bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of admissions to residential drug treatment agencies in New South Wales, 1988‐92: I. Illicit drug problems
Authors: DARKE SHANE , KELAHER MARGARET , HALL WAYNE , FLAHERTY BRUCE 
Published: October 2005

AbstractThe Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with illicit drug problems over the years 1988‐92. The mean age of admissions rose from 26.8 years to 27.9 years over the study period. There was a small increase in the proportion of male admissions to agencies (66.5% in 1988 to 69.9% in 1992). The proportion of admissions reporting opiates as their primary drug problem declined from 81% to 65%, while the proportion of admissions for stimulant problems doubled in that period (8% to 16%), as did those for cannabis (3.6% to 8.7%). There was a significant increase in the proportions of admissions who had drug problems of 10 or more years' standing (34.9–41.3%). The proportion of admissions that had never been in treatment decreased from 51% to 15% over the study period. Admissions with prior methadone experience rose from 37% to 69% between 1988 and 1992.
Pharmacological properties of ketamine
Authors: WHITE JASON M. , RYAN CHRISTINA F. 
Published: October 2005

AbstractKetamine is a dissociative anaesthetic that is being used in non‐medical contexts. The effects of ketamine are very similar to those of phencyclidine, another dissociative anaesthetic that has enjoyed considerable popularity as a recreational drug. The effects of ketamine include analgesia, cardiovascular and respiratory stimulation, dissociation, hallucinations and anaesthesia. The potential dangers of uncontrolled ketamine use include psychosis and violence, accidents and marked psychomotor and cognitive impairment. Although studies have shown potential for tolerance to and physical dependence on ketamine, further investigation of these phenomena is needed. Ketamine is thought to produce most of its effects through antagonist activity at the PCP site of the NMDA receptor complex. Ketamine has sympathomimetic properties resulting from enhancement of catecholamine, and particularly dopamine, activity. While opioid receptor activity has been identified, this is relatively weak and the contribution to the effects of ketamine is not clear. Although much is known of the clinical uses and effects of ketamine, as yet little is understood of ketamine as a recreational drug and potential drug of dependence.
Addressing dependent amphetamine use: a place for prescription
Authors: LINTZERIS NICK , HOLGATE FRAN , DUNLOP ADRIAN 
Published: October 2005

AbstractAmphetamines are among the most widely used of illicit drugs in Australia, and evidence documenting the occurrence of amphetamine‐related harms, particularly among chronic regular users, is increasing, A review of contemporary Australian treatment approaches suggests that conventional modalities are unlikely to address the needs of a large proportion of dependent amphetamine users. This has prompted clinicians in Australia and the United Kingdom to commence treatment programmes incorporating substitution therapy. Despite the positive impressions of clinicians involved in these programmes, further research is required to establish the role and efficacy of such treatment approaches. Issues to be addressed in the establishment of a controlled study are examined.
Reliability and validity of the Opiate Treatment Index among a sample of opioid users in the United Kingdom
Authors: ADELEKAN MORUF , GREEN ANNA , DASGUPTA NORU , TALLACK FENELLA , STIMSON GERRY V. , WELLS BRIAN 
Published: October 2005

AbstractTo validate the Opiate Treatment Index (OTI) for use in the United Kingdom, 72 subjects attending two methadone clinics in London completed confidential interviews with two researchers at two points in time, 1–2 weeks apart. About half the interviews were conducted by the same interviewer on both occasions, and the remaining by different interviewers. These research designs enabled an estimation of the test‐retest and inter‐rater reliability of the instrument. Subjects' responses were validated against key worker reports and self‐reported drug use against urinalysis results. The majority of the respondents were males (65%) and their mean age was 34.2 years (range 21–52; SD 8.5). Test‐retest reliability coefficients were high for all the scales (range 0.77‐0.86) in both the same and different interviewer situations. The internal reliability of the scales was generally high (Cronbach's α: range 0.34‐0.93). The correlation with key workers' reports was high with the percentage agreement on the items ranging 74–100 (mean 87). The percentage agreement of self‐reported drug use with urinalysis results was high (range 69–95; mean 89). These findings are similar to those obtained among Australian subjects and suggest a high cross‐cultural validity for the OTI. Minor changes to the OTI have been incorporated into a modified version for use in the UK.
Effects of needle exchanges in Hobart, Tasmania
Authors: LUCAS PETER , EASTHOPE GARY 
Published: October 2005

