bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compliance with hepatitis B vaccination in 1175 heroin users and risk factors associated with lack of vaccine response
Authors: Quaglio Gianluca , Talamini Giorgio , Lugoboni Fabio , Lechi Alessandro , Venturini Luca ,   Gruppo Intersert di Collaborazione Scientifica (GICS), Jarlais Don C. Des , Mezzelani Paolo 
Published: March 2003

ABSTRACTAims To investigate the feasibility of hepatitis B vaccination among heroin users, assessing adherence to the vaccination schedules and identifying factors associated with antibody response.Design and participants A large cohort study in nine public centres for drug users (PCDUs) in north‐eastern Italy, with data collected between January 1989 and December 1998. A total of 1175 heroin users were selected and vaccinated with a recombinant vaccine using two schedules (0–1–6 months and 0–1–2 months).Findings Eighty‐eight per cent of patients completed the vaccination series and a protective antibody response occurred in 77% of subjects. Completion of the vaccination series was not related to the length of the vaccination schedule or whether the patient was still in drug abuse treatment at the end of the series, but was related strongly to the number of patients enrolled at each PCDU (Spearman correlation = – 0.93, P < 0.001). Four variables were significantly associated with lack of seroconversion in response to vaccination: older age (AOR = 0.91 per year, 95% CI 0.88–0.94, P < 0.001), 2‐month vaccination schedule (AOR = 3.10, 95% CI 2.06–4.68, P < 0.001), HCV seropositivity (AOR = 0.69, 95% CI 0.47–0.99, P = 0.04), HIV seropositivity (AOR = 0.27, 95% CI 0.10–0.77, P = 0.01).Conclusions A large‐scale, multi‐site hepatitis B vaccination programme for heroin users proved feasible and effective. The factors associated with a lack of antibody response may be useful in identifying patients who would benefit most from routine post‐vaccination testing, with booster doses for non‐responders. These results suggest that hepatitis B vaccination for drug users should become a routine public health practice.
Hair morphine concentrations of fatal heroin overdose cases and living heroin users
Authors: Darke Shane , Hall Wayne , Kaye Sharlene , Ross Joanne , Duflou Johan 
Published: March 2003

ABSTRACTAimsTo compare heroin and other opiate use of heroin overdose fatalities, current street heroin users and drug‐free therapeutic community clients.DesignHair morphine concentrations that assess heroin use and other opiate use in the 2 months preceding interview or death were compared between heroin overdose fatalities diagnosed by forensic pathologists (FOD) (n= 42), current street heroin users (CU) (n= 100) and presumably abstinent heroin users in a drug‐free therapeutic community (TC) (n= 50).SettingSydney, Australia.FindingsThe mean age and gender breakdown of the three samples were 32.3 years, 83% male (FOD), 28.7 years, 58% male (CU) and 28.6 years, 60% male (TC). The median blood morphine concentration among the FOD cases was 0.35 mg/l, and 82% also had other drugs detected. There were large differences between the three groups in hair morphine concentrations, with the CU group (2.10 ng/mg) having concentration approximately four times that of the FOD group (0.53 ng/mg), which in turn had a concentration approximately six times that of the TC group (0.09 ng/mg). There were no significant differences between males and females in hair concentrations within any of the groups. Hair morphine concentrations were correlated significantly with blood morphine concentrations among FOD cases (r= 0.54), and self‐reported heroin use among living participants (r= 0.57).ConclusionsThe results indicate that fatal cases had a lower degree of chronic opiate intake than the active street users, but they were not abstinent during this period.
Substance abuse and fathering: adding poppa to the research agenda
Authors: McMahon Thomas J. , Rounsaville Bruce J. 
Published: March 2003

