bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug use and initiation in prison: results from a national prison survey in England and Wales
Authors: Boys A. , Farrell M. , Bebbington P. , Brugha T. , Coid J. , Jenkins R. , Lewis G. , Marsden J. , Meltzer H. , Singleton N. , Taylor C. 
Published: March 2003

ABSTRACTAims  To investigate heroin and cocaine use in a sample of British prisoners, and to explore the characteristics of inmates who use these drugs for the first time while in prison.Design, participants  A cross‐sectional survey of all prisons in England and Wales conducted as part of a major national study of psychiatric morbidity. A total of 3142 prisoners (88.2% of those selected) completed a structured interviewer‐administered questionnaire.Measurements  Interview measures of personal demographics, social history, psychiatric morbidity and drug use. Personality disorders were diagnosed via the Structured Clinical Interview for DSM‐IV (SCID‐II) and neurotic symptoms were assessed using the revised Clinical Interview Schedule (CIS‐R).Findings  More than 60% of the heroin users and cannabis users reported that they had used these drugs in prison compared with less than a quarter of the life‐time cocaine users. More than a quarter of the heroin users reported that they had initiated use of this drug in prison. The extent of an individual's experience of prison was related more consistently to heroin and/or cocaine use in and out of prison than other personal background, social history or psychiatric variables assessed.Conclusions  The findings indicate that prisons are a high‐risk environment for heroin and other drug initiation and use. Although related to drug use, psychiatric variables were not generally associated with initiation in prison, which was dominated by prison exposure. There is a need to explore ways of reducing heroin initiation in prison as part of a broader risk‐prevention strategy.
Parental substance use as a modifier of adolescent substance use risk
Authors: Li Chaoyang , Pentz Mary Ann , Chou Chih‐Ping 
Published: March 2003

ABSTRACTAims  A major question in national substance use prevention efforts is how much influence parents have on their children's substance use, answers to which could determine whether current school‐based prevention programs that address peer pressure are sufficient or whether parents need to be involved. The present study examines whether parents act as gatekeepers by testing the moderator effects of parents’ substance use on the relationships of friends’ substance use to adolescent substance use (cigarettes, alcohol and marijuana).Design  A longitudinal school‐based trial for prevention of substance use in adolescents.Setting  Indianapolis, Indiana, USA.Participants  As part of a large substance use prevention trial, entering middle school students were surveyed prospectively at baseline, 6 months and 18 months (n = 1807 from 57 schools).Measurements  A self‐reported survey was used to measure behaviors, attitudes and social influences related to adolescent substance use.Findings  Results of logistic regression analyses and multiple group structural equation modeling showed that increasing numbers of parents and friends using substances were associated with greater risk of adolescent substance use, as were more substance offers and lower levels of refusal self‐efficacy. Additionally, refusal self‐efficacy mediated the effects of baseline use and substance offers on subsequent use. However, non‐using parents had a buffering effect on friends’ influences to use substances, such that friends’ use did not affect adolescent use when parents were non‐users, and the effects of substance offers on refusal self‐efficacy were weaker.Conclusions  The findings suggest that parent substance use should be addressed in adolescent substance use prevention programs, and that continuing non‐use by parents should be reinforced.
Alcohol urges in alcohol‐dependent drinkers: further validation of the Alcohol Urge Questionnaire in an untreated community clinical population
Authors: Drummond D. Colin , Phillips Thomas S. 
Published: March 2003

