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Aims This study investigated the value of citation counts as an index of quality in the field of addiction and examined factors that contribute to papers being cited more or less frequently. Design The number of times papers published by the journal Addiction in 1995–98 that had been cited up to May 2000 were counted using the Science and the Social Science Citation Indexes. Articles in nine of the monthly issues from 1997 were rated by two independent expert raters for quality. Factors related to citation counts were also examined including: country of origin of the paper, substance type, solicited versus unsolicited papers and methodology used. Findings A total of 417 unsolicited research reports were included in the citation analysis, of which 79 were also subjected to quality ratings. The experts showed a moderate level of agreement in their ratings (intraclass correlation = 0.39, p < 0.001). However, there was no correlation between number of citations and expert ratings of article quality (R < 0.1). Papers from developing countries received significantly fewer citations than papers from other countries but substance type (e.g. nicotine, opiate, alcohol) and methodology (e.g. survey, treatment trial) were not related to number of citations. Conclusions This study involved just one journal but raised an important issue: the number of citations received by papers on addiction appears to reflect the geographical region of study rather than what experts would consider as 'quality'. If these findings are found to generalize they call into question the use of citation‐related indices as measures of quality in this field and perhaps in others as well. To our knowledge our methodology has not been used before and could be adapted to study the value of citations more widely. [ABSTRACT FROM AUTHOR]

Background/Aims: The COVID‐19 pandemic has significantly impacted face‐to‐face research. This has propelled ideas and plans for more remote styles of research and provided new perspectives on conducting research. This paper aimed to identify challenges specific to conducting remote forms of experimental addiction research, although some of these challenges apply to all types of addiction research. Argument The impact of the COVID‐19 pandemic has led to important lessons for future addiction research. Although remote research has been conducted for decades, little experimental research has been performed remotely. To do so require a new perspective on what research questions we can ask and could also enable preferential capture of those who may be more reluctant to engage in research based in clinical settings. There may, however, be crucial factors that will compromise this process. We illustrate our argument with three real‐world, ongoing case studies centred on gambling behaviour, opioid overdose, and cannabinoid psychopharmacology. We highlight the obstacles to overcome to enable more remote methods of study. Conclusions: The future of experimental research and, more generally, addiction research, will be shaped by the pandemic and may result in advantages, such as reaching different populations and conducting addiction research in more naturalistic settings. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) are considered the gold standard for causal inference. With a sufficient sample size, randomization removes confounding up to the time of randomization and allows the treatment effect to be isolated. However, RCTs may have limited generalizability and transportability and are often not feasible in addiction research due to ethical or logistical constraints. The importance of observational studies from real‐world settings has been increasingly recognized in research on health. This paper provides an overview of modern approaches to designing observational studies that enable causal inference. It illustrates three key techniques, Directed Acyclic Graphs (DAGs), modified Disjunctive Cause Criterion and Target Trial Emulation, and discusses the strengths and limitations of their applications. [ABSTRACT FROM AUTHOR]

In this article the author discusses the different approaches in conducting a research regarding alcohol beverage industry. He believes that researchers should see to it that reimbursement for a study equals indirect and direct costs. He explains that if the research is funded by the industry, the researcher must be ready always to demonstrate with guide questions such as why do many principles apply to one industry.

Aims Using terms of justification such as ‘corporate social responsibility’ and ‘partnerships with the public health community’, the alcoholic beverage industry (mainly large producers, trade associations and ‘social aspects’ organizations) funds a variety of scientific activities that involve or overlap with the work of independent scientists. The aim of this paper is to evaluate the ethical, professional and scientific challenges that have emerged from industry involvement in alcohol science. Method Source material came from an extensive review of organizational websites, newspaper articles, journal papers, letters to the editor, editorials, books, book chapters and unpublished documents. Results Industry involvement in alcohol science was identified in seven areas: (i) sponsorship of research funding organizations; (ii) direct financing of university-based scientists and centers; (iii) studies conducted through contract research organizations; (iv) research conducted by trade organizations and social aspects/public relations organizations; (v) efforts to influence public perceptions of research, research findings and alcohol policies; (vi) publication of scientific documents and support of scientific journals; and (vii) sponsorship of scientific conferences and presentations at conferences. Conclusion While industry involvement in research activities is increasing, it constitutes currently a rather small direct investment in scientific research, one that is unlikely to contribute to alcohol science, lead to scientific breakthroughs or reduce the burden of alcohol-related illness. At best, the scientific activities funded by the alcoholic beverage industry provide financial support and small consulting fees for basic and behavioral scientists engaged in alcohol research; at worst, the industry's scientific activities confuse public discussion of health issues and policy options, raise questions about the objectivity of industry-supported alcohol scientists and provide industry with a convenient way to demonstrate ‘corporate responsibility’ in its attempts to avoid taxation and regulation. [ABSTRACT FROM AUTHOR]

Background This paper reviews the early work of Griffith Edwards and his colleagues on alcohol in the criminal justice system and outlines the direction of research in this area in the Addiction Research Unit in the 1960s and 1970s. The paper outlines the link between that work and work undertaken in the more recent past in this area. Methods The key papers of the authors are reviewed and the impact of this work on policy and practice is discussed. Conclusions There is a rich seam of work on deprived and incarcerated populations that has been under way at the Addiction Research Unit and subsequently the National Addiction Centre, Institute of Psychiatry, London. Griffith Edwards initiated this work that explores the risks and problems experienced by people moving between the health and criminal justice system, and demonstrated the need for better care and continuity across this system [ABSTRACT FROM AUTHOR]

