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In 2011, the Australian National Health and Medical Research Council (NHMRC) initiated an inquiry to determine whether there is a need for expanded ethical guidance in the form of a discrete guidance document for alcohol and other drug (AOD) research. An issues paper was developed to frame the inquiry. AOD researchers, Human Research Ethics Committees and others were invited to discuss whether there are distinctive ethical issues facing researchers and Human Research Ethics Committees in the AOD setting. Based on the public submissions, the NHMRC recommended that no AOD research-specific guidance is required. The inquiry and the NHMRC decision were not widely publicized, and we feel there is a need for further discussion. In order to do so, we have analysed the public inquiry submissions and described the central themes. Few submissions in the inquiry explicitly agreed AOD research warrants a specific guidance framework. Most were concerned that the NHMRC issues paper unfairly targeted people who use drugs as complex research participants. The inquiry highlights tensions around research governance and ethics review boards dealing with illicit and stigmatised behaviours. While we agree that a specific guidance framework for AOD research is not needed and could potentially be harmful and restrictive, we are concerned that the wholesale rejection of a guidance framework has closed the door to much needed debate. There remains, we argue, a need for alternative strategies and tools to support ethical research, inform and streamline institutional ethics approval, and engage and protect participants. [ABSTRACT FROM AUTHOR]

This paper presents results from a study investigating relapse prevention options for indigenous clients of alcohol and drug intervention services. The study has 63 'stories' collected through a survey of nine substance misuse services. An adapted version of the Marlatt Relapse Prevention Model was developed to interview clients who had quit drinking but later relapsed into heavy use. The study identified situations influencing the decision to quit, obstacles and dilemmas arising during periods of abstinence, and major triggers associated with relapse into substance misuse. The paper analyses these major triggers and discusses the crucial issues of motivation to quit and maintenance of abstinence. The community environments where indigenous drinkers use alcohol strongly influence successful or unsuccessful attempts to quit. Relapse prevention should be part of a range of public health strategies for tackling substance misuse problems with Indigenous drinkers, and should be included at the minimal intervention level. [ABSTRACT FROM AUTHOR]

The transtheoretical model (TTM) is still enormously popular with practitioners, clinicians and many researchers in the addictions field. However, in a recent years a number of commentators have criticized aspects of the model and the research based on it. This paper extends a recent critique of the TTM as applied to smoking cessation to include applications of the model to cessation or reduction of alcohol or drug use. The first section discusses measures of the central construct of stages of change and notes a number of serious problems. Staging algorithms are based on arbitrary time periods and some are logically flawed. In the case of multi-dimensional questionnaires (the URICA, the SOCRATES and the RCQ), the pattern of correlations among the subscales shows that they are not measuring discrete stages of change. The one study to date that has compared the two different methods found low concordance, which is probably due to incompatible stage definitions. In the second section of the paper, the evidence base for the TTM is reviewed. The review is organized by the four research designs that have been used to test predictions from stage models: cross-sectional comparisons of people in different stages; examination of stage sequences; longitudinal prediction of stage transitions; and experimental studies of matched and mismatched interventions. It concludes that current evidence for the model as applied to substance use is meagre and inconsistent. Researchers are urged to develop better stage models. [ABSTRACT FROM AUTHOR]

The nature of drug craving and its role in the addictive process is a contentious issue in the addiction sciences. There are numerous disputes regarding the definition, assessment, manipulation and interpretation of craving, and progress toward resolving the enigmas of craving confronts numerous conceptual and methodological challenges. Greater attention to certain fundamental principles of measurement and manipulation should generate immediate and substantial improvements in efforts to understand and control alcohol craving. This paper provides suggestions for enhancing the measurement of self-reported alcohol craving and improving the manipulation of alcohol craving under controlled laboratory conditions. With regard to measurement, single-item scales commonly employed in craving research tend to be handicapped by limited reliability and validity. Multi-item craving scales are more likely to provide the accuracy required to accurately discriminate between different levels of craving across individuals or across different settings. Conceptual and practical considerations for the selection of multi-item craving instruments are discussed. With regard to the manipulation of alcohol craving in the laboratory, recent meta-analyses suggest that alcohol craving effects in such research may be relatively weaker than craving effects found in similar research with other addicts. Therefore, laboratory-based investigations into the nature of alcohol craving should utilize procedures and assessments that are particularly sensitive to the detection of alcohol craving. This paper offers methodological recommendations for enhancing the magnitude of alcohol craving effects generated in laboratory research. [ABSTRACT FROM AUTHOR]