ABSTRACTAlthough a number of socioeconomic forces have converged across cultures to make fathering one of the more prominent social issues of the new millennium, the status of substance‐abusing men as fathers is rarely acknowledged in the conceptualization of public policy, service delivery or research focusing on the adverse consequences of drug and alcohol abuse. In this commentary, the authors call for the substance abuse research community to expand understanding of fathering occurring across cultures in the context of chronic substance abuse. Building upon research being undertaken with other populations of fathers, the authors argue there is need to clarify (a) the number of substance‐abusing fathers, (b) patterns of reproduction among substance‐abusing men, (c) ways in which substance abuse contributes to compromise of fathering, (d) ways in which compromise of fathering contributes to psychological distress in substance‐abusing men, (e) ways in which compromise of fathering affects developmental outcomes for children, and (f) ways in which clinical and preventive intervention might be used to minimize the harm associated with paternal substance abuse.
Too drunk for a beer? A study of overserving in Stockholm
Authors: Wallin Eva , Gripenberg Johanna , Andréasson Sven 
Published: March 2003

ABSTRACTAimsTo evaluate the effects of a community alcohol prevention programme on the frequency of alcohol service to intoxicated patrons at licensed premises.DesignPretest (1996)–post‐test (1999) design.SettingLicensed premises in Stockholm, Sweden.InterventionThe community alcohol prevention programme, including server training in responsible beverage service (RBS) and policy initiatives in the community, has been conducted since 1996.Participants and measurementsActors were hired to enter licensed premises, enact a scene of severe intoxication and attempt to order a beer. At the baseline in 1996, actors visited 92 licensed premises, 47 from the central part of Stockholm and 45 from the southern part of Stockholm. At the follow‐up in 1999, 103 licensed premises were visited, 61 from the central part of Stockholm and 42 from the southern part of Stockholm. Observers monitored each visit.FindingsAt follow‐up the actors were denied service of alcohol at 47% of the licensed premises, a statistically significant improvement compared to 5% in the baseline study.ConclusionsLicensed premises refused service of alcohol to intoxicated patrons to a much greater extent than in the baseline study. The improved results can probably be explained by a combination of policy initiatives in the community, changes in the overall enforcement environment and RBS training.
Drug injection among street youth: the first time
Authors: Roy Élise , Haley Nancy , Leclerc Pascale , Cédras Lyne , Boivin Jean‐François 
Published: March 2003

ABSTRACTAims To describe the circumstances of the first drug injection among street youth.Design A cohort study conducted in 1995–2000.Participants Subjects aged 14–25 years old were recruited in all major Montreal organizations offering free services to street youth.Measurement Subjects who reported having ever injected drugs completed questions on the circumstances of their first injection (calendar time, location, type of relationship with the initiator, presence of others, drug first injected, source of needle and use of clean needle and other injection materials). Questions on characteristics of the initiator and prior use of the first injected drug were added during the course of the study.Findings Of 980 participants, 530 (54%) had ever injected drugs. Questionnaires were completed by 505 subjects, including 77 who also answered the additional questions. The mean age at first injection was 17.7 years. First injection occurred mainly in public places (41%). It was performed by a close friend (41%), the youth himself/herself (27%), an acquaintance (15%), a lover (10%) or another person (7%). Overall, 84% of youth first injected with a clean needle; only 62% used clean drug preparation equipment. The first drug injected was generally cocaine (47%) or heroin (41%). Two‐thirds (53/77) had used the drug of first injection previously; however, the majority was not dependent upon it.Conclusions Most street youth used clean needles at first injection, but use of other clean injection materials was less frequent. Factors other than dependence appear to play a significant role in initiation into injection.
A population‐based study of cigarette smoking among illicit drug users in the United States
Authors: Richter Kimber Paschall , Ahluwalia Harsohena K. , Mosier Michael C. , Nazir Niaman , Ahluwalia Jasjit S. 
Published: March 2003