ABSTRACT The Alcohol and Drug Abuse Research Unit (ADARU) was established at the South African Medical Research Council (MRC) at the beginning of 2001, although its origins lie in the activities of the Centre for Epidemiological Research in Southern Africa and other MRC entities. Initial challenges included attracting external funding, recruiting new staff, developing the skills of junior staff, publishing in international journals and building national and international collaborative networks. ADARU currently comprises a core staff of 33 members who work on 22 projects spanning substance use epidemiology and associated consequences, intervention studies with at-risk populations and services research. A large component of this portfolio focuses on the link between alcohol and other drug use and human immunodeficiency virus (HIV) risk behaviour, with funding from the US Centers for Disease Control and Prevention. Junior staff members are encouraged to develop independent research interests and pursue PhD studies. Research outputs, such as the 20 papers that were published in 2010 and the 35 conference presentations from that year, form an important part of the unit's research translation activities. We engage actively with policy processes at the local, provincial, national and international levels, and have given particular attention to alcohol policy in recent years. The paper includes an analysis of major challenges currently facing the unit and how we are attempting to address them. It ends with some thoughts on what the unit intends doing to enhance the quality of its research, the capacity of its staff and its international standing. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims The aim of this paper is to provide a critical overview of the development and current status of gambling in Australia. Methods The paper examines the history and current status of gambling in Australia with a particular focus on the prevalence of problem gambling in the community and developments in policy and treatment services. Results The paper highlights the contradictory role of State governments as both providers of treatment services as well as agents for the liberalization for gambling. It also shows how the notion of 'addiction' is conceptualized in Australian research and treatment services, including the preference for harm-based and public health approaches. Such perspectives view problem gambling as having multiple pathways and determinants that extend beyond the pathology of individuals. Conclusions Gambling in Australia provides a curious paradox. Highly liberalized State government policies that allow the proliferation of high intensity gambling coexist with extensive policy, regulation and research designed to address the negative impact of gambling on the Australian community. [ABSTRACT FROM AUTHOR]

Aims This paper has as its focus a study tour made by the author in 1961. Diary notes are used to capture a historical moment in the evolution of alcohol studies. The paper will argue for the continuing value today of such experiences in support of career development and the building of ‘the field’. Data sources Diary notes and personal recollection. Findings The United States was at the time more active than the United Kingdom in its response to alcohol problems. There was, however, a disjunction between the elite American research world and the world of action, which was not informed greatly by research. For the most part, treatment services and prevention strategies seemed driven by opinion rather than by evidence. But at the level of serious scientific endeavour there was opportunity to meet influential figures including Seldon Bacon, Morris Chafetz, Milton Gross, Ebbe Curtis Hoff, Harris Isbell, E. M. Jellinek, Mark Keller, Benjamin Kissen, Robert Strauss, Wolf Schmidt and Abraham Wikler, who generously made their time available. Conclusions These diary notes provide a snapshot of a field of endeavour at a critical stage of transition from uninformed assumptions towards establishment of a research base which can inform public action. The visit was of tangible value to the visitor in several different identified ways. Such an experience is inevitably time-bound and personal, but there are general conclusions to be drawn as to the benefits which will be derived from early travel opportunities in a field such as alcohol studies, which is all too easily culture-bound in its horizons and assumptions. Alcohol science needs to be more reflective on its history and the mechanisms that help to make it happen. [ABSTRACT FROM AUTHOR]

The article discusses a research that utilizes a case-series method to synthesize the current alcohol issues across 18 countries. The study focuses on how different nation states respond to alcohol-related problems. It presents various insights concerning the role of different historical, social and cultural factors on alcohol consumption and alcohol-related problems. Moreover, the research focuses solely on the immediate causes and consequences of alcohol consumption, particularly in genetic and biomedical field.

This paper describes the profile of the Israel Society for the Prevention of Alcoholism (ISPA), which is a nation-wide, public, non-profit association. It portrays various aspects of ISPA treatment and rehabilitation facilities-the residential treatment center, the rehabilitative hostel and the 'warm home' for homeless alcoholics. It depicts ISPA prevention activities, prevention materials and its usage of the media, and deals with ISPA involvement in policy issues. The paper also addresses the research reality of ISPA and its scientific journal, and refers to the society's structure and its future. [ABSTRACT FROM AUTHOR]

Aims This paper describes the current situation regarding gambling in Singapore in relation to its historical and cultural context. Methods A computerized search was performed of two databases (PubMed and PsychINFO) and the reference lists from the papers searched manually to identify relevant studies. The findings were synthesized and their implications assessed. Results In addition to state lotteries and much informal gambling, Singapore has two large resort casinos, which rank third after Las Vegas and Macau in terms of gross revenues. The major ethnic subgroups in Singapore have different cultural connections to gambling, including the active involvement of the Chinese and religious prohibition among the Malay. A range of secondary prevention and treatment services has been developed to attempt to minimize potential negative impacts. Overall, the prevalence of pathological gambling and problem gambling has decreased in recent years: an estimated 0.2% are classified as probable pathological gamblers compared with 1.4% in 2011, 1.2% in 2008 and 2.1% in 2005. Conclusions Singapore has experienced a reduction in problem gambling prevalence which may reflect the influence of multiple initiatives. [ABSTRACT FROM AUTHOR]

This paper puts the role of research into perspective in the policy-making context. It points out that there are differing 'policy' goals of government and the use of research might be vital for one element, e.g. health policy, but of lesser significance in, say, international policy. The paper then goes on to describe case studies of where research has had a major impact on government decision making in Australia in the past 2 years, notably in the area of proposed changes to the marketing and sale of alcoholic beverages. [ABSTRACT FROM AUTHOR]

In this article the authors provide their insights on the paper of D. Sellman on the facts concerning addiction. They explore the two points raised by Sellman at his paper such as the explanatory model rivalries and the critical role of therapists. Furthermore, they state the absence of a well-documented process of recovery at Sellman's paper.

