bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing society, changing drinking: solitary drinking as a non‐pathological behaviour
Authors: DEMERS ANDRÉE , BOURGAULT CHANTAL 
Published: March 2003

AbstractThis study describes solitary drinking as it appears in a general population. The data are derived from a telephone survey carried out in April 1993 an a representative sample of 2015 adult drinkers from the Montreal metropolitan area. Thirty‐one percent of the respondents (n = 633) reported drinking without being in the company of other people. First, solitary drinking is described according to drinking contexts and drinking patterns. Secondly, a comparison of solitary drinkers with Those who did not report this behaviour is presented according to socio‐demographic characteristics, social representations of drinking and overall drinking patterns. Finally, a logistic regression analysis is performed to identify the main characteristics of the drinkers associated with solitary drinking. The results show that solitary drinking occurs mainly at home, at the end of the day, to accompany a meal, to mark a transition between work and leisure or to accompany a rest time. The quantity involved in solitary drinking is generally moderate. The results also show that solitary drinking is associated with gender, living alone, employment status, tension‐reduction and harmful representations of drinking. However, the main predictor of solitary drinking is overall drinking frequency, indicating the constituent place of alcohol in solitary drinkers' life‐style.
The optimal size of attributor for use with the University of Manchester Drug Misuse Database
Authors: CRABBE TIM , DONMALL MICHAEL 
Published: March 2003

AbstractThis paper describes the anonymous, attributable code which is applied to different individuals when they are reported to the regional drug misuse databases using the University of Manchester system. It then reports on the effect of removing selected data items included in the attributor on the system's abuity to distinguish between different drug users reported to the database. All of the attributable codes that did net use the full set of data items were found to reduce the system's ability to distinguish between the reporting of new drug users and new episodes of drug use for users previously reported to the database.
Temporal drinking patterns and variation in social consequences
Authors: DAWSON DEBORAH A. 
Published: March 2003

AbstractTemporal drinking patterns and their associated social consequences are described for a sample of US adults aged IS years and over who drank at least 12 drinks in the preceding year and did not restrict their drinking to special occasions (n= 16 086). The earliest time of day when these current regular drinkers reported usually drinking was between 6 a.m. and II a.m. for 1.2%, between 11 a.m. and 3 p.m. for 7.3%, between 3 p.m. and 6 p.m. for 31.2%, and after 6 p.m. for 60.3%. Less than one‐tenth (7.7%) reported any drinking (not necessarily their earliest drinking) between midnight and 6 a.m. Characteristics associated with above‐average rates of both early (6 a.m.–3 p.m.) and late‐night (midnight–6 a.m.) drinking included male gender, black race, low education and income and heavy quantity of ethanol intake per drinking day. Early drinking was also characteristic of the elderly and daily drinkers. Prior to adjusting for background variables and quantity and frequency of intake, early drinking was associated with a two‐ to nine‐fold increase in the risk of alcohol‐related interpersonal problems, hazardous use, job/school problems and legal problems, and late‐night drinking was associated with a three‐ to eight‐fold increase in their prevalence. After adjusting for these factors in multiple logistic regression models, early drinking was associated with a 54% increase in the odds of interpersonal problems, a 39% increase in the odds of hazardous use and a 52% increase in the odds of legal problems. The association between early drinking and job/school problems fell just short of statistical significance. After adjusting for other factors, late‐night drinking retained a significant association with all of the outcomes except legal problems. The magnitude of its association was greater than that of early drinking but varied substantially (i.e. interacted) with quantity of intake, race, ethnicity and gender.
Fatal heroin ‘overdose’: a review
Authors: DARKE SHANE , ZADOR DEBORAH 
Published: March 2003

AbstractThe current paper examines critically the literature on deaths attributed to heroin overdose, and examines the characteristics and circumstances of such deaths. In particular, the dominance of the widely held belief that heroin‐related fatalities are a consequence of overdose is challenged. Deaths attributed to overdose represented in the literature are typically older, heroin‐dependent males not in drug treatment at the time of death. Fatalities involving only heroin appear to form a minority of overdose occasions, the presence of other drugs (primarily central nervous system depressants such as alcohol and benzodiazepines) being commonly detected at autopsy. Furthermore, deaths attributed to overdose are likely to have morphine levels no higher than those who survive, or heroin users who die from other causes. It is concluded that the term overdose is, in many cases, a misleading term, since it implies the same mechanism of death in all cases, an implication that is neither clinically useful nor consistent with published data. Implications for the prevention of heroin‐related deaths are discussed.
The effectiveness of inpatient and outpatient treatment for alcohol abuse: the need to focus on mediators and moderators of setting effects
Authors: FINNEY JOHN W. , HAHN ANNETTE C. , MOOS RUDOLF H. 
Published: March 2003

