bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reliability of self‐reported age of onset of tobacco, alcohol and illicit drug use
Authors: Johnson Timothy P. , Mott Joshua A. 
Published: March 2003

Aims. To examine the reliability of self‐reported age of first substance use experiences among national samples of adult and child respondents.

Design. Survey responses from seven waves of the National Longitudinal Survey of Youth (NLSY) were examined.

Participants. Adult and child NLSY respondents reporting age of first tobacco, alcohol, marijuana, cocaine and/or crack use during two or more survey interviews.

Measurements. Four indicators of reliability: intraclass correlation coefficients (ICC), mean and absolute mean differences in reported age and reports consistent within 1 year.

Findings. The adjusted mean ICC for all comparisons was 0.69. The adjusted mean difference in self‐reported age of first substance use was ‐ 0.52 years and the adjusted absolute mean difference was 2.00 years. The adjusted percentage of all comparisons reporting ages consistent within 1 year was 55.28%. More consistent reports were provided by adults, and in response to questions posed over 2 years as opposed to longer time intervals. Respondent answers to questions concerned with first use of marijuana were generally found to be most reliable; questions concerned with first use of crack were least reliable and reports of tobacco, alcohol and cocaine were intermediate. Logistic regression analyses also identified age, race, gender, education and poverty status as predictors of consistent reporting.

Conclusions. Self‐reports of age of first substance use experiences, as currently collected via survey questionnaires, are of sufficient reliability for most current epidemiological applications. For inquiries where age of substance use onset is itself a research focus, however, researchers should invest additional effort in improving the reliability of measurement.
Pre‐pregnancy drinking: how drink size affects risk assessment
Authors: Kaskutas Lee Ann , Graves Karen 
Published: March 2003

Aims. We considered the role of drink size in determining average daily consumption among groups at risk for Fetal Alcohol Syndrome.

Design. In‐person hour‐long interviews gathered cross‐sectional retrospective data about drinking before an index pregnancy.

Setting. Subjects were recruited at public clinics in Los Angeles and the San Francisco Bay area. To reach those not necessarily seeking prenatal care, community outreach in the same urban areas was undertaken.

Participants. Three hundred and twenty‐one pregnant women were interviewed: 102 Native Americans, 185 African Americans, and 34 Caucasians.

Measurements. Volume of drinking prior to pregnancy was assessed using the graduated frequency series, which asks respondents to specify their drinking in terms of standard drinks. Using vessel models and photographs, respondent‐defined drink sizes were then determined, and volume was recalculated accordingly.

Findings. For most beverages, the difference in milliliters between self‐selected drink size and a standard size drink was significant, with the mean self‐selected drink sizes ranging from 49% above the standard size (for beer) to 307% above the standard size (for spirits). For women whose pre‐pregnancy average daily volume (ADV) was at the risk level of ≥ 1 standard drink per day, ADV increased from four to almost 10 standard drinks per day when self‐defined drink sizes were instead considered. Similarly, for women having three or more standard drinks a day, their daily dose of ethanol increased from 57 g to 153 g of ethanol per day.

Conclusions. If risk levels have been based on underestimates that assume women with alcohol‐affected infants had standard drink sizes, then true risk levels may be higher than previously thought. Related, risk drinkers presenting at prenatal clinics may be missed if screening protocols do not ask about drink size.
The cost–effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States
Authors: Barnett Paul G. , Zaric Gregory S. , Brandeau Margaret L. 
Published: March 2003

Aims.
To determine the cost‐effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States, particularly its effect on the HIV epidemic.

Design. We developed a dynamic model to capture the effects of adding buprenorphine maintenance to the current opiate dependence treatment system. We evaluated incremental costs, including all health‐care costs, and incremental effectiveness, measured as quality‐adjusted life years (QALYs) of survival. We considered communities with HIV prevalence among injection drug users of 5% and 40%. Because no price has been set in the United States for a dose of buprenorphine, we considered three prices per dose: $5, $15, and $30.

