaviour Of this group, 65% reported that they had put others at risk of HIV, since they became aware of their own HIV + status. Only 16% stated that they would definitely not share their drug‐taking equipment in the future and 32% that they would always use a condom in sexual intercourse. In general, psychological and biographical variables were not strongly related to whether or not the respondents had put others at risk of HIV. Nor were there any significant differences in knowledge of at risk behaviour between those who had and those who had not put others at risk. However, there was some evidence for considerable independence between risk‐taking behaviour in the sexual and in the drug‐taking domains, in that risk‐taking in one area was not highly predictive of risk‐taking in the other.
Dying to be equal: women, alcohol, and cardiovascular disease
Authors: HANNA ELEANOR , DUFOUR MARY C. , ELLIOTT STEVEN , STINSON FREDERICK , HARFORD THOMAS C. 
Published: January 2006

The Data Notes Series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism.AbstractThis data note explores the relationship of gender, alcohol consumption and premature death from cardiovascular disease (MCVD). Data on the 8164 deaths attributed to MCVD from the National Mortality Followback Study (NMFS) were analyzed controlling for gender and consumption. Women who are heavy drinkers die young at a rate equal to that of men who drink heavily. In light of this, we recommend that future research and preventive efforts in this area include females as subjects and alcohol as a major risk factor.
Drinking habits and detection of heavy drinking among middle‐aged women
Authors: SEPPÄ KAIJA , KOIVULA TIMO , SILLANAUKEE PEKKA 
Published: January 2006

AbstractLittle is known about alcohol consumption and the efficiency of alcohol questionnaires among women. In the present study 40‐year‐old (n= 90) and 45‐year‐old (n= 75) women participating in a health screening gave a self‐report about their alcohol consumption and filled out the Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) and the CAGE questionnaires. Teetotallers comprised 11% of the 40‐year‐old group and 8% of the 45‐year‐old women. CAGE, but not Mm‐MAST ‐worked with the traditional cut‐off point of two recommended for men. When the criterion for heavy drinking was a self‐reported consumption ≥140g of absolute alcohol per week or a positive (≥ 2) finding in the CAGE or ≥4 ‘yes’ answers in the Mm‐MAST, 20% of the 40‐year‐old and 17% of the 45‐year‐old group (together 19%) proved positive. Neither of the two questionnaires nor self‐report atone worked perfectly for identifying eke heavy drinker group (n = 3l) screened. Using the three above criteria; of the heavy drinkers 52% were detected by self‐report, 55% by CAGE, and 45% by Mm‐MAST. CAGE in combination with self‐report detected 90% and this combination, being short and simple, can be recommended for clinical practice.
The community drug team
Authors: STRANG JOHN , SMITH MIKE , SPURRELL SALLY 
Published: January 2006

In this specially commissioned BJA series experienced clinicians will be giving their personal and frontline views as to how the practical business of treating people with substance problems is best handled.AbstractThe creation of a network of nearly 100 community drug teams (CDTs) across the UK stands as the most significant expansion to occur within drug services during the 1980s. Key characteristics include the narrowly defined geographical focus, the community emphasis, the multi‐disciplinary composition and the promotion of generic contribution through ‘consultancy’—as with Community Alcohol Teams. Subsequent adaptations have extended from the base of the CDT with outreach strategies and harm‐minimization techniques. However, the extent of collaboration from generic colleagues (especially general practitioners) has been initially poor and is only slowly improving. An unplanned abandonment of the original consultancy role for the CDT is widely evident, as CDT workers have become more actively involved in the delivery of care—either directly or on a ‘shared care’ basis. It is proposed that separate consideration should be given to short‐ and long‐term development strategies, including re‐examination of the target populations, staffing composition, and methods of work through consultancy and/or direct provision of care.
Effects of tobacco smoking on caloric intake
Authors: PERKINS KENNETH A. 
Published: January 2006

AbstractReduced body weight due to smoking may be an important factor inhibiting smoking cessation and promoting relapse after cessation in some smokers. It is popularly believed that smoking decreases body weight by suppressing appetite. However, cross‐sectional studies show that, despite their lower body weights, smokers do not eat less than non‐smokers or ex‐smokers and, in fact, tend to eat slightly more. Similarly, laboratory studies show no acute effects of smoking or nicotine intake via other means on caloric intake in smokers, although intake of non‐smokers may be reduced after nicotine. In contrast, longitudinal studies show that eating consistently increases in the first weeks after stopping smoking, but may recede to pre‐cessation levels with longer‐term abstinence, while resumption of smoking after cessation is accompanied by a reduction in eating. A similar pattern of results is seen for self‐reported hunger and some, but not all, constituents of diet. Thus, there appear to be no acute or chronic effects of smoking on eating in smokers maintaining regular smoking, but changes in eating are observed concomitant with changes in smoking status (i.e. cessation or relapse). Although tolerance to anorectic effects of nicotine is one potential explanation, these findings may be more parsimoniously explained by viewing changes in eating due to smoking as secondary to an alteration in the set point around which body weight is regulated. According to this notion, cessation is accompanied by increased eating only until a new, higher body weight set point is reached, while relapse (and perhaps initiation of smoking) decreases eating only until a lower set point is reached. Implications of these findings and a set point explanation for them are discussed.
Do cannabis drug abusers differ from intravenous drug abusers? The role of social and behavioural risk factors
Authors: STENBACKA MARLENE , ALLEBECK PETER , ROMELSJÖ ANDERS 
Published: January 2006

AbstractThe aim of the study was to investigate the association between social and behavioural factors, and the use of different types of drugs in a cohort of 8168 Swedish men conscripted for military service in 1969–70. Data about social and behavioural characteristics, self‐reported use of alcohol and narcotics was obtained from a survey of all Swedish conscripts. Information on intravenous drug abuse up to 1970 was obtained from a survey of injecting males among persons brought to the central police arrest. A higher proportion of intravenous drug abusers than cannabis abusers came from social class III, had divorced parents, had been in contact with the police and juvenile authorities, and had low emotional control. Indicators of deviant behaviour, e.g. truancy, having run away from home, and contact with police or juvenile authorities, were associated with high odds ratios for intravenous drug abuse and for cannabis abuse. In multivariate analyses, these risk factors still carried significantly increased odds ratios. In general, the odds ratios associated with these background factors were higher for intravenous drug abuse than for cannabis abuse. The risk increased, however, with increasing level of cannabis abuse. In conclusion, poor social background and deviant behaviour was strongly associated with future intravenous drug addiction, whereas the association was much weaker in the case of future cannabis abuse.
Prevalence of the proposed DSM‐IV alcohol use disorders: United States, 1988
Authors: GRANT BRIDGET F. 
Published: January 2006

AbstractData from a 1988 survey on United States drinking practices and related problems teas used to derive the proposed DSM‐IV definitions of alcohol abuse and dependence. The prevalence of DSM‐IV alcohol abuse and dependence combined, incorporating the DSM‐III‐R duration criterion, was 6.00% in this general population sample. The majority of respondents were classified as alcohol dependent (5.93%), dependent without abuse (5.24%), and dependent with physiological dependence (5.06%). The rate for DSM‐IV alcohol abuse was negligible (0.06%) while elimination of the duration criterion had little impact on the prevalence of DSM‐IV alcohol use disorders. Reasons for the extremely low prevalence of DSM‐IV alcohol abuse and the slight increase in the prevalence of DSM‐IV alcohol use disorders as the result of eliminating the duration criterion are discussed in terms of the content of the abuse category and its relationship to the dependence definition.