bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcoholism and family interaction
Authors: Schweitzer Robert , Wilks Jeffrey , Callan Victor J. 
Published: July 2006

AbstractIn 16 families, half of which had an alcoholic parent, both parents and an adolescent were videotaped interacting with each other. Mothers, fathers and the adolescent in each family viewed the videotaped interaction and completed ratings of themselves and the other two family members on levels of anxiety, involvement, dominance and friendliness. In families with an alcoholic parent, adolescents and their mothers rated family members as less anxious than did adolescents and mothers in families without a drinking problem. Also mothers in the alcoholic families rated family members as being more involved, and their ratings were higher than mothers in other families. Alcoholic families rated parent‐adolescent interactions as more dominant and friendlier. At least in these videotaped interactions where alcohol was not being consumed, mothers in alcoholic families adopted a more positive view of family members than mothers in other families. In addition, possibly due to the efforts of fathers not to drink and memories of interactions when he was drunk, alcoholic families perceived their family interactions as more dominant and friendlier than families without an alcohol‐related problem.
‘Horse trading’: prescribing injectable opiates to opiate addicts. A descriptive study
Authors: Battersby Malcolm , Farrell Michael , Gossop Michael , Robson Phillip , Strang John 
Published: July 2006

AbstractThe clinical audit of 40 opiate‐dependent individuals who were prescribed injectable drugs (heroin or methadone) between June 1987 and June 1989 is described. These subjects were characterized by the chronicity of their injecting and dependent opiate use, and by their refusal to comply with a treatment programme involving oral‐only prescribing. The key aim was to attract entrenched injectors into contact with treatment services and to promote movement away from injecting drug use and reduce HIV risk behaviour. On review 35 of the original 40 were either still receiving an injectable prescription or injecting illicit drugs. Despite this 14 (35%) were rated as making positive life changes. Nine (22.5%) had been admitted to the in‐patient unit and became drug free during their stay. The stability of the lives of eight (20%) had deteriorated. The benefits and drawbacks of this form of intervention are discussed with comparison to the other studies of injectable drug prescribing.
A comparison of private and public methadone maintenance patients
Authors: Caplehorn John R. M. 
Published: July 2006

AbstractA study was undertaken to examine claims that unsuitable individuals were being admitted into private methadone maintenance programs in New South Wales in late 1985, early 1986. A comparison was made of interview data collected by an independent team of researchers from 457 private and 91 public patients. Exhaustive attempts were made to identify individuals who failed current official admission criteria. While there were statistically and clinically significant differences between private and public methadone patients, there was no evidence that unsuitable individuals were being admitted into maintenance. The data and a review of the literature suggest that the rapid expansion of private sector methadone programs allowed suitable individuals more immediate and more equitable access to maintenance treatment.
Drug testing in the Australian workplace: overview of the issues
Authors: Blaze‐Temple Debra 
Published: July 2006

AbstractThis paper is an overview of the issues surrounding employee drug testing programs as they apply to the Australian workplace. Drug testing may be seen within a historical context of control over workers. Its practice is most prevalent in the USA, but it is also occurring in Australia, Canada and England. It is undeniable that alcohol and other drug use causes significant problems in many workplaces, though the apparently substantial costs to industry and the prevalence of drug use among workers are difficult to estimate with any degree of precision. Drug testing programs in the workplace appear to have majority public support in the USA and are even supported by some unions in Australia and the USA; there are, however, critics of the programs. The evaluation evidence to date is sparse, but is promising in that it suggests that drug testing programs can be responsible for reducing the prevalence of drug use among workers as well as dramatically reducing company costs for absenteeism, accidents and medical insurance claims. However, due to methodological shortcomings one cannot state conclusively that drug testing programs are as effective as they appear to be. Research using more rigorous designs and generating data that can be compared across studies is needed. Distasteful though drug testing is, we may see benefits in its use, similar in concept to random breath testing on our roads. Many of the procedural and legal problems in early US programs have been eliminated, refinements which should assist Australians. The legal issues, however, are quite different in Australia. A drug testing program should not be the sole remedy for reducing alcohol and other drug problems in the workplace and such a program must also be accompanied by rehabilitation and educational components. Ethical issues are briefly discussed.
The early alcoholism treatment movement in Australia, 1859‐1939
Authors: Lewis Milton J. 
Published: July 2006