AbstractAn examination was conducted of three Tasmanian cohorts of injecting drug users interviewed before the introduction of needle exchanges, during the operation of illegal exchanges and after the introduction of legal exchanges. The drugs reported as used were comparable with reports from Perth and Sydney samples. There are clear downward trends for both males and females toward reduced sharing of injecting equipment and increased use of new equipment which begin when the illegal exchanges were operating and accelerate when the number of exchanges increased and became legal. The use of bleach to clean equipment also increases in the 4‐year period. There was a much higher use of open fires to dispose of equipment than has been reported elsewhere. These results strongly suggest that needle exchanges do lead to reduced sharing and to less needles in public places; vital outcomes if AIDS and hepatitis are to be contained.
The prospects of a harm reduction approach among indigenous people in Canada
Authors: LANDAU TAMMY C. 
Published: October 2005

AbstractA harm reduction approach to alcohol and substance abuse is becoming increasingly popular as an alternative to prohibitionist and abstentionist policies. It is seen as particularly valuable for some high‐risk populations, such as injection drug users and street youth. A strong argument can be made that Aboriginal communities in Ontario, Canada, and probably across the country, are appropriate environments for a harm reduction approach. Aboriginal people are at extremely elevated risk for accident, illness and death. At the same time, alcohol use is a predominant factor in many of these outcomes, and elevates many of the risks associated with Aboriginal life. Isolated, remote reserve communities in northern Ontario present additional risks of extremely poor living conditions and extreme weather conditions. Prohibition and abstinence are currently the main approaches to alcohol and substance abuse in many of these communities, while the role of alcohol in morbidity, mortality and other social problems remains high. There are positive indications that the feasibility of harm reduction strategies could be broached in some communities. It is concluded that the obstacles are significant but a community‐by‐community approach is a strong feature of harm reduction, and may increase its prospects for piloting strategies in individual communities.
Alcohol, casemix and hospitals: an opportunity?
Authors: RYDER DAVID 
Published: October 2005

AbstractThe number of patients in hospitals who experience alcohol‐related problems is high, and the provision of intervention for these patients is a significant public health measure. The current move towards casemix funding of acute hospital services provides an opportunity for the development of such programmes. Modifications to the Diagnosis Related Groups categorization of alcohol‐related problems that would allow for appropriate funding are discussed.
Research methods for studying injecting drug users in a rural centre
Authors: SPOONER CATHERINE , BISHOP JANET , PARR JAN 
Published: October 2005

AbstractTargeted sampling, multiple data collection methods and peer interviewers have been used with success for studies of injecting drug users (IDUs) in main cities. This paper reports the success of a trial of these research methods with IDUs in a rural centre. Recruitment via outreach (for individual interviews and for focus groups), street intercept and service‐based surveys (methadone clinic and prison based surveys) were found to be viable and to vary in their success in recruiting subgroups of IDUs. Their use in combination is recommended so that the largest possible range of IDUs can be recruited. The close involvement of peer interviewers and of an advisory group in planning and implementing these data collections was essential. Advertising was not found to be successful for recruiting to a phone‐in, for focus groups nor to a community forum. Concerns about anonymity, ‘paranoia’ and a general lack of a cohesive IDU community were barriers to recruitment.
General practitioners' views and knowledge about anabolic steroid use—survey of GPs in a high prevalence area
Authors: GUPTA LEENA , TOWLER BERNIE 
Published: October 2005

