bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cigarette smoking is associated with increased severity of gambling problems in treatment‐seeking gamblers
Authors: Petry Nancy M. , Oncken Cheryl 
Published: March 2003

ABSTRACTAims Cigarette smoking and gambling often co‐occur, but very little is known about smoking or its correlates in disordered gamblers. This study compared gambling and psychosocial problems in treatment‐seeking gamblers who smoke versus those who do not.Methods At intake to gambling treatment programs, gamblers completed the addiction severity
index (ASI) and gambling questionnaires. Subjects were categorized into non‐daily
smokers (n = 107) and daily smokers (n = 210). Differences in demographics, gambling variables and ASI composite scores were compared between the groups.Results The daily smokers were more likely to have a history of treatment for a substance use disorder than the non‐daily smokers. After controlling for substance abuse treatment histories, gender and age, the daily smokers demonstrated more severe gambling, family/social and psychiatric problems. Compared to non‐daily smokers, the daily smokers gambled on more days and spent more money gambling; they also ‘craved’ gambling more and had lower perceived control over their gambling. The daily smokers were more likely to be taking psychiatric medications, and they experienced psychiatric symptoms, especially anxiety symptoms, on a greater number of days than non‐daily smokers.Implications Results from this study suggest that about two‐thirds of treatment‐seeking gamblers are current daily cigarette smokers, and smoking status is associated with more severe gambling and psychiatric symptoms. These results warrant further investigation of smoking in gamblers and whether smoking adversely affects the course of treatment or outcomes among gamblers.
HIV risk behaviors in African‐American drug injector networks: implications of injection‐partner mixing and partnership characteristics
Authors: Johnson Robert A. , Gerstein Dean R. ,   Alfred Pach III, Cerbone Felicia Gray , Brown Jerry 
Published: March 2003

ABSTRACTAims We explore the mechanisms by which ‘partnership‐level’ variables––the mix of characteristics of individuals who inject drugs together––affect the incidence of HIV risk behaviors, including receptive syringe sharing, and facilitate or impede the spread of HIV.Design We apply multivariate analysis techniques to data on injection partnerships (pairs of individuals who inject drugs together) collected using a network sample of 401 African‐American IDUs in Washington, DC.Findings Drug injectors tended to select injection partners of the same gender and similar age, but risk behaviors were most common in partnerships between individuals who are dissimilar in both gender and age. Partners who had a sexual relationship, injected drugs frequently together, smoked crack‐cocaine regularly, injected speedball (heroin mixed with cocaine) regularly and/or had close social ties were more likely to engage in risky injection practices than otherwise similar partners. These factors account largely for the association between the gender‐age mix of the partnership and injection risk behavior.Conclusions Among African‐American IDUs in Washington DC, partnership‐level variables appear critical in the transmission of HIV.
Operation safe crossing: using science within a community intervention
Authors: Voas Robert B. , Tippetts A. Scott , Johnson Mark B. , Lange James E. , Baker James 
Published: March 2003

ABSTRACTAimsTo evaluate a large drunk‐driving enforcement program at the US/Mexican border to reduce the number of youths crossing the border to drink in Tijuana. This paper also describes the research data used to develop and manage the program. Data from a border breath‐test survey were used to dramatize the problem and gain public support for action. The data were also used to help design the enforcement effort and measure progress in reducing the cross‐border drinking problem.DesignThe number of news events generated around the occurrence of special enforcement efforts were used to measure project activity and to predict changes in the numbers of youths crossing into Mexico, their returning BACs and reductions in alcohol‐related crashes during a 3‐year period.SettingAn urban county on the Mexican border.ParticipantsUnderage youths aged 18–20 years and young adults aged 21–30 years residing in San Diego County.MeasurementsImmigration and Naturalization Services provided population counts of the number of individuals crossing each weekend night from Tijuana into the United States through the San Ysidro border facility. Breath‐test surveys of a random sample of these returning crossers provided data on the number of US residents visiting bars and nightclubs in Tijuana and on alcohol consumption at Tijuana bars and nightclubs. Night‐time had‐been‐drinking crash data involving young drivers in several California counties served as an outcome measure of public health and safety.FindingsAnalysis of data involving more than 2 million pedestrians returning from Tijuana indicated that the Operation Safe Crossing program reduced the number of late‐night crossers by 31.6%.ConclusionsEffective use of data through media advocacy programs to support an enforcement effort can reduce alcohol‐related crashes.
Alcohol dependence: a public health perspective
Authors: Caetano Raul , Cunradi Carol 
Published: March 2003

