bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey of general practitioners' opinion and attitude to drug addicts and addiction
Authors: ABED R. T. , NEIRA‐MUNOZ E. 
Published: January 2006

SummaryA survey was carried out to investigate general practitioners’ attitude towards drug addicts and addiction. A questionnaire was sent to all GPs in the Norwich Health District and obtained an 87% response rate. A range of negative and positive attitudes was identified. The implications of these findings are discussed with particular reference to current government policy of encouraging GPs to extend their role in treating drug addiction.
Treatment for alcoholics in German speaking countries
Authors: FEUERLEIN WILHELM 
Published: January 2006

In this specially commissioned BJA series experienced clinicians give their personal and frontline views as to how the practical business of treating people with substance problems is best handled.AbstractThis article was triggered by suggestions given by the editors of the British Journal of Addiction (Edwards, 1989). The main question addressed teas: what do therapists really know and believe about how (alcoholic) patients are helped? In addition some more detailed issues were borne in mind, namely: the underlying philosophy of alcoholism (disease concept) and its treatment; patients’ socio‐cultural background and abuse practices; the special socio‐cultural factors which influence the therapists’ practice and patients’ expectations; treatment goals and outcome definitions; the therapists’ approaches to the patients’ assessments; the treatment modalities (attempts to strengthen motivation; the form of initial contact, duration, termination and intensity of treatment).
The ‘methadone by bus’ project in Amsterdam
Authors: BUNING E. C. , VAN BRUSSEL G. H. A. , VAN SANTEN G. 
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.AbstractOne of the methadone programmes of the Amsterdam Municipal Health Service is the ‘methadone by bus’ project. Two mobile clinics cruise the city, stopping at six different locations daily. The liquid methadone is consumed on the spot and clean needles and condoms are available. This project is based on the principles of ‘harm‐reduction’, i.e. if it is not (yet) possible to ‘cure’ a hard drug user, one should at least try to minimize the harm they cause to themselves and their environment. As soon as a client refrains from the use of illegal drugs, the client can ‘graduate’ to other methadone programmes with a higher threshold. To prevent double prescription, all Amsterdam methadone programmes participate in the central methadone registration. The Amsterdam Municipal Health Service has contact with over 50% of the drug users. The estimated number of hard drug users has remained stable over the last 5 years, whilst the average age of drug users has increased to 32 years. In the future, increasing the average dosage and the provision of injectable drug users will be discussed to assess their role in further harm reduction.
Is alcohol a carcinogenic risk?
Authors: TURNER CHARLOTTE , ANDERSON PETER 
Published: January 2006

AbstractConsumption of alcoholic beverages has been implicated as a risk factor for the development of various cancers including oesophageal, oral, pharyngeal, laryngeal, liver and breast cancers. This article is a commentary on an earlier paper entitled ‘Alcohol: a carcinogenic risk? which challenges some of the evidence relating alcoholic beverage consumption to risk for these cancers. In the course of commenting on this paper, evidence is reviewed which shows a relationship between these cancers and consumption of alcoholic beverages, which is often found to be dose‐related.
The definition of dependence and behavioural addictions
Authors: MIELE GLORIA M. , TILLY SARAH M. , FIRST MICHAEL , FRANCES ALLEN 
Published: January 2006

AbstractDSM‐III‐R and ICD‐10 have incorporated a much broader definition of chemical dependence than was included in DSM‐III. This broader definition no longer requires the presence of tolerance and withdrawal, and places greater emphasis on aspects of compulsive use. Using this broader definition, a number of behavioral syndromes, especially compulsive and impulse disorders, appear to share descriptive similarities with chemical dependence. Although these similarities in overt presentation may reflect underlying similarities in pathogenesis and treatment response, such a non‐specific definition may also obscure important differences. Given the available knowledge, it is unclear if it is more useful to highlight the similarities among chemical dependencies and other behavioral syndromes or to maintain their distinction.
Reply to comments on ‘behavioural (non‐chemical) addictions’
Authors: MARKS ISAAC 
Published: January 2006

