Search

The present study examined the impact of a novel intervention for children at risk for substance use or actively using substances that was provided to 783 children between 4 and 18 years of age in Afghanistan. They received the Child Intervention for Living Drug-free (CHILD) protocol while in outpatient or residential treatment. CHILD included age-appropriate literacy and numeracy, drug education, basic living safety, and communication and trauma coping skills. A battery of measures examined multiple child health domains at treatment’s start and end and 12 weeks later. For younger children, there were no significant Gender or Gender X Time effects (all p’s > .16 and .35, resp.). The time main effect was significant for all outcomes (all p’s < .00192, the prespecified per-comparison error rate). Post hoc testing showed significant improvements from residential treatment entry to completion for all scales. For older children, a time main effect was significant for (all p’s < .00192, the prespecified per-comparison error rate) all but one outcome. Community follow-up means were significantly lower than residential treatment entry means. CHILD had a positive impact on children, and treatment impact endured from posttreatment to follow-up assessment. [ABSTRACT FROM AUTHOR]

Background: Recently, social movements across the world have demanded reforms to education systems and other institutions. Although such movements have affected large numbers of people across multiple countries, we know little about the impacts they have had on population health. We focus on one example: the massive strikes and collective occupation of secondary schools across Chile, which occurred contemporaneously with a large increase in marijuana use among students in this age group. We aimed to evaluate the causal effects that the 2011 Chilean school strikes had on adolescent substance use, including the initiation of marijuana use and the use of alcohol and marijuana.Methods: School-level, aggregated panel design using data from the National Drug Surveys among Secondary Students from 2005 to 2015 for students in grades 9-12. We used a fixed-effects difference-in-difference model to estimate the effect of school occupations on prevalence of self-reported indicators of drug use.Results: Reported marijuana use doubled between 2009 and 2013 among Chilean adolescents. After controlling for secular trends in outcomes and for school characteristics, there was no evidence of increased marijuana initiation, alcohol and marijuana use, or of an increase in heavy use among adolescents being directly attributable to school strikes and occupations in 2011.Conclusions: The 2011 Occupy school movement in Chile had no detectable causal effect on substance use among Chilean adolescents. The increase in marijuana use from 2009 to 2013 seems to be part of broader social changes occurring among the school-age population. [ABSTRACT FROM AUTHOR]

The aim of this work is fitted in line with research that intended to raise levels of quality of preventive strategies developed, analyzing the differential effectiveness of the school-based programs depending on the application agent. This study analyses the effects of three schoolbased prevention programs on cannabis use and attitudes towards drugs use as a function of provider type. Two hundred eighty students from the first year of Secondary Education were distributed among seven experimental conditions: six treatment conditions (experimental groups) and waiting list condition (control group). Experimental groups were determined by two factors: Type of program (Construyendo Salud program, Saluda program, Barbacana program and Control Group) and Type of provider (regular teacher or external psychologist). The teachers applying the Barbacana and Saluda programs and psychologists applying the Construyendo Salud program obtain better outcomes in both cannabis use and attitudes. The results point out an interaction effect between type of program and type of applicators. [ABSTRACT FROM AUTHOR]

Aim Substance use by young people has long been a concern of western society, but opinion is mixed as to which prevention approach offers the greatest benefit, and whether indeed there is any benefit at all. This paper reviews the nature of prevention programmes, the research evidence that underpins these programmes and the prevention objectives against which effectiveness is measured. The aim of this is to create better understanding of the elements that maximize programme effectiveness, what can be achieved by prevention programmes and how programmes can be improved. Findings There is a range of prevention approaches for which there is evidence of effectiveness. Some are classroom-based; some focus upon parenting; some have substantial whole-of-school and community elements; and some target risk and protective factors in early childhood. All, however, are based substantially on the social influence model. In an attempt to improve practice lists of effective programmes have been developed, but there are concerns about the science behind selection. On balance, there is consistent evidence that social influence prevention programmes do have a small, positive effect on drug use, but this then raises the question as to whether harm, rather than use, would be the more worthwhile target for prevention. Prevention that seeks to reduce harm has been demonstrably effective, but has found little support in some jurisdictions. Conclusion Research has created a progressively better understanding of how to optimize programme effectiveness and what can be achieved realistically by even the most effective programmes. However, further research is required to identify which, if any, particular approach offers greater promise. The effectiveness of harm reduction should be compared with more traditional abstinence and the additional effects of whole of school, parent and community elements need to be measured more accurately. Contemporary social influence prevention programmes are flawed, but the approach is still the best way of influencing drug use behaviour in young people as a whole. Evidence-based refinement is the best option for greater benefit. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluated the brief intervention training which helps in reducing alcohol abuse by automating individualized coaching and role-play practice. Comparison of STAR Workshop and a web-based, self-guided electronic book for training the Engage for Change (E4C) brief intervention protocol. Results indicated that STAR Workshop is more accessible and cost-effective for students.