Several abstracts of research papers presented at the Australasian Professional Society on Alcohol & other Drugs Conference 2015 are presneted including Losing Your License to drink: Insights From Rand Evaluations of 24/7 Sobriety Programs, Impact of alcohol use on suicidal behaviors: Research and Prevention and Utilizing technology to address substance use and violence in fast paced clinical settings. [ABSTRACT FROM AUTHOR]

Background and Objective The Cochrane Drugs and Alcohol Group aims to produce, update, and disseminate systematic reviews on the prevention, treatment, and rehabilitation of problematic drug and alcohol use. This paper describes what the Group has done since the 1990s to produce evidence to guide policy, practice, and research. Method We analyze the coverage of topics by our reviews, the body of studies they have included, and the evidence produced. Results By July 2013, the Group had published 67 reviews, with 376 authors from 25 different countries. These reviews included 906 studies, of 3061 studies considered for inclusion. Most (90%) included studies were randomized trials. Considering the 'Implications for practice' section of each review, 41% interventions were classified as 'do it', 15% as 'do not do', and 44% as 'do only in research'. These proportions varied according to the type of substance of abuse studied. The proportion of 'do it' interventions were 46% for alcohol, 40% for opioids, 20% for psychostimulants, 40% for polydrugs, and 62% for prevention. Conclusion Cochrane Reviews produced by the Drugs and Alcohol Group provide evidence on the effectiveness of several interventions, and identify areas of uncertainty where new research is needed. [ABSTRACT FROM AUTHOR]

Issues. To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs. Approach. Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools. Key Findings. Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up. Conclusion. Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.[Teesson M, Newton NC, Barrett EL. Australian school-based prevention programs for alcohol and other drugs: A systematic review. Drug Alcohol Rev 2012;31:731-736] [ABSTRACT FROM AUTHOR]

ABSTRACT As opportunities to use and abuse drugs have tremendously increased during the past 50 years, so has addiction research. Here, we provide a systematic review on publication trends in the addiction research field. We examined publication trends in different subject categories of journals including general and multi-disciplinary science, neuroscience, pharmacology, psychiatry and, as a final and most important category, substance abuse. In this first report, we provide a brief comprehensive overview on what has been published in terms of addiction in the general and multi-disciplinary science category versus Addiction Biology within the past decade. We reviewed the literature within three time windows 1999/2000, 2004/2005 and 2009/2010 and selected the number of publications (1) according to the country/region where the original study was conducted; (2) according to the drug classes; (3) according to animal versus human studies; (4) and in terms of methodological trends such as genetic association studies and neuro-imaging. We found a 350% increase in addiction-related publications in the general and multi-disciplinary science category within the past decade. This increase, however, was mainly due to increased publication output from the United States. Concerning drug classes, alcohol-, nicotine- and psychostimulant-related publications clearly increased between 1999 and 2010, whereas published papers related to opioids decreased over time. There were also strongly increasing trends for genetic and imaging studies in the addiction field over time. These publication trends are also reflected to a certain degree by published studies in Addiction Biology. [ABSTRACT FROM AUTHOR]

Our project first explored the patterns of disempowerment within 113 Italian families facing the problem of a heavy alcohol or drug user in the family. It then provided therapeutic interventions for the members of a further fifty-two families, and thirdly, as a part of the diffusion of the results, it provided brief training for 1,011 professionals supplying services for those suffering from alcohol and drug addiction. Research undertaken in the UK, Mexico and Australia (Copello, Templeton, & Velleman, 2006; Orford et al., 2005a; Orford, Templeton, Velleman, & Copello, 2005b; Velleman & Templeton, 2003) on the impact of substance misuse on families, and on the development of effective interventions to assist those families, supplied the models for this participatory research in Italy. This article discusses the mobilization of health professionals in developing a participatory project within a cross-cultural framework, focusing on research that involved more than 70 researchers and other professionals all over Italy. Research team discussions, peer validation of gathered data and reflexivity all had a significant role. The paper illustrates various issues, which are often not explicitly mentioned in research reports, related to recruitment, cooperation between researchers, interactions between researchers and participants, information about decision-making and the actual modalities of execution of the project. Moreover, the careful descriptions of qualitative research principles within the action research approach and a mixed methods design should enhance the research competencies of psychologists and social scientists involved in the community. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims Alcohol problem use during adolescence has been linked to a variety of adverse consequences, including cigarette and illicit drug use, delinquency, adverse effects on pubertal brain development and increased risk of morbidity and mortality. In addition, heavy alcohol-drinking adolescents are at increased risk of comorbid psychopathology, including internalizing symptomatology (especially depression and anxiety). A range of genetic and non-genetic factors have been implicated in both alcohol problem use as well as internalizing symptomatology. However, to what extent shared risk factors contribute to their comorbidity in adolescence is poorly understood. Design We conducted a systematic review on Medline, PsycINFO, Embase and Web of Science to identify epidemiological and molecular genetic studies published between November 1997 and November 2007 that examined risk factors that may be shared in common between alcohol problem use and internalizing symptomatology in adolescence. Findings Externalizing disorders, family alcohol problems and stress, as well as the serotonin transporter ( 5-HTT) S-allele, the monoamine oxidase A ( MAOA) low-activity alleles and the dopamine D2 receptor ( DDR2) Taq A1 allele have been associated most frequently with both traits. An increasing number of papers are focusing upon the role of gene–gene (epistasis) and gene–environment interactions in the development of comorbid alcohol problem use and internalizing symptomatology. Conclusions Further research in adolescents is warranted; the increasing availability of large longitudinal genetically informative studies will provide the evidence base from which effective prevention and intervention strategies for comorbid alcohol problems and internalizing symptomatology can be developed. [ABSTRACT FROM AUTHOR]