AbstractAdvancing ideas pioneered in the United States of America, Australian medical reformers and their lay supporters persuaded colonial governments in the late nineteenth century to recognize that alcohol dependence was a treatable disease. In practice, that recognition was only partial. While inebriates legislation was enacted, the state never provided sufficient resources for adequate specialized treatment facilities to be developed. By the 1930s, the first wave of enthusiasm for specific institutional treatment of alcohol dependence had receded, and the treatment movement was in decline. Reasons are suggested for the failure of the movement.
Alcohol and recreational drug use by HIV‐seropositive homosexual men
Authors: GUINAN JAMES J. , HALL WAYNE , CLARKE J. CHRISTOPHER , GOLD JULIAN 
Published: July 2006

AbstractThe objectives of this study were to describe the patterns of alcohol and recreational drug use of HIV‐seropositive homosexual men and to determine the effect of alcohol use on HIV risk‐taking behaviour. Of particular interest was the effect of knowledge of HIV status on these behaviours. Information on alcohol and drug use was obtained from 485 HIV‐seropositive homosexual and bisexual men presenting to a HIV‐antibody testing and medical management clinic. Heavy alcohol use was common, with 46.2% reporting consumtpion of six or more standard drinks on one day recently. Men who knew that they were HIV infected drank significantly more than those men who had yet to learn of their HIV status at the time of interview. There was clear evidence in this study for a role of alcohol use in HIV risk‐taking behaviour. Almost one‐third (27%) of the HIV‐seropositive men reported unprotected anal intercourse during the previous 3 months with approximately one‐third of these (27/76, 35.5%) nominating alcohol as contributing to their high HIV‐risk behaviour.
Establishing a drug and alcohol service in an Australian rural area
Authors: HELLIWELL DAVID , REILLY DAVID , RIPPINGALE CHRISTOPHER 
Published: July 2006

AbstractThe response to drug and alcohol problems in a small Australian rural community is described. The town of Nimbin, the centre of this community, is characterized by alternative life‐styles. The area has received considerable publicity over illicit drug use, particularly marijuana‐growing and a recent increase in injecting drug usage. The town has one medical practice with two general practitioners and this centre has been actively involved in the development of drug and alcohol services. This paper describes the development of a drug and alcohol service from the perspective of a local general practitioner. Reference is made to problems of community resistance, hospital issues and the steps taken to acquire knowledge and skills in the management of patients presenting to the practice. The importance of a multidisciplinary team approach in the development of services which included a needle and syringe exchange and a methadone treatment programme is emphasized.
Neurochemical studies of hepatic encephalopathy
Authors: MADDISON JILL E. 
Published: July 2006

AbstractDespite intensive research, the neurochemical basis of hepatic encephalopathy (HE) has not been defined. Theories that are currently favoured to explain the cerebral dysfunction that accompanies acute or chronic hepatic failure include: (1) ammonia acting as the putative neurotoxin; (2) perturbed monoamine neutrotransmission as a result of altered plasmo amino acid metabolism; (3) an imbalance between excitatory amino acid neurotransmission, mediated by glutamate, and inhibitory amino acid neurotransmission, mediated by γ‐aminobutyric acid (GABA); and (4) increased cerebral concentrations of an endogenous benzodiazepine‐like substance. Studies of amino acid neurotransmitter receptors in HE have yielded conflicting results. The majority of studies in different animal models of acute and chronic HE and in patients have reported that brain GABA receptor density and affinity are unchanged. There have been fewer studies of excitatory amino acid receptors and these have also yielded conflicting results. However, the majority suggest that components of the glutamate receptor system are perturbed in HE. Further investigation is required to determine the significance of these findings to the pathogenesis of HE. [Maddison JE. Neurochemical studies of hepatic encephalopathy.
A 12‐month prospective comparison of court‐diverted with self‐referred heroin users
Authors: DESLAND MALCOLM L. , BATEY ROBERT G. 
Published: July 2006