ABSTRACTAimsTo review epidemiological research on alcohol dependence and to propose a public health approach to address this problem.Design and settingThe research under review is basically constituted by general population surveys.ParticipantsIndividuals in the community 18 years of age and older.MeasurementTwelve‐month rates of alcohol dependence are estimated using DSM criteria.FindingsThe prevalence of alcohol dependence has been stable in the United States, at around 6% for men and 2% for women. The risk of alcohol dependence begins at low levels of drinking and increases linearly with alcohol consumption. Mean group level of consumption shows some relationship to prevalence of dependence. Alcohol‐dependent individuals are responsible for about 50% of the social, legal and interpersonal alcohol‐related problems in society.ConclusionAlcohol dependence is present at relatively high levels in the community. Alcohol‐dependent individuals are responsible for a fair proportion of alcohol‐related problems in society. A public health approach to this problem, emphasizing prevention and group level interventions to lower prevalence levels, is warranted.
The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility
Authors: Group WHO ASSIST Working 
Published: March 2003

ABSTRACTAimsThe Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive substance use and related problems in primary care patients. This report describes the new instrument as well as a study of its reliability and feasibility.SettingThe study was conducted at participating sites in Australia, Brazil, Ireland, India, Israel, the Palestinian Territories, Puerto Rico, the United Kingdom and Zimbabwe. Sixty per cent of the sample was recruited from alcohol and drug abuse treatment facilities; the remainder was drawn from general medical settings and psychiatric facilities.MethodsThe study was concerned primarily with test item reliability, using a simple test–retest procedure to determine whether subjects would respond consistently to the same items when presented in an interview format on two different occasions. Qualitative and quantitative data were also collected to evaluate the feasibility of the screening items and rating format.ParticipantsA total of 236 volunteer participants completed test and retest interviews at nine collaborating sites. Slightly over half of the sample (53.6%) was male. The mean age of the sample was 34 years and they had completed, on average, 10 years of education.ResultsThe average test–retest reliability coefficients (kappas) ranged from a high of 0.90 (consistency of reporting ‘ever’ use of substance) to a low of 0.58 (regretted what was done under influence of substance). The average kappas for substance classes ranged from 0.61 for sedatives to 0.78 for opioids. In general, the reliabilities were in the range of good to excellent, with the following items demonstrating the highest kappas across all drug classes: use in the last 3 months, preoccupied with drug use, concern expressed by others, troubled by problems related to drug use, intravenous drug use. Qualitative data collected at the end of the retest interview suggested that the questions were not difficult to answer and were consistent with patients’ expectations for a health interview. The data were used to guide the selection of a smaller set of items that can serve as the basis for more extensive validation research.ConclusionThe ASSIST items are reliable and feasible to use as part of an international screening test. Further evaluation of the screening test should be conducted.
Survey of doctors prescribing diamorphine (heroin) to opiate‐dependent drug users in the United Kingdom
Authors: Metrebian Nicky , Carnwath Tom , Stimson Gerry V. , Storz Thomas 
Published: March 2003