This article reviews the new ideas emerging from neuroscience regarding the question of why some people are compelled to use drugs. During the process of drug exposure, the brain's motivational system is changed and these changes, along with changes in the brain's self-regulatory structures, compel an individual to use drugs. Ways to reverse those changes in an addicted brain have been identified, as have ways to enhance self-regulatory control. The information from neuroscience offers a new perspective on “loss of control” as well as offering implications for treatment. [ABSTRACT FROM AUTHOR]

In the Fall of 2004, 1,948 5th grade students from Phoenix, AZ enrolled in an evaluation of a school-based, substance use prevention intervention. To assess the consistency of Mexican and Mexican-American students' self-reports of lifetime substance use, the present study analyzed data reported by 1,418 students who reported Mexican ancestry and completed 2 to 6 questionnaires administered over a 40-month period. By wave 6, which was completed in March 2008, lifetime alcohol, cigarette, marijuana, and inhalant use rates were 86.0%, 65.0%, 64.5%, and 62.1%, respectively. Corresponding rescission rates were 24.0%, 9.6%, 5.8%, and 9.2%. Reporting patterns with one "Yes-No" sequence accounted for more than 88% of the inconsistent self-reports. This finding suggests that the majority of Mexican/Mexican-American preadolescents participating in a substance use prevention intervention provided logically consistent self-reports of lifetime substance use. [ABSTRACT FROM AUTHOR]

The National Institute of Drug Abuse has promoted drug abuse research in the past two decades focusing on women and gender differences. One hundred twenty-eight Hispanic and White women have participated in this comparative descriptive study that has examined the differences between chemically dependent (CD) women in recovery and non-chemically dependent (non-CD) women in regard to resilience and self-differentiation-demographic variables associated with resilience and self-differentiation and recovery variables associated with resilience and self-differentiation in the CD women. Findings indicate that the CD women and Hispanic women have scored significantly lower on measures of resilience and self-differentiation. Among the recovery variables, resilience and self-differentiation are significant for children support but community support is not significant. The finding that Hispanic and White women in recovery score lower on resilience and self-differentiation is important for designing treatment strategies supportive of women in recovery. [ABSTRACT FROM AUTHOR]

Abstract: Replacement therapy with the synthetic μ-opioid agonist methadone is an efficacious treatment for opioid abuse. While much is known about methadone''s pharmacology, its discriminative stimulus properties remain largely unexplored. The present study sought to establish methadone discrimination in rats. Moreover, some research suggests that route of administration alters the discriminative stimulus of methadone. Thus, the present study also compared intraperitoneal (i.p.) and subcutaneous (s.c.) routes of administration. Male Sprague–Dawley rats were trained to discriminate 3.0mg/kg methadone (i.p.) from vehicle in a two-lever discrimination procedure. Generalization tests were conducted with a variety of compounds administered i.p. and s.c. Methadone fully substituted for itself, yielding ED50s of 1.5mg/kg (i.p.) and 0.2mg/kg (s.c.). Naltrexone (i.p.), an opioid antagonist produced a dose-dependent reduction in methadone-appropriate responding. The methadone stereoisomers fully substituted for methadone when given s.c.; however, when administered i.p., (+) and (−) methadone produced partial and no substitution, respectively. Heroin fully generalized to methadone regardless of administration route, while morphine fully substituted when given s.c., but not i.p. The kappa-agonist U50-488 failed to generalize to methadone with either route of administration. These results demonstrated that methadone''s discriminative stimulus is mediated through μ-opioid receptor activity and is similar to that of commonly abused opioids (heroin, morphine). Additionally, route of administration produced differential results for many of the drugs tested, suggesting decreased drug bioavailability following i.p. administration due to hepatic first pass metabolism. Taken together, these results suggest that methadone''s shared subjective effects with abused opioids, as well as its unique metabolic properties contribute to its efficacy in opioid maintenance therapy. [Copyright &y& Elsevier]

While researchers have developed more effective programs and strategies to prevent the initiation of substance use and increasingly communities are delivering these interventions, determining the degree to which they are delivered as they were designed remains a significant research challenge. In the past several years, more attention has been given to implementation issues during the various stages of program development and diffusion. This paper presents the findings from a substudy of an evaluation of a newly designed middle and high school substance abuse prevention program, Take Charge of Your Life delivered by local Drug Abuse Resistance Education officer instructors. A key aspect of the study was to determine the extent to which implementation fidelity, using the measures of content coverage and appropriate instructional strategy, was associated with improvement in the program mediators of realistic normative beliefs, understanding the harmful effects of substance use and the acquisition of decision-making and resistance skills. Although it was found that higher fidelity was associated with better scores on some of the mediators, this was not a consistent finding. The mixed results are discussed within the context of the lesson activities themselves. [ABSTRACT FROM AUTHOR]

The self-assembly of labeled aptamer sub-units in the presence of their substrates provides a method for the optical (fluorescence) or electrochemical detection of the substrate. One of the sub-units is linked to CdSe/ZnS quantum dots (QDs), and the self-assembly of the dye-functionalized second sub-unit with the modified QDs, in the presence of cocaine, stimulates fluorescence resonance energy transfer (FRET). This enables the detection of cocaine with a detection limit corresponding to 1 × 10−6M. Alternatively, the aptamer fragments are modified with pyrene units. The formation of a supramolecular aptamer-substrate complex allosterically stabilizes the formation of excimer supramolecular structure, and its characteristic emission is observed. In addition, the thiolated aptamer sub-unit is assembled on an Au electrode. The Methylene Blue-labeled sub-unit binds to the surface-confined fragment in the presence of cocaine. The amperometric response of the system allows the detection of cocaine with a detection limit of 1 × 10−5M. The approach is generic and can be applied to other substrates, e.g.adenosine triphosphate. [ABSTRACT FROM AUTHOR]