ABSTRACTBackground Alcohol craving is a key element of the alcohol dependence syndrome. However, there is a lack of consensus about the precise nature of craving and the most appropriate method of measurement. Alcohol urges measured by the Alcohol Urge Questionnaire showed a unidimensional structure and evidence of validity and reliability in a US clinical population. The main aim of this study was to establish the validity of the AUQ in an untreated UK clinical population, and its relationships to drinking and personality factors.Subjects All subjects (n = 80) were alcohol‐dependent (DSM‐IV) and presenting for pre‐treatment assessment at a community alcohol team in South‐west ­London.Method All subjects completed the AUQ, Severity of Alcohol Dependence ­Questionnaire (SADQ), Spielberger's State Trait Anxiety Inventory (STAI) and Eysenck Personality Questionnaire (EPQ) and provided a breath specimen for alcohol analysis (BAL).Results Principal components analysis of AUQ revealed one factor which accounted for 69% of variance with high interitem correlations, and an alpha reliability of 0.93. AUQ was significantly correlated with SADQ, BAC, state and trait anxiety and negatively correlated with time since last drink. There were no significant correlations between AUQ and any of the EPQ subscales. SADQ was correlated with neuroticism, but not other EPQ subscales. A regression analysis showed that only SADQ, time since last drink and BAL were significant predictors of alcohol urges.Conclusions This study confirmed the AUQ factor structure and provided further evidence for the validity of AUQ. The relationship between BAL and urges deserves further research. The results did not support the contention that ­anxiety and personality factors predict urges when drinking‐related variables, which also predict urges, are controlled for. The AUQ is a useful measure for clinical and experimental alcohol craving research.
Alcohol‐related human losses in Russia in the 1980s and 1990s
Authors: Nemtsov A. V. 
Published: March 2003

ABSTRACT Aims  The estimation of alcohol‐related human losses in Russia in the 1980s and 1990s.Design  The  estimation  was  made   by  comparing  changes   in   the   total   number of deaths and in specific categories, and alcohol consumption in Russia during this time.Setting  The anti‐alcohol campaign, launched in 1985, and the market reforms launched in 1992 were associated with large and rapid changes of alcohol ­consumption in Russia.Findings  In the early 1980s, the aggregate number of direct and indirect alcohol‐related life losses was more than 500 000 per annum, or 32% of total deaths. Half of the alcohol‐related human losses in Russia over the period studied were due to accidents, poisoning and violence. Following the anti‐alcohol campaign and reduction in annual per capita alcohol consumption from 14.2 (1984) to 10.5 l (1986), mortality decreased from 1161.6 to 1054.0 per 100 000   of   the   population.   It   is   estimated   that   from   1986   to   1991   the   lives of 1.22 million people were spared; that is, 11.4% of the number of deaths expected without the anti‐alcohol campaign. All categories of deaths were reduced with the exception of neoplasms, infectious and parasitic diseases. In the period of the so‐called market reforms both alcohol consumption and mortality increased sharply. The total number of alcohol‐related deaths for 1994 was 751 000 in the population, or 33% of all deaths (direct and indirect losses). In 1995 alcohol consumption started to decrease. A decrease in mortality was registered despite the sharp deterioration of the quality of life in the country. However, a new growth of total mortality, fatal alcohol poisonings and number of alcohol psychoses began in 1999–2000.Conclusion  The results of this study show the enormous scale of alcohol‐related mortality in Russia. It has been revealed that alcohol‐related deaths are at the top of the hierarchy of all premature deaths in the country. Decreasing alcohol consumption is an important means of decreasing total mortality in Russia.
Reassessing the marijuana gateway effect
Authors: Morral Andrew R. , McCaffrey Daniel F. , Paddock Susan M. 
Published: March 2003