AbstractPrevious reviews have concluded that there was no evidence for the superiority of inpatient over outpatient treatment of alcohol abuse, although particular types of patients might be more effectively treated in inpatient settings. In this review, we first consider the conceptual rationales that have been offered to support inpatient and outpatient treatment. Following that, the results of the relevant research on setting effects are presented. Five studies had significant setting effects favoring inpatient treatment, two studies found day hospital to be significantly more effective than inpatient treatment, and seven studies yielded no significant differences on drinking‐related outcome variables. In all but one instance in which a significant effect emerged, patients in the ‘superior’ setting received more intensive treatment and patients were not ‘preselected’ for their willingness to accept random assignment to treatment in either setting. Studies finding significant setting effects also conducted more treatment contrasts (18.6 vs. 4.9), on average, and had a mean statistical power level of 0.71 (median 0.79) to detect a medium‐sized effect, whereas studies with no significant findings had an average power level of 0.55 (median 0.57). When inpatient treatment teas found to be more effective, outpatients did not receive a respite in the form of inpatient detoxification and the studies were slightly less likely to have social stability inclusion criteria and to use random assignment to treatment settings. We consider the implications of our findings for future research, especially the need to examine the conceptual rationales put forward by proponents of inpatient and outpatient treatment, i.e. mediators and moderators of setting effects.
Heroin addiction in Bahrain: 15 years experience
Authors: ABDEL‐MAWGOUD MOHAMED , AL‐HADDAD MOHAMED K. 
Published: March 2003

AbstractThis study describes the development and outcome of a new treatment programme for the management of heroin addiction in Bahrain. The problem reached its peak in the early 1980s with several reported deaths and with the involvement of many disciplines in the overall response. In 1983, treatment of all addicts was restricted by law to the government psychiatric hospital. The newly established specialized drug unit was overwhelmed by the number of patients seeking treatment. The lack of sufficient resources and suitably trained staff forced the unit to adopt an outpatient maintenance therapy approach for most of its clients. In 1987, a new comprehensive treatment programme was introduced that relies on a clear philosophy, safe detoxification (using objective scales for withdrawal manifestations) rather than maintenance therapy, followed by psychological and social rehabilitation. A national committee for drug addiction leas formed and an intensive programme of education was started at ail levels. The results indicate an initial increase at inpatient level but a marked drop of outpatient attendance. The use of the Opioid Objective Withdrawal Manifestations Scale (OOWMS) revealed that only a small number of our patients developed moderate or severe signs of withdrawal that required detoxification, and the rate of dispensed controlled medication was reduced by 99%. The effect of this approach is discussed, with special reference to the need for a collaborative effort from all disciplines in planning, implementing, continuously evaluating and modifying the national programmes for handling the serious problem of addiction.
A comparison of positive and negative alcohol expectancy and value and their multiplicative composite as predictors of post‐treatment abstinence survivorship
Authors: JONES BARRY T. , McMAHON JOHN 
Published: March 2003

AbstractWithin social learning theory, positive alcohol expectancies represent motivation to drink and negative expectancies, motivation to restrain. It is also recognized that a subjective evaluation of expectancies ought to moderate their impact, although the evidence for this in social drinkers is problematic. This paper addresses the speculation that the moderating effect will be more evident in clinical populations. This study shows that (i) both expectancy and value reliably, independently and equally predict clients’abstinence survivorship following discharge from a treatment programme (and that this is almost entirely confined to the negative rather than positive terms). When (ii) expectancy evaluations are processed against expectancy through multiplicative composites (i.e. expectancy X value), their predictive power is only equivalent to either expectancy or value on its own. However (Hi) when the multiplicative composite is assessed following the statistical guidelines advocated by Evans (1991) (i.e. within the same model as its constituents, expectancy and value) the increase in outcome variance explained by its inclusion is negligible and casts doubt upon its use in alcohol research. This does not appear to apply to value, however, and its possible role in treatment is discussed.
The “WAM” score: sensitivity and specificity of a user friendly biological screening test for alcohol problems in trauma patients
Authors: NILSSEN ODD , RIES RICHARD , RIVARA FREDRICK P. , GURNEY JAMES G. , JURKOVICH GREGORY J. 
Published: March 2003