Background Alcoholics Anonymous (AA) is a world-wide recovery mutual-help organization that continues to arouse controversy. In large part, concerns persist because of AA's ostensibly quasi-religious/spiritual orientation and emphasis. In 1990 the United States' Institute of Medicine called for more studies on AA's effectiveness and its mechanisms of behavior change (MOBC) stimulating a flurry of federally funded research. This paper reviews the religious/spiritual origins of AA and its program and contrasts its theory with findings from this latest research. Method Literature review, summary and synthesis of studies examining AA's MOBC. Results While AA's original main text ('the Big Book', 1939) purports that recovery is achieved through quasi-religious/spiritual means ('spiritual awakening'), findings from studies on MOBC suggest this may be true only for a minority of participants with high addiction severity. AA's beneficial effects seem to be carried predominantly by social, cognitive and affective mechanisms. These mechanisms are more aligned with the experiences reported by AA's own larger and more diverse membership as detailed in its later social, cognitive and behaviorally oriented publications (e.g. Living Sober, 1975) written when AA membership numbered more than a million men and women. Conclusions Alcoholics Anonymous appears to be an effective clinical and public health ally that aids addiction recovery through its ability to mobilize therapeutic mechanisms similar to those mobilized in formal treatment, but is able to do this for free over the long term in the communities in which people live. [ABSTRACT FROM AUTHOR]

An introduction is presented noting that the special supplement issue focuses on the contributions of British addictions researcher Griffith Edwards, with the articles in the issue adapted from papers given at a January 2013 conference at the Institute of Psychiatry, Kings College, London, England.

Aims Regression to the mean (RTM) refers to the tendency for a group of cases that differ from the population mean to move (regress) towards the mean, on average, when re-assessed, if scores at the two points are less than perfectly correlated. This paper considers factors that affect the magnitude of RTM and how RTM may impact findings from primary studies and reviews of substance use disorder (SUD) treatment. Design and methods The paper is guided largely by A Primer on Regression Artifacts by Campbell and Kenny. It reviews potential RTM effects in three areas of SUD treatment research. One is the extent to which within-group improvement in comparative treatment trials, including ‘placebo effects’, is a function of RTM. The second is the vulnerability of treatment evaluations employing non-equivalent control group designs to RTM and biased estimates of treatment effects when matching, or statistical equating is used to adjust for pre-existing group differences. The final issue is the impact of RTM in syntheses of research findings on SUD treatments. In particular, the tendency for later studies of a particular intervention to have smaller treatment effect sizes relative to earlier studies is considered as an RTM phenomenon. Findings RTM is a pervasive, but often unrecognized phenomenon that can bias findings in SUD treatment studies and in systematic reviews of that research. Conclusion SUD treatment researchers should be aware of RTM, take any available steps to reduce it, and try to diagnose whether it is still affecting research findings. [ABSTRACT FROM AUTHOR]

Background and aims Screening, Brief Intervention and Referral to Treatment (SBIRT) programs have been implemented widely in medical settings, with little attention focused on how well providers adhere to evidence-based service delivery in everyday practice. The purposes of this paper were to: (1) introduce a flexible, relatively simple methodology, the SBIRT Checklist for Observation in Real-time (SCORe), to assess adherence to evidence-based practice and provide preliminary evidence supporting its criterion validity; and (2) illustrate the feasibility and potential utility of the SCORe by analyzing observations of providers within four large-scale SBIRT programs in the United States. Methods Eighteen potential adherence judges were trained to recognize SBIRT service elements presented in realistic taped portrayals constructed to serve as criterion coding standards. Across the four SBIRT programs, 76 providers were observed performing 388 services in three types of medical settings; emergency departments ( n = 10), hospital out-patient/ambulatory clinics ( n = 16) and hospital in-patient settings ( n = 5). Results Across two exercises, trainees identified 81% of screening and 75% of brief intervention (BI) elements correctly; for the six FRAMES components (Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy), agreement ranged from 69% to 91%. Across programs, 56% of screening, 54% of brief intervention (BI) (81% of FRAMES) and 53% of referral to treatment elements were observed. Programs differed significantly in adherence [screening, P = 0.024; BI, P < 0.001; FRAMES, P < 0.001; referral to treatment (RT), P < 0.001]; medical setting differences were minimal. Conclusions The Screening, Brief Intervention and Referral to Treatment Checklist for Observation in Real-time provides a flexible method for assessing adherence to evidence-based Screening, Brief Intervention and Referral to Treatment service protocols. Preliminary evidence supports the criterion validity, feasibility and potential utility of the Screening, Brief Intervention and Referral to Treatment Checklist for Observation in Real-time protocol. [ABSTRACT FROM AUTHOR]

Background and aims The alcohol industry produces 'responsible drinking' advertising campaigns. There is concern that these may promote drinking while persuading governments and the general public that the industry is acting responsibly. This paper examined young people's thoughts and feelings in response to one of these campaigns in Australia. Design A qualitative analysis of introspection data provided by young drinkers after exposure to a responsible drinking advertisement produced by DrinkWise called 'How to Drink Properly'. Setting Perth, Western Australia. Participants Forty-eight 18-21-year-old drinkers. Measurements The qualitative data were imported into NVivo10 and coded according to the various stages of advertising effects frameworks. A thematic analysis approach was used to identify patterns in the data relating to (i) perceptions of the source and purpose of the advertisement and (ii) any resulting attitudinal or behavioural outcomes. Findings Despite the sample comprising mainly high-risk drinkers, participants were generally unable to relate to the heavy drinkers depicted in the DrinkWise advertisement. This disassociation resulted in a perceived lack of need to modify their own drinking behaviours. Instead, the study participants found the advertisement to be entertaining and supportive of existing social norms relating to heavy drinking among members of this age group. Conclusions The 'How to Drink Properly' advertisement by Drinkwise in Australia may reinforce existing drinking attitudes and behaviours among young drinkers. [ABSTRACT FROM AUTHOR]