ABSTRACTAims  Strong associations between marijuana use and initiation of hard drugs are cited in support of the claim that marijuana use per se increases youths’ risk of initiating hard drugs (the ‘marijuana gateway’ effect). This report examines whether these associations could instead be explained as the result of a common factor—drug use propensity—influencing the probability of both marijuana and other drug use.Design  A model of adolescent drug use initiation in the United States is constructed using parameter estimates derived from US household surveys of drug use conducted between 1982 and 1994. Model assumptions include:(1) individuals have a non‐specific random propensity to use drugs that is normally distributed in the population; (2) this propensity is correlated with the risk of having an opportunity to use drugs and with the probability of using them given an opportunity, and (3) neither use nor opportunity to use marijuana is associated with hard drug initiation after conditioning on drug use propensity.Findings  Each of the phenomena used to support claims of a ‘marijuana gateway effect’ are reproduced by the model, even though marijuana use has no causal influence over hard drug initiation in the model.Conclusions  Marijuana gateway effects may exist. However, our results demonstrate that the phenomena used to motivate belief in such an effect are consistent with an alternative simple, plausible common‐factor model. No gateway effect is required to explain them. The common‐factor model has implications for evaluating marijuana control policies that differ significantly from those supported by the gateway model.
Hepatitis‐associated knowledge is low and risks are high among HIV‐aware injection drug users in three US cities
Authors: Heimer Robert , Clair Scott , Grau Lauretta E. , Bluthenthal Ricky N. , Marshall Patricia A. , Singer Merrill 
Published: March 2003

AbstractAims  Injection drug use is a major risk factor for HIV and hepatitis infections. Whereas programs to prevent new infections have focused on HIV, they have generally neglected hepatitis B and C. This study was designed to examine the interrelationships among HIV and hepatitis knowledge, risky drug preparation and injection practices, and participation in syringe exchange programs (SEPs).Design  Surveys of injection drug users (IDUs) collected data on socio‐demographics, medical history, drug use and injection practices, and HIV‐ and hepatitis‐related knowledge.Setting  Inner‐city US neighborhoods in Chicago, IL, Hartford, CT and Oakland, CA.Participants The study population was a convenience sample of 493 IDUs recruited using street outreach and snowball sampling strategies.Measurements  HIV and hepatitis knowledge, injection‐related risks for virus transmission, associations between the two, and with SEP use.Findings  HIV knowledge was significantly higher than hepatitis knowledge among SEP customers and non‐customers alike. Elevated hepatitis knowledge was associated with a history of substance abuse treatment, hepatitis infection, hepatitis B vaccination and injection practices that reduced contact with contaminated blood or water but not with SEP use. SEP customers were consistently less likely to engage in risk behaviors, with the notable exception of safely staunching blood postinjection.Conclusion  Increased hepatitis awareness among IDUs is necessary for reducing hepatitis transmissions. Although SEPs continue to effectively disseminate HIV prevention messages—as evidenced by lowered risk behaviors among their customers—they must do more to prevent hepatitis transmissions.
Measuring therapeutic attitudes in the prison environment: development of the Prison Attitude to Drugs scale
Authors: Airey Nick , Marriott James 
Published: March 2003

ABSTRACTAims  To develop and test the validity of a scale measuring therapeutic attitudes among prison staff working with drug misusers.Design  A cross‐sectional postal questionnaire study using 27 statements with a five‐point Likert scale.Setting  Four prisons in the south‐west of EnglandParticipants  A total of 252 prison staff (response rate 70%), including 67 for test–retest (response rate 57%).Findings  The study resulted in a three‐dimensional, nine‐item scale: the Prison Attitude to Drugs scale (PAD). The three subscales measure confidence in skills (four items), personal rewards (three items) and job satisfaction (two items). Test–retest correlations for the questions were above 0.7, with each factor having an internal coherence (coefficient alpha) of greater than 0.7.Conclusions  The PAD is a reliable tool that can be used in the prison environment.
Supply control and harm reduction: lessons from the Australian heroin ‘drought’
Authors: Weatherburn Don , Jones Craig , Freeman Karen , Makkai Toni 
Published: March 2003

ABSTRACTAims  To examine the effects of supply‐side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin.Setting  Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin.Design  Data were drawn from a survey of 165 heroin users in South‐Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database.Findings  Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin ‘drought’.Conclusion  Supply control has an important part to play in harm reduction; however, proponents of supply‐side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug.
Aggression involving alcohol: relationship to drinking patterns and social context
Authors: Wells Samantha , Graham Kathryn 
Published: March 2003