The challenge for drug and health promotion services is to keep up-to-date with the dynamics of drug use patterns and trends both nationally and within certain groups (Kilpatrick, 2000). The traveller community present with lower but similar levels and patterns of drug use than the general population, but are particularly vulnerable to early onset of drug use and problematic substance use relating to their life circumstances. Drug use in the traveller community is facilitated and mediated by a combination of risk and resilience factors, which include lack of education, unemployment, comprised health and poor housing conditions.The research aimed to provide an explorative account of the issue of drug use in the traveller community and consisted of focus groups (N=12) of travellers (N=57) with a gender balance (47/53%) based on self-selection and volunteerism. The focus groups (4-5 individuals) were predominantly peer-accompanied where a traveller guided the facilitation of the traveller focus groups and were also gender based. The focus groups incorporated the following key themes relating to the travellers and drug use; traveller culture and drug use, drug availability and dealing, gender differences in drug use, types of drugs used, reasons for drug use, levels of drug related knowledge, attitude to drug use, drug taking contexts and patterns, problematic drug use in the traveller community, drug awareness, perceptions of risk and experiences of drug treatment and community services.The travellers indicated increased drug availability in recent years. Some members of their community were dealing in and using drugs, as a result of unemployment, lack of education, depression, and increasing contact with the settled community. This has lead to a fragmentation of traveller culture. Traveller men are at heightened risk of substance dependency in terms of increased contact with drugs such as cocaine, speed, hash and ecstasy. In contrast, traveller women reported prescription medication abuse. The travellers described a fear of problematic drug use within their communities coupled with concern in terms of discriminatory experiences with health and drug services, lack of awareness of current service provision and the lack of culturally appropriate drug education material and addiction counseling. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate if a school-based education and counseling program (Life Skills Training Program) would have an impact on school-aged children/adolescents' views of substance abuse. The study also investigated the degree and direction of change. Participants were 338 elementary or middle-school students in the metro Houston, Texas, area. Results indicated that preexisting views significantly differed from post-intervention views, and that the Life Skills Training Program provided participants with a more accurate view of substance abuse. Findings support formulated hypotheses and effectiveness of the Life Skills Training Program with the sampled population. [ABSTRACT FROM AUTHOR]

Context: The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective: To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs) on prescription opioid abuse admissions. Design and Setting: A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database) and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set) in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group) for the period 1997-2003. Results: From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001). PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063). A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764-0.785). Conclusions: PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible "chilling effect" on physician prescribing. [ABSTRACT FROM AUTHOR]

The use of illicit and licit drugs continues to be a major public health concern. Many prevention and drug education programs address this issue by attempting to enhance self-esteem. The idea is that increased levels of self-esteem will serve as a protective factor in decreasing the motivation and increasing the resistance to use drugs. This study explored the relationship between area specific self-esteem and adolescent substance use. Participants (n = 700) completed a self-report questionnaire which included items measuring the use and expected use of selected substances. Results indicated significant differences in home and school self-esteem scores between users/expected users and non-users of a given substance for all 14 behavioral measures. Additionally, the peer, home, and school sub-scales as a set were found to distinguish between users and non-users for all 14 behavioral measures. Results should be of value to those designing prevention programming. [ABSTRACT FROM AUTHOR]

This article describes an innovative drug prevention pilot in which developing a substance abuse video served as a vehicle for teaching youth healthy attitudes and behaviors. Seven 10- to 12-year-old African Americans from a public housing development participated in 10 weekly sessions focusing on video skills and substance abuse. Based on the principles of capacity building and cognitive dissonance theory, the children learned about substance abuse in their community and movie-making, which they used to created an antidrug video. Six activities were identified as critical to the program's success: family involvement, community engagement, adapting drug education content to fit community characteristics, using the camcorder as a central vehicle for learning, community field assignments. and evaluation-based learning. [ABSTRACT FROM AUTHOR]

The purpose of the current study was to assess the rate of substance use in patients with medical diseases who were admitted to different wards at Shiraz hospitals affiliated to the Shiraz University of Medical Sciences. Data were gathered from 600 randomly selected patients by a structured interview that included DSM-IV criteria for substance dependency. The mean ages for men and women were 45.8 and 44.7 years, respectively. In this group, 76.7% of the men and 83.7% of the women were married. The majority (29%) of the patients were current nicotine users, and 7.2% were opium users; none used cocaine or LSD. The reported reasons for initial use of substance(s),in order of frequencies, were enjoyment, modeling and release of tension; for current users the reasons were habit, enjoyment and need. Substance use, especially cigarettes, was found to be common among patients. Cultural attitudes toward substance use were thought to affect the type and amount of use. These findings can be considered when planning preventive programs. [ABSTRACT FROM AUTHOR]

Although program recipients' attitudes toward instructors are crucial to program outcomes, they have not been adequately examined in the substance abuse prevention literature. This study uses survey data to explore attitudes toward instructors of prevention programming held by students from a national longitudinal evaluation of a school-based substance abuse prevention program delivered by Drug Abuse Resistance Education (D.A.R.E.) officers. Our analyses indicated that students who had police officers as instructors evaluated program instructors significantly higher than students who had non-police officers as instructors. The evaluation of police instructors varied according to students' socio-demographic characteristics. Implications for future research and practice are considered. [ABSTRACT FROM AUTHOR]