ABSTRACTAimsPeople who use illicit drugs are thought to have high rates of cigarette smoking; however, few population‐based studies have been reported. We describe smoking patterns among illicit drug users, assess whether cigarette smoking is more prevalent among illicit drug users than it is among non‐users and explore how smoking relates to level and type of drug use.Design, setting, participantsWe used adult responses to the 1997 National Household Survey on Drug Abuse (n = 16 661). Multivariate analyses used SUDAAN to adjust standard errors for the sampling design and controlled for age, race, sex, education, depression, treatment history and alcohol.MeasurementsSmoking rates, cessation rates and smoking levels.FindingsSeventy‐one per cent of recent illicit drug users smoked cigarettes at least once in the past month. Their adjusted odds of being a smoker were much greater than for the general population (OR = 3.07, P < 0.0001). Their quit rate, although substantial, was half that of non‐users (23% versus 56%, P = 0.0001). Odds of being a smoker were higher for poly‐ versus monodrug users (OR = 2.35, P = 0.0020) and rose with increased drug use (OR = 1.36, P = 0.0374). Illicit drug users who perceived smoking to be risky were four times less likely to smoke (OR = 0.23, P = 0.0008).ConclusionsAlthough most recent illicit drug users smoke, some are able to quit. Better understanding of concurrent cigarette and illicit drug use may provide impetus for policy change and shed light on underlying mechanisms of addiction. Clinicians, policy makers and user advocates should address tobacco use in drug treatment and in harm reduction interventions.
A multi‐site study of alcohol subtypes: classification and overlap of unidimensional and multi‐dimensional typologies
Authors: Epstein Elizabeth E. , Labouvie Erich , McCrady Barbara S. , Jensen Noelle K. , Hayaki Jumi 
Published: March 2003

ABSTRACTAims The current study examined the usefulness of four prevailing alcohol typologies, assessed in terms of replicability of the multi‐dimensional schemas, percentage of the sample classified by each typology, distribution of subtypes by gender and treatment site and construct validity of Type 1/Type 2. In addition, overlap of classification systems was examined to determine whether the four typologies may be narrowed to a smaller set of meaningful, non‐redundant subtype schemas.Design Baseline data from five treatment outcome studies were used to facilitate subtyping according to four alcohol typologies: antisocial (ASP) versus non‐ASP, early versus late onset, Type 1/Type 2 and Type A/Type B.Setting The studies were conducted at several in‐patient and out‐patient treatment sites.ParticipantsThe sample included 342 participants (23% female) who met DSM‐III‐R criteria for alcohol abuse or dependence.Measurements Subjects were assessed on substance use severity, family history, psychopathology, personality and psychosocial functioning.Findings Type 1/Type 2 and Type A/B typologies were replicated. Type 1/Type 2 had poor construct validity due to symptom cluster overlap between the two subgroups. Only 14% of the subjects met criteria for ASP. The two strongest associations including that between early versus late onset and Type 1/Type 2 and that between ASP versus non‐ASP and Type A/Type B, were expected and reflect overlaps in conceptual definitions. In comparison, the relationship between early versus late onset and ASP versus non‐ASP and Type A/B was weak.Conclusions Clinical utility of the ASP/non‐ASP typology is limited in non‐Veterans Administration (VA) samples, due to low prevalence. The Type 1/Type 2 subtyping schema was redundant with the age of onset schema, and was the least internally valid of all four typologies. In general, the Type A/B schema was most promising of prevailing typologies studied. It was relatively inclusive, and the A, B groups were distinct from one another. However, dichotomous typologies may not be complex enough to be clinically useful descriptors of alcoholic samples. Aside from ASP and Type B, there appears to be heterogeneity within groups typically considered homogeneous, such as ‘early versus late onset’ alcoholics.
A longitudinal study of the effects of tobacco and cannabis exposure on lung function in young adults
Authors: Taylor D. Robin , Fergusson David M. , Milne Barry J. , Horwood L. John , Moffitt Terrie E. , Sears Malcolm R. , Poulton Richie 
Published: March 2003