Findings. If buprenorphine increases the number of individuals in maintenance treatment by 10%, but does not affect the number of individuals receiving methadone maintenance, the cost‐effectiveness ratios for buprenorphine maintenance therapy are less than $45 000 per QALY gained for all prices, in both the low‐prevalence and high‐prevalence communities. If the same number of individuals enter buprenorphine maintenance (10% of the number currently in methadone), but half are injection drug users newly entering maintenance and half are individuals who switched from methadone to buprenorphine, the cost‐effectiveness ratios in both communities are less than $45 000 per QALY gained for the $5 and $15 prices, and greater than $65 000 per QALY gained for the $30 price.

Conclusions. At a price of $5 or less per dose, buprenorphine maintenance is cost‐effective under all scenarios we considered. At $15 per dose, it is cost‐effective if its adoption does not lead to a net decline in methadone use, or if a medium to high value is assigned to the years of life lived by injection drug users and those in maintenance therapy. At $30 per dose, buprenorphine will be cost‐effective only under the most optimistic modeling assumptions.
The validity of the interviewer severity ratings in groups of ASI interviewers with varying training
Authors: Alterman Arthur I. , Mulvaney Frank D. , Cacciola John S. , Cnaan Avital , McDermott Paul A. , Brown Lawrence S. 
Published: March 2003

Aims.
This study evaluated the hypothesis that the subjective interviewer severity rating (ISR) summary indices of the intake Addiction Severity Index (ASI) of less trained interviewers are less valid than those of more highly trained interviewers.

Design. Baseline ASIs from three completed studies whose interviewers varied in degree of initial ASI training and subsequent quality assurance monitoring were examined. Associations between baseline ISRs and three other sets of ASI summary indices not based on interviewer ratings—composite scores, clinical indices and evaluation indices—were compared for three groups of interviewers with varying amounts of training. The assumption underlying these analyses was that more reliable ISRs, found in more trained interviewers, would be more highly associated with the other more objective indices.

Setting. Methadone maintenance patients in the Philadelphia and New York City areas.

Participants. Thirty‐five interviewers with the most intense training who administered 295 interviews; 10 interviewers with an intermediate level of training who administered 763 interviews; and eight identified (and other unidentified) least trained interviewers who administered a total of 276 interviews.

Measurements and methods. Four sets of summary indices from the above ASIs. Both bivariate and multivariate analyses were performed.

Findings. The study found that the validity of the validity of ISRs was greater in more trained interviewers.

Conclusions. Greater training and subsequent monitoring of ASI interviewers generally appears to be associated with increased ISR validity.
Intra‐ and extra‐familial influences on alcohol and drug misuse: a twin study of gene–environment correlation
Authors: Jang Kerry L. , Vernon Philip A. , Livesley W. John , Stein Murray B. , Wolf Heike 
Published: March 2003

Aims.
Genotype‐environment correlation refers to the extent to which individuals are exposed to environments as a function of their genetic propensities. These correlations are important in the study of psychopathology because they identify environments that may maintain the expression of underlying genetic liabilities for a disorder. The present study examined the correlation between genetic liabilities for alcohol and drug misuse with perceptions of the social environments of the family of origin and the classroom.

Design. Postal survey data were collected from monozygotic and dizygotic twin pairs.

Setting. Twin pairs were recruited from Vancouver, British Columbia, Canada using newspaper advertisements and media stories.

Participants. Eighty‐five monozygotic and 77 dizygotic twin pairs were recruited from the general population.

Measurements. Twin pairs completed self‐report measures of alcohol and drug misuse contained in the Dimensional Assessment of Personality Pathology, the Family Environment Scale, the Classroom Environment Scale, and the Traumatic Events Questionnaire.

Findings. Genetically indexed alcohol and drug misuse scores were regressed on the environmentally indexed FES and CES scales. Genetic liabilities for alcohol and drug misuse were associated with decreased perceived family moral‐religious emphases, family cohesion and classroom task orientation and increased perceptions of classroom order and organization (strictness).

