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Screening instruments for substance abuse can be expeditious and effective clinical tools. A training needs assessment conducted with a randomly selected sample of substance abuse treatment providers (n = 1684) in licensed facilities in New England identified the adequacy of training, interest in training, clinical skill, and training need in the use of 13 substance abuse screening instruments. The results revealed that New England substance abuse treatment providers are not skilled in the use of screening instruments and have a high level of training need in this area. Differences in screening skill were found among the New England states. In addition, women and those with less treatment experience have lower screening skill; similarly, women, those having less experience in the field, and social workers and nurses evidenced higher training need in screening. The discussion considers skill, adequacy of training, training interest, and training need. The conclusion suggests that one approach to the coexisting increased need for screening skills due to managed care requirements and the lack of interest in these skills is to study managed care marketplace demands to determine training priorities. Keywords - screening; substance abuse; needs assessment; training; brief treatment.

Some patients in methadone maintenance treatment programs have substantial difficulty adjusting to changes in methadone formulation and shifts in other program policies. Clinicians can benefit from the ability to identify individuals who are 'at risk' for methadone formulation and other change intolerance. By studying a cohort of 177 patients who were receiving methadone maintenance in a program that changed methadone dispensing formulations, this study revealed significant differences between two underlying patient groups (i.e., change tolerant or intolerant). These patients were distinguished by personal characteristics prior to the formulation change and methadone dose level shifts after the formulation change. Change-intolerant patients experienced formulation-related narcotic withdrawal whereas change-tolerant patients adapted to the new medication format. Gender, treatment history, and methadone abuse were three sociodemographic variables that significantly predicted patients who were intolerant to a methadone formulation change. These findings suggest the need for more research, including plasma and metabolic studies, to clarify the potential biological effects of changes in methadone formulations. In addition, the treatment implications for patients who experience change intolerance are discussed. Keywords - methadone; addiction; formulation change; treatment.

Critics often cite the use of illicit drugs among methadone maintenance patients as evidence of this treatment modality's failure. The fact that methadone maintenance treatment does not lead quickly to abstinence in most clients can be a disappointment to treatment professionals and the public. By studying a cohort of 41 patients for their first year in a methadone maintenance prog this study revealed significant trends of diminished narcotic and cocaine use. However, increased benzodiazepine use was also identifed. More importantly, this study identified some chrono patterns of drug using that predicted less drug use at the end of one year of treatment. These findings reflect the need for additional research to clarify the meaning of illicit drug use b methadone maintenance patients. In addition, the implications for providing, stopping, and determini effective drug treatment are discussed. Keywords--drug abuse; methadone; addiction; self-medication; treatment., Patients on methadone maintenance program are evaluated for the incidence of substance abuse. The use of drugs during and after one year of methadone maintenance was evaluated through urine analysis for traces of the abused substances. Results indicate that there is a diminished trend of narcotic and cocaine use after one year of methadone treatment even if drug use during therapy predicted higher incidences after. There is also observed polydrug usage and depressive disorders. Future research should consider the psychological and social aspects of drug use patterns.

We have outlined the elements of a social policy that could deal effectively with the drug problem. These elements include (1) treating drug abusers in areas other than just their drug abuse; (2) providing more accurate information in drug education programs; (3) providing a series of symbolic but geniune gestures that indicate our society is willing to make real changes; and (4) coordinating these measures with more pragmatic and swift law enforcement. This policy would not end drug use. Nothing can do that. Neither would it be a surrender nor just a repetition of an old policy that has not worked.

Abstract Background In an attempt to reduce harm related to gambling problems, an Internet sports betting service provider, bwin Interactive Entertainment, AG (bwin), imposes limits on the amount of money that users can deposit into their online gambling accounts. We examined the effects of these limits on gambling behavior. Methods We compared (1) gambling behavior of those who exceeded deposit limits with those who did not, and (2) gambling behavior before and after exceeding deposit limits. We analyzed 2 years of the actual sports gambling behavior records of 47000 subscribers to bwin. Results Only 160 (0.3%) exceeded deposit limits at least once. Gamblers who exceeded deposit limits evidenced higher average number of bets per active betting day and higher average size of bets than gamblers who did not exceed deposit limits. Comparing the gambling behavior before and after exceeding deposit limits revealed slightly more unfavorable gambling behavior after exceeding deposit limits. Conclusion Our findings indicate that Internet gamblers who exceed deposit limits constitute a group of bettors willing to take high risks; yet, surprisingly, they appear to do this rather successfully because their percentage of losses is lower than others in the sample. However, some of these gamblers exhibit some poor outcomes. Deposit limits might be necessary harm reduction measures to prevent the loss of extremely large amounts of money and cases of bankruptcy. We discuss how these limits might be modified based on our findings.

