bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acamprosate treatment in a long‐term community‐based alcohol rehabilitation programme
Authors: POLDRUGO F. 
Published: January 2006

Abstract Aims. To evaluate the efficacy of acamprosate in maintaining abstinence in weaned acohol‐dependent patients. Design. A multicentre, double‐blind, randomized control trial. Patients were individually randomly allocated to active or placebo conditions. Abstinence was assessed during a 6‐month treatment period and after a 6‐month follow‐up period. Setting. A community‐based, outpatient alcohol rehabilitation programme. Participants. Two hundred and forty‐six alcohol‐dependent patients between the ages of 18 and 65 years were recruited immediately following acute, inpatient withdrawal treatment. Measurements. The primary outcome measure was self‐reported abstinence from alcohol since the previous sessions at 3, 6, 9 and 12 months following the start of treatment, with treatment taking place for a period of 6 months. Findings. A significantly higher proportion of patients in the acamprosate group were abstinent after 3 months and 6 months of treatment. The percentage of patterns with continuous abstinence at the end of the treatment period was almost double for the acamprosate group than for the placebo group (40.7% vs. 20.8%, respectively). Acarnprosate significantly increased the retention of patients in the treatment programme. Six months after drug treatment ceased, the criterion of abstinence since the previous visit was reached by significantly more patients from the acamprosate group (43.4%) than from the placebo group (29,8%), but Ms difference was not statistically significant at the 3‐month point after cessation of study medication. Conclusions. Acamprosate may be a useful pharmacological compound for the long‐term treatment of alcohol‐dependence when applied in a community‐based rehabilitation programme.
Assessing the relationship between maternal cocaine use and abruptio placentae
Authors: HULSE G. K. , MILNE E. , ENGLISH D. R. , HOLMAN C. D. J. 
Published: January 2006

AbstractAbruptio placentae during pregnancy can result in significant morbidity and mortality to both mother and infant. A comprehensive literature search of publications from 1966 to April 1995 identified 11 studies on the association between maternal cocaine use and abruptio placentae. Their results were combined in a meta‐analysis. The pooled odds ratio for abruptio placentae and maternal cocaine use was 3.92 (95% confidence interval 2.77‐5.46). The strength and consistency of the association, its biological plausibility and the results of experimental studies in animals all suggest that cocaine use during pregnancy causes abruptio placentae.
Maternal cannabis use and birth weight: a meta‐analysis
Authors: ENGLISH D. R. , HULSE G. K. , MILNE E. , HOLMAN C. D. J. , BOWER C. I. 
Published: January 2006

Abstract Aims. To estimate the effect of maternal cannabis use on birth weight. Design. Meta‐analysis of published observational studies adjusted for cigarette smoking. Separate analyses were performed for studies of low birth weight and mean birth weight. We used fixed and random effects models, but in all cases the results were identical. Setting. From the Medline database, we identified 10 studies in which the results were adjusted for cigarette smoking. In seven studies, information on cannabis use was collected prenatally. Five studies reported results for differences in mean birth weight associated with maternal cannabis use. Participants. 32 483 women giving birth to live‐bom infants. Measurements. Mean birth weight and odds ratio for low birth weight. Findings. Three analyses of the studies on mean birth weight were conducted to avoid double‐counting women from one study. The largest reduction in mean birth weight for any cannabis use during pregnancy was 48 g (95% confidence interval (CI) 83‐14 g), with considerable heterogeneity among the five studies. Mean birth weight was increased by 62 g (95% CI 8 g reduction‐132 g increase; p heterogeneity 0.59) among infrequent users (weekly) whereas cannabis use at least four times per week had a 131 g reduction in mean birth weight (95% CI 52‐209 g reduction; p heterogeneity 0.25). From the five studies of low birth weight, the pooled odds ratio for any use was 1.09 (95% CI 0.94‐1.27, p heterogeneity 0.19). Conclusions. There is inadequate evidence that cannabis, at the amount typically consumed by pregnant women, causes low birth weight.
A comparison of ‘visible’ and ‘invisible’ users of amphetamine, cocaine and heroin: two distinct populations?
Authors: ROBSON PHILIP , BRUCE MALCOLM 
Published: January 2006