Introduction. This paper reports the results of the 1995, 1998, 2001 and 2004 Australian and US household surveys, with emphasis on changes since 2001. Design and Methods. The US survey data were recalculated to match age groups in the Australian data. Statistically significant changes are reported. Differences in prevalence of use by gender within age group were tested for significance. Results. The past-year use of 'any illicit drug', cannabis, cocaine, tranquillisers and injecting drugs decreased between 2001 and 2004 in Australia, but remained stable for all these drugs except ecstasy between 2002 and 2004 in the United States. The use of hallucinogens decreased in both countries. Alcohol and use of many illicit drugs by teenage girls in both countries increased to rates similar to or higher than boys, and teens in both countries reported binge and heavy drinking in the past month. Australians in their 20s had the highest rates of use, but in the United States, past-year use of many drugs was highest among teenagers. Discussion. More treatment services are needed, particularly for people dependent upon non-opiate drugs. The changes in acceptability of use of different drugs and their perceived availability are related to changes in prevalence rates. Even with the similarities in levels of use, there are differences in patterns of use and preferences for certain drugs in each country, and geographic proximity to drug sources is a factor. [Maxwell JC. Are we becoming more alike? Comparison of substance use in Australia and the United States as seen in the 1995, 1998, 2001, and 2004 national household surveys. Drug Alcohol Rev 2008;27:473-481] [ABSTRACT FROM AUTHOR]

Australian Indigenous imprisonment rates are higher now than they were at the time of the Royal Commission into Aboriginal Deaths in Custody. The Commission attributed Indigenous imprisonment to Indigenous cultural, economic and social disadvantage. Noel Pearson has argued that Indigenous drug and alcohol use is a more important cause of Indigenous contact with the justice system than Indigenous disadvantage. In this paper I argue that the available evidence provides strong support for Pearson's view and for the proposition that future efforts to reduce Indigenous imprisonment should place more emphasis on supply-side strategies for reducing Indigenous drug and alcohol abuse. [Weatherburn DJ. The role of drug and alcohol policy in reducing Indigenous over-representation in prison. Drug Alcohol Rev 2008;27:91 - 94] [ABSTRACT FROM AUTHOR]

Background In 1977 the World Health Organization (WHO) published a report entitled ‘Alcohol-Related Disabilities’. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. Aims This paper seeks to identify the multiple influences which shaped the evolution of this report. Methods Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Results Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. Conclusions The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports. [ABSTRACT FROM AUTHOR]