ABSTRACTAims  The present study examines the relationships between: (1) alcohol involvement/perceived intoxication level of participants and aggression severity; (2) respondent drinking patterns and involvement in alcohol‐related aggression; and (3) social context and alcohol‐related aggression.Design  Random digit dialing (RDD) with computer assisted telephone interviewing (CATI) was used to obtain a random sample of Ontario adults aged 18–60 (response rate of 67%).Participants  Respondents who reported that they had been involved personally in physical aggression in the past 12 months were the focus of the present study.Measurements  Questions were asked regarding the most recent incident of physical aggression, including whether the respondent and opponent drank alcohol prior to aggression, perceived intoxication levels at the time, number of participants, relationship to opponent, social context of aggression, time of day and day of week. Three items were used to assess aggression severity: injury to respondent, use of threats by respondent or opponent and police involvement.Findings  (1) Injury to respondent and threats by respondent were not associated with alcohol involvement per se, but were significantly related to perceived level of alcohol intoxication; (2) drinking pattern of respondent was significantly associated with alcohol‐related aggression but unrelated to aggression that did not involve alcohol; and (3) a number of contextual factors (e.g. gender, number of participants, time of day) were found to be associated with alcohol involvement in aggression.Conclusions  The results suggest that both drinking pattern and contextual factors are important in distinguishing between alcohol‐related aggression and non‐alcohol‐related aggression. As well, alcohol intoxication may be an important predictor of aggression severity.
Male drugs‐related deaths in the fortnight after release from prison: Scotland, 1996–99
Authors: Bird Sheila M. , Hutchinson Sharon J. 
Published: March 2003

ABSTRACTAims  To assess if 15–35‐year‐old males released after 14 + days’ imprisonment in Scotland, 1996–99, had a higher drugs‐related death rate in 2 weeks after release than during subsequent 10 weeks; higher than expected death rate from other causes; and if drugs‐related deaths in the first fortnight were three times as many as prison suicides.Design  Confidential linkage of ex‐prisoner database against deaths.Setting  Scotland's male prisons and young offenders’ institutions during July to December 1996–99; 19 486 index releases after 14+ days’ incarceration.Measurements  Relative risk of drugs‐related death in the first 2 weeks after release (34 deaths) versus subsequent 10 weeks (23). Other causes of death (21) relative to expectation. Drugs‐related deaths in first 2 weeks after release relative to suicides in prison (12).Findings  Drugs‐related mortality in 1996–99 was seven times higher (95% CI: 3.3–16.3) in the 2 weeks after release than at other times at liberty and 2.8 times higher than prison suicides (95% CI: 1.5–3.5) by males aged 15–35 years who had been incarcerated for 14+ days. We estimated one drugs‐related death in the 2 weeks after release per 200 adult male injectors released from 14 + days’ incarceration. Non‐drugs‐related deaths in the 12 weeks after release were 4.9 times (95% CI: 2.8–7.0) the 4.3 deaths expected.Conclusion  Investment in, and evaluation of, prison‐based interventions is needed to reduce substantially recently released drugs‐related deaths.
The prevalence and correlates of gamma‐hydroxybutyrate (GHB) overdose among Australian users
Authors: Degenhardt Louisa , Darke Shane , Dillon Paul 
Published: March 2003

