bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pipecolic acid in rumen fluid and plasma in ruminant animals
Authors: HUSSAIN‐YUSUF Hazizul , SULTANA Halima , TAKAHASHI Toshihiro , MORITA Tetsuo , SATO Hiroyuki , ITABASHI Hisao , ONODERA Ryoji 
Published: December 2004

ABSTRACTA survey was conducted to investigate the physiological levels of pipecolic acid (Pip) in rumen fluid and plasma of ruminants such as goats and cattle in the presence or absence of rumen protozoa. The concentration of Pip was determined using HPLC. Basal Pip levels in the rumen fluid and plasma of normal faunated animals were 21 ± 8 and 2.3 ± 1.3 µM, respectively, and levels increased 1–2 h after feeding. The Pip levels in the rumen fluid and plasma of faunated goats and cattle were significantly higher than those of defaunated goats and unfaunated cattle. A small amount of Pip was also found in the rumen fluids of the defaunated and unfaunated animals; this appeared to be derived from feeds such as hay cube and corn silage. The results obtained in the present study suggest that a significant amount of rumen‐produced Pip is likely to be absorbed into the plasma of the host animals and that rumen protozoa significantly enhance the concentration of Pip in the rumen fluid and plasma of ruminant animals.
Prevalence and correlates of intravenous methadone syrup administration in Adelaide, Australia
Authors: Humeniuk Rachel , Ali Robert , McGregor Catherine , Darke Shane 
Published: December 2004

AbstractAims  The aims of this study were to determine the prevalence of methadone syrup injecting in Adelaide, South Australia and to characterize methadone injectors, including their heroin use and risk behaviours associated with heroin overdose.Design  Cross‐sectional design.Setting  Community setting, principally metropolitan Adelaide.Participants  Current heroin users (used heroin in the last 6 months), recruited through snowballing.Measurements  Structured questionnaire.Findings  Of 365 participants, 18.4% reported having ever injected methadone syrup and 11.0% had injected methadone in the last 6 months. Those that had injected methadone were more likely to be male, and were more likely to be receiving methadone maintenance. They were also maintained on higher doses of methadone than subjects not injecting methadone. A history of methadone injection was associated with more heroin overdose experiences and greater dependence on heroin. Methadone injectors were also more likely to engage in risky behaviours associated with heroin overdose, including using heroin when no other people were present, not trial‐tasting new batches of heroin and polydrug use.Conclusions  Methadone syrup injectors appear to be at greater risk of a series of harms than subjects not injecting methadone. The prevalence of methadone syrup injecting in Adelaide, South Australia was 11%, which was lower than prevalence in Sydney, New South Wales, but higher than in Melbourne, Victoria. Jurisdictional differences concerning the prevalence of methadone syrup injecting may reflect differing policies by each state to methadone dispensing.
Trends in drug overdose deaths in England and Wales 1993–98: methadone does not kill more people than heroin
Authors: Hickman Matthew , Madden Peter , Henry John , Baker Allan , Wallace Chris , Wakefield Jon , Stimson Gerry , Elliott Paul 
Published: December 2004

AbstractAims  To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends.Design and setting  Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug‐related poisoning mortality database from 1993 to 1998 in England and Wales.Measurements  Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone‐related overdose compared to dying from heroin/morphine overdose.Findings  From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22–28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6–13%) for methadone only. This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (95% CI 1.29–1.71) for methadone‐only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% CI 0.95–1.25) if the weekend was defined as Friday and Saturday.Conclusions  There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue.
Estimating prevalence of problem drug use at national level in countries of the European Union and Norway
Authors: Kraus Ludwig , Augustin Rita , Frischer Martin , Kümmler Petra , Uhl Alfred , Wiessing Lucas 
Published: December 2004