AbstractForty‐seven heroin users referred by the Drug and Alcohol Court Assessment Programme (DACAP) were compared with 45 self‐referred heroin users at 13 months post‐presentation. Data at presentation indicated distinct subpopulations were generated by each referral source. Differences were recorded in age, heroin use, marital status, educational level, employment history and age of onset of anti‐social behaviour. The DACAP scheme exerted an earlier health intervention effect in a sample experiencing dysfunction in other areas, principally legally and socially. Prospective data demonstrated that both samples reported significant reductions in the proportion using heroin. Differences between samples evident at presentation were expressed prospectively, in rates of employment, incarceration and involvement in methadone maintenance programmes. The limitations of diverting clientele from the legal system to the treatment system is discussed in light of these results.
Risk of benzodiazepine dependence resulting from hospital admission
Authors: HECKER ROBERT , BURR MICHAEL , NEWBURY GLORIA 
Published: July 2006

AbstractBenzodiazepines may result in dependence after relatively brief periods of prescription. This study reports the continued use of either temazepam or nitrazepam as a hypnotic 3–4 months after the provision of the drug as a discharge prescription following an acute hospital stay. Of 160 patients contacted by telephone (out of 275 given such a prescription on discharge), 68 (42.5%) were still taking the hypnotic when contacted and 23 (14%) of these had not previously used a hypnotic regularly prior to hospital admission. The risks of the use of benzodiazepine hypnotics, particularly in the elderly, are discussed and recommendations made to restrict in‐patient hypnotic use to no more than 5 days at any one time. Patients should be counselled about the risks of the development of dependence and withdrawal insomnia. Discharge prescription of benzodiazepine hypnotics should not exceed three days duration and preferably be avoided altogether.
Injecting drug users and the Human Immunodeficiency Virus: what do we know?
Authors: DARKE SHANE 
Published: July 2006

AbstractThis article examines the results of 10 years of research on the relationship between injecting drug use and the Human Immunodeficiency Virus (HIV). The two main transmission modes of HIV among injecting drug users (IDU)—parenteral drug use and sexual behaviour—are examined in detail, as well as the efficacy of attempted interventions to reduce the spread of HIV among this population.
Mortality of intravenous drug users: attenders of the Wellington Drug Clinic, 1972‐89
Authors: DUKES P. D. , ROBINSON G. M. , ROBINSON B. J. 
Published: July 2006

AbstractA mortality study of 997 patients registered for treatment at the Wellington Drug Clinic since 1971 was undertaken by examining the New Zealand death records. Sixty‐seven known deaths were reported. The mortality rates were increased 11.5 times under the age of 25 years, and 5.8 times for age 25–34 years, but not significantly thereafter. There were 7 deaths from trauma, 8 from suicide, and 28 accidental deaths. Myocarditis was the cause of death in four cases. In the 28 drug‐related deaths the principle drugs incriminated were dextropropoxyphene, barbiturates, chloral hydrate, methadone and other opiates. Twenty‐one deaths were due to unrelated diseases. It was considered important to document mortality in intravenous drug users in the 'pre‐HIV era. This study demonstrates quite low death rates from opioid drugs themselves.
Group therapy in a detoxification unit
Authors: POWELL JANET E. 
Published: July 2006