Existing literature suggests that Blacks and to some extent Hispanics are less likely than Whites to use substances in their youth. However, by age 35 their use rates are higher than those of Whites. This has been referred to as the race/ethnic age crossover effect in substance use. However, more research is needed to clarify whether this is true for Blacks and Hispanics, males and females, and for drugs and alcohol. It is also empirically unclear why this crossover effect occurs. The present study explores these issues. The National Household Survey of Drug Abuse is merged for four years (1999-2002) to study the race/ethnic age crossover effect (n = 208,878). The results suggest that the race/ethnic age crossover effect cannot be used to describe Hispanic relative to White substance use. However, it is applicable to Black substance use, in particular illegal drug use for Black males and heavy drinking for Black females. Additional analyses reveal that the crossover effect for Blacks is eliminated when socio-demographic controls are included. With controls, drug use and heavy drinking for Blacks are lower than that of Whites for all age groups and for both males and females. Process differences are also revealed in the effects of the socio-demographic correlates. More specifically, these analyses of composition and process suggest that drug availability/exposure is a particularly important factor which likely contributes to the crossover effect in substance use and deserves further study. [ABSTRACT FROM AUTHOR]

Psychoactive substance use by students is common in many countries, obliging schools to deliver drug education. However, some jurisdictions do not prepare teachers for engaging their students in honest, knowledge-based education. This article looks at the history and queries the purposes of contemporary drug education. It compares current approaches to drug education with those of other “vice” issues addressed in the history of public schools, such as sex education and temperance education. It critically challenges the question of knowledge definition and production related to psychoactive substances. Finally, some of the theoretical groundings on which to base teacher education for drug education are considered. [Copyright &y& Elsevier]

Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts' psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts' psychological health: before the intervention, the scores of Self-Rating Anxiety Scale (SAS), the positive and negative dimensionahties of Simple Coping Style Questionnaire (SCSQ) and Chinese Perceived Stress Scales (CPSS) had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ's positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts' social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts' psychological health significantly. [ABSTRACT FROM AUTHOR]

This article discusses the ineffectiveness of the publicly-funded substance abuse prevention program entitled Drug Abuse Resistance Education (D.A.R.E.). Although the program continues to receive widespread support, there is overwhelming evidence of its ineffectiveness. Many communities have dropped the program because of the evidence about its ineffectiveness, but many have ignored the evidence and have retained the program because they believe that it has helped to improve relationships between police, children, and schools. The authors argue that the program administrators have tried to discredit negative reports about ineffectiveness and politicians support it for political gain.

Abstract: Acupuncture stimulation elicited a composite of sensations termed deqi that is related to clinical efficacy. Neurobiological studies have identified the hypothalamus as an important component in mediating the deqi. Functional changes in hypothalamus persist after abstinence in addicts. We investigated the activation in the hypothalamus associated with acupuncture stimulation in healthy volunteers and heroin addicts by fMRI. Cortisol level and psychophysical responses, including the deqi sensation (an acupuncture effect of needle-manipulation), anxiety, and sharp pain, were also assessed. The activation of the hypothalamus was more robust in the addicts than that in the healthy subjects during acupuncture stimulation. The deqi scores of the heroin addicts were significantly higher than those of the healthy subjects during acupuncture treatment. An acupuncture sensation scale predicted the activation of the hypothalamus associated with the deqi sensation. [Copyright &y& Elsevier]

This article describes the implementation of an innovative curriculum called Drugs-At-Work (DAW), which was evaluated in three phases. In phase-one, data collected after the third year of the study suggested that the curriculum had a significant impact on the fifth-grade participants, who in turn influenced their sixth-grade classmates the following year. In comparison to their sixthgrade baseline counterparts, the DAW participants and their classmates were significantly less likely to have used tobacco, alcohol or other illicit drugs (ATOD) and less likely to know other elementary students who did so. In phase-two, data were examined on a year-by-year basis using a modified A-B-A design. These data revealed a drop from baseline in ATOD use during the intervention years and a return-to-baseline after the program ended. In phase-three, comparisons were made among participants in the Combined Baseline Group, the Combined DAW Group and the Transition Group (those exposed to DAW but not surveyed until a year after the grant closed). These analyses revealed that the DAWsignificantly reduced ATOD use for the total sample and for the Mexican-American, the Anglo, and the African-American students examined separately. [ABSTRACT FROM AUTHOR]

In this article, the authors examine factors associated with initial and present Ecstasy use among young adults. Face-to-face structured interviews were conducted in Atlanta. Georgia among 261 active Ecstasy users. The median age at which respondents first heard of Ecstasy was 16 years, whereas the median age of first Ecstasy use was 18 years. Initial Ecstasy use frequently involved polydrug use, including alcohol (50.4%). In terms of their current use, 47.5% of respondents were considered heavy Ecstasy users (using on 10 or more separate occasions in the last 90 days). White respondents. those who used more than one pill during their initial use, and those who used again within one month after their initial use were more likely to be current heavy Ecstasy users. Women, those who waited a longer time between initial and subsequent Ecstasy use, and those who considered themselves in the upper SES bracket were less likely to be current heavy Ecstasy users. A better understanding of initial and current Ecstasy use patterns, including polydrug use, is essential for effective prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Abstract: This study, based upon epidemiological survey data from the United States (U.S.) National Household Surveys on Drug Abuse (NHSDA) from 2000 to 2001, presents new estimates for the risk of developing a hallucinogen dependence syndrome within 24 months after first use of any hallucinogen (median elapsed time ∼12 months). Subgroup variations in risk of becoming hallucinogen dependent also are explored. Estimates are derived from the NHSDA representative samples of non-institutionalized U.S. residents ages 12 and older (n =114,241). A total of 2035 respondents had used hallucinogens for the first time within 24 months prior to assessment. An estimated 2–3% of these recent-onset hallucinogen users had become dependent on hallucinogens, according to the NHSDA DSM-IV computerized diagnostic algorithm. Controlling for sociodemographic and other drug use covariates, very early first use of hallucinogens (age 10–11 years) is associated with increased risk of hallucinogen dependence (p <0.01). Excess risk of developing hallucinogen dependence was found in association with recent-onset use of mescaline; excess risk also was found for recent-onset users of ecstasy and of PCP. This study''s evidence is consistent with prior evidence on a tangible but quite infrequent dependence syndrome soon after the start of hallucinogen use; it offers leads that can be confirmed or disconfirmed in future investigations. [Copyright &y& Elsevier]