ABSTRACTAim  The aim of this study was to examine the correlates, context and risk perceptions regarding gamma‐hydroxybutyrate (GHB) overdose among a sample of recreational GHB users in Australia.Design  A cross‐sectional survey of 76 GHB users who were administered a structured interview on GHB use. They were asked a series of questions regarding whether they had ever experienced a GHB overdose, the context of their most recent GHB overdose, and about their perceptions of the risks of GHB overdose.Findings  This sample of GHB users had not had a long or extensive experience with GHB use; despite this, half (53%) had experienced a GHB overdose. This sample of GHB users appeared to be well‐educated, employed and a history of either drug treatment or incarceration was uncommon. There were no differences between those who had or had not overdosed in terms of socio‐demographic characteristics, extent of other drug use or typical patterns of other drug use when using GHB. However, those who had overdosed on GHB had used it more times during their life‐time, and had been using it for a longer period of time.Conclusions  GHB‐related overdoses were common among a sample of GHB users who had only recently begun using the drug. The only apparent distinguishing factor between those who had and had not overdosed on GHB was the amount of experience with GHB use.
A flicker paradigm for inducing change blindness reveals alcohol and cannabis information processing biases in social users
Authors: Jones Barry T. , Jones Ben C. , Smith Helena , Copley Nicola 
Published: March 2003

ABSTRACTAim  To apply a new paradigm using transient changes to visual scenes to explore information processing biases relating to ‘social’ levels of alcohol and cannabis use.Participants  Male and female student volunteers (n = 200) not self‐reporting substance‐related problems.Setting  Quiet testing areas throughout the university campus.Design  A flicker paradigm, for inducing change blindness with lighter and heavier social users of alcohol (experiment 1, n= 100) and social users and non‐users of cannabis (experiment 2, n= 100), explored the associations between habitual level of use and the latency to detection of a single substance‐related or neutral change made to a scene of grouped substance‐related and neutral objects.Measurements  Alcohol use was measured as the number of units of the heaviest drinking day from the previous week; cannabis use as the number of months of use in previous 12. Change–detection latency comparisons were used to evaluate processing biases.Findings  In both experiments, (i) heavier social users detected substance‐related changes quicker than lighter and non‐users; (ii) lighter and non‐users detected substance‐neutral changes quicker than heavier users; (iii) heavier social users detected substance‐related quicker than substance‐neutral changes; and (iv) lighter and non‐users detected substance‐neutral changes quicker than substance‐related changes.Conclusions  Alcohol and cannabis processing biases are found at levels of social use, have the potential to influence future consumption and for this reason merit further research.
Drug use patterns and infection with sexually transmissible agents among young adults in a high‐risk neighbourhood in New York City
Authors: Friedman Samuel R. , Flom Peter L. , Kottiri Benny J. , Zenilman Jonathan , Curtis Richard , Neaigus Alan , Sandoval Milagros , Quinn Thomas , Des Jarlais Don C. 
Published: March 2003

ABSTRACTAims To determine relationships between drug use ‘hardness’ (defined in increasing order of hardness as no drug use, marijuana use, non‐injected heroin or cocaine use, crack smoking and injection drug use) and prevalences of several sexually transmissible infections among young adults in a high‐risk neighbourhood. Drug users, particularly injection drug users and crack smokers, may be a core group for some sexually transmitted infections.Design Cross‐sectional survey and assays of young adults from (a) a household probability sample and (b) a targeted sample of youth who have used injected drugs, crack, other cocaine or heroin.Setting Bushwick, an impoverished New York City minority neighbourhood with major drug markets.Participants A total of 363 18–24‐year‐olds from a household probability sample; 165 Bushwick 18–24‐year‐olds who have used injected drugs, crack, other cocaine or heroin.Measurements Drug use by self‐report; serum‐ and urine‐based assays for HIV, hepatitis B and C, syphilis, gonorrhoea, chlamydia and herpes simplex (type 2).Findings Household‐sample prevalences: HIV, hepatitis C and syphilis, 1%; gonorrhoea 3%; chlamydia 5%; past or present hepatitis B infection 8%; herpes simplex (type 2) 18%. In combined household and targeted samples, hepatitis C and HIV were concentrated among drug injectors. Herpes simplex (type 2), syphilis and hepatitis B increased among women with ‘hardest drug ever used’.Conclusions Using ‘harder’ drugs is associated with some but not all of these infections. Prevention efforts should help youth avoid unsafe sex and higher‐risk drugs.