Public health groups, researchers, the beverage alcohol industry, and other stakeholders have promoted and applied the concept of "responsible drinking" for the past 50 years. However, little is known about the state of the existing responsible drinking evaluation research and its application to policy and practice. This project provides a scoping review of studies evaluating responsible drinking interventions. Two primary research questions guided this investigation: (1) To what extent have authors attempted to define the concept of responsible drinking while evaluating responsible drinking interventions? and (2) What is the state of the responsible drinking intervention evaluation literature? We retrieved 49 peer-reviewed articles that evaluated interventions designed to promote "responsible drinking." Four articles provided, or attempted to provide, an explicit definition of responsible drinking; these four definitions lacked consensus. The existing responsible drinking interventions varied considerably in terms of the messages they attempted to convey (e.g., avoid binge drinking, use protective behavioral strategies, stick to relatively safe drinking limits), again suggesting lack of consensus. We observed greater consensus concerning the approach to evaluating responsible drinking interventions: studies typically recruited college students to complete brief, well-controlled experiments and measured potential predictors of drinking behavior (e.g., attitudes, expectancies, intentions) rather than actual drinking behavior. We discuss limitations of this methodological approach and the need for greater consensus regarding the concept of responsible drinking. [ABSTRACT FROM AUTHOR]

Abstract Background This article reports the first national assessment of patterns of drinking and gambling-related rulemaking on college campuses (e.g., punitive versus recovery oriented). Analyses relating school policies to known school rates of drinking or gambling identified potentially influential policies. These results can inform and encourage the development of guidelines, or "best practices," upon which schools can base future policy. Methods The college policy information was collected from handbooks, Web sites and supplemental materials of 119 scientifically selected colleges included in the fourth (2001) Harvard School of Public Health College Alcohol Study (CAS). A coding instrument of 40 items measured the scope and focus of school alcohol and gambling policies. This instrument included items to measure the presence of specific policies and establish whether the policies were punitive or rehabilitative. A total of 11 coders followed a process of information extraction, coding and arbitration used successfully in other published studies to codify policy information. Results Although all schools had a student alcohol use policy, only 26 schools (22%) had a gambling policy. Punitive and restrictive alcohol policies were most prevalent; recovery-oriented policies were present at fewer than 30% of schools. Certain alcohol and gambling policies had significant relationships with student binge drinking rates. Conclusions The relative lack of college recovery-oriented policies suggests that schools might be overlooking the value of rehabilitative measures in reducing addictive behaviors among students. Since there are few college gambling-related policies, schools might be missing an opportunity to inform students about the dangers of excessive gambling.

During the past few decades, response rates have declined across social science research. Although some researchers are willing to accept this state of affairs, in this comment, we argue that low response rates weaken the value of social science research, thereby jeopardizing science research and associated knowledge. We describe the case of a Hong Kong-based multi-site study of addiction treatment seekers to examine approaches to stimulating clinical research and response rates. For this case of addiction treatment seekers, the overall response rate was acceptable (69.7%), despite variation among the three study sites. We discuss factors that likely contributed to this response rate variation to illustrate practical steps that investigators can undertake to improve response rates instead of capitulating to the status quo. [ABSTRACT FROM AUTHOR]