AbstractThe aim of this study was to assess GPs' attitudes, clinical behaviour, information needs and contact with anabolic‐androgenic steroid (AAS) users in an area reported to have a high prevalence of AAS use. It was a cross‐sectional study of GPs using a self‐administered questionnaire. The sample comprised of 202 GPs practising in the Central Business District and inner city area of Sydney took part. Of 164 eligible GPs, 143 responded (87% response rate). Fifty‐three per cent of respondents reported that they had seen at least one patient in the last year who told them they had used AASs for non‐medical purposes; 6% indicated that they had seen more than 20 patients who mentioned AAS use. Two per cent of respondents reported prescribing AASs for body‐building purposes and 6% indicated a willingness to do so in a hypothetical situation. Forty per cent of respondents reported that they would be willing to provide harm minimization advice to AAS users; 77% of respondents were interested in obtaining more information about AAS use, most frequently requested in the form of a fact sheet or pamphlet. Most GPs in the area surveyed had some contact with AAS users in their practice. Some GPs had favourable attitudes towards prescription of AASs for non‐medical purposes. These attitudes require further exploration. The results of this survey invite a reappraisal of many policy initiatives involving GPs aimed at reducing AAS‐related harm.
Alcohol use patterns, problems and policies in Malaysia
Authors: JERNIGAN D. H. , INDRAN S. K. 
Published: October 2005

AbstractThe roots of Malaysia's drinking patterns lie in the introduction of most forms of alcohol by Europeans. Although Malaysia today has relatively low per capita alcohol consumption, available studies and interviews with alcohol industry officials point to a small segment of the population that drinks heavily and causes and experiences substantial alcohol related‐problems. Indians are over‐represented in this sub‐population, but studies also reveal substantial drinking problems among Chinese and Malays. Government officials categorize alcohol as an Indian problem. The government devotes little resources to monitoring drinking patterns, use or problems; or to preventing, treating or educating the public about alcohol‐related problems. Alcohol‐producing transnational corporations own shares of all of Malaysia's major alcohol producers. In the face of high alcohol taxes and a ban on broadcast advertising of alcoholic beverages, these companies market alcohol aggressively, making health claims, targeting heavy drinkers and encouraging heavy drinking, employing indirect advertising, and using women in seductive poses and occupations to attract the mostly male drinking population. Monitoring of the country's alcohol problems is greatly needed in order to establish alcohol consumption more clearly as a national health and safety issue, while stronger controls and greater corporate responsibility are required to control alcohol marketing.
Cannabis policy in Australia and New Zealand
Authors: ABEL SALLY 
Published: October 2005

AbstractThis paper describes and compares current developments in policies to deal with cannabis in Australia and New Zealand. Both countries are bound by international conventions to control cannabis and in each case cannabis use, possession, cultivation and supply is illegal. In both countries almost all the supply is grown locally and patterns of use and health concerns appear to be similar. Strategies used to deal with cannabis include: demand reduction through enforcement of legislation, drug education and treatment; supply reduction through enforcement of legislation and crop recovery operations; and harm reduction through diversion of some offenders from the courts system, lenient enforcement policies for users and, in Australia, the formal decriminalization of cannabis use in two states/territories and de facto decriminalization in another. Australia has had a co‐ordinated national drugs policy with a stated harm reduction focus for over a decade, while in New Zealand efforts to co‐ordinate policy have been delayed by ongoing debates about cannabis's harm potential and what constitutes an appropriate approach. However, a national drugs policy with a professed harm reduction focus is currently being finalized. Despite these developments, government cut‐backs and international and local prohibitionist influences on policy in both countries suggest that a harm reduction model may not necessarily be secure.
An open trial of naltrexone for opiate dependence
Authors: FOY AIDAN , SADLER CRAIG , TAYLOR ANDREW 
Published: October 2005