Conclusions. Genotype‐environment correlations, in particular, moral‐religious emphases in the home, appear to be important in the development of substance misuse.
No effect of cigarette smoking on attention or mood in non‐deprived smokers
Authors: Herbert Mireille , Foulds Jonathan , Fife‐Schaw Chris 
Published: March 2003

Aim.
This study aimed (a) to assess whether smoking reduces anxiety when paired with a pleasant distractor and (b) to investigate the effect of smoking a cigarette on cognitive performance in non‐deprived smokers.

Design. Participants were allocated randomly to four conditions in a 2 × 2 factorial design: 1, Smoke + Distractor; 2, Smoke + No Distractor; 3, No Smoke + Distractor; 4, No Smoke + No Distractor.

Setting. University psychology department (University of Surrey, UK).

Participants. Forty‐five volunteer cigarette smokers (mean consumption = 16 cigarettes per day) allowed to smoke normally prior to the study.

Intervention. Participants were either allowed to smoke a cigarette of their choice in a manner of their choosing or not allowed to smoke, either with or without a concurrent distractor (a music video).

Measurements. Rapid Visual Information Processing (RVIP) performance was measured via computer before and after a 10‐minute break (during which the interventions took place). Mood was measured by (a) State Anxiety Inventory (SAI) and (b) Feeling State Questionnaire (FSQ), before and after the first RVIP task and then immediately after the break/cigarette.

Findings. The RVIP task produced a significant increase in both measures of anxiety (SAI and FSQ stress subscale). Smoking, when paired with a distractor, did not decrease anxiety compared with when no distractor was present. Furthermore, smoking did not decrease anxiety or increase attentional (RVIP) performance compared with not smoking.

Conclusion. The findings of this study failed to support the idea that smoking has anxiety‐reducing or attention‐enhancing properties in non‐abstinent smokers.
Methodological characteristics and quality of alcohol treatment outcome studies, 1970–98: an expanded evaluation
Authors: Moyer Anne , Finney John W. , Swearingen Carolyn E. 
Published: March 2003

ABSTRACTAims To examine the methodological quality of the research literature examining treatment for alcohol use disorders.Design In total, 701 studies first reported between 1970 and 1998 were evaluated with a scoring system covering 19 areas of research quality.Findings Methodological quality improved from a score of 8.2 out of a possible 28.5 in the 1970s, to 10.6 in the 1990s. Strengths included reporting the initial number of participants and conducting follow‐ups of 12 months or longer. Although the percentage of studies with adequate power also increased overall, the average statistical power of comparative studies to detect a medium‐sized treatment effect was low (0.54).Conclusions Areas with room for improvement include: ensuring that follow‐up data are collected when respondents are not under the influence of alcohol, testing for differential dropout among treatment groups with respect to participant background characteristics, reporting the number of individuals being treated in the programs from which samples are drawn, noting the reliability and validity of measures used and conducting process analyses to examine potential mechanisms underlying treatment effects.
Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders
Authors: Miller William R. , Wilbourne Paula L. 
Published: March 2003

ABSTRACTAim A 3‐year update with 59 new controlled trials is provided for the ongoing Mesa Grande project reviewing clinical trials of treatments for alcohol use disorders. The project summarizes the current evidence for various treatment approaches, weighting findings differentially according to the methodological strength of each study.Design The review includes 361 controlled studies that (1) evaluated at least one treatment for alcohol use disorders, (2) compared it with an alternative condition (such as a control group, a placebo, a brief intervention or an alternative treatment), (3) used a procedure designed to create equivalent groups before treatment and (4) reported at least one outcome measure of drinking or alcohol‐related consequences. Studies were rated by two reviewers on 12 methodological criteria, and outcome logic was analyzed for the specific treatment modalities tested.Findings Methodological quality of studies was significantly but modestly correlated with the reporting of a specific effect of treatment. Among psychosocial treatments, strongest evidence of efficacy was found for brief interventions, social skills training, the community reinforcement approach, behavior contracting, behavioral marital therapy and case management. For the first time, two pharmacotherapies also appeared among the most strongly supported approaches: opiate antagonists (naltrexone, nalmefene) and acamprosate. Least supported were methods designed to educate, confront, shock or foster insight regarding the nature and causes of alcoholism.Conclusions Treatment methods differ substantially in apparent efficacy. It would be sensible to consider these differences in designing and funding treatment programs.
The self‐perceived survival ability and reproductive fitness (SPFit) theory of substance use disorders
Authors: Newlin David B. 
Published: March 2003