ABSTRACTAim To assess the possible effects of tobacco and cannabis smoking on lung function in young adults between the ages of 18 and 26.Setting and participants A group of over 900 young adults derived from a birth cohort of 1037 subjects born in Dunedin, New Zealand in 1972/73 were studied at age 18, 21 and 26 years.Measurements Cannabis and tobacco smoking were documented at each age using a standardized interview. Lung function, as measured by the forced expiratory volume in one second/vital capacity (FEV1/VC) ratio, was obtained by simple spirometry. A fixed effects regression model was used to analyse the data to take account of confounding factors.Findings When the sample was stratified for cumulative use, there was evidence of a linear relationship between cannabis use and FEV1/VC (P < 0.05). In the absence of adjusting for other variables, increasing cannabis use over time was associated with a decline in FEV1/VC with time; the mean FEV1/VC among subjects using cannabis on 900 or more occasions was 7.2%, 2.6% and 5.0% less than non‐users at ages 18, 21 and 26, respectively. After controlling for potential confounding factors (age, tobacco smoking and weight) the negative effect of cumulative cannabis use on mean FEV1/VC was only marginally significant (P < 0.09). Age (P < 0.001), cigarette smoking (P < 0.05) and weight (P < 0.001) were all significant predictors of FEV1/VC. Cannabis use and daily cigarette smoking acted additively to influence FEV1/VC.Conclusions Longitudinal observations over 8 years in young adults revealed a dose‐dependent relationship between cumulative cannabis consumption and decline in FEV1/VC. However, when confounders were accounted for the effect was reduced and was only marginally significant, but given the limited time frame over which observations were made, the trend suggests that continued cannabis smoking has the potential to result in clinically important impairment of lung function.
The social cost of illegal drug consumption in Spain
Authors: García‐Altés Anna , Ollé Josep Ma , Antoñanzas Fernando , Colom Joan 
Published: March 2003

ABSTRACTAimsThe objective of this study was to estimate the social cost of the consumption of illegal drugs in Spain.DesignWe performed a cost‐of‐illness study, using a prevalence approximation and a societal perspective. The estimation of costs and consequences referred to 1997. As direct costs we included health‐care costs, prevention, continuing education, research, administrative costs, non‐governmental organizations and crime‐related costs. As indirect costs we included lost productivity associated with mortality and the hospitalization of patients. Estimation of intangible costs was not included.FindingsThe minimum cost of illegal drug consumption in Spain is 88 800 million pesetas (PTA) (467 million dollars). Seventy‐seven per cent of the costs correspond to direct costs. Of those, crime‐related costs represent 18%, while the largest part corresponds to the health‐care costs (50% of direct costs). From the perspective of the health‐care system, the minimum cost of illegal drug consumption is 44 000 million PTA (231 million dollars). The cost of illegal drug consumption represents 0.07% of the Spanish GDP. This gross figure compares with 2250 million PTA (12.5 million dollars) invested in prevention programmes during the same year, and with 12 300 million PTA (68.3 million dollars) spent on specific programmes and resources for the drug addict population.ConclusionsAlthough there are limitations intrinsic in this type of study and the estimations obtained in the present analysis are likely to be an underestimate of the real cost of this condition, we estimate that illegal drug consumption costs the Spanish economy at least 0.2% of GDP.
Evaluation of a motivational interview for substance use within psychiatric in‐patient services
Authors: Baker Amanda , Lewin Terry , Reichler Heidi , Clancy Richard , Carr Vaughan , Garrett Rachel , Sly Ketrina , Devir Holly , Terry Margarett 
Published: March 2003

ABSTRACTAimsTo assess the effectiveness of a motivational interview among hospitalized psychiatric patients with comorbid substance use disorder in reducing alcohol and other drug (AOD) use.DesignSubjects were assigned randomly to receive an individual motivational interview (n=79) or a self‐help booklet (control condition; n=81).SettingSubjects were volunteers recruited from a major public psychiatric hospital.ParticipantsSubjects met abuse or dependence criteria on the structured clinical interview for diagnosis (SCID) for alcohol, cannabis or amphetamine or they reported hazardous use during the last month of one or more of these drug types on the opiate treatment index (OTI).InterventionEither one 30–45‐minute motivational interview or brief advice.MeasurementsThe SCID and OTI were the main measures.FindingsThere was a modest short‐term effect of the motivational interview on an aggregate index of alcohol and other drug use (polydrug use on the OTI). Cannabis use remained high among the sample over the 12‐month follow‐up period.ConclusionAlthough motivational interviewing appears feasible among in‐patients in psychiatric hospital with comorbid substance use disorders, more extensive interventions are recommended, continuing on an out‐patient basis, particularly for cannabis use.
South of the border: a legal haven for underage drinking
Authors: Lange James E. , Voas Robert B. , Johnson Mark B. 
Published: March 2003