AbstractThe aim of this study was to discover residents' perceptions of supportive group therapy conducted as part of a week‐long alcohol and other drug detoxification programme. A brief questionnaire was adapted from Yalom's Q sort and administered to 105 residents at the end of group sessions. The instrument elicited ratings of the extent to which each of ten outcomes had occurred. Outcomes rated positively included universality, the instillation of hope, group cohesion and guidance.The results are interpreted as providing support for the continuation of non‐confrontational group therapy in the detoxification unit, with an increased emphasis on brief advice‐giving.
Cognitive functioning in excessive drinkers: evidence for dissociable impairments
Authors: FOX ALLISON M. 
Published: July 2006

AbstractThis article reviews the evidence for neuropsychological impairments in excessive drinkers. The view that the neuropsychological impairments reflect clinically heterogeneous manifestations of a unitary ‘Wernicke‐Korsakoff complex’ resulting from thiamine deficiency is discounted on the basis of a variety of mediating factors which have been demonstrated to affect the pattern of cognitive abilities and deficits in excessive drinkers. In contrast, this article argues that detailed analysis of the apparent clinical heterogeneity in the cognitive status of these patients may provide a means for determining the most appropriate treatment regime and rehabilitation procedures for an individual. These impairments are applied to a theoretical model of information processing identifying dissociable impairments which have been described as the ‘frontal‐lobe’ and the ‘right hemisphere’ hypotheses of the effects of alcohol on cognitive functioning. Interpretation of research results in terms of functional characteristics rather than localization characteristics is proposed. Two mediating factors, thiamine deficiency and liver dysfunction, are discussed in relation to their differential involvement in these impairments.
Is there more than one neuropsychological disorder commonly associated with alcohol dependence?
Authors: BOWDEN STEPHEN C. 
Published: July 2006

AbstractThere are two popular neuropsychological entities commonly attributed to the effects of alcohol dependence: the well‐known Wernicke‐Korsakoff syndrome, and the putative alcoholic encephalopathy. Wernicke‐Korsakoff syndrome is a highly variable neurological and neuropsychological disorder, which is frequently missed or misdiagnosed on clinical examination. The available prevalence figures suggest that Wernicke‐Korsakoff neuropathology probably occurs with a high incidence in hospitalized alcohol‐dependent people. Thus, Wernicke‐Korsakoff syndrome confounds clinical descriptions of the alcoholic encephalopathy and may account for most cases presumed to suffer from the latter disorder. Even if it is assumed that there is a specific alcoholic neurotoxicity, the clinical descriptions of this condition encompass features which are all attributable to Wernicke‐Korsakoff syndrome. In other words, the proponents of the alcoholic encephalopathy have failed to provide a distinctive description, thus precluding positive identification.
Treatment is an art to which science can contribute: the 2nd James Rankin Oration
Authors: DREW LES R. H. 
Published: July 2006

AbstractWorking models—beliefs—are an essential element of behaviour. Clients' models and non‐scientific treatment models, need to be respected. It is contended that, practically and theoretically, scientific models have little validity or relevance for understanding and managing addictive behaviour. The WHO model of drug use, with two added elements (the self and the functions of choice and decision making; and random variation of neurophysiological activities), is used as an example. The scientific method consists of dissecting a complex phenomenon into simpler parts, testing hypotheses about these parts, collecting and summating the data, and applying the conclusions to individual cases. It is presumed that if we know enough about a person then we can predict their future behaviour, including response to therapeutic interventions. Four major arguments are produced against that presumption. The scientific method depends upon the use of meaningful numbers (representing discrete, replicable categories) and its results are presented in statistical formats (with limited individual relevance). Measurement in the behavioural sphere is neither precise nor objective. This is critical with complex interactive systems (such as the WHO model) in which an apparently insignificant change in input can result in dramatic changes in output. Progress may have been made technically, e.g. to reduce relapse, but therapy remains an art. In future, scientific endeavours should be complemented by attention to other disciplines.
The effect of random breath testing on perception of likelihood of apprehension and on illegal drink‐driving
Authors: MOORE VIVIENNE , BARKER JENNIFER , RYAN ANTHONY , MCLEAN JACK 
Published: July 2006