In contrast to "Just Say No" lectures on drug use common in K to 12 drug education programs (e.g., Drug Abuse Resistance Education, or D.A.R.E.), this activity used peer teaching in an Introductory Psychology course to promote active learning and open discussion of controversial issues about drug use. Working in small groups, students researched the neurological and behavioral effects of an assigned drug and presented controversial discussion questions. One week later they presented their findings to the class. Students reported that the presentations were informative and awarenessraising, provided an open environment for discussion, and allowed them to make more informed decisions about drug use. [ABSTRACT FROM AUTHOR]

This article analyzes school-based substance use prevention programs, comparing programs in the United States and Nordic countries, explores how cultural factors influence the ways in which prevention programs are designed and implemented, and how evaluation is affected by design and implementation. [ABSTRACT FROM AUTHOR]

Prescription drug abuse is an enormous problem in modern society. Studies have shown that it results in more injuries and deaths to Americans than all illegal drugs combined. In this review, the author discusses the prescribing of controlled substances by residents as it relates to intercollegial and other non-patient workplace encounters. Physician drug abuse, medical/legal issues regarding controlled substance prescriptions, and ethical conflicts will be discussed. These issues will be specifically addressed as they relate to the academic institutions where residents can potentially be placed in a moral, ethical and legal dilemma by supervisors and co-workers. Finally, a recommendation for an institutional policy will be suggested to help residents and other physicians recognize and deal with drug seeking behavior by coworkers. Also, a recommendation regarding strict institutional regulation of resident prescription practices regarding controlled substances will be presented. [ABSTRACT FROM AUTHOR]

Aims: To explore, in-depth, substance misuse nurses’ roles in assessment and decision making, the relative role of the client, the nurse and others in this process and to consider policy implications.Methods: Semi-structured, face-to-face interviews were conducted with a sample of substance misuse nurses managing individuals with drug problems across Scotland (n = 29). The sample was identified from respondents to a questionnaire distributed to all substance misuse nurses in a linked study. Interviewees were purposively sampled to cover a range of gender, years’ experience, attitudes and NHS area. Twenty-nine interviews were conducted across six areas. Interviews focused on assessment and treatment decision making. Thematic Analysis was undertaken.Findings: Nurses’ descriptions of assessment and decision making reflected a client-centred approach with clients being the main influence in decision making. Protocols and guidelines provided an evidence-based background and nurses occasionally have to manage conflict between the client's objectives of treatment and the evidence. Other professionals were consulted for complicated cases. Additional policy issues included the time between assessment and implementing treatment.Conclusions. Nurses demonstrated professional autonomy in treatment decision making. A model of consultation described in general medical literature as an ‘evidence-based, patient-choice consultation’ (Ford, Schofield, & Hope, 2003) was practised. Ongoing legislative changes to extend nurse prescribing to substance misuse would legitimize current practice. [ABSTRACT FROM AUTHOR]

Aims: To identify the proportion of drug users contacting drug treatment services in Scotland who were able to become abstinent 33 months after having started a new episode of treatment and to identify which services were most closely associated with such abstinence. Design: Follow-up survey of 695 of the Drug Outcome Research in Scotland respondents 33 months following recruitment into the study. Setting: Scotland. Participants: Injecting drug users who were initially contacted at drug treatment services and then followed up for 33 months post-recruitment. Measurements: Self-reported drug use and service usage. Findings: Although becoming drug free was the expressed goal of the majority of drug users recruited into the Drug Outcome Research in Scotland study, at 33 months following recruitment only 5.9% of females and 9.0% of males had been totally drug free (excluding possible alcohol and tobacco use) for a 90-day period in advance of being interviewed. There was considerable variation within this study in the proportion of drug users becoming drug free dependent upon the services they had been in contact with. The level of achieved abstinence in this Scottish study was substantially lower than that identified in the National Treatment Outcomes Research Study in England. Conclusions: There is a need to establish why so few drug users in contact with the methadone programme in Scotland appear able to become drug free 33 months after having contacted this service. On the basis of the results presented in this paper there is a need to ensure that drug users seeking help in becoming drug free are able to access residential rehabilitation services although at the present time such services are relatively rare within Scotland. [ABSTRACT FROM AUTHOR]