This paper describes the relationship between research and policy in the development of server training policy in Ontario. With the emergence of civil liability for the conduct of intoxicated patrons, there has been a growing movement toward the training of managers and servers in licensed establishment in the responsible service of alcohol. As part of a major government reform of alcohol regulations which has led to a new Liquor Licence Act, all persons who serve alcohol in licensed establishments in Ontario will be required to attend a server training course. The process leading to new alcohol regulations in Ontario is summarized with particular attention to the implementation of mandatory server training. The paper concludes with a discussion of the role of research in policy development. It is argued that the role of research in policy making is limited by an inherent conflict between the nature of scientific enquiry and the exigencies of policy development. [ABSTRACT FROM AUTHOR]

Commercial gambling is expanding rapidly across the globe. However, the field of gambling research has not kept pace with this expansion, and continues to focus on prevalence studies and individuated treatment regimes, with little attention to the political, economic or technological underpinnings of commercial gambling. The implications of this lack of sophistication in the research agenda are that society is ill-equipped to understand the nature and underlying causes of gambling harms, and how these might best be avoided, minimized or ameliorated. Around the world, various levels of government benefit from gambling revenue, with consequences for the independent regulation of gambling. Further, there is considerable industry influence on the research agenda, often involving similar techniques to those employed previously by the tobacco and alcohol industries to engage researchers. This influence is compounded by a failure of many gambling researchers and journals to adopt traditional academic safeguards, such as the disclosure of conflicts of interest, and by many arguing for a 'partnership model' with industry to advance the research agenda. This paper identifies five basic principles to restore reasonable standards of integrity in gambling studies: (1) research should not be funded by the proceeds of gambling; (2) research priorities should not be influenced by the beneficiaries of gambling; (3) conferences and other research fora should not be influenced by industry; (4) funding sources should be disclosed in journals and at conferences; and (5) meaningful access to gambling products and environments must be part of licensing. We also propose a range of actions to promote greater transparency and independence in the gambling research field. [ABSTRACT FROM AUTHOR]

ABSTRACT The Research Institute on Addictions (RIA) was established in 1970 as a research component of the New York State Department of Mental Hygiene. After three decades of serving as a research component of New York State agencies concerned with alcohol and substance abuse, RIA was legislatively transferred to the University at Buffalo in 1999. Today, RIA's cadre of senior research scientists are engaged individually and collaboratively on a multitude of addictions-related studies. The majority of the Institute's ongoing research studies relate to one or more of the following seven broad research domains: causes and consequences of alcohol, marijuana and other drug use; biological and neuroscience; gambling behavior; gender-related studies; dissemination and professional training; treatment; and youth, families and relationships. In this paper, an overview of the structure of the Institute is provided, along with a description of the organizational and scientific culture at RIA. Further information about the Institute, its scientists and its activities can be found at . [ABSTRACT FROM AUTHOR]

BSTRACT [ABSTRACT FROM AUTHOR]

The Centre for Addiction and Mental Health is one of the premier centres for research related to substance use and addiction. This research began more than 50 years ago with the Addiction Research Foundation (ARF), an organization that contributed significantly to knowledge about the aetiology, treatment and prevention of substance use, addiction and related harm. After the merger of the ARF with three other institutions in 1998, research on substance use continued, with an additional focus on comorbid substance use and other mental health disorders. In the present paper, we describe the structure of funding and organization and selected current foci of research. We argue for the continuation of this successful model of integrating basic, epidemiological, clinical, health service and prevention research under the roof of a health centre. [ABSTRACT FROM AUTHOR]

The authors discuss the study of Donovan and colleagues related to the importance of consumptive behavior to addictions treatment research and that of Tiffany and colleagues on the inclusion of treatment outcomes beyond drug addiction. The authors cite the identification between primary and secondary outcomes related to the classification of outcomes. They also mention the quantification of outcomes that are used in both studies as they are important in clinical process. Moreover, the authors cite principles that can be used when measuring psychological outcomes.

Aim To examine the risks taken by health, research and community organizations when they opt to receive funding from dangerous consumption industries and to identify ways in which they might generate their own assessment of these risks. Methods Common risks associated with industry involvements are examined, along with potential barriers to self-reflection. Results Funds derived from tobacco, alcohol, gambling and other dangerous consumptions are accessed increasingly by public good organizations. The variety of risks these involvements incur place individuals and organizations somewhere along a continuum of moral jeopardy, stretching from those with minor involvements to those with unmanageable conflicts of interest. The concept of a ‘continuum’ is preferable to a ‘binary’ interpretation in that the latter tends to lock understandings into all-or-nothing positions, thereby discouraging reflection and discussion regarding ethical and moral issues. Active scrutiny of these risks can be assisted through strategies that promote ongoing self-assessment. This is illustrated in the application of criteria that help breakdown risks and provide guidance in deciding on the extent of involvement with industry funding. Conclusion The paper finishes with practical examples of educational and assessment strategies that could assist in reducing moral jeopardy. [ABSTRACT FROM AUTHOR]

Purpose This paper is the first in a series that examines methods for improving the validity and utility of randomized clinical trials (RCTs) in addictions treatment research. The specific foci of this article are treatment implementation and research design. Scope We begin by considering the conditions under which the RCT provides an appropriate design choice. Sections that follow discuss methodological issues with respect to RCT structure and collaborative arrangements; treatment specification, delivery and cost; experimental design; and randomization/blinding procedures. We emphasize the importance of advance planning; treatment integrity and discriminability; treatment standardization; staff training and supervision; client compliance; maintenance of between-group equivalence across study conditions; and inclusion of appropriate comparison groups in study designs. Conclusions Investigators are encouraged to maximize the internal validity of RCTs, but also to consider methods for enhancing external validity. The utility of addictions RCTs for advancing theory and improving clinical practice can be enhanced by investigating underlying mechanisms of action. [ABSTRACT FROM AUTHOR]