ABSTRACTA new theory of substance use disorders is proposed—the SPFit theory—that is based on evolutionary biology and adaptive systems. Self‐perceived survival ability and reproductive fitness (SPFit) is proposed as a human psychobiological construct that prioritizes and organizes (i.e. motivates) behavior, but is highly vulnerable to temporary, artificial activation by drugs of abuse. Autoshaping/ sign‐tracking/feature positive phenomena are proposed to underlie the development of craving and expectations about drugs as the individual learns that abused drugs will easily and reliably inflate SPFit. The cortico–mesolimbic dopamine system and its modulating interconnections are viewed as the biological substrate of SPFit; it is proposed to be a survival and reproductive motivation system rather than a reward center or reward pathway. Finally, the concept of modularity of mind is applied to the SPFit construct. Although considerable empirical data are consistent with the theory, new research is needed to test specific hypotheses derived from SPFit theory.
Psychotropic substance‐seeking: evolutionary pathology or adaptation?
Authors: Sullivan R. J. , Hagen E. H. 
Published: March 2003

ABSTRACTAccording to a conventional evolutionary perspective, the human propensity for substance use is the product of a ‘mismatch’ between emotional mechanisms that evolved in a past without pure drugs or direct routes of drug administration, and the occurrence of these phenomena in the contemporary environment. The primary purpose of this review is to assert that, contrary to the conventional view, humans have shared a co‐evolutionary relationship with psychotropic plant substances that is millions of years old. We argue that this ‘deep time’ relationship is self‐evident both in the extant chemical–ecological adaptations that have evolved in mammals to metabolize psychotropic plant substances and in the structure of plant defensive chemicals that have evolved to mimic the structure, and interfere with the function, of mammalian neurotransmitters. Given this evidence, we question how emotional mechanisms easily triggered by plant toxins can have evolved. Our argument is also supported with archeological and historical evidence of substance use in antiquity suggesting that, for people in the past, psychotropic plant substances were as much a mundane everyday item as they are for many people today. Our second, and more speculative objective is to suggest provisional hypotheses of human substance‐using phenomena that can incorporate the evolutionary implications of a deep time relationship between psychotropic substances and people. We discuss hypotheses of selective benefits of substance use, including the idea that neurotransmitter‐analog plant chemicals were exploited as substitutes for costly, nutritionally constrained endogenous neurotransmitters. However, even if substance seeking was adaptive in the environment of our hominid ancestors, it may not still be so in the contemporary environment. Thus, the implications of our argument are not that the mismatch concept does not apply to human substance‐using phenomena, but that it must be reconsidered and extended to incorporate the implications of a substance‐rich, rather than substance‐free, evolutionary past.
A review of the published literature into cannabis withdrawal symptoms in human users
Authors: Smith Neil T. 
Published: March 2003