Aims Major classification systems for alcohol use disorders (DSM-IV and ICD-10) contain elements of the 1976 Edwards and Gross formulation of the Alcohol Dependence Syndrome (ADS). However, issues remain about the criteria that identify Alcohol Dependence (AD) as distinct from Alcohol Abuse (AA) in DSM-IV and Harmful Use in ICD-10. These issues, in part, have their roots in changing historical perceptions of alcohol use and its problems. We discuss current diagnostic criteria for AA and AD, collectively called Alcohol Use Disorders (AUDs), in the context of their historical evolution; research progress in understanding alcohol problems, including alcohol dependence; new findings on the severity of AUDs as classified by DSM-IV; and the role of alcohol consumption patterns in future classifications of AUDs. Methods This paper is based largely on the 2006 H. David Archibald Lecture. Parts of the original lecture have been modified to reflect more recent findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) of the US National Institute on Alcohol Abuse and Alcoholism (NIAAA). Results The original Edwards and Gross ADS construct is supported by advances in biological and behavioral science over the past 30 years. New findings indicate that DSM-IV AA and AD are not diagnostically distinct entities, but represent a continuum of severity of AUDs. The ADS criteria may best represent one quantifiable dimension of alcohol use problems and this scale can be related to that of the frequency of harmful patterns of drinking. Conclusion The Edwards and Gross ADS criteria can be used as the basis for beginning the development of scalable multi-dimensional criteria for diagnosing AUDs in new initiatives to revise DSM-IV and ICD-10. [ABSTRACT FROM AUTHOR]

The high prevalence of co-occurring mental health and substance use disorders in young people is well established. Despite this, there are low rates of detection of co-occurring disorders across alcohol and other drug (AOD) services within Australia. This paper describes the development, implementation and evaluation of a mental health screening tool and training programme within the youth AOD sector. Thirty youth AOD workers received training in mental health screening, and the screening tool was subsequently piloted on 84 young people accessing two youth AOD services. Training was evaluated using measures of the trainee's mental health knowledge, attitudes, skills and confidence in mental health screening at baseline and 12-month follow-up. Feedback from young people supported the feasibility, acceptability and relevance of the screening tool. Evaluation of the associated training programme indicated improvements in AOD workers' mental health knowledge, skills and confidence in mental health screening. These findings provide preliminary evidence of the feasibility and acceptability of the mental health screening tool to young people and the effectiveness of the training package within the youth AOD sector. [Hides L, Lubman DI, Elkins K, Catania LS, Rogers N. Feasibility and acceptability of a mental health screening tool and training programme in the youth alcohol and other drug (AOD) sector. Drug Alcohol Rev 2007;26:509 - 515] [ABSTRACT FROM AUTHOR]

There are limited treatment options available for young drug users with comorbid mental health problems who present to alcohol and other drug (AOD) services within Australia. While there is some evidence for the use of cognitive-behaviour therapy (CBT) in the treatment of co-occurring disorders, CBT is rarely used to address comorbidity in the AOD sector. This paper describes the development, implementation and evaluation of a brief cognitive-behavioural skills (BCBS) training programme for addressing comorbidity within two youth AOD services in Australia. Ten youth AOD workers completed a 2-day training programme in the BCBS. Training was evaluated using measures of trainees' cognitive-behavioural knowledge, attitudes towards mental health interventions and level of skills and confidence in each of the BCBS pre- and 6 months post-training. The BCBS training had a positive impact on the knowledge, skills and confidence of trainees and was perceived to be highly relevant and appropriate. These findings provide preliminary support for the feasibility and effectiveness of the BCBS training programme for workers within the youth AOD sector. [Hides L, Elkins K, Catania LS, Mathias S, Kay-Lambkin F, Lubman DI. Feasibility and outcomes of an innovative cognitive-behavioural skill training programme for co-occurring disorders in the youth alcohol and other drug (AOD) sector. Drug Alcohol Rev 2007;26:517 - 523] [ABSTRACT FROM AUTHOR]

There is a growing interest in Clinical Supervision (CS) as a central workforce development (WFD) strategy. This paper provides a definition of and rationale for CS, characterises its various forms, identifies selection and training issues, and advises on policy and implementation issues central to redressing shortcomings in supervision practice within the alcohol and other drugs (AOD) field. Relevant selective literature is reviewed. Key conceptual issues were identified, and strategies developed to address implementation barriers and facilitate relevant policy. There is a common conceptual confusion between administrative supervision and CS. Clarification of the role, function and implementation of CS is required. Priority issues for the AOD field include: enhancing belief in CS; ensuring adequate resource allocation; developing evaluation protocols; and addressing specific arrangements under which supervision should occur. CS has been underutilised to date but holds considerable potential as a WFD strategy. It is fundamental to workers' professional development, can contribute to worker satisfaction and retention, and may improve client outcomes. Critical next steps are to establish the generalisability to the AOD field of the benefits observed from CS in other disciplines, and evaluate longer-term gains of CS programs. [Roche AM, Todd CL, O'Connor J. Clinical supervision in the alcohol and other drugs field: an imperative or an option? Drug Alcohol Rev 2007;26:241 - 249] [ABSTRACT FROM AUTHOR]