Research has shown significant declines in gateway drug use among participants in a school/community substance abuse prevention intervention in a midwestern, suburban school district (Lohrmann, Alter, Greene, & Younoszai, 2005). Though still at or below national levels, student marijuana use was not impacted as positively. The current study investigated the possibility that efforts to prevent alcohol use resulted in an unintentional substitution effect thereby increasing marijuana use. Factors including perceived access to alcohol and marijuana, along with perceived harm associated with alcohol and marijuana use, were examined to determine their role in marijuana use. Findings revealed a relationship between perceived access to and perceptions of harm associated with marijuana and its use that depended on the level of perceived access to and harm associated with alcohol. [ABSTRACT FROM AUTHOR]

This study compared a Motivational Interviewing in- spired group intervention with standard care in naturalistic alcohol/other drug abuse samples. A community-recruited alcohol/other drug abuse or dependent sample (N = 67) was provided up to four sessions of group-adapted Motivational Interviewing (GAMI). Newly admitted patients (N = 64) in two multimodal treatment settings were also recruited. Quasi-experimental comparison of outcomes from GAMI versus real-world standard care (SC) indicated significant within-group improvement on all main outcomes in both groups. SC was associated with significantly more abstinence days, and better family and social outcomes at six-month posttreatment compared to GAMI. Differences in reductions in alcohol or drug-related dysfunction were not detected. Thus, group-delivered MI intervention was associated with significant improvements in alcohol/other drug use outcomes. However, consideration of group-delivered MI as a replacement for more intensive standard care is, for the moment, uncertain. [ABSTRACT FROM AUTHOR]

Adolescent American Indians and Alaska Natives are a diverse and heterogeneous population with significant social, psycho- logical, and substance use risk factors. This paper reviews the adolescent research to date that has examined the overlap between alcohol/other drug abuse/dependence, mental disorders, and psychiatric symptoms. In the few studies that have been completed there has been significant over- lap. No national studies have been done, but there are scattered local and tribal reports. Of the studies that were surveyed, many of them report a significant co-morbidity of alcohol/other drug abuse/dependence with affective and disruptive disorders (ADHD, conduct, oppositional defiant). [ABSTRACT FROM AUTHOR]

A great deal of progress has been made in identifying explanations for the links between drug use and crime. However, less progress has been made in the application of these explanations. In particular, less is known about whether some explanations are more common than others, whether some are linked to certain conditions, whether some apply only to certain individuals, and whether some apply only to certain kinds of drug use and crime. In this article, we investigate the extent to which explanations for the connection between drug misuse and crime vary by type of drug user, type of drug use and type of crime by looking at users' own accounts of the connection. The research is based on data collected as part of the New English and Welsh Arrestee Drug Abuse Monitoring (NEW-ADAM) program conducted in 16 custody suites in England and Wales. The analysis investigates the proportion of drug users who believe that there is a connection and looks at variations in accounts of the connection by individual and behavioral factors. The implications for government policy designed to reduce drug-related crime are discussed. [ABSTRACT FROM AUTHOR]

Strengthening parents' capacity to reduce children's risk of alcohol, tobacco and other drug-related harm is recognised as an important public health strategy in Australia, but engaging parents' involvement in these training programs is known to be challenging. This study utilised a self-complete questionnaire and structured small group discussions with parents in order to identify their needs in terms of communicating with their children about drinking alcohol and smoking cigarettes. It also investigated their preferences regarding the nature of a parent drug education intervention as well as strategies to recruit and actively engage them in parent-directed interventions. Parents identified numerous barriers to their participation in such programs and reported any intervention targeting them should be able to be completed in their home, be non-judgemental, easy to read, time-efficient, easy to use, fun, colourful and interactive. Parents recommended practical communication skills (such as how to talk with children, how to raise the topic and what topics to talk about) be addressed in the intervention. They also recommended a range and combination of strategies to promote and maintain parent involvement, such as providing small rewards for the children of parents who participate. Despite some limitations, the findings of this study contribute important practical knowledge regarding how to recruit, engage and retain higher percentages of parents in parent training programs. [Beatty SE, Cross DS. Investigating parental preferences regarding the development and implementation of a parent-directed drug-related educational intervention: an exploratory study. Drug Alcohol Rev 2006;25:333 – 342] [ABSTRACT FROM AUTHOR]

The literature suggests that administering drug surveys to public school students is best done by persons outside of the school system (or at least unfamiliar to the students). This is the approach used by the long-time Monitoring the Future project. Because of the increased costs that administration by outside research associates requires (both time and transportation), we decided to design an experiment that would compare it to administration by school personnel. Six school systems were split, and 3756 surveys were administered, about half by outside research associates and half by school personnel. The results indicate that there were minimal and non-significant differences between the two groups. On the basis of these results, we draw the conclusion that school personnel are able to administer survey instruments without affecting the quality of the results and, thus, that school districts may safely use such data in the evaluation of their drug education and drug prevention programs. [ABSTRACT FROM AUTHOR]

Abstract: The extent to which dependence occurs with or without abuse is important because of the potential for underestimation and biased estimates of drug dependence in surveys that rely on abuse as a screening method for dependence. The purpose of this paper was to present the prevalence of DSM-IV drug dependence with and without drug abuse in a nationally representative sample, as well as in subgroups defined by sex, age and race/ethnicity. Among all respondents with current drug dependence, 22.0% did not additionally meet criteria for abuse (19.5% among males and 27.8% among females). Current drug dependence without abuse was especially common among females age 45–64 (52.6% of all cases). Among those with lifetime diagnoses of drug dependence, a small proportion overall, 5.0% had no symptoms of abuse, with the highest proportion again found among females aged 45–64 (19.5% of all cases). The use of drug abuse as a screening method for drug dependence in large epidemiologic studies will differentially underestimate the prevalence of dependence by subgroup, affecting many types of research. Dependence with and without abuse may represent heterogeneous phenotypes for genetic and gene-environment research, which should be explored. [Copyright &y& Elsevier]