AbstractObjectives  This paper will present the most recent estimates for problematic drug use in European Member States and explore the problems of comparability.Methods  Estimates of problematic drug use, derived according to agreed guidelines, were collected from all EU countries and Norway. Methods included multipliers based on treatment, police, mortality or AIDS/HIV data, the capture–recapture method and the multivariate indicator method. Prevalence estimates were transformed into rates per 1000 population aged 15–64 years.Results  Target populations varied according to data selection. Estimates for six partially overlapping types of drug use could be identified: ‘problem opiate use’, ‘problem opiate or cocaine use’, ‘problem amphetamine or opiate use’, ‘problem drug use’, ‘(current) injecting’ and ‘life‐time injecting’. Rates of injectors ranged from 2.6 in Germany to 4.8 in Luxembourg; rates in Austria, Denmark, Finland, Portugal and the United Kingdom fell within this range. For problem opiate use, a group of high prevalence countries were found with average rates exceeding six cases (Italy, Luxembourg, Spain and the United Kingdom) and a group with lower prevalence with average rates close to three cases (Austria, Germany, Ireland, the Netherlands). Rates obtained for France (problem opiate or cocaine use), Finland and Sweden (problem amphetamine or opiate use) are not directly comparable and fall between these rates.Conclusions  Cross‐national comparisons should be made with care and estimated target populations may vary greatly between countries. For estimating various forms of problem drug use at national level, a multi‐method approach is recommended.
Linking alcohol‐ and drug‐dependent adults to primary medical care: a randomized controlled trial of a multi‐disciplinary health intervention in a detoxification unit
Authors: Samet Jeffrey H. , Larson Mary Jo , Horton Nicholas J. , Doyle Kathleen , Winter Michael , Saitz Richard 
Published: December 2004

AbstractAim  Pragmatic approaches to integration of medical care and substance abuse treatment are desired. We assessed the effectiveness of a novel multi‐disciplinary clinic for linking patients in a residential detoxification program to primary medical care.Participants  We enrolled patients undergoing in‐patient detoxification from alcohol, heroin or cocaine who had no primary care physician into a randomized controlled trial. The intervention consisted of a clinical evaluation at the detoxification unit in the health evaluation and linkage to primary care (HELP) clinic by a nurse, social worker and physician and facilitated referral to an off‐site primary care clinic. The primary outcome of interest was attendance at a primary care appointment within 12 months. Secondary outcomes assessed over 24 months were addiction severity, health‐related quality of life, utilization of medical and addiction services and HIV risk behaviors.Findings  Of the 470 subjects enrolled, 235 were randomized to the HELP clinic intervention. Linkage to primary medical care occurred in 69% of the intervention group compared to 53% in the control group (P = 0.0003). The clinic was similarly effective for subjects with alcohol and illicit drug problems. Randomization to the HELP clinic resulted in no significant differences in secondary outcomes.Conclusions  The HELP clinic, a multi‐disciplinary clinic located in a detoxification unit, effectively linked alcohol‐ and drug‐dependent individuals to primary medical care. This intervention utilized a ‘reachable moment’, the period of addiction care, as a window of opportunity for linking substance abusers to medical care.
Use of morphine and 6‐monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users
Authors: Fugelstad Anna , Ahlner Johan , Brandt Lena , Ceder Gunnel , Eksborg Staffan , Rajs Jovan , Beck Olof 
Published: December 2004

AbstractAims To detect risk factors for sudden death from heroin injection.Design Evaluation of data from forensic investigations of all fatal cases of suspected heroin death in a metropolitan area. Only cases with detectable morphine and 6‐monoacetylmorphine (6‐MAM) in blood were included in order to select heroin intoxication cases.Setting Stockholm, Sweden.Measurements Autopsy investigation and toxicological analysis of blood and urine; and police reports.Findings In two‐thirds of the 192 cases, death occurred in public places, and mostly without any time delay. Blood concentrations of morphine ranged from 50 to 1200 ng/g, and of 6‐MAM from 1 to 80 ng/g. Codeine was detected in 96% of the subjects. In the majority of cases the forensic investigation indicated polydrug use, the most common additional findings being alcohol and benzodiazepines. However, in one‐quarter of the cases other drug combinations were found. Previous abstinence from heroin and use of alcohol were identified as risk factors. For 6‐MAM there was also a correlation with the presence of THC and benzodiazepines. Despite a high frequency of heart abnormalities (e.g. myocarditis and focal myocardial fibrosis), these conditions did not correlate with morphine or 6‐MAM blood concentrations.Conclusions We confirm that alcohol intake and loss of tolerance are risk factors for death from heroin use, whereas no connection to heart pathology was observed. Further, prospective, studies should focus on other possible risk factors.
Short‐term outcomes after brief ambulatory opioid detoxification with buprenorphine in young heroin users
Authors: Gandhi Devang H. , Jaffe Jerome H. , McNary Scot , Kavanagh Greg J. , Hayes Michael , Currens Marian 
Published: December 2004