AbstractBehavioural addictions involve routines of dysfunctional and purposeful behaviour. Taxonomy is a program for action and coloured by values. This is obvious in ‘panic disorder’ and may affect the classification of addictions. Biologically minded psychiatrists may attach less weight than do behavioural scientists to overarching similarities across chemical and nonchemical addictive syndromes. There is no foolproof guide to classification, be it response to therapy, aetiology, maintaining mechanism, or phenomenology. Communalities across behavioural and chemical addictions do not exclude potentially important differences among them. Both pharmacological and behavioural interventions may be useful in different cases. Control over an addictive routine is reduced rather than lost and may rise with treatment. Broadening one's repertoire of activities may be preventive and therapeutic. Motivation to change is a multifactorial state that may vary with time and be augmented by therapy; lay organisations can have useful lessons for clinicians. Relevant political influences can be crucial and hard to modify.
Teaching about substance abuse in medical school
Authors: WALLER JULIAN A. , CASEY RICHARD 
Published: January 2006

AbstractPhysicians often fail to diagnose and treat (or treat properly) alcoholism and other chemical dependence in patients. This failure may result from inadequate training, a sense of futility about effectiveness of treatment, belief that this is a social problem rather than disease or denial because the physician him/herself is from a family with substance abuse. A survey of 81 first year medical students identified six (7%) with past or present patterns suggesting abuse of alcohol or other drugs, five (6%) reporting both personal and immediate family abuse patterns, and 25 (31%) who reported such patterns in parents, grandparents or siblings. Students who are adult children of alcoholics (ACOAs) often need emotional support while learning about alcoholism and its treatment. Medical school training about substance abuse must take these needs into consideration and provide services approved by, but insulated from, the dean's office to help students cope with effects of personal or family substance abuse.
Development of a District Training Strategy
Authors: TOBER GILLIAN , RAISTRICK DUNCAN 
Published: January 2006

AbstractThis paper reiterates the need for training in addiction for primary care workers and proposes motivational and structural explanatory frameworks to further our understanding of the difficulties in recruitment of staff from the variety of occupational groups to substance misuse training. This analysis is applied to inform the design and delivery of training locally. The basic tenets of a district training strategy are derived from this analysis and the training strategy for the two Leeds District Health Authorities is described. The strategy is based upon identification of the specific occupational needs of each primary care worker group at each stage of their career, and upon the utilization of available resources to fulfil their training needs in the occupation specific context. The different occupational groups have different roles to play in the prevention and management of substance misuse and the specific skills required will be closely tied into their particular role and based upon pre‐existing skills. The resources for and methods of implementing the strategy are described.
The unofficial history of drug use: a study in a Brazilian sample
Authors: GALDURÓZ JOSÉ CARLOS FERNANDES , MASUR JANDIRA 
Published: January 2006

AbstractInterviews were conducted with 59 former intensive users of illicit drugs with no evidence of current social or behavioural dysfunction. Data were gathered by in‐depth standardized interviews through which, past and current psychoactive substance use (including alcohol, tobacco and tranquillizers) were assessed. Special attention was given to the subjects' attributions as to what had caused the change in the drug use pattern. Events attributed for ending or substantially decreasing drug use were categorised as follows: ‘physical‐mental problems/disliked side effects’ (27.1% of respondents), ‘developmental/maturational/existential reasons’ (27.1%), formal or informal drug treatment system’ (11.8%), ‘interpersonal reasons’ (10.2%), ‘job or school/performance lowering’ (10.2%), “religious/spiritual involvement” (6.8%), and ‘legal/financial problems’ (6.8%). The major finding was that only 7 out of the 59 respondents (11.8%) reported having ever been in any formal or informal drug treatment system.
Drug use, injecting practices and sexual behaviour of opioid users in Sydney, Australia
Authors: DARKE SHANE , HALL WAYNE , CARLESS JACQUELINE 
Published: January 2006