This paper discusses the relationship of research to policy in the matter of dram shop liability and server training in the USA. The discussion is made difficult by the apparent lack of any such relationship. While research in the area has only just been published, dram shop liability in the USA actually dates to the nineteenth century, with its current form shaped by the repeal of prohibition in 1933. Because liability law and liability insurance vary from state to state, current movements for reform and server training arise somewhat spontaneously in different localities and with different emphases. Research constitutes only a minor influence among several others more salient to the political process of policy formation. The advent of mandatory server training in the state of Oregon is used to illustrate the somewhat capricious nature of progress in responsible beverage service. [ABSTRACT FROM AUTHOR]

An overview of community-based action research projects is presented focusing on the community/research agenda interaction, the difficulties and rewards of this approach, and the unique opportunities of these projects. The potential for policy development as a result of these initiatives has not been fully explored, and some suggestions for the implementation of policies based on the results of action research projects are made. The policy implication of several specific interventions are discussed, along with the limitations and benefits of policy components within a project, rather than as spin-offs. The paper concludes with suggestions for planning community action projects to enhance the policy formulation aspect of these projects. [ABSTRACT FROM AUTHOR]

Background and Aims: This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective. Design: A narrative summary of the contents of the book according to five major issues. Findings An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high‐, middle‐ and low‐income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol‐related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink‐driving counter‐measures, brief interventions with at‐risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high‐risk contexts and groups of hazardous drinkers. Conclusion: Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence‐based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best. [ABSTRACT FROM AUTHOR]

Background and aims: Graph theoretic analysis of structural covariance networks (SCN) provides an assessment of brain organization that has not yet been applied to alcohol dependence (AD). We estimated whether SCN differences are present in adults with AD and heavy‐drinking adolescents at age 19 and age 14, prior to substantial exposure to alcohol. Design Cross‐sectional sample of adults and a cohort of adolescents. Correlation matrices for cortical thicknesses across 68 regions were summarized with graph theoretic metrics. Setting and participants: A total of 745 adults with AD and 979 non‐dependent controls from 24 sites curated by the Enhancing NeuroImaging Genetics through Meta Analysis (ENIGMA)–Addiction consortium, and 297 hazardous drinking adolescents and 594 controls at ages 19 and 14 from the IMAGEN study, all from Europe. Measurements Metrics of network segregation (modularity, clustering coefficient and local efficiency) and integration (average shortest path length and global efficiency). Findings The younger AD adults had lower network segregation and higher integration relative to non‐dependent controls. Compared with controls, the hazardous drinkers at age 19 showed lower modularity [area‐under‐the‐curve (AUC) difference = −0.0142, 95% confidence interval (CI) = −0.1333, 0.0092; P‐value = 0.017], clustering coefficient (AUC difference = −0.0164, 95% CI = −0.1456, 0.0043; P‐value = 0.008) and local efficiency (AUC difference = −0.0141, 95% CI = −0.0097, 0.0034; P‐value = 0.010), as well as lower average shortest path length (AUC difference = −0.0405, 95% CI = −0.0392, 0.0096; P‐value = 0.021) and higher global efficiency (AUC difference = 0.0044, 95% CI = −0.0011, 0.0043; P‐value = 0.023). The same pattern was present at age 14 with lower clustering coefficient (AUC difference = −0.0131, 95% CI = −0.1304, 0.0033; P‐value = 0.024), lower average shortest path length (AUC difference = −0.0362, 95% CI = −0.0334, 0.0118; P‐value = 0.019) and higher global efficiency (AUC difference = 0.0035, 95% CI = −0.0011, 0.0038; P‐value = 0.048). Conclusions: Cross‐sectional analyses indicate that a specific structural covariance network profile is an early marker of alcohol dependence in adults. Similar effects in a cohort of heavy‐drinking adolescents, observed at age 19 and prior to substantial alcohol exposure at age 14, suggest that this pattern may be a pre‐existing risk factor for problematic drinking. [ABSTRACT FROM AUTHOR]

Aims: To test the efficacy of 'MiQuit', a tailored, self‐help, text message stop smoking programme for pregnancy, as an adjunct to usual care (UC) for smoking cessation in pregnancy. Design Multicentre, open, two‐arm, parallel‐group, superiority randomised controlled trial (RCT) and a trial sequential analysis (TSA) meta‐analysis combining trial findings with two previous ones. Setting: Twenty‐four English hospital antenatal clinics. Participants: A total of 1002 pregnant women who were ≥16 years old, were ≤25 weeks gestation and smoked ≥1 daily cigarette and accepted information on cessation with no requirement to set quit dates. Interventions: UC or UC plus 'MiQuit': 12 weeks of tailored, smoking cessation text messages focussed on inducing and aiding cessation. Measurements Primary outcome: biochemically validated cessation between 4 weeks after randomisation and late pregnancy. Secondary outcomes: shorter and non‐validated abstinence periods, pregnancy outcomes and incremental cost‐effectiveness ratios. Findings RCT: cessation was 5.19% (26/501) and 4.59% (23/501) in MiQuit and UC groups (adjusted odds ratio [adj OR] for quitting with MiQuit versus UC, 95% CI = 1.15 [0.65–2.04]); other abstinence findings were similar, with higher point estimates. Primary outcome ascertainment was 61.7% (309) and 67.3% (337) in MiQuit and UC groups with 71.1% (54/76) and 69.5% (41/59) abstinence validation rates, respectively. Pregnancy outcomes were similar and the incremental cost per quality‐adjusted life year was −£1118 (95% CI = −£4806–£1911). More MiQuit group women reported making at least one quit attempt (adj OR [95% CI]) for making an attempt, 1.50 (1.07–2.09). TSA meta‐analysis: this found no significant difference in prolonged abstinence between MiQuit and UC (pooled OR = 1.49, adjusted 95% CI = 0.62–3.60). Conclusions: Irrespective of whether they want to try quitting, when offered a tailored, self‐help, text message stop smoking programme for pregnancy (MiQuit) as an adjunct to usual care, pregnant women are not more likely to stop smoking until childbirth but they report more attempts at stopping smoking. [ABSTRACT FROM AUTHOR]