Abstract: Although readiness for substance abuse treatment is a potent predictor of short-term clinical response, predictors of readiness are still poorly understood. Predictive models are customarily not predicated on dependence or abuse, but usually focus instead on intrapsychic motivational change or external contextual incentives. Based on a secondary analysis of the drug abuse treatment outcome studies (DATOS) data set for adults and a similar data set for adolescents (DATOS-A), latent variables were constructed to represent readiness for treatment, various psychosocial and behavioral features of substance use, substance-related problems and specific substance use frequency. Identical measures were used for each group. The two groups were then directly compared using a series of constrained covariance structure models. A path model using all hypothesized latent variables, treatment modality and demographics predicted Readiness for treatment in each separate group. Substance problems, a latent variable reflecting cross-substance symptoms of dependence and abuse, was the strongest predictor of Readiness for treatment in both age groups. Health problems and deviant family/peers were also strong predictors of readiness in both age groups. Demographic variables and specific substances used predicted readiness directly and indirectly in an age-specific manner. This study links readiness for substance abuse treatment to the core disorders targeted by that treatment in adults and adolescents for the first time. [Copyright &y& Elsevier]

In the past, incentive payments have proven successful in increasing survey response rates. In particular, incentives have been shown to increase the yield rate for harder-to-interview respondents. Despite this success, incentives are not without controversy. Opponents note that incentives may make the survey appear less important, destroy civic responsibility, and create an unnecessary expectation. Over time researchers may have to pay sizable incentives to achieve the response rates obtained 20 years ago before the use of incentives was common. Incentives could also have a detrimental impact on sample composition. The Alcohol and Drug Services Study (ADSS) included an incentive payment sub-study as part of its client follow-up phase. The sample for this sub-study randomized clients into four groups. One group was paid $25, the amount received by other responding clients in the ADSS main study. Respondents in the other three groups were paid an alternative amount (i.e., $0, $10, or $35). In examining the impact of varying incentives to sampling benchmarks, such as response rate and sample composition, the ADSS incentive sub-study found that the fears of opponents concerning the use of incentives were substantially unfounded, at least among the substance abuse treatment clients in the follow-up phase of ADSS. [ABSTRACT FROM AUTHOR]

The Alcohol and Drug Services Study (ADSS) was conducted for the Substance Abuse and Mental Health Services Administration between 1996 and 1999 to assess the nation's substance abuse treatment system. The sample for ADSS was selected using a multi-stage stratified design. Clients were sampled from selected substance abuse treatment facilities as part of the Phase II sample. Client follow-up comprised interviews and urine specimen collection in Phase III of the survey. One component of ADSS examined the impact of different incentive payments on measures of response rate and response quality using ADSS Phase III client interview data. To test for the effects of four payment levels, several measures of response quality were used. The analysis of consistency involving respondent self-reports, abstracted record data, and urine test results showed no conclusive evidence that incentive payments have any positive or negative effect on data consistency. The analysis of item non-response rates showed that an increase in incentive payments was associated with a subtle decrease in item type non-response rates. Furthermore, mixed results were observed when analyzing the relationship between incentive payment and clients reporting more (or less) of certain types of behavior. [ABSTRACT FROM AUTHOR]

Incentive payments to survey respondents have been used extensively for many years to improve survey response rates. There is considerable research evidence supporting the value of compensation for increasing cooperation and improving the speed and quality of response in a broad range of data collection efforts. This paper examines current issues in the use of monetary incentives in sample surveys, including a review of the literature concerning the direct and indirect impact of incentives on survey statistics, and the practical and operational issues for their use. This paper also examines the two recent experiments conducted to assess the effectiveness of incentives in studies of substance use – the Alcohol and Drug Services Study and the National Household Survey on Drug Abuse. These studies are reviewed in light of the current issues identified in the literature. They are described in detail in the companion papers included in this issue of the Journal of Social and Economic Measurement. [ABSTRACT FROM AUTHOR]

Religious support systems offer much promise for collaborative interventions with alcohol and other drug abuse organizations. This article presents a case study of an asset assessment of eleven Puerto Rican Pentecostal churches in a New England community and the alcohol and other drug abuse and other types of services provided to the community. A set of recommendations will be presented for the development of agency collaborative projects/activity with this important Puerto Rican natural support system. [ABSTRACT FROM AUTHOR]

Background: Two previous studies have demonstrated the parlous state of undergraduate medical education. A third study was undertaken to evaluate any change. Methodology: All deans, heads of psychiatry and addiction specialists working in 28 British medical schools were surveyed by questionnaire. Items included time allocated to formal training, clinical resources, training objectives, professional confidence and competence, postgraduate facilities, plans for change, opinion on the importance of addiction in the curriculum, and scientific credibility. Findings: There was a 100%, 71% and 46% response rate from specialists, heads, and deans respectively. Medical students were receiving, on average, six hours of formal training in substance misuse over their entire course. Although there was disparity in responses between the three groups, there was a clear consensus that the addiction field had scientific credibility. However, this achievement has not been translated into more training, and there is pessimism about any likelihood of change. Discussion: Barriers to training such as too few addiction specialists, stigma, and tensions in academia resulting from the Research Assessment Exercise, are identified. Conclusion: Since the General Medical Council and the Alcohol Harm Reduction Strategy have explicitly stated the need for undergraduate training, ways in which medical students, as 'users' of the undergraduate training package, may be the drivers of change, are suggested. [ABSTRACT FROM AUTHOR]