Abstract Aim. To compare the characteristics of heroin, cocaine and amphetamine users having no history of contact with services with those of a group in contact. Method. Multiple agency sampling and field work which included ‘snowballing’ using ‘privileged access interviewers’. Each subject underwent a structured interview which included the Severity of Dependency Scale (SDS), and completed a confidential, self‐report questionnaire. Setting. Three contrasting provincial urban locations. Participants. Five hundred and eighty‐one regular users of the target drugs. Of these, 380 (65%) denied any contact with police or helping agencies in connection with drug use. Findings. Most zero‐contact users (79%) expressed little or no concern about their drug use, and no wish for help or advice. They were much more likely to use stimulants only; less likely ever to inject any drug or, for those that did, to share equipment; less likely to use opioids, amphetamine or cocaine powder on a daily basis; more likely to use Ecstasy; and yielded significantly lower SDS scores for all target drugs save crack. Prevalence of crack use was lower, but the proportion of daily users was the same as in the contact group. Most (69%) contact users remained concerned about their drug use, but 58% expressed little or no confidence that local services could meet their needs. In both groups, SDS scores for cocaine powder were comparable to those for cannabis, LSD and Ecstasy. Of the 495 cannabis smokers identified (85% of the sample), 72% reported daily consumption. Conclusions. The findings are consistent with the hypothesis that ‘visible’ and ‘invisible’ drug users are distinct populations in terms of behavioural characteristics, vulnerability to compulsive use, and prevalence of drug‐related problems or concern. Purchasers and providers with limited resources should concentrate on improving the range and quality of services for users already in contact rather than attempting to uncover invisible populations. On the basis of SDS scores, cocaine HCI seems to have a relatively modest addictive potential.
The transition from injecting to smoking heroin in three Spanish cities
Authors: DE LA FUENTE LUIS , BARRIO GREGORIO , ROYUELA LUIS , BRAVO MARIA J. ,   THE SPANISH GROUP FOR THE STUDY OF THE ROUTE OF HEROIN ADMINISTRATION
Published: January 2006

Abstract Aims. To measure the current prevalence of different routes of heroin administration among users and to describe the most frequent patterns in the evolution of the main route from the time of first use to the present and their implications for the control of the HIV epidemic. Design. Cross‐sectional study. Face‐to‐face interviews using a structured questionnaire. Setting and participants. Nine hundred and nine regular heroin users from Madrid, Barcelona and Seville (about 300 per city), half of them recruited in treatment centres and the other half out of treatment. Measurements. Socio‐demographic characteristics, current and historical behaviours related to route of administration. Findings. Before 1980 injection was the first main route of heroin administration for most users in Barcelona and Madrid; in Seville smoking already predominated, although 40% of users began by injecting. Sniffing subsequently became predominant in Barcelona, while smoking became the predominant first route in Madrid and Seville (smoking has been the only first route in Seville since 1991). The prevalence of injection as the main route of administration during the last 30 days was 77.3% in Barcelona, 24.3% in Madrid and 23.9% in Seville; smoking predominated in the latter two cities. The factors most strongly associated with injection as the preferred route were city of recruitment and having a partner who injected. Some 73% of those who stopped injecting in their last change of route stated that the results of their HIV test or fear of becoming infected had been important in making this decision. Conclusions. The change from injecting to smoking will greatly facilitate the control of HIV infection in Spain. However, the main causal factor does not appear to be the perception of HIV risk, but rather other, ecological factors (cultural or market‐related). The absence of these factors in some areas may impede the spread of smoking.
Treating grouped data as continuous in alcohol consumption measures
Authors: de BURGH SIMON , BERRY GEOFFREY 
Published: January 2006