ABSTRACTRecent experimental papers have been published suggesting the appearance of withdrawal symptoms upon the cessation of cannabis use in human users and proposing the introduction of a diagnostic category for such symptoms. Research also continues to be published into the physiological effects of cannabis on animals via self‐administration paradigms and the use of cannabinoid antagonists. Animal research does not provide a clear picture of a consistent withdrawal effect. The literature on withdrawal symptoms appearing in human users following the cessation of cannabis is investigated in this paper to clarify this issue further and enhance the scientific and lay debate on the status of the drug. Methodological weaknesses in the literature are highlighted. These include variable levels of drug‐dose administered in laboratory conditions, lack of controlled studies and the absence of definitions of the withdrawal syndrome sought. It is suggested that the studies conducted to date do not provide a strong evidence base for the drawing of any conclusions as to the existence of a cannabis withdrawal syndrome in human users, or as to the cause of symptoms reported by those abstaining from the drug. On the basis of current research cannabis cannot be said to provide as clear a withdrawal pattern as other drugs of abuse, such as opiates. However, cannabis also highlights the need for a further defining of withdrawal, in particular the position that rebound effects occupy in this phenomenon. It is concluded that more controlled research might uncover a diagnosable withdrawal syndrome in human users and that there may be a precedent for the introduction of a cannabis withdrawal syndrome before the exact root of it is known.
α2‐Adrenergic agonists in opioid withdrawal
Authors: Gowing Linda R. , Farrell Michael , Ali Robert L. , White Jason M. 
Published: March 2003

ABSTRACTObjectives This paper presents the main findings of a systematic (Cochrane) review of the effectiveness of α2‐adrenergic agonists in managing opioid withdrawal.Design The original systematic review included controlled trials that compared α2‐adrenergic agonists with another form of treatment (or placebo) in participants who were primarily opioid‐dependent.Main findings Ten studies compared a treatment regime based on an α2‐adrenergic agonist with one based on reducing doses of methadone. Withdrawal intensity is similar to, or marginally greater with α2‐adrenergic agonists, but signs and symptoms of withdrawal occur and resolve earlier in treatment. Participants stay in treatment longer with methadone. The likelihood of completing withdrawal is similar, or slightly less, with clonidine or lofexidine. Clonidine is associated with more adverse effects than reducing doses of methadone. Three studies compared the α2‐adrenergic agonists, clonidine and lofexidine. Lofexidine does not reduce blood pressure to the same extent as clonidine, but is otherwise similar to clonidine.Conclusions Participants stay in treatment longer with methadone regimes, which may provide greater opportunity for psychosocial intervention. Methadone regimes may be preferable for withdrawal in outpatient settings where the risk of relapse to heroin use is high. The use of methadone may also facilitate transfer to maintenance treatment should completion of withdrawal become unlikely. For those who are well prepared for withdrawal and seeking earlier resolution of withdrawal symptoms, α2‐adrenergic agonist treatment may be preferred. Clonidine and lofexidine appear equally effective for inpatient settings, but the lower incidence of hypotension makes lofexidine more suited to use in outpatient settings.
The effects of drug abuse prevention at school: the ‘Healthy School and Drugs’ project
Authors: Cuijpers Pim , Jonkers Ruud , De Weerdt Inge , De Jong Anco 
Published: March 2003

ABSTRACTAims To examine the effects of the ‘Healthy School and Drugs’ project, a Dutch school‐based drug prevention project that was developed in the late 1980s and disseminated during the 1990s. This programme is currently being used by 64–73% of Dutch secondary schools and it is estimated that at least 350 000 high school students receive this intervention each year.Design, setting and participants A quasi‐experimental study in which students of nine experimental (N = 1156) schools were compared with students of three control schools (N = 774). The groups were compared before the intervention, 1 year later, 2 years later and 3 years later.Measurements Self‐report measures of tobacco, alcohol and marijuana use, attitudes towards substance use, knowledge about substances and self‐efficacy.Findings Some effects on the use of tobacco, alcohol and cannabis were found. Two years after the intervention, significant effects could still be shown on alcohol use. Effects of the intervention were also found on knowledge, but there was no clear evidence for any effects on attitude towards substance use and on self‐efficacy.Conclusions This study shows the Healthy School and Drugs project as implemented in Holland may have some effect on drug use in the children exposed to it.