AbstractBased on a weighted aggregation of three biological alcohol markers (gamma‐glutamyltransferase, blood alcohol and mean corpuscular volume), this study presents a screening instrument for alcohol problems in trauma patients. The sex‐specific performance of this instrument was explored on 1088 male and 352 female patients, 18years or older, admitted with blunt or penetrating trauma during a 30‐month period to a regional level one trauma center in Seattle, Washington (USA). The sum of the differentially weighted alcohol markers (“WAM”), determined from one blood sample, formed a “score continuum” ranging from 0 to 24, The WAM scores distributed themselves across the trauma population with higher WAM scores being correlated to higher screening instrument scores for alcohol problems. By using two of the best established screening tests for alcohol problems (CAGE and SMAST) to define cut‐off points for likely “alcohol abuse/dependence”, the WAM score of ≥ 7 in males showed 75% sensitivity and 83% specificity, whereas the WAM score of ≥ 6 for females displayed 85% sensitivity and 85% specificity. We conclude that a weighted combination of biological alcohol markers (WAM score) is a useful tool for identifying alcohol problems among trauma patients. Representing an alternative or addition to a more extensive interview, it could be used as a routine pan of the care of trauma patients.
WHO working group on population levels of alcohol consumption
Authors: ANDERSON PETER 
Published: March 2003

AbstractTarget 17 of the Health Policy for Europe calls for the health‐damaging consumption of dependence‐producing substances such as alcohol, tobacco and psychoactive substances to be significantly reduced in all Member States between the year 1980 and the year 2000. With regard to alcohol, if is suggested that alcohol consumption be reduced by 25%, with particular attention to reducing harmful use. A question posed by a number of Member Slates is what is the level of per capita alcohol consumption of lowest risk to physical, psychological and social harm. A working group was convened to consider population levels of alcohol consumption with particular reference to the Member States of the European Region of WHO. A basis for understanding population problem experience can be established through the interaction between individual risk and distribution of consumption levels within the population. The working group concluded that public health policy within the European Region should continue to advise decreases of per capita consumption. Even when taking into account coronary heart disease, it can be concluded at the population level, across all ranges of alcohol consumption found in almost all countries of Europe, that a reduction in consumption is linked to better health. However, public health policy concerning alcohol should not be based solely on mortality. All outcomes of drinking, that is mortality, morbidity, social and criminal consequences, as well as quality of life, should be considered. The existing data relating alcohol consumption to health originates from countries primarily with a cultural experience of consuming alcohol. In those countries, where there is a cultural or religious tradition of not consuming alcohol, there can be no public health grounds for recommending alcohol consumption.
Public health consequences of the J‐curve hypothesis of alcohol problems
Authors: SKOG OLE‐JØRGEN 
Published: March 2003

AbstractThis paper addresses some issues related to the hypothesis that the risk for premature death is a J‐shaped function of alcohol intake. The first part of the paper contains a discussion of the individual level epidemiological evidence. It is argued that the evidence is not yet good enough to allow precise statements about ‘safe limits’, nor does it allow a precise location of the ‘optimum’ consumption level. Measurement errors and confounding variables not yet controlled for remain substantial problems. In particular, future studies need to control for social integration, as this factor may affect both health status and alcohol consumption. The second part of the paper discusses the population level relationship. It is argued that, typically, what is optimum for an individual is too much for a population. Unintended side effects of major public health importance should be expected in this area. In the last section, a plea is made for aggregate level studies as a way of addressing the public health side of the issue.
Per capita alcohol consumption and total mortality: an analysis of historical data
Authors: NORSTRÖM THOR 
Published: March 2003

AbstractSince total mortality is a classical proxy for the overall health status of the population, its degree of association with per capita alcohol consumption is of great interest. Existing evidence, based on historical data from the turn of the century, is mostly in graphical form. These data arc analysed using modern statistical tools. The results suggest a significant alcohol effect; a 1‐l increase in consumption is expected to increase mortality (middle‐aged men) by about 1 %. This effect might seem fairly modest but it is noted that it may well be locally substantial because of its concentration to specific categories of the population. The alcohol effect is also compared with the impact of a factor that is a surrogate for a large number of etiological agents, namely real wages. Although the latter factor seems to be the more important one the difference is not overwhelming. The shift in the cause of the death panorama during this century, with an increasing share of CHD‐mortality, may well have attenuated the aggregate relationship between alcohol and mortality.
Alcohol consumption in high school adolescents: frequency of use and dimensional structure of associated problems
Authors: LEWINSOHN PETER M. , ROHDE PAUL , SEELEY JOHN R. 
Published: March 2003

AbstractThe goal of this paper is in present data regarding the occurrence of alcohol consumption and the relative prevalences and the factorial structure of DSM‐IV symptoms of alcohol abuse/dependence in a sample of 1507 older (14–18 years) community adolescents. Participants were diagnostically assessed at two time points, approximately 1 year apart. Three‐quarters of the sample had tried alcohol. Boys in general had greater usual frequency and quantity of alcohol consumption than girls and began drinking at an earlier age; girls with a diagnosis of alcohol abuse/dependence had a significantly earlier mean age of alcohol disorder onset and were more likely to have a relapse of alcohol disorder. However, gender differences in symptom prevalence were non‐significant. Seventeen per cent of the sample had at least one alcohol abuse/dependence symptom. The most frequent symptoms included reduced activities because of alcohol use, consumed more than intended, and tolerance. Eight of the 11 symptoms made a unique contribution to the prediction of diagnosis in a multiple logistic regression analysis. Components analysis supported the general division of symptoms into the categories of abuse and dependence.
The latent dimensionality of DIS/DSM‐III‐R nicotine dependence: exploratory analyses
Authors: JOHNSON ERIC O. , BRESLAU NAOMI , ANTHONY JAMES C. 
Published: March 2003