Sardinian alcohol-preferring (sP) and -non-preferring (sNP) rats are one of the pairs of rat lines selectively bred for high and low alcohol preference and consumption, respectively, under the homecage, continuous two-bottle choice regimen. sP rats meet most of the fundamental criteria for an animal model of alcoholism, in that they voluntarily consume sufficient amounts of alcohol to achieve significant blood alcohol levels and produce psychopharmacological effects, including anxiolysis and motor stimulation. sP rats are also willing to ‘work’ (such as lever-pressing) for alcohol. Chronic alcohol drinking in sP rats results in the development of tolerance to a given effect of alcohol (specifically, motor incoordination) and relapse-like drinking (the alcohol deprivation effect). Conversely, sNP rats avoid alcohol virtually completely; their avoidance for alcohol being resistant even to an environmental manipulation such as long-term exposure to alcohol plus sucrose. sP and sNP rats have been characterized for different phenotypes, possibly associated to their different alcohol preference and consumption. In comparison with sNP rats, alcohol-naive sP rats displayed (1) more anxiety-related behaviors; (2) higher initial sensitivity to the locomotor stimulating and sedative/hypnotic effects of alcohol; and (3) lower sensitivity to the aversive effects of alcohol. The present paper reviews the data collected to date on alcohol drinking behavior and other alcohol-related behaviors in sP and sNP rats. The behavioral profile of sP rats is also compared with that of other lines of selectively bred alcohol-preferring rats and the heterogeneity resulting from this comparison is discussed in terms of different animal models for the different forms of alcoholism. [ABSTRACT FROM AUTHOR]

The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented. [ABSTRACT FROM AUTHOR]

To assess the reliability of drug use reports by young respondents, this study examined the extent of recanting previous drug use reports within an ongoing longitudinal survey of adolescent drug use. Here, recanting was defined as a positive report of life-time drug use that was subsequently denied 1 year later. The covariates of recanting were also studied. An ongoing longitudinal survey of young adolescents (Belfast Youth Development Study) in Northern Ireland. Pencil and paper questionnaires were administered to pupils within participating schools. Measures analysed included (a) recanting rates across 13 substances, (b) educational characteristics, (c) offending behaviour and (d) socio-economic status. High levels of drug use recanting were identified, ranging from 7% of past alcohol use to 87% of past magic mushroom use. Recanting increased with the social stigma of the substance used. Denying past alcohol use was associated with being male, attending a catholic school, having positive attitudes towards school, having negative education expectations and not reporting any offending behaviour. Recanting alcohol intoxication was associated with being male and not reporting serious offending behaviour. Cannabis recanting was associated with having negative education expectations, receiving drugs education and not reporting serious offending behaviour.The high levels of recanting uncovered cast doubts on the reliability of drug use reports from young adolescents. Failure to address this response error may lead to biased prevalence estimates, particularly within school surveys and drug education evaluation trials. [ABSTRACT FROM AUTHOR]

The aim of this study was to provide an overview of the first year of the NSW Minimum Dataset for Alcohol and Other Drug Treatment Services data collection, including describing the patterns and correlates of people having received treatment in New South Wales. All closed treatment episodes for the 2000 - 2001 financial year were included for descriptive, univariate and multivariate analyses. There were 33 459 closed episodes of care in New South Wales in the 2000/2001 financial year. The majority of clients (69%) were male and the mean age was almost 34 years. The majority of treatment is sought for problems related to alcohol (37%) and heroin (33%) use. More than a third (40%) of clients were new to drug and alcohol treatment. Half the clients had a history of injecting drug use with 6.3% of those with heroin as their principal drug of concern, never having injected. The most common main service provided was in-patient withdrawal (26%). Multivariate logistic regression revealed that being older, not homeless, non-indigenous and having heroin as the principal drug of concern predicted receiving out-patient withdrawal management. Analyses of length of stay in residential treatments and number of service contacts in non-residential treatments are reported. The NSW MDS AODTS is a critical information source for policy development, service planning and surveillance. The results of this paper illustrate the utility of the data collection for identifying emerging issues in the patterns of drug use and service delivery for clients with alcohol and other drug problems. [Copeland J, Indig D. Patterns and correlates of treatment: findings of the 2000 - 2001 NSW minimum dataset of clients of alcohol and other drug treatment services. Drug Alcohol Rev 2004;23:185 - 194] [ABSTRACT FROM AUTHOR]