A recent systematic review of the responsible gambling research suggests that there are no significant differences between gambling industry and non-industry funded research with regard to research design and outcomes. This study empirically synthesizes the outcomes of a larger sample of the scientific gambling literature to determine the generalizability of these original results. Our goal was to determine the extent to which funding sources might differentially influence characteristics of research design and outcomes. We conducted a comprehensive review of 18 research databases and examined studies published between January 2008 and August 2018. For four gambling-related journals, we reviewed all of the available studies. For 14 addiction-related journals, we examined only studies that examined gambling-related outcomes. To be included in this study, publications had to be quantitative and include a clear gambling-related hypothesis. After retrieving 1731 gambling studies, we applied the inclusion criteria and retained 720 studies for our final analytic sample. We used hypothesis confirmation and funding source information to determine the presence or absence of funding bias. Gambling industry funded studies were no more likely than studies not funded by the gambling industry to report either confirmed, partially confirmed, or rejected hypotheses. Nonetheless, studies funded by the gambling industry were more likely than other types of funding sources to include a conflict of interest statement. Studies with disclosed funding sources were more likely than those with undisclosed funding sources to include a conflict of interest statement. These findings highlight the importance of transparency and disclosure during research dissemination. [ABSTRACT FROM AUTHOR]

This brief report examines whether there are differences in aspects of different characteristics, including design/methodologies of responsible gambling (RG), between studies funded by industry as compared to other sources. To investigate this, the authors used those studies included in a recent meta-analysis focusing on the empirical basis of RG initiatives (Ladouceur et al. in Addict Res Theory 25:225-235, 2017). We examined eight associations between funding sources, and different design/methodological characteristics of these studies; type of strategy, inclusion of comparison groups, measurement scales and repeated measures, publication source, number of inclusion criteria met, secondary sources of funding, publication year. The results revealed no statistically significant difference between the funding source, and the index study characteristics. These results do not support claims that funding exerts influence on the design or methodologies of RG studies. However, the absence of statistically significant findings should not be used to assert the absence of a funding effect because there are many reasons for failing to find differences, or interpretation of findings. Unexpectedly, a third of the papers included in this study failed to disclose their funding sources. This finding highlights the need for more open and transparent disclosures. [ABSTRACT FROM AUTHOR]

Daily fantasy sports (DFS), a rapidly growing industry, allows players to create fantasy teams of real-life players and potentially win cash prizes, derived from entry fees. Some stakeholders have expressed concern that DFS's accelerated nature and other features might promote excessive play and related harm. We conducted the first descriptive summary of actual DFS play using records from a cohort of subscribers to a dominant operator, DraftKings. Participants (N = 10,385) initially entered paid National Football League (NFL) contests. Across all participants, players entered a median of two contests per entry day and typically submitted a single entry for each contest they entered. Players paid a median of $87 in entry fees throughout the 2014 NFL season and experienced an overall median net loss of $30.7. However, we identified heavily involved sub-groups of players based on number of contests entered, total entry fees, and net loss. These top 1% groups were less likely to restrict themselves to NFL games, exhibited greater time involvement, but also won a greater percentage of the contests they entered than typical players. Our observations of typical and heavily involved players tend to mirror those generated in previous Internet sports gambling research. [ABSTRACT FROM AUTHOR]

This article describes a collaborative research project between the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School Teaching Hospital, and the Integrated Centre on Addiction Prevention and Treatment (ICAPT) of the Tung Wah Group of Hospitals (TWGHs) in Hong Kong. The goal of this research is to better understand the syndrome model of addiction by establishing an epidemiology of addiction treatment seekers across various expressions of addiction (e.g., alcohol and other psychoactive drugs, gambling, sexual behaviors, online gaming). This paper presents initial findings about the demographic and psychological characteristics of three groups of treatment seekers in TWGHs in Hong Kong: (1) a group seeking treatment for chemical expressions of addiction (n = 35); (2) a group seeking treatment for behavioral expressions of addiction (n = 125); and (3) a comparison group seeking services (n = 18) unrelated to addiction. The initial findings identified various common psychological vulnerabilities (i.e., trait anxiety, state anxiety, depression, using emotional support and venting as psychological coping, higher levels of attentional impulsiveness) shared among both the behavioral expression and chemical expression groups, and possible unique psychological characteristics associated with each expression of addiction (e.g., coping mechanisms). These findings provide support for conceptualizing addiction as a syndrome. [ABSTRACT FROM AUTHOR]

Is addiction that involves psychoactive drug-taking (for example, heroin dependence) the same as addiction that does not involve drug-taking (such as excessive shopping)? How can we distinguish the recurring central [...]