In a global project of self-determination and cultural revitalization, indigenous peoples are demanding recognition of distinct values, traditions and experiences in the design and delivery of health and social programs. Within the addictions field in southern Australia and northern Aotearoa/New Zealand, alternative approaches to education and training initiatives, informed by and inclusive of indigenous paradigms, are emerging in response to hegemonies of power, knowledge and practice. Questioning received understandings about the etiology and resolution of addictive behaviours, emergent discourses draw attention to the roles of colonialism, neo-colonialism, and cultural oppression in addiction and recovery. Moreover, although supported by social and virtual networks, emergent discourses are complicated-at times, fractured-by vigorous debate surrounding critical issues and complex identity positions. [ABSTRACT FROM AUTHOR]

This clinical trial investigated effects of motivational enhancement treatment (MET) and group coping-skills training (CST) tailored for cocaine dependence. Effects of MET were hypothesized to be greater with CST and for less motivated patients. A 2 × 2 design investigated two individual sessions of MET compared to meditation–relaxation (MRT), followed by four group sessions of CST versus drug education (ED), as daily adjuncts to intensive treatment. The substance abuse program provided full-day treatment with a learning-theory and 12-Step orientation. Cocaine-dependent patients were recruited. Assessment included treatment retention; change in cocaine-related urge, self-efficacy, pros and cons, and motivation; substance use and problems during 12-month follow-up. Of 165 patients, follow-up status is known for 90% ( n = 149). Patients in MET with low initial motivation to change reported less cocaine and alcohol relapse and use days and fewer alcohol problems than MET patients with higher initial motivation. MET produced more employment improvement than MRT, with no other significant benefit for MET. Patients with higher motivation had more cocaine use and alcohol problems after MET than MRT. Group CST reduced cocaine and alcohol use during follow-up for women only and reduced alcohol relapse for men and women. MET is more beneficial for patients with lower initial motivation than for patients with high initial motivation. CST reduced cocaine and alcohol use for women only and reduced alcohol relapses, in contrast to results with lengthier individual CST. [ABSTRACT FROM AUTHOR]

A bstract A survey of drug use in the past year was completed by 124 clubbers (50% male, 50% female, age range 14-44, mean 24 years). Participants were self selecting and recruited in clubs and pre-club bars. Prevalence rates for alcohol, cannabis, and ecstasy were over 80%; 63% reported cocaine and 53% amphetamine use, 15%-43% used ketamine, psilocybin, LSD and nitrites. A pattern of polydrug and co-drug use was identified. Most participants (70%) bought their drugs through friendship/family networks. Main reasons given for drug use were relaxing, socializing and dancing. Risk behaviours identified were drug driving (19%), unprotected sex (39%); and 'taking too many drugs' (44%). At least 40% reported anxiety, nausea and paranoia. Three focus groups aided the interpretation of data, for example describing the strategic use of drugs and alcohol throughout a night and explaining how negative experiences may change, but not necessarily stop, drug use. The study provides further evidence that there is a characteristic pattern of dance-drug use, while identifying an increase in cocaine and alcohol use. Older participants' greater experience with cocaine and fewer negative drug-related experiences are discussed in relation to health promotion. [ABSTRACT FROM AUTHOR]

The present study examined the effectiveness of Project PRIDE, a school-based, counselor-administered, drug and alcohol prevention program. The study is presented in the context of Project PRIDE'S efforts to keep itself current and effective via continual evaluation-based development. In this outcome evaluation, Project PRIDE participants demonstrated greater pretest to posttest gains on five of six outcome measures compared to control students, although many of the changes were small or moderate and only two were statistically significant. Further, as predicted, gains in more factual or objective areas of the program were greater than in more subjective areas dealing with student perceptions and feelings. The limitations and implications of the findings are discussed. Also discussed are the advantages of the Binomial Effect Size Display as a data presentation mode that promotes both client and general audience understanding of results. [ABSTRACT FROM AUTHOR]

The problems associated with the use of alcohol, tobacco, and other drugs (ATOD) extract a significant health, social, and economic toll on American society. While the field of substance abuse prevention has made great strides during the past decade, two major challenges remain. First, the field has been disorganized and fragmented with respect to its research and prevention practices; that is, there are often separate ATOD prevention "specialists." Second, both the prevention researchers who test the efficacy of specific prevention strategies and the practitioners who implement prevention efforts often lack an overall perspective to guide strategy selection. To address these limitations, we present an ATOD causal model that seeks to identify those variables (Domains) that are theoretically salient and empirically connected across alcohol, tobacco, and illicit drugs. For the researcher, the model demonstrates important commonalities, as well as gaps, in the literature. For the practitioner, the model is a means to recognize both the complexity of the community system that produces ATOD problems and the multiple intervention points that are possible within this system. Researchers and practitioners are thus challenged to work synergistically to find effective and cost-effective approaches to change or reduce ATOD use and associated problems. [ABSTRACT FROM AUTHOR]