This paper presents an outline of the Japanese Society of Alcohol-Related Problems. The precursor of the Society was the Japan Alcoholism Treatment Research Group, inaugurated in 1979, by merging two local research groups in the Tokyo and Osaka areas, both of which were exclusive gatherings of psychiatrists associated with alcoholism clinics. The Research Group developed into the Society in 1992, as the number of participants including those from other medical professions increased yearly, and the subjects of the group widened to include all addictive behaviours. In reflecting the process of establishment, it is unique in many aspects as a scientific society. The Society is not a science-orientated body for presentation of new research findings. The main programme of the annual meeting is therefore a set of symposia in which members participate and discuss clinical and/or social problems arising from dependency on alcohol or drugs. Perhaps because of its content, the annual meeting is attended each year by the largest number of participants among all the societies in Japan concerned with alcohol and drugs. For the next several years, the Society's activities will be directed at (1) establishment of guidelines for early identification of and intervention in alcohol-related problems; (2) expansion of its membership to include those in related fields of medicine and non-medical professions; (3) improvement of the system of journal publication; and (4) creation of a system for timely adequate response to social problems associated with drugs and alcohol. [ABSTRACT FROM AUTHOR]

In this study, we sought to evaluate a modification of the Michigan Alcohol Screening Test designed to include problems associated with other drug abuse/dependence besides alcohol. Scores of the lifetime Michigan Assessment-Screening Test/Alcohol-Drug (MAST/AD) were compared to other lifetime measures of substance abuse and dependence and to psychiatric scales reflecting current or recent symptoms. Two university medical centers with alcohol-drug programs located within departments of psychiatry hosted 520 patients with alcohol-drug-related diagnoses. Patients completed their own MAST/AD using a paper-and-pencil format. Based on interviews with the patient, a research associate rated the patients' substance-related problems on the Minnesota Substance Abuse Problem Scale (M-SAPS) and obtained information on lifetime treatment for substance abuse. An addictions psychiatrist determined abuse or dependence and made a current diagnosis of alcohol abuse/dependence only, drug abuse/dependence only, and alcohol plus drug abuse/dependence. The MAST/AD was highly correlated with the M-SAPS and several other measures of substance abuse morbidity. Patients with alcohol-only and drug-only diagnoses did not differ from one another on the MAST/AD, although both groups had lower scores than those with alcohol plus drug diagnoses. Current psychosocial morbidity as assessed by the patient and the psychiatrist was associated with the MAST/AD, although less strongly than with lifetime substance abuse measures. The lifetime MAST/AD demonstrates reliability as a severity measure for alcohol and/or drug abuse. With minor modification, this standard measure can be expanded from alcohol diagnoses to all substance diagnoses. This study in a clinical population did not demonstrate its utility as a screening instrument; additional work is needed to reveal its utility for this purpose. [ABSTRACT FROM AUTHOR]

In this paper it is argued that the sheer extent of the co-occurrence of mental health and drug dependency disorders means inevitably that alcohol and other drug (AOD) staff encounter such problems. However, it is contended that the AOD work-force has a number of characteristics that often act as impediments to people with co-occurring disorders receiving, in that sector, appropriate, integrated, 'one-stop-shop' care. Nevertheless, because of the configuration of mental health services in Australia, as essentially acute services for people with severe mental illnesses, there has been, and will continue to be, an overspill of people with mental health disorders and drug problems disorders into the AOD sector. It is there absolutely necessary that initiatives are put into place that support and enable the AOD sector to respond more effectively to people with co-occurring disorders. [ABSTRACT FROM AUTHOR]

General practitioners (GPs) and increasingly other medical practitioners are well placed to address alcohol and other drug (AOD) problems. Their involvement in this area of care, however, is assessed to be less than optimal. There is, however, a growing body of evidence for the potential efficacy of medical practitioner intervention at the primary care, emergency department and in-patient level. There is also considerably expanded scope to operate from an evidence-based perspective. However, key questions arise regarding what constitutes best practice in the translation of the growing AOD knowledge base into clinical practice behaviours. This paper explores possible contributory factors to the low level of engagement with AOD issues by GPs and examines a wide range of individual, structural and systemic issues that may be amenable to change. Strategies for the dissemination of research findings, changing professional practice behaviour and introducing sustainable structural reforms are also addressed. [ABSTRACT FROM AUTHOR]