AbstractIn quantity‐frequency methods used for self‐report measurement of alcohol intake (or other exposures), respondents mark the appropriate ranges, e.g. ‘5 to 8 drinks’, ‘5 or 6 times per week’. To calculate average consumption only single values, not ranges, can be multiplied, and midpoints are commonly used. This results in bias if the range lies in the tail of a distribution, as often happens with drinks per occasion. The same bias occurs when risk, for example, is plotted against consumption levels, which inevitably are grouped into ranges. Consequently, estimates of aggregate consumption can be exaggerated and curves of risk against exposure level can be misleading. A method is described to calculate a relatively unbiased representative value for a range, requiring only knowledge of the normal distribution table, the log‐normal distribution, and basic arithmetic. Part of the procedure is also useful for estimating percentile points in data that have been grouped differently, suck as income in dollar groups.
Cognitive impairment among the dually‐diagnosed: substance use history and depressive symptom correlates
Authors: CARPENTER KENNETH M. , HITTNER JAMES B. 
Published: January 2006

AbstractThe present study examined the effects of substance use history and depressive symptomatology on the cognitive functioning of 149 male and 72 female dually diagnosed inpatients. Logistic regression models examined the effects of life‐time alcohol and cocaine use, previous month's alcohol and cocaine use and depression on abstract reasoning as assessed by the Shipley Institute of Living Scale (SILS) and neuropsychological functioning as measured by the Screening Test for the Luria‐Nebraska Neuropsychological Battery (ST‐LNNB). Results indicated differential effects of substance use across the two cognitive outcome measures. Specifically, a significant relationship was demonstrated for previous month's alcohol use on Shipley classification. However, after adjusting for possible borderline cases, previous month's alcohol use dropped to non‐significance and in its stead an association between Shipley classification and life‐time use was demonstrated. No significant effects were demonstrated for cocaine use, recent alcohol use, depressive symptoms or any of the interaction terms. The Luria‐Nebraska performance classifications were significantly associated with both educational level and life‐time cocaine use. No significant relationships were obtained for previous month's cocaine use, the alcohol use variables, depressive symptoms, or any of the interaction terms. The degree of classification agreement between the two outcome measures was slightly better than chance (K = 0.24 for ST‐LNNB and traditional or full scale SILS; K = 0.35 for ST‐LNNB and modified SILS). These kappa coefficients suggest that the SILS and ST‐LNNB assess partially independent dimensions of cognitive functioning. The findings are discussed in light of previous research and implications for clinical assessment and treatment are outlined.
Treatment of substance abusers: single or mixed gender programs?
Authors: HODGINS DAVID C. , EL‐GUEBALY NADY , ADDINGTON JEAN 
Published: January 2006

AbstractSingle‐gender groups are advocated for women because substance abuse treatment programs tend to be male dominated both in numbers and in style. Although there is a paucity of empirical work that directly addresses this assumption, a body of literature that indirectly supports it is reviewed. Male and female substance abusers report different histories and courses for their disorders and display different needs and characteristics in treatment settings. Men and women may benefit from different treatment approaches with less structure required for women, particularly problem drinkers. Moreover, specific characteristics such as victimization, sexual orientation, sex‐role conflict and degree of antisocial traits may be important mediating factors in whether single‐gender groups are optimal. Social psychological research illustrates the effect of gender composition of groups for men and women. In general, mixed groups are associated with more variation in interpersonal style for men but are restrictive for women who show more variation in style in single‐gender groups. These findings are suggestive of testable hypotheses concerning the effects of single and mixed gender programming. Such investigations have the potential of enhancing treatment efficacy.
Reaching out beyond the hills: HIV prevention among injecting drug users in Manipur, India
Authors: HANGZO CHINGZANING , CHATTERJEE ANINDYA , SARKAR SWARUP , ZOMI* GINZAMANG T. , DEB B. C. , ABDUI‐QUADER ABU S. 
Published: January 2006