ABSTRACTAimTo determine the scale and practice of diamorphine (heroin) prescribing for opiate dependence in the United Kingdom in 2000.DesignPostal survey.SettingEngland, Scotland and Wales.ParticipantsOne hundred and eleven of the 164 doctors in the United Kingdom on the Home Office record as holding a licence to prescribe diamorphine (response rate 68%), and 59 of the 108 doctors in the United Kingdom eligible to hold a licence (working in drug clinics), but not doing so (response rate 54%).MeasurementsThe characteristics of doctors (a) holding a licence and (b) currently prescribing; the number of opiate users receiving a prescription; current treatment delivery, clinical criteria for patient eligibility; and reasons for prescribing or not prescribing diamorphine.FindingsSeventy of the 111 doctors actually held a licence. While the majority were consultant psychiatrists, five were general practitioners. Forty‐six were currently prescribing to 448 patients. The majority of prescribers reported that they had not initiated a prescription for diamorphine but had inherited patients already receiving such a prescription. Most of those who prescribed considered that in selected cases it could produce clinical and social improvement. There were great variations in clinical criteria for patient eligibility, prescribing practice, daily dose prescribed (range 5–1500 mg) and the daily dose‐equivalent of 100 mg methadone (range 50–900 mg). Many respondents cited lack of appropriate resources as a reason for not prescribing to more patients. Reasons for non‐prescribing varied from lack of resources to little evidence of its effectiveness.ConclusionsThe prescribing of diamorphine to opiate dependent drug users remains rare in the United Kingdom. Not all eligible doctors seek a licence to prescribe, and not all those with licences actually prescribe it. There is no clear consensus on who should be treated with diamorphine and in what way.
Dysregulation of the hypothalamic–pituitary–thyroid axis in alcoholism
Authors: Hermann Derik , Heinz Andreas , Mann Karl 
Published: March 2003

ABSTRACTThyroid dysfunction is a prominent finding in alcoholism. Subclinical and clinical hypothyroidism have been associated with clinical depression and cognitive impairment and may increase the relapse risk among alcoholics. In spite of these important clinical associations, there is no consensus on thyroid dysfunction in alcoholism in the literature. In this paper, we present a review of the literature and develop a hypothesis that may explain dysfunction of the hypothalamic–pituitary–thyroid axis in alcoholism. Based on a Medline research of the years 1980–2001 we found 33 empirical studies that assessed thyroid function in alcoholism. The most consistent findings were a reduction in total thyroxine and total and free triiodothyronine concentrations during early abstinence. About one‐third of all alcoholics also displayed a blunted thyroid stimulation hormone (TSH) response in the thyrotrophin‐releasing hormone test (TRH‐test). Blunting was observed frequently during detoxification, but was also present in some alcoholics after several weeks of abstinence. We suggest that a reduction in peripheral thyroid hormones may be caused by a direct toxic effect of alcohol on the thyroid gland, which induces a central compensatory activation of the hypothalamic–pituitary axis with an increased TRH release. The TRH release induces a downregulation of pituitary TRH receptors, which manifest as a blunted TSH response to the TRH test. We discuss further additional effects of alcohol on thyroid‐hormone metabolizing deiodinases and on monoaminergic systems, which may interact directly with mood states among abstinent alcoholics.
The association between knowledge of hepatitis C virus status and risk behaviors in injection drug users
Authors: Kwiatkowski Carol F. , Fortuin Corsi Karen , Booth Robert E. 
Published: March 2003