AbstractAims  This study examines the outcomes at 1, 3 and 6 months after a very brief outpatient detoxification with buprenorphine in 18–25‐year‐old heroin users.Design  Prospective follow‐up study.Setting  Outpatient drug treatment clinic, providing brief detoxification in downtown Baltimore, Maryland, USA.Participants  One hundred and twenty‐three subjects between 18 and 25 years old; 56% male; 95% Caucasian; seeking detoxification; living in Baltimore City and five surrounding counties.Intervention  Detoxification with buprenorphine over 3 days. Follow‐up at 1, 3 and 6 months.Measurements  Drug use history, the Addiction Severity Index at baseline and follow‐up, urine drug screens, evaluation of the detoxification experience.Findings  By self‐report, 37% of the total sample were not currently using heroin at 1 month, 32% at 3 months and 29% at 6 months, and 6.7%, 10.1% and 11.8% had an opioid negative urine test at 1, 3 and 6 months, respectively. There was a significant reduction from the baseline in mean Addiction Severity Index drug use composite score, as well as the mean number of days of heroin and cocaine use during past 30 days, that was sustained over the three follow‐up points. Engagement in aftercare was generally poor.Conclusions  The findings show a reduced frequency and intensity of drug use, suggesting a possible role for brief outpatient detoxification in reducing the severity of dependence for some younger heroin users who may not yet be ready to engage in long‐term abstinence‐oriented or opioid substitution treatments.
Buprenorphine versus methadone maintenance therapy: a randomized double‐blind trial with 405 opioid‐dependent patients
Authors: Mattick Richard P. , Ali Robert , White Jason M. , O'Brien Susannah , Wolk Seija , Danz Cath 
Published: December 2004

AbstractAims  To assess the efficacy of buprenorphine compared with methadone maintenance therapy for opioid dependence in a large sample using a flexible dosing regime and the marketed buprenorphine tablet.Design  Patients were randomized to receive buprenorphine or methadone over a 13‐week treatment period in a double‐blind, double‐dummy trial.Setting  Three methadone clinics in Australia.Participants  Four hundred and five opioid‐dependent patients seeking treatment.Intervention  Patients received buprenorphine or methadone as indicated clinically using a flexible dosage regime. During weeks 1–6, patients were dosed daily. From weeks 7–13, buprenorphine patients received double their week 6 dose on alternate days.Measurements  Retention in treatment, and illicit opioid use as determined by urinalysis. Self‐reported drug use, psychological functioning, HIV‐risk behaviour, general health and subjective ratings were secondary outcomes.Findings  Intention‐to‐treat analyses revealed no significant difference in completion rates at 13 weeks. Methadone was superior to buprenorphine in time to termination over the 13‐week period (Wald χ2 = 4.371, df = 1, P = 0.037), but not separately for the single‐day or alternate‐day dosing phases. There were no significant between‐group differences in morphine‐positive urines, or in self‐reported heroin or other illicit drug use. The majority (85%) of the buprenorphine patients transferred to alternate‐day dosing were maintained in alternate‐day dosing.Conclusions  Buprenorphine did not differ from methadone in its ability to suppress heroin use, but retained approximately 10% fewer patients. This poorer retention was due possibly to too‐slow induction onto buprenorphine. For the majority of patients, buprenorphine can be administered on alternate days.
Defining ‘current drinkers’ in national surveys: results of the 2000 National Alcohol Survey
Authors: Midanik Lorraine T. , Greenfield Thomas K. 
Published: December 2004

AbstractAims  The purpose of this study is to determine which respondents of national surveys who report low ‘usual’ past year drinking frequency, are unsure of their drinking frequency or refuse to answer, are misclassified either as ‘current drinkers’ or as ‘ex‐drinkers.’Design and setting  The data are from the 2000 National Alcohol Survey, a national household telephone probability sample of adults in all 50 US States and Washington, DC (n = 7612).Participants  A subsample of 1734 respondents who reported drinking ‘less than once a month but at least once a year’, ‘less than once a year’, ‘refused’ and ‘don’t knows’ were also asked if they had consumed a whole drink of any alcoholic beverage in the 12 months using dates to anchor the question.Measurements  Five alcohol measures were used to compare groups who changed or did not change their drinking status based on the followup question: volume, mean number of days 5 +, social consequences, dependence symptoms and DSM‐IV.Findings  The results indicate that only 4.6% of respondents (n = 349) changed their drinking status, and the percentages were equal in both directions. Women were more likely to change their drinking status and specifically become ex‐drinkers based on the follow‐up question. Respondents who became current drinkers drank significantly at a lower average volume than those who remained current drinkers. The prevalence rates based on the five alcohol measures were not affected by how ‘current drinker’ is defined.Conclusions  Adding the follow‐up question is recommended for new alcohol surveys so that fewer respondents are misclassified.
Delphi survey of experts’ opinions on strategies used by community pharmacists to reduce over‐the‐counter drug misuse
Authors: McBride Andrew J. , Pates Richard , Ramadan Reem , McGowan Christopher 
Published: December 2004