AbstractOutreach interventions using ex‐IDUs to inform and educate their peers about HIV/AIDS prevention measures have been found to be effective in the United States and other developed countries. While HIV/AIDS prevention programmes targeting IDUs have also been implemented in a number of developing countries, very little information is available on the process of implementation of these programmes. This paper attempts to document some of this knowledge by describing the implementation process of an outreach intervention targeting IDUs in a small town—Churachandpur—with high injection drug use and high HIV infection rates, in the north‐eastern state of Manipur. The paper describes the barriers encountered in implementing the outreach and how these barriers were minimized. In conclusion, the paper makes the case for targeting outreach to the larger community before targeting the IDUs.
Concepts of drugs: differences in conceptual structure across groups with different levels of drug experience
Authors: FABRICIUS WILLIAM V. , NAGOSHI CRAIG T. , MACKINNON DAVID P. 
Published: January 2006

AbstractSeventy‐seven college students varying in degree of drug use experience rated the perceived similarities of all possible combinations of 16 drug classes (cigarettes, other tobacco, alcohol, marijuana, barbiturates, minor and major tranquilizers, amphetamines, amphetamine derivatives, cocaine, heroin, opiates, hallucinogens, inhalants, PCP, anti‐depressants). Multidimensional scaling (INDSCAL) and network models (PFNET) indicated that abstainers had only one pharmacological category involving sedatives/depressants, and that they attached more importance to whether drugs were licit vs. illicit than to whether they were depressants vs. stimulants. Conceptions became more coherent, differentiated and based on pharmacological properties for more experienced drug users. In line with previous work, groups with greater experience with drugs had more sophisticated conceptions not only about the drugs they had used, but also about drugs they had not used. These findings suggest that early on in drug behavior sophisticated and interrelated concepts are developing that should be taken into account when designing interventions and information campaigns.
High‐ and low‐dose alcohol‐related expectancies and the differential associations with drinking in male and female adolescents and young adults
Authors: WIERS REINOUT W. , HOOGEVEEN KEES‐JAN , SERGEANT JOSEPH A. , GUNNING W. BOUDEWIJN 
Published: January 2006

AbstractA Dutch questionnaire was developed consisting of positive and negative expectancies relating to low and high doses of alcohol. The associations of these four types of expectancies with current alcohol consumption were investigated in three samples: secondary school pupils of 11‐15 years old, secondary school pupils of 16 and older, and university undergraduate students (total n = 554). Using restrictive factor analyses, a common factor‐model of the expectancies was shown to fit adequately across subgroups. Which expectancies were associated with current alcohol consumption varied substantially across the subgroups. As expected from previous research, inclusion of high dose expectancies did not substantially improve the prediction of drinking in university students. However, positive and negative high‐dose expectancies were found to be powerful predictors of current alcohol consumption in secondary school boys of 16 and older, the subgroup with the highest average alcohol consumption on each occasion. Possible implications are discussed for future research and interventions.
A national household survey of drug misuse in Britain: a decade of development
Authors: RAMSAY MALCOLM , PERCY ANDREW 
Published: January 2006

AbstractLike most other countries, Britain has lagged behind the United States in developing a fully‐fledged national household survey of drug misuse. Building on some initial efforts in the early 1990s, the 1994 British Crime Survey (BCS) and the 1995 National Drugs Campaign Survey (NDCS) and various other large‐scale household surveys have provided fresh insights into drugs prevalence and patterns of misuse. These developments—their achievements and their limitations—are reviewed here. Particular attention is paid to the development of self‐report methodologies: both the BCS and the NDCS rely on interviewees personally entering their responses on to laptop computers. Some of the main findings of these surveys are oho briefly discussed.
A community‐wide Responsible Beverage Service program in three communities: early findings
Authors: SALTZ ROBERT F. , STANGHETTA PAULA 
Published: January 2006