Background and Aims The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives which, in turn, can misdirect research effort and waste money. Methods We review factors that may contribute to poor study reproducibility and an excess of 'significant' findings within the published literature. Specifically, we consider the influence of current incentive structures and the impact of these on research practices. Results The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g. unplanned post-hoc tests) to the calculated and serious (e.g. fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasize the research question and study design, rather than the results obtained. This has the potential to minimize significance chasing and non-publication of null findings. Conclusions Significance chasing, questionable research practices and poor study reproducibility are the unfortunate consequence of a 'publish or perish' culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g. funders and journals) will be required to address problems of poor reproducibility. [ABSTRACT FROM AUTHOR]

Aim: To test the association of alcohol consumption with total and cause‐specific mortality risk. Design Prospective observational multi‐centre population‐based study. Setting: Sixteen cohorts (15 from Europe) in the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project. Participants: A total of 142 960 individuals (mean age 50 ± 13 years, 53.9% men). Measurements Average alcohol intake by food frequency questionnaire, total and cause‐specific mortality. Findings In comparison with life‐time abstainers, consumption of alcohol less than 10 g/day was associated with an average 11% [95% confidence interval (CI) = 7–14%] reduction in the risk of total mortality, while intake > 20 g/day was associated with a 13% (95% CI = 7–20%) increase in the risk of total mortality. Comparable findings were observed for cardiovascular (CV) deaths. With regard to cancer, drinking up to 10 g/day was not associated with either mortality risk reduction or increase, while alcohol intake > 20 g/day was associated with a 22% (95% CI = 10–35%) increased risk of mortality. The association of alcohol with fatal outcomes was similar in men and women, differed somewhat between countries and was more apparent in individuals preferring wine, suggesting that benefits may not be due to ethanol but other ingredients. Mediation analysis showed that high‐density lipoprotein cholesterol explained 2.9 and 18.7% of the association between low alcohol intake and total as well as CV mortality, respectively. Conclusions: In comparison with life‐time abstainers, consuming less than one drink per day (nadir at 5 g/day) was associated with a reduced risk of total, cardiovascular and other causes mortality, except cancer. Intake of more than two drinks per day was associated with an increased risk of total, cardiovascular and especially cancer mortality. [ABSTRACT FROM AUTHOR]

The Centre for Addictions Research of British Columbia (CARBC) was established as a multi-campus and multi-disciplinary research centre administered by the University of Victoria (UVic) in late 2003. Its core funding is provided from interest payments on an endowment of CAD$10.55 million. It is supported by a commitment to seven faculty appointments in various departments at UVic. The Centre has two offices, an administration and research office in Victoria and a knowledge exchange unit in Vancouver. The two offices are collaborating on the implementation of CARBC's first 5-year plan which seeks to build capacity in British Columbia for integrated multi-disciplinary research and knowledge exchange in the areas substance use, addictions and harm reduction. Present challenges include losses to the endowment caused by the 2008/2009 economic crisis and difficulties negotiating faculty positions with the university administration. Despite these hurdles, to date each year has seen increased capacity for the Centre in terms of affiliated scientists, funding and staffing as well as output in terms of published reports, electronic resources and impacts on policy and practice. Areas of special research interest include: drug testing in the work-place, epidemiological monitoring, substance use and injury, pricing and taxation policies, privatization of liquor monopolies, polysubstance use, health determinants of indigenous peoples, street-involved youth and other vulnerable populations at risk of substance use problems. Further information about the Centre and its activities can be found on . [ABSTRACT FROM AUTHOR]

The article discusses the publication's policies with respect to the authorship of scientific articles it publishes.

Background and aims: Research from cohorts of individuals with recreational cannabis use indicates that cannabis withdrawal symptoms are reported by more than 40% of those using regularly. Withdrawal symptoms are not well understood in those who use cannabis for medical purposes. Therefore, we prospectively examined the stability of withdrawal symptoms in individuals using cannabis to manage chronic pain. Design, Setting, Participants: Using latent class analysis (LCA) we examined baseline cannabis withdrawal to derive symptom profiles. Then, using latent transition analysis (LTA) we examined the longitudinal course of withdrawal symptoms across the time points. Exploratory analyses examined demographic and clinical characteristics predictive of withdrawal class and transitioning to more or fewer withdrawal symptoms over time. A cohort of 527 adults with chronic pain seeking medical cannabis certification or re‐certification was recruited between February 2014 and June 2015. Participants were recruited from medical cannabis clinic waiting rooms in Michigan, USA. Participants were predominantly white (82%) and 49% identified as male, with an average age of 45.6 years (standard deviation = 12.8). Measurements Baseline, 12‐month and 24‐month assessments of withdrawal symptoms using the Marijuana Withdrawal Checklist–revised. Findings A three‐class LCA model including a mild (41%), moderate (34%) and severe (25%) symptom class parsimoniously represented withdrawal symptoms experienced by people using medical cannabis. Stability of withdrawal symptoms using a three‐class LTA at 12 and 24 months ranged from 0.58 to 0.87, with the most stability in the mild withdrawal class. Younger age predicted greater severity and worsening of withdrawal over time. Conclusions: Adults with chronic pain seeking medical cannabis certification or re‐certification appear to experience mild to severe withdrawal symptoms. Withdrawal symptoms tend to be stable over a 2‐year period, but younger age is predictive of worse symptoms and of an escalating withdrawal trajectory. [ABSTRACT FROM AUTHOR]

The authors reflect on the implementation of an effective clinical interventions against problem drinking and smoking by the World Health Organization (WHO). They state that the World Health Assembly (WHA) has supported the execution of therapy programmes for patients with alcohol use disorders to reduce the harmful use of alcohol. The authors highlight the importance of medical journals and information to the development of clinical medicine in healthcare professionals.