AbstractDecisions on DSM‐IV criteria for alcohol dependence were based in part on latent structure analyses of field survey data on alcohol problems. Analogously, to investigate the latent structure of nicotine dependence in an epidemiological sample, we carried out a dichotomous item factor analysis of DSM‐III‐R symptom data gathered from 394 young adults who reported a history of sustained daily smoking. Smokers and their dependence symptoms were identified by means of the NIMH Diagnostic Interview Schedule version III revised, administered to a random sample of 1007 21–30‐year‐olds who were members of a health maintenance organization in the Detroit area. Comparing different latent structure models using LISCOMP software with bootstrap re‐sampling, followed by multiple logistic regression, vie found that a two‐factor model indicating a ‘general dependence’ and a ‘failed cessation’ dimension best accounted for the observed data. Current smoking status (persistent vs. past smoking) was associated with the two factors independently. Replication and additional research on construct, discriminant and convergent validity are needed.
Combining methods to identify new measures of women's drinking problems Part I: the ethnographic stage
Authors: AMES GENEVIEVE , SCHMIDT CATHERINE , KLEE LINNEA , SALTZ ROBERT 
Published: March 2003

AbstractIn recent years, some researchers in the alcohol survey field have raised concerns about the shortcomings in severity/frequency scales for drinking and drinking problems used for both clinical and household survey purposes, especially with regard to women. This article reports on Part I of a two‐part study that used ethnographic and survey methods to assess indicators of drinking problems among women across various US subcultures. Methodology for the ethnographic component consisted of three steps: analysis of findings in literature on indicators of women's drinking problems, and analysis of indicators addressed in the most commonly used standard instruments for alcohol assessment; semi‐structured interviews with 12 specialists in treatment and/or research who focused on alcohol problems of women; and semi‐structured interviews with 65 women from four ethnic populations who were clients in alcohol treatment centers. Analysis of these data from the ethnographic component produced a taxonomy of indicators of women' s drinking problems and fourteen novel indicators that are not included or are inadequately examined in the most commonly used alcohol assessment instruments. The novel indicators were then incorporated into a questionnaire used for a county‐wide survey of men and women that assessed indicators of drinking problems. Report of findings from the survey are presented in the second paper of this series.
Black identity and drinking in the US: a national study
Authors: HERD DENISE , GRUBE JOEL 
Published: March 2003

AbstractThe relationship between ethnic identity and drinking patterns was explored in 1947 black adults from a nation‐wide study of drinking behavior. Factor analysis revealed that a multi‐dimensional construct which included four factors‐media preferences, socio‐political awareness, endogamy and social networks‐was necessary to operationalize and measure the concept of ethnic identity. Using structural equation modeling, a model was tested which analyzed the impact of ethnic identification on religiosity and drinking norms, which in turn were predictors of drinking and heavier drinking latent variables. The results showed that ethnic identity influenced drinking behavior indirectly through its effects on drinking norms and religiosity as well as directly. Most aspects of ethnic identity decreased drinking levels. Respondents who scored higher on involvement with black social networks and black social and political awareness drank at lower levels than other respondents. These results were attributed to the prevalence of norms for abstinence and high levels of social control regarding drinking in black communities. However, high scores on using black media increased drinking rates. It was suggested that the promotion of alcohol use in black orientated media as well as the social settings attended by those who prefer black media might increase alcohol consumption.
Validity of the SCID in substance abuse patients
Authors: KRANZLER HENRY R. , KADDEN RONALD M. , BABOR THOMAS F. , TENNEN HOWARD , ROUNSAVILLE BRUCE J. 
Published: March 2003

AbstractStructured or semi‐structured interviews, including the Structured Clinical Interview far DSM‐III‐R (SCID), are used widely to maximize the reliability and validity of psychiatric diagnoses. Although the reliability of such interviews appears adequate, there has been little effort to evaluate their validity. In a sample of 100 substance abuse patients, we evaluated the concurrent, discriminant and predictive validity of SCID substance use diagnoses, as well as co‐morbid disorders that occur commonly among these patients. The validity of current and life‐time substance use diagnoses obtained by a research technician using the SCID was good; it was moderate for antisocial personality disorder and major depression and poor for anxiety disorders. Although accurate diagnosis of substance use disorders in substance abuse patients can be accomplished by a research technician, the diagnosis of co‐morbid psychiatric disorders requires either additional expertise or the use of a diagnostic instrument specially designed for that purpose.