Founded in 1969, SOCIDROGALCOHOL is a reference point for professionals interested in drug dependencies, both for Spaniards and for professionals belonging to Spanish-speaking areas. In its 32 years of existence SOCIDROGALCOHOL has spread to all the regions of Spain and most of the Latin-American countries. In the past 5 years SOCIDROGALCOHOL has undergone notable growth, increasing the number of members (from 460 to 816), as well as the number of scientific activities carried out. The National Conferences represent an annual meeting point for the members, where multiple scientific sessions take place, as well as the ordinary general assembly. They are usually held in the spring and last 3 days, with an attendance of around 400 professionals. Within the field of ongoing training, SOCIDROGALCOHOL also carries out other activities: the Autumn School, the Latin-American Virtual Congress of Drug Dependence, distance learning courses, etc. Special mention should be made to the official journal of the Society, Adicciones, founded in 1989. Adicciones is published quarterly in Spanish and its articles are subjected to peer review; 2000 copies of each issue are published. The abstracts can be accessed free on the website of the Society, www.SOCIDROGALCOHOL.org. In this paper the most relevant historical aspects of SOCIDROGALCOHOL will be summarized, along with its current activities and future perspectives. [ABSTRACT FROM AUTHOR]

Quantitative trait locus (QTL) mapping has allowed dramatic progress toward the detection and chromosome mapping of minor and major gene loci involved in murine responses to alcohol and other drugs of abuse. Here we focus on the identification of QTLs for one particular trait relevant to addiction, drug withdrawal following acute or chronic drug administration. To date, five significant QTLs (p < 5 × 10[sup -5]) and six suggestive QTLs (p < 0.001) have been mapped to specific murine chromosomes for alcohol and pentobarbital withdrawal, indicating the presence of a relevant gene or genes at each location. Overlapping QTLs for alcohol withdrawal and pentobarbital withdrawal are identified on murine chromosomes 1, 4, and 11, and may detect the influence of common genes. For many QTLs, candidate genes with relevant neurobiological function lie within the mapped region. Notably, several QTLs for alcohol and pentobarbital withdrawal are in proximity to genes that directly or indirectly affect GABA[sub A] receptor-mediated transmission, which has been implicated in some of the actions of alcohol and other drugs. These include a cluster of GABA[sub A] receptor genes and genes encoding the enzymes steroid 5α-reductase-1 (involved in biosynthesis of the neuroactive steroid allopregnanolone) and glutamic acid decarboxylase-1 (involved in GABA biosynthesis). This paper will discuss data that examines the involvement of GABAergic genes in withdrawal and other drug responses, including genetic variation in gene sequence, expression and function. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on the importance of genetic influences in the development of alcohol abuse and dependence (alcoholism). The alcohol use disorders are fairly typical of most complex genetic conditions in that multiple genetic influences combine together to explain approximately 40% to 60% of the risk. One useful approach for identifying specific genes related to alcoholism involves identifying a population in which known genetic factors are controlled and using genome scan and/or case-control, association approaches to search for specific genes. Several characteristics, or endophenotypes, have been identified as both genetically influenced and contributing toward the risk for alcoholism, including alcohol-metabolizing enzymes, the low level of response to alcohol, and electrophysiological measures. The potential importance of each of these characteristics is reviewed, and data relating to the search for specific genetic material for each endophenotype are presented. These findings are placed in the perspective of the impact that they are likely to have on both prevention and treatment efforts in the alcohol field. [ABSTRACT FROM AUTHOR]

This paper reports the social, demographic and drug abuse backgrounds of cocaine abusers seen at an alcohol and drug abuse assessment centre in Kitchener, Ontario. It compares cocaine abusers to cannabis users and alcoholics of the same age at the same centre. Cocaine and cannabis abusers abusers are mainly young, single males while alcohol abusers are much older. The cocaine and cannabis abusers are both heavy drinkers but the cocaine group contained more high-risk drinkers, more drug injectors and had a higher alcohol consumption. Cocaine abusers are young poly-drug users for whom drinking is also a major problem. Treatment plans should take these problems into account. [ABSTRACT FROM AUTHOR]

Presents comments on Kozlowski and Wilkinson's paper, titled 'Use and Misuse of the Concept of Craving by Alcohol, Tobacco and Drug Researchers,' published in the 'British Journal of Addiction'.