AbstractThis paper examines drug use, injection practices, and sexual behaviour in a sample of 100 opioid users, both in and out of current opiate treatment. Approximately three‐quarters of subjects reported that they had used more than one illicit substance in the month prior to being interviewed. Needle sharing was common, with 29% of subjects having used a needle in the past month after it had been used by someone else, and 25% having passed on a needle after they had used it. The level of condom use was low, with 66.7% of subjects never having used a condom with their regular partner in the month prior to interview, and 20.7% of subjects who had engaged in sex with a casual partner during this period not having used a condom. Variables which were predictive of HIV risk‐taking behaviour in relation to needle use were poly‐drug use, not being in current treatment, and level of heroin use. Only age was predictive of risky sexual behaviour, with younger subjects being associated with more risk‐taking behaviour. It was concluded that while opiate treatment was associated with lower levels of risky injecting practices, there was no association between treatment and safer sexual practices. Given the importance of sexual transmission of HIV more attention needs to be given to the sexual risk‐taking behaviour of intravenous drug users.
Effects of the elimination of a state monopoly on distilled spirits’ retail sales: a time‐series analysis of Iowa
Authors: HOLDER HAROLD D. , WAGENAAR ALEXANDER C. 
Published: January 2006

AbstractSince the end of prohibition in the USA, only one slate, Iowa, has eliminated its state retail monopoly of distilled spirits sales for off‐premise consumption. In March 1987 all slate retail stores were closed, and private establishments were licensed to sell distilled spirits. Interrupted time‐series analyses of apparent spirits consumption in Iowa, controlling for nationwide sales trends over the past two decades, identified a statistically significant 9.5% increase in spirits sales following the policy change. While there was a corresponding 13.7% decline in wine sales, and no change in beer sales, privatization of spirits retail sales yielded a net increase in total alcohol consumption in Iowa. No changes were found in spirits sales in states bordering Iowa.
Changes in the use of intoxicants after onset of pregnancy
Authors: IHLEN B. M. , AMUNDSEN A. , SANDE H. A. , DAAE L. 
Published: January 2006

AbstractA sample of 416 pregnant women were interviewed with emphasis on their use of alcohol, tobacco, and legally prescribed and illegal drugs before and after onset of pregnancy. The results indicate a significant reduction in alcohol consumption, tobacco smoking and the use of legally prescribed and illegal drugs in connection with the pregnancy. There was no correlation between socio‐economic level and use of intoxicants. There was a correlation, however, between the use of intoxicants by the pregnant women and the use of such substances by other significant persons in their environment.
The efficiency of a questionnaire in detecting heavy drinkers
Authors: SEPPÄ KAIJA , SILLANAUKEE PEKKA , KOIVULA TIMO 
Published: January 2006

AbstractThe suitability of the nine‐question Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST) was tested on 133 40‐year‐old men and 140 45‐year‐old men attending a voluntary population health screening in a typically week‐end‐drinking society. With a cut‐off level of two yes' answers 29% of the middle‐aged male population has been reported to give a positive result in this questionnaire. In our study alcoholics were excluded. The amount and type of alcohol consumed per week was asked. The subjects were divided into three groups: (1) social drinkers (0 or 1 yes' answer), (2) suspect abusers (two “yes” answers), and (3) abusers (three or more yes' answers or drinking at least 280 g absolute alcohol per week). Group 2 reported drinking more than group I, but according to biological markers they belonged better to group 1 than group 3. With the originally recommended cut‐off level of two yes'answers 50.8% of 40‐year‐old men and 36.5% of 45‐year‐old men in our study proved positive. With the three yes’answer criterion the corresponding percentages were 28.5 and 24.0. Forty‐ and 45‐year‐old men in group 2 gave many positive answers in the question concerning week‐end drinking and avoidance of alcohol for a time, as did 40‐year‐old men in the question concerning bad conscience after drinking. Beer and spirits were the most popular beverage combination and week‐end drinking was the commonest drinking habit. The number of positive answers correlated well with the announced amount of alcohol. In Mm‐MAST typical week–end drinking is linked with many positive answers although the weekly amount of alcohol remains low. In many cases the questionnaire was the only way to diagnose alcohol abuse. It should be kept in mind that the specificity of questionnaires is not equal in different cultures. Concerning the Mm‐MAST questionnaire we recommend three yes’answers as a cut‐off level in week‐end‐drinking societies.
Screening for hepatitis B and vaccination of injecting drug users in NHS drug treatment services
Authors: FARRELL MICHAEL , BATTERSBY MALCOLM , STRANG JOHN 
Published: January 2006