ABSTRACT Aims The research describes the characteristics and motivations of youthful San Diego County residents who patronize the bars and nightclubs in Tijuana, Mexico. Design Two random‐digit‐dial surveys of San Diego County residents—one group aged 18–20 years and one aged 21–30 years—was conducted during a 2‐year period. Those who reported having visited the bars in Tijuana in the last year were compared with those who had not. Setting All respondents were residents of San Diego County, California, USA. Participants The study comprised 2200 youths between 18 and 30 years of age. Measurements The interview protocol included questions covering demographic characteristics, drinking and drug‐use history, experience with Tijuana bars, and ratings of bar features in San Diego and Tijuana. Findings About half of the 18–20‐year‐olds and a third of the 21–30‐year‐olds reported visiting bars in Tijuana at least once in the past 12 months. Race, age, gender, heavy drinking and drug‐use history were significantly associated with visits to Tijuana bars. The price of alcohol and the perceived freedom to get drunk in Tijuana bars were considered attractive features leading to cross‐border drinking. Conclusions The features of the alcohol service in Mexican bars that attract youthful drinkers (low cost and liberal availability of alcohol, lack of formal controls, and presence of heavy drinkers) are similar to those present in other drinking locales that lead to drunkenness. Thus, a better understanding of the characteristics and motivations of the US youths patronizing bars in Tijuana can lead to improved interventions to reduce heavy, risky drinking.
Multiple hospital presentations by adolescents who use alcohol or other drugs
Authors: Tait Robert J. , Hulse Gary K. , Robertson Suzanne I. , Sprivulis Peter 
Published: March 2003

ABSTRACTAimsTo investigate ‘all cause’ and the subset of ‘alcohol or other drug’ (AOD) related hospital emergency department (ED) presentations over 12 months by adolescents with a previously identified AOD ED presentation.Design and settingA retrospective review of medical records in four metropolitan hospitals in Perth, Australia.ParticipantsOne hundred and fifty‐two adolescents (13–19 years) identified during a previous 4‐week study. The median age was 17.5 (interquartile range (IQR) 16–19); 61 (40%) were female.MethodMedical records were reviewed for the 6 months either side of a previously identified index AOD presentation. Hospital events in this period were collapsed as ‘all cause’ morbidity with a subclassification of AOD related.FindingsOver half (n=87, 57%) had no additional hospital events and 10 (7%) had only ‘follow‐up’ treatment for their index event. The drug identified for both these groups was primarily alcohol or alcohol plus other drugs compared with mainly heroin or prescription drugs for those with multiple presentations. There were 55 (36%) adolescents who had 236 presentations, including 39 with 147 AOD presentations: six polydrug users accounted for 47% of multiple presentations. Polydrug users had more ‘all cause’ and AOD presentations (Mann–Whitney U=168.5, P < 0.001) than single drug users, as did ‘heroin users’ compared with other AOD users (U=177.5, P < 0.001). There were no significant gender differences in the total number of ‘all cause’ or AOD presentations.ConclusionsAlcohol users were the largest group at index presentation, but accounted for few of the presentations over 12 months. Polydrug users typically had multiple presentations and may benefit from additional non‐medical hospital support. A more labour‐intensive and structured approach might help the small number of polydrug users who accounted for a large proportion of repeat presentations over the 12‐month period.
Patterns of smoking in Estonia
Authors: Pärna Kersti , Rahu Kaja , Rahu Mati 
Published: March 2003

ABSTRACTAimsTo describe the pattern of current smoking and its relation to socio‐demographic factors in Estonia.DesignNationwide cross‐sectional survey.SettingEstonia in 1996.ParticipantsStratified random sample of 2086 adults aged 30–59.MeasurementsPrevalence of current smoking; socio‐demographic factors related to smoking, investigated by logistic regression analysis.FindingsThe prevalence of current smoking was 57.9% among men and 25.7% among women. For both genders, smoking rates were consistently lowest in the age group 50–59 years and highest in the age group 30–39 years. Smoking was significantly more common among divorced and widowed people. Education was associated with smoking among men but not among women. No relationship, however, was established between smoking and ethnicity, type of residence, and household income.ConclusionsEstonia needs an effective antismoking policy. Public health efforts need to be focused on quitting smoking in younger adults and prevention efforts should target less educated socio‐economic groups.