AbstractEvidence accumulating over the past 10 years or so suggests that commercial servers of alcoholic beverages mill intervene to reduce levels of impairment among their patrons and will refuse service to intoxicated customers. While some Responsible Beverage Service (RBS) programs have had significant effects on server and patron behavior, others have not. This leads us to consider issues of implementation and program effectiveness. In the current paper, a community‐wide RBS program is described in some detail. The program was comprised by a larger comprehensive community intervention project in three sites across California and South Carolina. Process evaluation data, to track program implementation and proximal effects, provide early findings. Expressed support for RBS principles was high for both the public and the hospitality industry in all sites. A telephone survey of managers also suggests that prevention policies at bars and restaurants are beginning to show up, but a direct measure of server intervention with heavy drinkers does not yet demonstrate a program effect.
Use of spatial models for community program evaluation of changes in alcohol outlet distribution
Authors: MILLAR ALEXANDER B. , GRUENEWALD PAUL J. 
Published: January 2006

AbstractAlcohol outlets have geographic and spatial characteristics which are important for researchers to consider taken planning and evaluating community prevention programs. Community‐level dam used in monitoring alcohol problems across community areas and over time exhibit spatial dependencies. Statistical procedures which depend on assumptions of independence may fail to give proper results in such a situation. Specific statistical techniques have been developed which adjust for the effects of spatial dependencies in measures across geography. This paper provides an example of the creation and use of computer Geographic Information Systems to display community alcohol outlets and alcohol‐involved problems and the use of statistical analysis techniques which account for such spatial dependencies over time. This paper introduces the concepts, terminology, and justification for considering spatial analysis in community prevention planning, research and evaluation. The selection of a geographical unit of analysis will be discussed. Finally, as a demonstration, a variety of spatial statistics are applied to community spatial data for evaluation.
The prepared mind: Marie Nyswander, methadone maintenance, and the metabolic theory of addiction
Authors: COURTWRIGHT DAVID T. 
Published: January 2006

AbstractMarie Nyswander was the co‐discoverer of methadone maintenance. In the 1960s she and Vincent Dole carried out clinical trials and established the first officially sanctioned methadone clinics, which became models‐far maintenance programs throughout the world. In 1967 she and Dole theorized that heroin addicts had undergone a permanent metabolic change. They needed narcotics in a visceral way, which explained why abstinence was not a realistic goal—a claim that remains hotly disputed. Nyswander's work in the 1960s marked an abrupt shift in her chinking about addiction. Her previous approach had been centered on psychoanalysis. Her embrace of methadone maintenance and the metabolic theory amounted to an intellectual conversion. Nyswander was prepared for that conversion by years of patient relapse; she was frustrated with orthodox therapy. At the same time the success of such drugs as chlorpromazine suggested that psychiatric disorders might yield more readily to chemotherapy than talking therapy. Her own heavy smoking may have led her to question whether addiction was a psychiatric disorder in the first place. Finally, Nyswander had a long history of self‐reinvention, having previously changed her politics, her medical specialty, and even her name. She was temperamentally suited for a conversion experience.
Opium revisited: a brief review of its nature, composition, non‐medical use and relative risks1
Authors: KALANT H. 
Published: January 2006

AbstractUnlike the pure opioids such as morphine and heroin, opium is a complex and variable mixture of substances reflecting differences in both the starting material and the traditional practices of the regions in which it is produced. Analytical methods have improved greatly in recent years, to the point that the source of a preparation can often be identified by its opioid content and its impurities. Daily amounts used, both by smoking and by mouth, vary widely from less than a gram to 30 g, equivalent to 75—3000 mg of morphine. The effects of opium are essentially those of morphine but unexpected toxicities, suck as oesophageal cancer associated with “dross opium” and polyneuropathy due to deliberate addition of arsenic, are problems in some specific regions. Prevalence of use in different areas and countries is governed by the same factors of ease of availability, price and social acceptance that apply to the use of alcohol and other drugs in western countries. The risk of addiction to opium smoking appears to be somewhat less than to parenteral use of heroin, but appreciably greater than to alcohol Even in countries where its use is traditional, opium smoking carries substantial risks of harm to health and social functioning.