Background and aims: Culturally relevant and feasible interventions are needed to address limited professional resources in sub‐Saharan Africa for behaviorally treating the dual epidemics of HIV and alcohol use disorder. This study tested the efficacy of a cognitive–behavioral therapy (CBT) intervention to reduce alcohol use among HIV‐infected outpatients in Eldoret, Kenya. Design Randomized clinical trial. Setting: A large HIV outpatient clinic in Eldoret, Kenya, affiliated with the Academic Model Providing Access to Healthcare collaboration. Participants: A total of 614 HIV‐infected outpatients [312 CBT; 302 healthy life‐styles (HL); 48.5% male; mean age: 38.9 years; mean education 7.7 years] who reported a minimum of hazardous or binge drinking. Intervention and comparator: A culturally adapted six‐session gender‐stratified group CBT intervention compared with HL education, each delivered by paraprofessionals over six weekly 90‐minute sessions with a 9‐month follow‐up. Measurements Primary outcome measures were percentage of drinking days (PDD) and mean drinks per drinking day (DDD) computed from retrospective daily number of drinks data obtained by use of the time‐line follow‐back from baseline to 9 months post‐intervention. Exploratory analyses examined unprotected sex and number of partners. Findings Median attendance was six sessions across condition. Retention at 9 months post‐intervention was high and similar by condition: CBT 86% and HL 83%. PDD and DDD marginal means were significantly lower in CBT than HL at all three study phases. Maintenance period, PDD – CBT = 3.64 (0.696), HL = 5.72 (0.71), mean difference 2.08, 95% confidence interval (CI) = 0.13 – 4.04; DDD – CBT = 0.66 (0.96), HL = 0.98 (0.098), mean difference = 0.31, 95% CI = 0.05 – 0.58. Risky sex decreased over time in both conditions, with a temporary effect for CBT at the 1‐month follow‐up. Conclusions: A cognitive–behavioral therapy intervention was more efficacious than healthy lifestyles education in reducing alcohol use among HIV‐infected Kenyan outpatient drinkers. [ABSTRACT FROM AUTHOR]

Aims: To test the efficacy of a brief intervention to reduce alcohol or drug use and to promote use of addiction services among patients seeking mental health treatment. Design and setting: A multi‐centre, longitudinal, two‐group randomized controlled trial with randomization within each of two mental health treatment systems located in Ventura County and Los Angeles County in California, USA. Participants: A total of 718 patients (49.2% female) aged 18 and older with a mental health diagnosis and either a heavy drinking day or any use of cannabis or stimulants in the past 90 days. Intervention and comparator: A motivation‐based brief intervention with personalized feedback (screening, brief intervention and referral to treatment (SBIRT) condition) (n = 354) or a health education session (control condition) (n = 364). Measurements Primary outcomes included frequency of heavy drinking days, days of cannabis use and days of stimulant use at the primary end‐point 3 months post‐baseline. Secondary outcomes included frequency and abstinence from substance use out to a 12‐month follow‐up and the use of addiction treatment services. Findings Participants in the SBIRT condition had fewer heavy drinking days [odds ratio (OR) = 0.53; 95% credible interval (CrI) = 0.48–0.6] and fewer days of stimulant use (OR = 0.58; 95% CrI = 0.50–0.66) at the 3‐month follow‐up compared with participants in the health education condition. Participants in the SBIRT condition did not comparatively reduce days of cannabis use at the 3‐month follow‐up (OR = 0.93; 95% CrI = 0.85–1.01). Secondary outcomes indicated sustained effects of SBIRT on reducing the frequency of heavy drinking days and days of stimulant use. No effects were observed on abstinence rates or use of addiction treatment services. Conclusions: Screening and brief intervention for unhealthy alcohol and drug use in mental health treatment settings were effective at reducing the frequency of heavy drinking and stimulant use. [ABSTRACT FROM AUTHOR]

The author discusses the article "Naltrexone in the treatment of opioid-dependent pregnant women: the case for a considered and measured approach to research" by H. E. Jones and colleagues in the April 2012 issue. The author hopes that the paper will initiate an international project enabling a gradual increase of knowledge on naltrexone treatment efficiency with the possibility of detecting early signs of long-term developmental problems.

The discusses the existence of more mice or a better mouse trap that reflects on primary outcome of drug abuse treatment in clinical trials. He is critical of the measures undertaken by A. Uchtenhagen to evaluate substance abuse treatment involving the psychosocial function, quality of life, and patient satisfaction. Also investigated the possibility that the use secondary outcome measures the broader complexities of clinical outcomes as well as clinical trials.

The article presents a reply by the authors of an article on policy options for alcohol price regulation, to comments on it. They point out that the response to their paper has been twofold, with sections like the media, industry an policy makers focusing either on methodological issues, or on the impacts that the changes are likely to make. The arguments of several critics are discussed and concluded that it makes for an ambitious and exciting program of future research.

In this article the authors discuss the findings expressed at the paper by C.J. Morgan and colleagues on ketamine abuse. They note the provision of the scientific dangers in using ketamine by the authors of the research. Furthermore, they mention the ability of the authors in garnering information out from their recruitment of ketamine users.