This paper reports the results of a community survey on the use of professional help, reading materials, and group programs for three common problems in living: coping with stress and anxiety, dealing with problems in child- rearing, and coping with problems with alcohol or drugs. Respondents were 581 residents of a city in the Canadian Midwest. Reading material was the most commonly used source of help for child-rearing and stress and anxiety problems, followed by professional help and group programs. The three sources of help were used with approximately equal frequency for alcohol and drug problems. The results suggest that the self-help reading materials and group programs have a high degree of public acceptance and that the optimal utilization of these services should be studied in more depth. [ABSTRACT FROM AUTHOR]

This paper presents the results of an audit of people with eating disorders treated by adult mental health services. Information was obtained about the severity and nature of the eating disorder, treatment received and outcome of treatment for 128 clients who were assessed or treated for an eating disorder by eight adult mental health teams or mental health dietitians between April and September 1994 (inclusive). These teams serve a population of 541986. Referral rates corresponded with those reported by previous studies. Psychiatric comorbidity was commonly reported, particularly depression, however low levels of purging behaviours and alcohol and drug abuse suggest that these behaviours were underreported by clients. The role of generic mental health services in the treatment of people with eating disorders is discussed. [ABSTRACT FROM AUTHOR]

This paper describes an inpatient treatment programme specifically designed for normal- weight bulimia nervosa patients who have a co-morbidity marked by alcohol and drug abuse, ’cutting’, repeated overdosing or stealing, or sexual disinhibition (multi- impulsive bulimia). The programme uses a rigorous ward regime and simple behavioural counselling, under the direction of a nurse-counsellor to bring control to the many addictive and self-damaging behaviours. The underlying emotional and personality issues are addressed by focal-interpretive (psychodynamic) and cognitive techniques in both group and individual sessions. Major use is made of creative therapies and reality-orientated therapies. General psychodynamic groups are mixed with focal groups using cognitive techniques. Patients respond well and the improvement in symptomatology is maintained during follow-up. Those patients who describe poor peer relationships in adolescence and who find engagement in psychotherapy difficult, do poorly. [ABSTRACT FROM AUTHOR]

Presents information on issues pertaining to drug and alcohol addiction. Recommendations from the Working Group of the British Medical Association on the misuse of alcohol and other drugs by doctors; Details on human immunodeficiency virus and injecting drug use in the Netherlands; Reference to a paper launched in the United Kingdom called `Combating Drink-Driving--Next Steps.'

Introduction: Over the past two decades, alcohol consumption of Icelandic adolescents has decreased dramatically. The aim of this study was to quantify the extent of this reduction and compare it with the trend in cannabis use over a 20 year period and to identify possible explanations.Methods: We used data from the Icelandic participants to the European School Survey Project on Alcohol and Other Drugs study (collected via paper-and-pencil questionnaires in classrooms). The sample included all students in the 10th grade (54-89% response rate).Results: The percentage of participants who had never used alcohol during their lifetime rose from 20.8% in 1995 to 65.5% in 2015. Similarly, there was a decline in the proportion of students who had consumed alcohol 40 times or more, from 13.7% to 2.8%. During the same period, the number of students who had never used cannabis rose from 90.2% to 92.0%. In contrast, we found a small, but statistically significant, increase in the prevalence of those who had used cannabis 40 times or more, from 0.7% in 1995 to 2.3% in 2015. Parental monitoring increased markedly between 1995 and 2015, but availability of alcohol decreased. Perceived access to cannabis and youth attitudes towards substance use remained unchanged.Discussion: Although Iceland has enjoyed success in lowering alcohol use among adolescents over the past decades, and somewhat fewer claim to have ever tried cannabis, there has been a threefold increase among heavy users of cannabis. Increased parental monitoring and decreased availability of alcohol explain some of the changes seen. [ABSTRACT FROM AUTHOR]

The article presents the author's views about a research done by researcher D.A. Dawson and his colleagues on alcoholism. The author says the good news is that if he had to point a student to a single large epidemiological study that was representative of the course of alcoholism in the United States, he could not point to a paper superior to that of Dawson's. The bad news is that Dawson and his colleagues are correct to warn us that their "cross-sectional data do not necessarily reflect the course of recovery across time for any individual." This acknowledgement makes many of their findings suspect. What comes out of computers, even if you add decimals, is only as good as what goes in. At the heart of the difficulties raised by their paper is a paradox. If you wish to predict an election, a large representative sample of the population, interviewed by a trained staff, is a necessity. If you wish to study secrets of which the owner does not wish to be aware, for example incest or not being in control of one's drinking over the past year, a small intensively studied, but often unrepresentative, sample whom the investigator has actually met, is a necessity. In some facets of alcohol abuse the first strategy is preferable, but if one wishes to study return to controlled drinking one needs to include other informants and to conduct observations over time until the "secret" emerges or can be ruled out on a case-by-case basis.