AbstractThis study examines the links between random breath testing (RBT), driver perception of the likelihood of apprehension if illegally drink‐driving, and drink‐driving behaviour in Adelaide, South Australia. It is based on information gained from surveys of night‐time drivers in metropolitan Adelaide, during 1987, 1989 and 1991. Overall, about 25% of the sample in each year thought that illegal drink‐driving was likely to result in apprehension. This perception was consistently lower for males and for those aged less than 30 years than for their counterparts, however, there was evidence that it increased with exposure to RBT, notably when that exposure was recent. Also, compared with other drivers, fewer drivers who thought that apprehension was likely had an illegal blood alcohol concentration (BAC) when surveyed, or reported that they would be likely to drive if they thought that they had an illegal BAC. However, the majority of drivers who thought that detection was unlikely also reported that they would be unlikely to drink‐drive. These results suggest the need for some re‐direction of current RBT activities.
The genetic transmission of alcoholism: implications for prevention
Authors: NOBLE ERNEST P. 
Published: July 2006

AbstractEvidence obtained from adoption and twin studies suggests an important hereditary component in alcoholism. Following our initial observation that the Al allele of the D2 dopamine receptor (DRD2) gene was associated with alcoholism, a number of studies, both in the United States and abroad, have attempted to replicate and extend this finding in different Caucasian populations. In eight independent studies containing a total of 444 heterogeneous alcoholics (less severe and severe) and 495 heterogeneous controls (alcoholics excluded or not excluded), the prevalence of the Al allele was 45.5% in the former group compared to 25.7% in the latter group (p < 10−7). In 176 severe alcoholics and 176 controls free of alcoholism, the prevalence of the Al allele was 49.4% in the former group compared to 17.0% in the latter group (p < 10−8). The severity of alcoholism and the types of controls used are key determinants in Al allelic association with alcoholism. The total evidence at hand suggests that the DRD2 Al allele may represent the most prominent single gene determinant of susceptibility to severe alcoholism. However, the larger role is still played by environmental factors and other genes.
Rites of passage: smoking and the construction of social identity
Authors: BANWELL CATHY L. , YOUNG DORIS 
Published: July 2006

AbstractThe following article, based on a qualitative study of young women from a Melbourne suburb, is concerned with the role smoking plays in the presentation of social identity. These women, in their early teens, are viewed as being in the liminal or transitional phase of a rite of passage to adulthood. The passage to adulthood is attained with the construction of a social identity corresponding to popular notions of the feminine, which fall into the familiar categories of the bad and good woman. Smoking is one of the props in the stereotypical representation of the bad woman. Conventional anti‐smoking health messages have little relevance for young women who have chosen such a social identity for themselves.
Multiple drug use by older people: exploring the health development and political economy perspectives
Authors: LEGGE DAVID G. , BAMMER GABRIELE 
Published: July 2006

AbstractThe use of multiple medications by a large number of older people provides grounds for concern in terms of quality of life as well as cost. We argue that problems faced by older people are being over‐medicalized in a manner that palliates and obscures social causes such as loss of income, the falling away of social support and a discounted role in society. Primary health care is a policy model for the development of health services which offers a credible strategy for addressing clinical problems associated with growing old in ways that also contribute to recognizing and addressing social and structural problems that may be expressed in people's private troubles.
Giving away the grog: an ethnography of Aboriginal drinkers who quit without help
Authors: BRADY MAGGIE 
Published: July 2006

AbstractThe paper presents preliminary findings from a qualitative study of Australian Aboriginal men who have stopped drinking without the assistance of residential treatment, counselling or other programs. Main reasons advanced by interviewees for ceasing drinking were one or more of: medical condition and/or doctor's warning; family factors; trauma from accidents; conversion to Christianity. The author concludes that employment both helps and hinders abstention from drinking, and that social ties often pose major difficulties for those trying to give up drinking. The paper also discusses the importance of Aboriginal beliefs regarding personal autonomy.