AbstractHepatitis B vaccines are now available for people at high risk of infection. Injecting drug users are at particular risk. A UK national survey of statutory drug treatment facilities was conducted to assess what screening and vaccination procedures were offered to drug taken. Of the respondents 64% did not screen for hepatitis B and 71% did not offer vaccination to hepatitis B negative individuals. However, 63% of respondents said they would advise vaccination for injecting drug users who continued to share. Fifty‐eight per cent thought that the partners of hepatitis B positive clients should be screened and 50% thought that vaccination of partners was advisable. A policy of screening and vaccination for hepatitis B is recommended.
Withdrawal symptoms and alcohol dependence: fruitful mysteries★
Authors: EDWARDS GRIFFITH 
Published: January 2006

AbstractFive types of question are posed around withdrawal symptoms. (1) The reasons for the fluctuations over time in medical awareness of alcohol's capability to produce withdrawal symptoms. (2) What type of drinking schedules instigate withdrawal experience? (3) Do withdrawal phenomena get worse over time? (4) The ‘addiction memory’ question; and lastly (5) Is withdrawal a reinforcer for drinking behaviour? These issues point to a need for a renascence in the kind of research which is based on clinical observation and on listening to what patients have to tell, with such lines of work brought into much closer contact than before with corresponding laboratory investigation.
The prevalence and sociodemographic correlates of high‐risk and problem drinking at an industrial worksite
Authors: WEBB GLORIA R. , REDMAN SELINA , HENNRIKUS DEBORAH , ROSTAS JOHN A. P. , SANSON‐FISHER ROBERT W. 
Published: January 2006

AbstractThe study of 833 employees aimed to determine the prevalence and sociodemographic correlates of high‐risk and problem drinking in an industrial population. Variables measured included stressful life events, neuroticism, job satisfaction, years of service, job classification and type of shift. As measured by a 7‐day retrospective diary, 12.5% of the sample were abstainers, 78.7% were light drinkers and 8.8% were high‐risk drinkers. As measured by the Mortimer‐Filkins test of problem drinking, 79.2% were non‐problem drinkers, 15.2% were presumptive problem drinkers and 5.7% were problem drinkers. Variables that best predicted high–risk drinking were marital status, type of shift and education. Variables that best predicted problem drinking were stressful life events, marital status, education and neuroticism. The results indicate the need for a work‐based intervention and provide information to identify at‐risk employees and assist in the design of appropriate treatment programmes, including assistance with social and other problems.
Methadone treatment in medical private practice: outcome according to the number of courses followed
Authors: MEYSTRE‐AGUSTONI GIOVANNA , WIETLISBACH VINCENT , MARTIN JEAN , HALLER‐MASLOV ELVIRE 
Published: January 2006

AbstractIn the Swiss Canton of Vaud, methadone treatment is mostly provided by the private medical practitioners. 562 opioid dependent persons followed at least one course of treatment between 1976 and 1986; at that time, 209 of them had completed a first course, 118 a second one and 31 a third one. Evolution of the persons was observed from the end of their last course to the end of the study. Outcome was evaluated according to the rank of the last course. Whatever its rank, each course resulted in about 17% of stable abstainers and 6% of chronic opioid‐dependent persons. In contrast, the risks to start a new course, to be imprisoned and to enter into a therapeutic community showed a clear gradient with the rank of the course: they were about 38%, 27% and 10% respectively one year after a first or a second course, and rose to 43%, 38% and 28% one year after a third course.
The alcohol treatment‐seeking process from a problems perspective: responses to events
Authors: WEISNER CONNIE 
Published: January 2006