AbstractAims  The three primary objectives of this study were (1) to document the prevalence of the hepatitis C virus (HCV) and awareness of one's status in a sample of street‐recruited injection drug users (IDUs); (2) to compare the drug use and HCV risk behaviors of IDUs who reported that they were HCV infected with those who were unaware of their status and subsequently tested positive for HCV antibodies; and (3) to assess associations between risk factors and HCV status by comparing those who tested positive with those who tested negative.Design  IDUs responded to structured interview questions assessing HCV risk behaviors and were offered a free HCV test.Setting  Subjects were recruited through street outreach in Denver, CO, USA.Participants  Participants were current, out‐of‐treatment IDUs.Measurements  A modified version of the Risk Behavior Assessment (RBA) and HCV test results were used.Findings  Of the 197 participants, 20% had been diagnosed previously with HCV. Of those who did not know their status, 61% tested positive for HCV antibodies. Those who knew they were positive had been injecting longer but engaged in fewer HCV risk behaviors than those who did not know their status. Compared to those who tested negative, those who tested positive were more likely to be male, non‐white and older. They also had been injecting longer, were more likely to use heroin and/or crack cocaine and consumed more alcohol.Conclusions  In this study, a very large proportion of injection drug users who had hepatitis C were unaware of it, and they were engaging in more risk behaviors than those who were aware of their positive status. Risk factors associated with positive HCV status were identified so that those who are most at‐risk for HCV might be targeted for testing and subsequent prevention or care.
Persistence of cigarette smoking: familial liability and the role of nicotine dependence
Authors: Johnson Eric O. , Chase Gary A. , Breslau Naomi 
Published: March 2003

AbstractAims It has been suggested that high genetic vulnerability may explain why smoking persists in spite of general acceptance of the health risks of cigarette smoking. Indeed, heritability estimates for smoking persistence range from 27% to 70%. It has also been suggested that genetic influences on smoking persistence may operate through nicotine dependence, which epidemiological studies have found to be an important risk factor for smoking persistence. We examined alternative ways that familial liability to persistence, nicotine dependence and smoking persistence may be related.Design Cohort study.Setting South‐east Michigan, United States.Participants A subset of 389 daily smokers informative for familial smoking characteristics from an epidemiological sample of young adults 26–35 years old (n = 979).Measurements Nicotine dependence criteria were assessed using the NIMH‐DIS revised interview and diagnosed according to the DSM‐III‐R. Familial smoking characteristics were assessed by subject report.Findings Absent nicotine dependence, daily smokers with medium and high familial density of persistence were at increased risk of smoking persistence (OR = 4.2 and 7.0, respectively). However, familial density of persistence was not associated with smoking persistence among nicotine dependent daily smokers. Level of education also appeared to limit the influence of familial liability, although nicotine dependence also modified this effect.Conclusions Nicotine dependence does not appear to be in the causal pathway from familial liability to smoking persistence, but rather modifies the association between them.
The impact of regular ecstasy use on memory function
Authors: Simon Neil G. , Mattick Richard P. 
Published: March 2003

ABSTRACTAim  To assess memory impairment in a group of regular users of ecstasy compared with a group of regular users of cannabis, after accounting for possible confounding factors such as other drug use, premorbid intelligence and psychopathology.METHOD  Comparative and regression analysis was used to determine the presence or absence of a difference in memory function between 40 regular ecstasy users and 37 regular users of cannabis, who were interviewed at the National Drug and Alcohol Research Centre in Sydney, Australia. Regression analysis was used to find associations between life‐time exposure to ecstasy use and memory performance. Memory function was assessed using an age‐standardized memory test. Other scales were used to assess premorbid intelligence, physical and psychological health, drug withdrawal and other drug use.Results  Initial comparative analysis showed a trend towards a significantly poorer performance by the regular ecstasy‐using group on the ‘auditory immediate memory’ and ‘auditory delayed memory’ indices. When regression analysis was performed an estimate of verbal intelligence was found to be the most predictive of most memory indices including ‘auditory immediate memory’ and ‘auditory delayed memory’. Life‐time exposure to ecstasy was not predictive of the memory indices. The current frequency of cannabis use was found to have some predictive effect for immediate and delayed visual memory.Conclusion  This study does not show memory impairment in a group of ecstasy users relative to cannabis using controls. The previously reported association of life‐time exposure to ecstasy and memory was not found. The findings may indicate a confounding role of cannabis use, as has been recently reported.
A randomized controlled trial of buprenorphine in the management of short‐term ambulatory heroin withdrawal
Authors: Lintzeris Nicholas , Bell James , Bammer Gabriele , Jolley Damien J. , Rushworth Louise 
Published: March 2003