Background and Aims: Guidelines recommend the 5As model of brief intervention for providing smoking cessation support in clinical settings. This study assessed patient and hospital characteristics associated with self‐reported receipt of the 5As (ask, advise, assess, assist and arrange). Design Multi‐center cross‐sectional study. Setting and participants: Adult inpatients (n = 1047) were randomly selected from 13 hospitals in the Barcelona province of Spain in 2014–2015. Measurements We explored participants' receipt of the 5As through a questionnaire. Given the progressiveness of the 5As, we recoded the fulfillment of the intervention as: A0: no intervention; A1: ask; A2: ask and advise; A3: A2 and assess; A4: A3 and assist; and A5: A4 and arrange a follow‐up. We explored patient (e.g. age, sex, comorbidities) and hospital (e.g. type of hospital, unit) characteristics. We adjusted multi‐level robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of the association between the recoded 5As intervention received. Findings A total of 60.4% (n = 624) of patients had been asked (A1) about their smoking status. Among smokers, 46.5% (n = 90) were advised (A2), 26.6% (n = 48) assessed (A3) and 4.6% (n = 10) received all the components of the 5As (A5). Middle‐aged smokers [aPR = 3.63; 95% confidence interval (CI) = 1.69–7.79] with a respiratory disease (aPR = 2.19; 95% CI = 1.11–4.34) were most likely to have been asked, advised and assessed (A3). The cessation intervention was most frequently performed by physicians. Conclusions: In the Barcelona province of Spain, it appears that fewer than half of hospitalized patients who smoke were advised to quit and few received the full 'five As' brief intervention for smoking cessation. [ABSTRACT FROM AUTHOR]

In this article, the author discusses aspects in the proposed merger of the National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism (NIAAA). The author says that the establishment of the National Institutes of Health (NIH) allows for individual institutes to map onto health issues and their treatment and prevention. He says that on these NIH bases, he would consider a merger of separate drug and alcohol institutes.

In this article the authors discuss the various misconceptions overlooked by Dr. Sellman at his paper on addiction treatment. They contend the Sellman's belief that treatment advancement goes with the improvement of research. Furthermore, they reject the statement of Sellman that anything one does works.

Aims: In Iran, injecting drug use has been the major route of human immunodeficiency virus (HIV) transmission. In order to control the HIV epidemic, a harm reduction program was initiated and has been expanded in recent years. The aim of this study was to provide an updated estimate of HIV prevalence among people who inject drugs (PWID) in Iran, investigate prevalence differences over time and assess prevalence correlates. Design A comprehensive systematic review was undertaken in the international, regional and national bibliographic databases in November 2018 and extensive contacts with authors were made. For studies conducted before 2005, we used data from a previous published systematic review. Setting: All studies conducted in Iran were included. Recruitment settings included anywhere except studies conducted in infectious diseases wards or HIV counseling centers. Participants: PWID with any definition utilized in the studies. Thirty‐six studies were included, which were conducted in 24 of 31 provinces with a sample size of 22 160 PWID. Measurements We included studies that had performed HIV testing and had a confirmed diagnosis of HIV through repeating the enzyme‐linked immunosorbent assay (ELISA) or Western immunoblot assay (WB). Pooled prevalence of HIV was calculated for the total sample and for different subgroups, by available socio‐demographic and behavioral factors. For assessing the trend of HIV prevalence over time, a linear meta‐regression model was fitted separately for before 2007 and during 2007 and afterwards. Findings The pooled prevalences of HIV before 2007 and in 2007 and afterwards were 14.3% [95% confidence interval (CI) = 9.8–18.9] and 9.7% (95% CI = 7.6–11.9), respectively. HIV prevalence increased until 2005–06 and then slowly declined until 2009–10, which was not significant. Prevalence of HIV was significantly higher in PWID above age 25 years, and in those with history of imprisonment and history of needle/syringe‐sharing. HIV prevalence was higher in men than in women, but the difference was insignificant. Conclusion: The prevalence of HIV among people who inject drugs in Iran decreased after 2006 which could, at least in part, be attributed to the development of extensive harm reduction programs in the country. [ABSTRACT FROM AUTHOR]

Background and Aims: The United States Food and Drug Administration has proposed regulation to require that cigarettes contain very low nicotine content (VLNC). In contrast, reducing the number of cigarettes per day (CPD) is the most common current method to reduce nicotine. This trial aims to explore whether gradually transitioning to VLNC cigarettes plus nicotine patch or reducing CPD plus nicotine patch is more effective at decreasing nicotine dependence. Design A two‐arm, individually randomized open‐label trial. Setting Community setting, Vermont, USA. Participants: Sixty‐eight adult daily smokers (40% female) of ≥ 10 cigarettes/day who were not planning to quit in the next 30 days. Interventions: All participants smoked study cigarettes with a nicotine yield similar to most commercial cigarettes ad libitum for 1 week (baseline). Participants then gradually reduced to 70, 35, 15 and 3% of baseline nicotine over 4 weeks by either (a) transitioning to lower nicotine content cigarettes (n = 36) or (b) reducing the number of full nicotine cigarettes (n = 32). All participants received nicotine patches. Measurements The primary outcome was change in nicotine dependence assessed at baseline and weekly during the intervention with the Nicotine Dependence Syndrome Scale. Findings Dependence declined over time for both VLNC and CPD participants, but declined more for VLNC (mean decrease in Z‐score of 1.0) than CPD (mean decrease in Z‐score of 0.5) participants over time (interaction P = 0.018). Conclusions: Transitioning to very low nicotine content cigarettes reduced nicotine dependence over a 4‐week period to a greater extent than reducing cigarettes per day when both conditions were aided by nicotine patch. [ABSTRACT FROM AUTHOR]

The article discusses the use of alcohol and other drugs by Indigenous peoples in developed countries, noting key research challenges and possible future directions for the field. Observational and surveillance research was used and it was found that many commonly used alcohol and other drug (AoD) screening tools are not adapted for use with Indigenous peoples. Future research opportunities in the epigenetics of stress are also discussed.