AbstractThe objective of this study was to conduct a pilot study of naltrexone in opiate‐dependent patients in order to determine the sample size for a double‐blind controlled trial, to identify possible confounders and to obtain experience with the drug's side effects and acceptability to patients. Opiate‐dependent patients presenting to a public hospital for treatment for their dependence were invited to participate. Patients with major organic illness, another Axis I diagnosis, or who were pregnant were excluded. Naltrexone was prescribed at a dose of 50 mg daily for 6 months. Data were collected on drug use, social stability, physical and mental health before during and after the treatment programme. Patients were seen weekly for 6 months then monthly for a further 6 months. Forty‐four patients were enrolled, but three stopped naltrexone early because of possible side effects. Of the remainder, 32 were followed for at least 12 months. Eight (25%) ceased opiate use from the start, and another two were no longer using at the end of 12 months giving an abstinence rate of 31% at 12 months. Retention in treatment was 34%. Of the abstinent patients however, only two took naltrexone for the whole 6 months. Naltrexone was well tolerated and associated with a significant abstinence rate, but most patients do not feel they need to take the drug for 6 months. A double‐blind controlled trial would be justified.
Route of drug use and its implications for drug effect, risk of dependence and health consequences
Authors: STRANG JOHN , BEARN JENNY , FARRELL MICHAEL , FINCH EMILY , GOSSOP MICHAEL , GRIFFITHS PAUL , MARSDEN JOHN , WOLFF KIM 
Published: October 2005

AbstractRoute of administration has a profound, but often overlooked, influence on the actual experience of the drug use itself, on the risk of resulting development of dependence, and on the nature of the harms to which drug users are exposing themselves. These three areas are reviewed. The influence of route of administration on drug effect is considered first with regard to overall effectiveness of absorption, and also with regard to speed of onset of effect. The implications for risk of dependence cover animal and human laboratory studies of reinforcement schedules, epidemiological studies, the attitudes of drug users themselves to the different routes of possible drug use and associated dependence risk and the postulated influences on progression to dependence. Finally, the relationship between route of drug use and health sequelae is explored for the three most widely used routes of administration of illicit drugs—snorting, smoking and injecting.
Women injecting drug users in London: the extent and nature of their contact with drug and health services
Authors: HUNTER GILLIAN M. , JUDD ALI 
Published: October 2005

AbstractImproved access to drug treatment and other health services remains central to HIV prevention and other harm reduction strategies among injecting drug users (IDUs) in the UK. Efforts have therefore been focused upon making such services more accessible and ‘user friendly’. Women who use drugs are considered a ‘hard to reach’ population. This is largely based on data from a variety of official sources which have suggested that women are under‐represented as clients of drug services. While current literature provides numerous explanations for this, there have been few empirical studies exploring the nature and extent of women's contact with such services. This paper presents findings from an European Community funded survey of women IDUs in London. Data from this survey suggest that women IDUs have surprisingly high levels of contact with a range of specialist and generic health services in relation to their drug use.
Cohort trends in age of initiation to heroin use
Authors: LYNSKEY MICHAEL T. , HALL WAYNE 
Published: October 2005

AbstractThis paper examines gender differences and trends over time in the age of initiation to heroin use. Data from two large surveys: the Sydney component of the ANAIDUS, conducted in 1989, and the ASHIDU, conducted in 1994, were used to examine this issue. Together, these studies contained information on 1,292 individuals who identified themselves as heroin users. Results indicated that, while there were no significant gender differences in age of initiation to heroin use, there was a significant (p< 0.001) time trend in the mean age at which heroin was first used. Specifically, the mean age of first heroin use among individuals born during the interval 1940–1949 was 20.5 years while among those born during 1970–1979 the mean age of first heroin use was 16.5 years. These findings were confirmed by analyses of the National Household Survey. Further analysis of the ASHIDU data indicated that younger age of initiation to heroin use was associated with polydrug use, overdose and crime after the effects of duration of heroin use had been statistically controlled. These findings suggest that there has been both an increase in the willingness of young people to experiment with heroin and an increased availability of the drug over this time. In combination with evidence that there has been an increase in the amount of heroin being imported into Australia, and an increased demand for treatment for opiate dependence, these data suggest that Australia is experiencing an increase in the use of heroin, particularly among youth.
Survey of amphetamine prescribing in England and Wales
Authors: BRADBEER T. M. , FLEMING P. M. , CHARLTON P. , CRICHTON J. S. 
Published: October 2005