AbstractAll consecutive intakes of a US county's publicly operated and contracted alcohol treatment programs were sampled (N=747) and interviewed regarding problematic events in the year prior to treatment. The paper examines the relationship of the responses of family and friends and of community institutions to events reported as major reasons for coming to treatment. Events (N= 1824) are the unit of analysis. For most events, treatment was suggested less than half the time the event occurred, and there was little agreement between families and friends and community institutions for which types of events treatment was suggested. There were positive relationships between treatment suggestion and the reporting of events as major reasons for treatment.
Social and drug‐taking behaviour of ‘maintained’ opiate addicts
Authors: STRANG JOHN , JOHNS ANDREW , GOSSOP MICHAEL 
Published: January 2006

SummaryThe roles of the prescribing of maintenance methadone and of prescribing injectable drugs in the management of opiate addicts have become subjects of active debate since the advent of HIV. Data are presented on the social circumstances and drug‐taking behaviour of 26 opiate addicts who had been receiving maintenance methadone (24 of whom had been receiving at least part of the prescription as injectible methadone ampoules).
Fallacies and phobias about addiction and pain
Authors: LANDER JANICE 
Published: January 2006

SummaryResearch has indicated that approximately three‐quarters of patients in acute care hospitals experience moderate to severe pain. It is thought that inadequately controlled pain is the result of poor clinical performance on the part of nurses and physicians. Faulty knowledge about pain mechanisms and pharmacology have been targeted as the source of their poor performance. In addition, practitioners may have fallacious beliefs about narcotics and pain. This study examined some of the misconceptions nurses have about addiction and pain management. A number of fallacies were identified. These included a very strong opiophobia or fallacy about addiction liability of narcotics even under conditions of normal hospital use.
Review and analysis of literature on indicators of women's drinking problems
Authors: SCHMIDT CATHERINE , KLEE LINNEA , AMES GENEVIEVE 
Published: January 2006

SummaryOur goal is to identify more relevant indicators of women's drinking problems. We first reviewed the literature on women's drinking problems to uncover the major issues and research problems that previous studies have raised. We then systematically analyzed 464 indicators of women's alcohol problems cited in the literature from 1970–86. We calculated the frequency of their appearance by source (literature review, clinical studies, research articles, or surveys) and organized them into a comprehensive indicator taxonomy that included physiological, social, psychological and behavioral categories. The resulting taxonomy can serve as a baseline for grounding indicators of women's alcohol problems collected from other sources, such as ethnographic studies of particular populations or surveys of the general population.
Crack and cocaine use in South London drug addicts: 1987–1989
Authors: STRANG JOHN , GRIFFITHS PAUL , GOSSOP MICHAEL 
Published: January 2006

SummaryThere has been great concern in recent years about the abuse of cocaine, particularly in its smokable form ‘crack’. This paper presents data drawn from 441 patients seen by a South London Community Drug Team between 1987 and 1989. Only four (1%) cited cocaine abuse as the main drug problem. Heroin was the most common main drug. Detailed information was available on 355 of these subjects. During the study period 63 patients reported using cocaine and the proportion of subjects using cocaine increased from 13% to 29%. Within the sub‐group of cocaine users, there was a marked increase in the use of smokable forms of cocaine from 15% in 1987 to 75% in 1989. In view of the increased dependence risk associated with smoking cocaine, this is seen as an ominous development.
Dyschromatopsia in heroin addicts
Authors: Dias P. L. R. 
Published: January 2006

SummaryThe Farnsworth‐Munsell 100‐hue test was employed to determine whether there was any defect of colour vision in 29 confirmed male heroin addicts who had been successfully detoxified. Forty age‐matched males served as controls. A typical normal error score on the FM test is about 40 and an error score of over 100 indicates poor colour discrimination; 86.2% of the eyes of the control group had an error score below 100 while only 17.2% of the eyes of heroin addicts had an error score below 100. The colour confusion among the heroin addicts was in the blue‐purple (475–495 mu) range. These results indicate that colour vision defects are more common in heroin addicts.