AbstractAim  To explore the views of experts within the fields of pharmacy and addiction on the value of current strategies and possible alternatives and to reach an agreement on best practice in the sale of over‐the‐counter (OTC) medicines which are liable to misuse.Design  Using a modified Delphi approach, an anonymous, international, three‐stage, postal questionnaire was conducted that generated both qualitative and quantitative data.Participants  Of those contacted by telephone (164) from the United Kingdom, Australia, Canada, New Zealand and United States, 109 experts (66%) agreed to take part. Forty‐three per cent (47/109) completed all three stages of the study.Measurements  A Delphi technique was employed to gather data. The second and final questionnaires were constructed from the responses to the preceding questionnaires. Content analysis of the qualitative data was carried out at each stage. Statistical analyses of the influence of demographic factors, degree of shift in overall opinion between the first and second stages and degree of agreement between respondents at each stage were also conducted.Findings  A consensus was reached on the strategies considered the most important and effective. Key areas include improving access to current information, improved staff training, addressing the issues of non‐pharmacy outlets and Internet pharmacy sites. Concerns were expressed regarding the possible conflict between commercial and customer interests.Conclusions  The consensus view presented offers practical and realistic guidance for policy‐makers and community pharmacists on the sale of OTC products. It reflects the best evidence to date of expert views in this area and accords with current UK guidelines. The effective implementation of these strategies can only be achieved with improved communication and coordination at local and national level.
Efficacy of exercise counselling as an aid for smoking cessation: a randomized controlled trial
Authors: Ussher Michael , West Robert , McEwen Andy , Taylor Adrian , Steptoe Andrew 
Published: December 2004

AbstractAim  To examine whether exercise counselling increases smoking abstinence and reduces tobacco withdrawal and gains in weight and body fat.Design  A randomized controlled trial.Setting  A community‐based stop smoking clinic.Participants  Two hundred and ninety‐nine male and female smokers.Intervention  Participants were assigned randomly to a 7‐week smoking cessation programme, including nicotine replacement therapy plus either (i) exercise counselling, or (ii) health education advice with equal contact time as for the exercise counselling condition.Measurements  Six weeks of smoking abstinence was confirmed by expired carbon monoxide.Findings  There was no significant difference in smoking abstinence between the exercise group (n = 154) and the controls (n = 145) at 6 weeks (39.6% versus 38.6%), nor was there any difference in gains in weight or body fat, although those in the exercise group increased their exercise levels. Exercise participants reported less tension, anxiety and stress than the controls during the first week of smoking abstinence (P = 0.03, 0.01 and 0.04, respectively), less irritability throughout 2 weeks of abstinence (P = 0.03), and less restlessness throughout 3 weeks of abstinence (P = 0.04).Conclusions  Adding brief exercise counselling to a smoking cessation programme did not increase smoking abstinence or reduce gains in weight or body fat significantly, although exercise levels were raised and there were some beneficial effects on psychological symptoms.
Longer‐term primary prevention for alcohol misuse in young people: a systematic review
Authors: Foxcroft D. R. , Ireland D. , Lister‐Sharp D. J. , Lowe G. , Breen R. 
Published: December 2004

AbstractObjective  To identify and summarize rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people aged up to 25 years, especially over the longer term (>3 years).Methods  Cochrane Collaboration Systematic Review.Data sources  A comprehensive search of 22 databases and recursive checking of bibliographies for randomized and non‐randomized controlled trials and interrupted time‐series studies.Main outcome measures  Objective or self‐report measures of alcohol use and misuse.Results  Fifty‐six studies were selected for inclusion in the systematic review. Twenty of the 56 studies showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short‐ and medium term were possible. Over the longer term (>3 years), the Strengthening Families Programme (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 years for three alcohol initiation behaviours (alcohol use, alcohol use without permission and first drunkenness) was 9 (for all three behaviours). One study also highlighted the potential value of culturally focused skills training over the longer‐term (NNT = 17 over 3.5 years for 4+ drinks in the last week)Conclusions  (1) Research into important outcome variables needs to be undertaken; (2) the methodology of evaluations needs to be improved; (3) the SFP needs to be evaluated on a larger scale and in different settings; (4) culturally focused interventions require further development and rigorous evaluation; and (5) an international register of alcohol and drug misuse prevention interventions should be established and criteria agreed for rating prevention interventions in terms of safety, efficacy and effectiveness.