AbstractA survey was undertaken of senior medical specialists in drug dependence in England and Wales, enquiring about their attitudes and practices concerning the prescription of amphetamines to dependent users. Of the 149 who replied, 60% saw a role for amphetamine prescribing, with 46% currently doing so. Of those who did not prescribe, 32% would like to have done so. Respondents often did not know if general practitioners in their area were prescribing amphetamines. Many could not estimate the percentage of injecting amphetamine users in their area. There was a wide range in the dosage of amphetamine prescribed with a mean maximum of 66 mg. There was agreement about entry criteria for prescribing programmes and also on ways of monitoring those receiving amphetamine. Our results indicate that amphetamine prescribing is widespread in England and Wales although there is little scientific evidence for its efficacy. We have developed some guidelines for good practice, drawing on our own and others' experience.
The benefit of alcohol in moderation
Authors: DOLL RICHARD 
Published: October 2005

AbstractSmall amounts of alcohol were held to be beneficial in the 19th century, but the idea died out. Scientific evidence that moderate amounts prolonged life, published in 1926, was ignored. Further evidence accumulated from the early 1950s but the belief that alcohol was only harmful had become so ingrained that the idea has been taken seriously only since the early 1980s. Now, the evidence that small amounts reduce the risk of vascular disease by about a third and reduce total mortality in middle and old age is massive. Alternative explanations for the observed inverse relationships have been ruled out and beneficial effects have been shown to be biologically plausible. The reduction in mortality is mainly attributable to ischaemic heart disease and cerebral thrombosis, but some other diseases may also contribute to it. The increasing mortality with larger amounts is attributable to many causes that have long been recognized. The optimum level varies with sex and age and may be zero under about age 45 years. The benefit is directly due to ethanol and the extra benefit attributed to wine is due to the pattern of drinking. Public policy needs to take account of medical and social effects other than mortality and will vary in different communities depending on background patterns of injury and disease.
Drinking patterns and alcohol‐related social problems: frameworks for analysis in developing societies
Authors: ROOM ROBIN 
Published: October 2005

AbstractThe relation of alcohol to social and casualty problems is considered, with particular attention to patterns in developing societies. Potential problems for the drinker include accidental and intentional injuries; problems in major social roles: in the family, at work and in public roles; and problems from the reaction of others to the drinking. Potential problems for those in the drinker's environment include mental health problems, injuries and social problems from role failure. Potential problems for a society or collectivity include social disintegration, and aggregate‐level equivalents of the problems for the drinker and those around the drinker. Cultures vary in the dominant type of drinking pattern and, accordingly, in the extent and mixture of alcohol‐related social and casualty problems. A series of cultural factors influencing the relation between drinking patterns and problems are considered.
Alcohol intoxication and school dropout
Authors: WICHSTRØM LARS 
Published: October 2005

AbstractThe aim of the study was to investigate if alcohol intoxications predict dropout from senior high school over and beyond the effect of alcohol consumption and to seek out potential confounding or mediating mechanisms in the form of a longitudinal cohort‐sequential survey. The participants were a nationally representative sample of Norwegian junior and senior high school students (n = 5308). Measures used were of alcohol consumption, number of intoxications, school dropout, conduct problems, drug use, friends' problem behaviour, truancy, attitude to school, educational aspirations, grades, homework, youth centrism, leisure time activities, religiosity, depression, academic self‐concept, attachment to parents. Intoxications did override the effect of alcohol consumption and predicted dropout. This effect was confounded by parental attachment, whereas truancy and associating with peers high in problem behaviour mediated the effect of intoxications. Frequent alcohol intoxications increase the risk for school dropout by means of increased truancy and differential association with counternormative peers.