ABSTRACT Aim  To determine whether buprenorphine is more effective than clonidine and other symptomatic medications in managing ambulatory heroin withdrawal.Design  Open label, prospective randomized controlled trial examining withdrawal  and 4‐week postwithdrawal outcomes on intention‐to‐treat.Setting  Two specialist, out‐patient drug treatment centres in inner city Melbourne  and Sydney, Australia.Participants  One hundred and fourteen dependent heroin users were recruited. Participants were 18  years or over, and with no significant other drug dependence, medical or psychiatric conditions or recent methadone treatment. One hundred and one (89%) participants completed a day 8 research interview examining withdrawal outcomes, and 92 (81%) completed day 35 research interview examining postwithdrawal outcomes.Interventions  Participants randomized to control (n  =  56) (up to 8  days of clonidine and other symptomatic medications) or experimental (n  =  58) (up to 5  days of buprenorphine) withdrawal groups. Following the 8‐day withdrawal episode, participants could self‐select from range of postwithdrawal options (naltrexone, substitution maintenance, or counselling).Measurements  Retention in withdrawal; heroin use during withdrawal; and retention in drug treatment 4  weeks after withdrawal.Secondary outcomes  Withdrawal severity; adverse events, and heroin use in the postwithdrawal period.Findings  The experimental group had better treatment retention at day 8 (86% versus 57%, P  =  0.001, 95% CI for numbers needed to treat (NNT)  =  3–8) and day 35 (62% versus 39%, P  =  0.02, 95% CI for NNT  =  4–18); used heroin on fewer days during the withdrawal programme (2.6  ±  2.5 versus 4.5  ±  2.3, P  <  0.001, 95% CI  =  1–2.5  days) and in the postwithdrawal period (9.0  ±  8.2 versus 14.6  ±  10, P  <  0.01, 95% CI  =  1.8–9.4); and reported less withdrawal severity. No severe adverse events reported.Conclusions  Buprenorphine is effective for short‐term ambulatory heroin withdrawal, with greater retention, less heroin use and less withdrawal discomfort during withdrawal; and increased postwithdrawal treatment retention than symptomatic medications.
Trajectories of drinking from 18 to 26 years: identification and prediction
Authors: Casswell Sally , Pledger Megan , Pratap Sarah 
Published: March 2003

ABSTRACT Objective  To identify developmental trajectories of drinking between the ages of 18 and 26  years and to identify variables, amenable to policy influence, which predict these trajectories.Design  Longitudinal data were analysed using latent class mixture modelling.Setting  Participants were interviewed in a central location.Participants  Provincial city birth cohort, cross‐national studies suggest findings are generalizable to other similar market economies.Measurements  The frequency of drinking over the past year and the typical quantity consumed per drinking occasion were computed from five location‐specific questions. Measures used to predict membership of trajectory groups were ease of access to alcohol, drinking on licensed premises, response to alcohol advertising, educational achievement, parental consumption, age of onset of regular drinking and living arrangements.Results  Three trajectories of quantities consumed showed reduced consumption after age 21 but one trajectory showed marked increases. Three trajectories of frequency of drinking increased or remained stable over time. Access to licensed premises at age 18 had the most significant impact on membership of the trajectory groups and educational achievement had a significant impact on membership of the heavier quantity trajectory groups. Parental alcohol consumption, access to alcohol at 15  years, liking for alcohol advertising, living arrangement and age of onset of regular drinking also influenced trajectory membership.Conclusions  Quantity and frequency of drinking in adolescence and early adulthood had different trajectories. Membership of heavier drinking groups was affected by environmental influences which are subject to policy change, particularly that of earlier access to licensed premises. In a small group high‐quantity consumption did not decrease at age 26.